Sex Diversity in the Emerging United States Arthroplasty Workforce Is Limited

Background: Sex diversity remains limited in the United States arthroplasty workforce. This study evaluates fellowship program characteristics associated with increased sex diversity in US-based fellowship programs and the pipeline of women trainees before arthroplasty fellowship.

Methods: Demographic data from 233,981 allopathic medical school graduates, 11,364 orthopaedic surgery residents, and 1,501 arthroplasty fellows were analyzed. Women trainee representation was calculated among allopathic medical students, orthopaedic surgery residents, and arthroplasty fellows (2012 to 2022). Fellowship program characteristics associated with increased sex diversity among arthroplasty fellows were evaluated with Chi-square tests.

Results: Female representation in arthroplasty fellowship training (5.9%) was less than that in orthopaedic surgery residency (15.1%) and allopathic medical school (47.6%) training (P < 0.001). Sex diversity in arthroplasty fellowship training increased over the study period (2.4 to 9.9%, P < 0.001). The presence of women faculty, geographic region, accreditation status, annual number of fellows, and total number of faculty were not associated with increased sex diversity of arthroplasty fellows (P > 0.05).

Conclusions: Sex diversity in arthroplasty fellowship training has improved over the past decade. Yet, women trainees remain under-represented relative to the trainee pipeline. Increased efforts to recruit female medical students and orthopaedic residents may help promote workforce diversity in arthroplasty.