Summary

This study examines the prevalence of Diversity, Equity, and Inclusion (DEI) statements and faculty roles in orthopaedic sports medicine fellowships, finding an association with higher female representation among faculty and fellows, along with varying prevalence and gender disparities across geographic regions and program types.

Abstract

Objectives: The purpose of this study was to identify the prevalence of Diversity, Equity, and Inclusion (DEI) statements and DEI faculty roles in orthopaedic sports medicine fellowships and report any association with female representation among sports medicine fellows and faculty. The secondary aim of the study was to identify other potential trends in prevalence of DEI advocacy and fellow/faculty gender proportions, disparities in these variables among different geographic regions and program types.

Materials And Methods

From April 20, 2023-June 20, 2023, the following data was collected from 87 eligible sports medicine fellowship program websites: geographic location, program type (university or community based), full names of sports medicine faculty and fellows, number of fellows per year, DEI statements, and DEI faculty positions. A complete list of Accreditation Council for Graduate Medical Education (ACGME) accredited sports medicine fellowship programs were obtained from the Arthroscopy Association of North America (AANA) Fellowship Directory and the American Orthopaedic Society for Sports Medicine (AOSSM) Fellowship Database. Internet searches were conducted for each faculty member and fellow, and gender was classified by pronouns used in biographical webpages. Individuals using “she/her” pronouns in their biographies were recorded as “female”, those using “he/him” pronouns were recorded as “male”, and those using “they/them” or other non-binary pronouns were recorded as “non-binary”. This study refers to gender as defined by the socially constructed roles, behaviors, and identities of individuals, as opposed to sex, which is defined by a set of biological attributes associated most often with internal and external anatomy. Geographic locations were categorized into regions based on the US Census Bureau definitions. Descriptive statistical analysis was performed, and gender proportions were compared using two sample t-test.

Results

Of 87 fellowship program websites, 74.7% (65/87) published DEI statements and 64.4% (56/87) listed DEI faculty positions (e.g., Diversity Dean, DEI Chair, Chief Diversity Officer, etc.). Programs with DEI statements had a significantly greater proportion of female sports medicine faculty compared to programs without (80/578, 13.8% ± 15.3% vs. 10/166, 6.0% ± 4.0%, p=0.017). Programs with DEI statements also had a notable, although not statically significant, increased proportion of female sports medicine fellows (25/147, 17% ± 25.5% vs. 3/71, 4.2% ± 8.5%, p=0.056). All University programs (32/32) included DEI statements and roles, while markedly fewer community programs included statements (9/24, 37.5%) or roles (5/24, 20.8%). Most of the programs in the Northeast included statements (20/22, 90.9%) and roles (16/22, 72.7%), while only 11/19 (57.9%) of programs in the West included statements and only 8/19 (42.1%) included information about DEI-related roles.

Conclusion

Most orthopaedic sports medicine fellowship programs include DEI statements and DEI-related faculty positions, although these roles generally exist outside the department of orthopaedic surgery. Programs with DEI statements and/or DEI faculty roles are correlated with higher female representation among sports medicine faculty and fellows. This correlation presents an opportunity to explore further the effects of DEI initiatives on gender diversity within orthopaedics, potentially guiding program directors in enhancing DEI efforts.