Residency Match Rates in Orthopaedic Surgery Based on Sex, Under-Represented in Medicine Status, and Degree Type

Abstract

Introduction: Orthopaedic surgery is well recognized as one of the most competitive and least diverse medical specialties. Despite efforts toward improving diversity, studies have shown that gender and racial/ethnic disparities continue to persist in orthopaedic graduate medical education. Therefore, we sought to identify the match rates of traditionally under-represented groups within orthopaedic surgery-female candidates, racial and ethnic minorities under-represented in medicine (URiM), and osteopathic physicians-compared with their application rates. Methods: A retrospective review of the Electronic Residency Application Service (ERAS) application data from the 2017 to 2021 application cycles was performed, and the total number of applicants, sex, race/ethnicity, and degree type of all students applying for orthopaedic surgery were recorded. A separate database, the Orthopaedic Residency Information Network (ORIN), which is a database self-reported by residency programs to provide information to applicants, was also queried to identify the total number of residents, sex, race/ethnicity, and degree type of all current residents in June 2022, corresponding to those residents who matched in 2017 to 2021. Results: From the ERAS application data, a total of 7,903 applicants applied to orthopaedic surgery during the study period. A total of 1,448 applicants (18%) were female, 1,307 (18%) were URiM, and 1,022 (15%) were from an osteopathic medical school. Based on the ORIN database, 688 of 3,574 residents (19%) were female, 1,131 of 7,374 (19%) were URiM, and 1,022 of US medical school graduates (12%) had a DO degree. The application and match rates were not significantly different for female (p = 0.249) and URiM (0.187) applicants; however, there was a significant difference in the application and match rates (15% vs 12%; p = 0.035) for US medical graduates with a DO degree. Conclusion: In recent years, there has been a significant and necessary push to increase diversity in the field of orthopaedic surgery. From 2017 to 2021, match rates of female and URiM candidates are reflective of their application rates. Osteopathic applicants in orthopaedic surgery have a lower match rate than their allopathic counterparts. Level of Evidence: III Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSOA/A485).

Exponential Growth in Female Residency Applicants in Orthopaedic Surgery Over the Past 15 Years

“…This study predicts that it will take approximately 16 years for female medical student application rates in orthopaedic surgery to achieve a previously defined rate of gender parity in orthopaedic surgery. Although this study does not directly address match rates, a recent study suggests that female applicants match into orthopaedics concordant with their application rates 26 . Further studies are needed to validate these findings.…”

“…A recent study investigating match rates of traditionally underrepresented groups in orthopaedic surgery, including females, found that female applicants applying to orthopaedic surgeries successfully match at a rate reflective of their application rates 26 . This thereby suggests that an increasing number of female applicants will likely lead to a predictable increase in female orthopaedic surgery residents and ultimately practicing physicians.…”

Examining diversity recruitment efforts in US-Based Physical Medicine and Rehabilitation residencies: A survey of program directors on gender, ethnic and racial diversity and Implications for Recruitment efforts

“…Residency programs are recognizing the importance of recruiting diverse classes. 27,28 As there are only a finite number of applicants to PM&R each year, supporting recruitment practices that promote increasing diversity can allow for better maximization of the available talent pool. It is important to recognize that there are many different subtypes of diversity.…”

“…29 In the field of orthopedic surgery, often identified as one of the least diverse medical specialties, increasing recruitment of women and minority groups has been an area of focus for over 20 yrs. 30 Despite this, match rates of female and URiM candidates continue to be at or below their application rates, 28,30 leading to continued disparities when compared with the makeup of the general population. Program directors hold important leadership roles in the recruitment process and, when surveyed, can provide unique perspectives.…”

Equity360: Gender, Race, and Ethnicity: The Affirmative Action Ban and the Orthopaedic Pipeline

“…From 2014 to 2019, 37 orthopaedic residency programs had no women trainees [19]. While the percentage of women entering orthopaedic surgery residency increased from 20.1% to 36.4% from 2001 to 2022, and application and match rates for women appear comparable to those of men [21], this growth remains less than other surgical subspecialties [20], and orthopaedics continues to consistently have the lowest representation of women among surgical subspecialties [8], at 18.3% by most-recent ACGME data [1]. Students from underrepresented racial and ethnic groups are less likely to match into orthopaedics [16].…”