The Sex or Race of Program Directors May Not Play a Significant Role in Impacting Diversity Among Orthopaedic Surgery Residents.

PURPOSE: To identify residency program characteristics, including the presence of underrepresented minority in medicine (URiM) and/or female Program Director's influence on the race and sex distribution of Orthopaedic Surgery Residency trainees.

METHODS: All active and ACGME-accredited orthopaedic surgery residency programs from 2017-2021 that reported usable information on the Residency Explorer Tool were included. Data collected included program characteristics, faculty and resident sex distribution, ethnicity, race, and demographic characteristics. The program director's (PDs) specific sex, ethnicity, race, and demographic characteristics were collected utilizing residency program websites. The prevalence of factors in programs with the top quartile of female and underrepresented residents were compared with the lower three quartiles.

RESULTS: Data were obtained from 148/200 ACGME-accredited programs (n=3,694 residents). The 52 excluded programs had no usable information on the Residency Explorer Tool or an identifiable program website. Overall, 15.9% of residents were female and 14% were underrepresented minorities in Orthopaedic surgery residency programs. Female PDs made up 12.4% and chairs 6.9% while URiM PDs and chairs were 8.3% and 4.6%, respectively. Programs with more female residents were not associated with a female PD (p=0.79) or with URiM PDs (p=0.48). Programs with a greater percentage of URiM residents were not associated with URiM PDs (p=0.16). No correlation was found with higher percentages of underrepresented residents and female PDs (p=0.76). Larger (p = 0.021) and university-based programs (p=0.048) had a greater percentage of female residents. Orthopaedic residency programs with Visa Sponsorship had a greater percentage of URiM residents (p = 0.017).

CONCLUSION: Programs with a higher percentage of female or URiM residents did not show a significant association with having female or URiM program directors. Larger programs and university-affiliated programs were more likely to have a larger percentage of female residents, while programs that offered visa sponsorship had a higher percentage of URiM residents.