Andrew Bi, MD and colleagues explored the roles of female leaders and highlighted the need for improvement at the leadership level in orthopaedics and presented their research in the poster Female Representation within Orthopaedic Leadership: Where Are We Now? at the 2021 ACGME Annual Educational Conference in late February.
Primary Author: Andrew Bi, MD
Co-Authors: Nina D. Fisher, MD; Kenneth A. Egol, MD; Mara Karamitopoulos, MD
ACGME: Tell us about your academic and professional role.
Bi: I am one of the orthopaedic surgery residents in my second year at NYU. In an academic role, we participate actively in research projects and education of younger residents and medical students. Professionally, as a second-year orthopaedic surgery resident, we spend time taking in-house call, in clinic seeing patients, and in the operating room performing a variety of procedures, such as joint replacements, spine surgery, and orthopaedic trauma cases.
ACGME: Can you briefly describe your project for us?
Bi: Our project is a cross-sectional evaluation of all academic orthopaedic surgery departments in the country, investigating quantitative descriptors of female versus male leaders. Leaders we examined included department chairs and program directors. After the poster submission, we also expanded the data collection to assistant program directors, vice chairs, and subspecialty chiefs. We wanted to look at how many women were in leadership roles across departments, whether there were certain factors (such as publications, years in practice, where they trained, fellowship choice) that were associated with leadership roles, and whether "junior" positions such as assistant program directors had higher percentages of females.
ACGME: What inspired you to do this project?
Bi: I was a fourth-year medical student doing rotations and getting ready to apply to orthopaedic surgery residency and began to realize how few women orthopaedic surgeons I was interacting with. There is already a drastic difference in the number of females in orthopaedic residency (~14%), but that difference was even more pronounced at the top among leadership roles that I was meeting and interviewing with.
ACGME: What did you discover?
Bi: We found a stark contrast in the number of females compared to males in leadership roles; 11.2% of program directors were female and only 2.6% of chairs were female. This makes sense in relation to data that shows that women are an increasing percentage of orthopaedic surgeons in younger age groups. We found that female program directors had fewer years in practice compared to their male counterparts, but similar numbers of years in their program director positions. They had similar numbers of publications and percentage of full professorship. Women were significantly more likely to stay at their home institution from medical school or residency than males. Female chairs had significantly fewer years in their chair positions compared to their male counterparts, but similar numbers of years in practice.
ACGME: What was the main takeaway?
Bi: The main takeaway was the amount of room for improvement orthopaedic surgery has for acknowledging and working on diversity at the leadership level in academic programs. Additional data collection after the poster was submitted is promising in that "junior" positions such as assistant program directors had higher percentages of females (> 20%), perhaps indicating a trend of a younger generation's mindset.
ACGME: Who could benefit from this research?
Bi: All orthopaedic surgeons, residents in training, and medical students who aspire to go into orthopaedics. Not only that, but leadership positions in other subspecialties can use this data and compare and contrast their own diversity, or be inspired to evaluate their subspecialty's diversity around the country.
ACGME: Any additional follow-up plans?
Bi: As of now, there is no centralized database that displays orthopaedic surgery residency program chairs, program directors, vice chairs, department heads, assistant/associate program directors in one online location, making it difficult for applicants to find information on orthopaedic programs. We'd like to start one, to make this information more accessible, as well as provide a database that can track trends in leadership changes over the years.