Haddad David, Nelson Deborah, Sherman Nathan, Tatusko Megan, DeSilva Gregory
Department of Orthopaedic Surgery, The University of Arizona College of Medicine-Tucson, Tucson, Arizona.
The University of Arizona College of Medicine-Tucson, Tucson, Arizona.
JB JS Open Access. 2024 May 15;9(2). doi: 10.2106/JBJS.OA.23.00124. eCollection 2024 Apr-Jun.
Gender representation among orthopaedic surgery applicants and residents has increased over the past two decades. The aims of this study were to evaluate trends of female fellows in ACGME-accredited orthopaedic subspecialties between 2007 and 2021, and to compare the fellowship trends of female representation to those of ACGME-accredited orthopaedic residencies.
We conducted a retrospective review of publicly available ACGME-accredited fellowship demographic data from 2007 to 2021. The distribution of genders (male vs. female) across subspecialties and orthopaedic surgery residency programs was compared. Chi-square, Spearman correlation, and logistic regression tests were performed to analyze the relationships between year, gender, and fellowship.
Chi-square analysis demonstrated a significant relationship between gender and year for orthopaedic residency (p < 0.001), but not for any fellowship. There was a significant negative Spearman correlation between the two variables for hand (r(1844) = -0.06, p = 0.02) and sports medicine (r(2804) = -0.05, p = 0.01) fellowships. The negative Spearman correlation for pediatrics (r(499) = -0.09, p = 0.054) approached but did not reach statistical significance. Logistic regression analysis revealed that, holding year constant and comparing to orthopaedic residency, the odds of male participation increased by 173% (95% CI, 1.8-4.1) in spine, increased by 138% (95% CI, 1.7-3.3) in adult reconstruction, increased by 51% (95% CI, 1.3-1.7) in sports medicine, decreased by 41% (95% CI, 0.5-0.7) in hand, decreased by 36% (95% CI, 0.5-0.9) in foot and ankle, decreased by 48% (95% CI, 0.4-0.7) in musculoskeletal oncology, and decreased by 68% (95% CI, 0.3-0.4) in pediatrics.
Although the percentage of female orthopaedic residents in ACGME-accredited programs increased significantly from 2007 to 2021, this has not translated to ACGME-accredited fellowship positions. Future research optimizing methods to improve the representation of females in orthopaedic surgery should be considered.
III.
在过去二十年中，骨科手术申请者和住院医师中的性别比例有所增加。本研究的目的是评估2007年至2021年期间美国研究生医学教育认证委员会（ACGME）认证的骨科亚专业中女性研究员的趋势，并将女性代表的研究员趋势与ACGME认证的骨科住院医师趋势进行比较。
我们对2007年至2021年公开可用的ACGME认证的研究员人口统计学数据进行了回顾性分析。比较了各亚专业和骨科手术住院医师项目中的性别分布（男性与女性）。进行了卡方检验、斯皮尔曼相关性检验和逻辑回归检验，以分析年份、性别和研究员之间的关系。
卡方分析表明，骨科住院医师的性别与年份之间存在显著关系（p < 0.001），但在任何研究员项目中均无此关系。手部（r(1844) = -0.06，p = 0.02）和运动医学（r(2804) = -0.05，p = 0.01）研究员项目的这两个变量之间存在显著的负斯皮尔曼相关性。儿科的负斯皮尔曼相关性（r(499) = -0.09，p = 0.054）接近但未达到统计学显著性。逻辑回归分析显示，在年份不变并与骨科住院医师进行比较时，脊柱领域男性参与的几率增加了173%（95%置信区间，1.8 - 4.1），成人重建领域增加了138%（95%置信区间，1.7 - 3.3），运动医学领域增加了51%（95%置信区间，1.3 - 1.7），手部领域减少了41%（95%置信区间，0.5 - 0.7），足踝领域减少了36%（95%置信区间，0.5 - 0.9），肌肉骨骼肿瘤学领域减少了48%（95%置信区间，0.4 - 0.7），儿科领域减少了68%（95%置信区间，0.3 - 0.4）。
尽管2007年至2021年期间ACGME认证项目中女性骨科住院医师的比例显著增加，但这并未转化为ACGME认证的研究员职位。应考虑未来进行研究以优化方法，提高女性在骨科手术中的代表性。
三级
