From the Wayne State University School of Medicine, Detroit, MI (Smith, DeYoung, and Pum), Departments of Anesthesiology and Surgery, Boston Children's Hospital, Boston, MA (Zurakowski), Harvard Medical School, Cambridge, MA (Zurakowski), Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, KS (Templeton), Department of Orthopedic Surgery at Henry Ford Health, Wayne State University School of Medicine, Detroit, MI (Day), Michigan State University College of Human Medicine, East Lansing, MI (Day).
J Am Acad Orthop Surg. 2024 Nov 1;32(21):1003-1010. doi: 10.5435/JAAOS-D-24-00015. Epub 2024 Jul 16.
Despite widespread acceptance of the importance of diversity in leadership, systemic challenges in leadership attainment in orthopaedic surgery still exist for several groups. We hypothesize that women, underrepresented in medicine groups, and Asians have decreased odds of achieving program director and chairperson positions compared with peers.
Demographic data were collected from the Association of American Medical Colleges for faculty, program directors, and chairpersons in orthopaedic surgery. Odds ratios were calculated treating race, ethnicity, or sex as the predictor variables and attainment of a leadership position as the outcome, comparing the composition of program directors in 2020 and chairpersons in 2019 with faculty in 2019.
Significantly decreased odds were found for women at 0.37 (0.264 to 0.51 [ P < 0.0001]) and the Other category at 0.16 (0.065 to 0.3864 [ P = 0.0001]) while significantly increased odds were found for White and Black/African American faculty at 1.32 (1.02 to 1.71 [ P = 0.0314]) and 1.95 (1.17 to 3.26 [ P = 0.011]), respectively, in holding program director positions. Significantly decreased odds of attaining chairpersonship were found for women at 0.17 (0.07 to 0.41 [ P = 0.0075]) and Asian faculty at 0.33 (0.14 to 0.75 [ P = 0.0062]) while White faculty demonstrated significantly increased odds at 2.43 (1.41 to 4.19 [ P = 0.0013]).
Women showed markedly decreased odds of leadership attainment while Black/African American faculty had increased likelihood of becoming program directors but were not markedly more likely to become chairs. Asian faculty were less likely to become program directors and markedly less likely to become chairs. While decreased odds for women were expected based on current literature, decreased odds of Asians becoming chairs and an increased likelihood of Black/African American orthopaedic surgeons becoming program directors but not attaining the role of chairs at the same rate were novel findings, revealing concerning trends for these groups.
尽管领导力多元化已得到广泛认可，但在骨科领域，仍有一些群体在获得领导职位方面面临系统性挑战。我们假设与同龄人相比，女性（在医学领域代表性不足的群体）和亚洲人在担任项目主任和主席职位方面的几率较低。
从美国医学院协会收集了骨科领域教员、项目主任和主席的人口统计学数据。将种族、民族或性别视为预测变量，将获得领导职位的情况作为结果，计算比值比，比较 2020 年项目主任的构成和 2019 年主席与 2019 年教员的构成。
与白人相比，女性的几率明显降低（0.37 [0.264 至 0.51]，P < 0.0001），其他种族的几率明显降低（0.16 [0.065 至 0.3864]，P = 0.0001）；而白人（1.32 [1.02 至 1.71]，P = 0.0314）和非裔美国人（1.95 [1.17 至 3.26]，P = 0.011）的教员担任项目主任的几率明显增加。与白人相比，女性担任主席的几率明显降低（0.17 [0.07 至 0.41]，P = 0.0075），亚洲人的几率明显降低（0.33 [0.14 至 0.75]，P = 0.0062）；而白人教员的几率明显增加（2.43 [1.41 至 4.19]，P = 0.0013）。
女性担任领导职务的几率明显降低，而非裔美国人的几率增加，但担任主席的几率并没有明显增加。亚洲人担任项目主任的几率较低，担任主席的几率明显较低。虽然女性的几率降低是基于现有文献的预期，但亚洲人担任主席的几率降低，而非裔美国人担任骨科医生项目主任的几率增加，但担任主席的几率没有同等增加，这是新的发现，揭示了这些群体令人担忧的趋势。
