Anand Malini, Julian Kaitlyn R, Mulcahey Mary K, Wong Stephanie E
Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California.
School of Medicine, University of California, San Francisco, San Francisco, California.
JB JS Open Access. 2024 Sep 13;9(3). doi: 10.2106/JBJS.OA.24.00057. eCollection 2024 Jul-Sep.
There is a historic sex imbalance in the field of orthopaedic surgery in the United States, with female physicians being vastly underrepresented. In addition, this sex imbalance is particularly pronounced in certain subspecialties. As such, we sought to analyze the distribution of graduating female residents and their fellowship match trends from 2017 to 2022.
The American Medical Association Fellowship and Residency Electronic Interactive Database was used to identify all orthopaedic surgery residency programs in the United States during the 2016 to 2017 and the 2021 to 2022 academic years. The data were supplemented with the Accreditation Council for Graduate Medical Education (ACGME) Data Book to include data on all ACGME-accredited programs in 2017 and 2022. The percentage of female orthopaedic surgery residents matching into each subspecialty was calculated. Continuous data were analyzed with independent test, and significance was set at p < 0.05.
From 2017 to 2022, there has been a significant increase in the percentage of female residents matching in orthopaedic surgery fellowships (14.6% vs. 19.5%, p < 0.001). In the orthopaedic hand subspecialty, 24 (15.8%) female residents matched into a hand fellowship in 2017 vs. 56 (35.2%) in 2022 (p < 0.001). Spine, trauma, adult reconstruction, oncology, pediatrics, foot and ankle, shoulder and elbow, and sports medicine fellowships have not seen a significant change in the distribution of female residents matching over the past 5 years.
Between 2017 and 2022, the total number of female orthopaedic surgery fellows increased, and there was significant growth in the percentage of matched female fellows in the subspecialty of hand. Other orthopaedic subspecialties including spine, trauma, adult reconstruction, oncology, pediatrics, foot and ankle, shoulder and elbow, and sports medicine have seen no significant change in the distribution of women fellows over the past 5 years. Further investigation is warranted to determine factors leading to growth in certain fellowships among female residents to encourage sex diversity among all subspecialties in orthopaedic surgery.
在美国骨科手术领域存在历史性的性别失衡，女性医生的占比极低。此外，这种性别失衡在某些亚专业中尤为明显。因此，我们试图分析2017年至2022年毕业的女性住院医师的分布情况及其专科住院医师匹配趋势。
利用美国医学协会住院医师和专科住院医师电子交互数据库，确定2016至2017学年以及2021至2022学年美国所有骨科手术住院医师项目。数据通过毕业后医学教育认证委员会（ACGME）数据手册进行补充，以纳入2017年和2022年所有经ACGME认证项目的数据。计算匹配到各亚专业的女性骨科手术住院医师的百分比。连续数据采用独立t检验进行分析，显著性设定为p<0.05。
2017年至2022年期间，匹配到骨科专科住院医师项目的女性住院医师百分比显著增加（14.6%对19.5%，p<0.001）。在骨科手部亚专业中，2017年有24名（15.8%）女性住院医师匹配到手部专科住院医师项目，而2022年为56名（35.2%）（p<0.001）。在过去5年中，脊柱、创伤、成人重建、肿瘤、儿科、足踝、肩肘和运动医学专科住院医师项目中，匹配的女性住院医师分布没有显著变化。
2017年至2022年期间，女性骨科专科住院医师总数增加，手部亚专业中匹配的女性专科住院医师百分比显著增长。包括脊柱、创伤、成人重建、肿瘤、儿科、足踝、肩肘和运动医学在内的其他骨科亚专业在过去5年中女性专科住院医师的分布没有显著变化。有必要进一步调查导致女性住院医师在某些专科住院医师项目中增长的因素，以促进骨科手术所有亚专业中的性别多样性。
