Diversity.

Abstract

Expanding diversity of all types, including but not limited to race, gender, and sexual orientation, is a crucial goal of orthopaedic surgery as a field and adult reconstruction as a subspecialty. Orthopaedic surgery is the least diverse field of all medical and surgical specialties. Women comprise greater than 50% of medical school graduates, yet only 14% of orthopaedic residents are female, and orthopaedic surgery has lagged behind other male-dominated surgical subspecialties in growth of female representation [[1]Rao R.D. Khatib O.N. Agarwal A. Factors motivating medical students in selecting a career specialty: relevance for a robust orthopedic pipeline.J Am Acad Orthop Surg. 2017; 25: 527-535Crossref PubMed Scopus (27) Google Scholar,[2]Chambers C.C. Ihnow S.B. Monroe E.J. Suleiman L.I. Women in orthopaedic surgery: population trends in trainees and practicing surgeons.J Bone Joint Surg Am. 2018; 100: e116Crossref PubMed Scopus (78) Google Scholar]. Racial diversity has also been lacking in our field, with 13.5 white applicants for every African American applicant for a surgery residency spot and less than 2% each of African American and Hispanic practicing orthopaedic surgeons in the United States [[3]Day C.S. Lage D.E. Ahn C.S. Diversity based on race, ethnicity and sex between academic orthopedic surgery and other specialties: a comparative study.J Bone Joint Surg Am. 2010; 92: 2328-2335Crossref PubMed Scopus (78) Google Scholar,[4]Macdonald T.C. Drake L.C. Replogle W.H. Graves M.L. Brooks J.T. Barriers to increasing diversity in orthopaedics: the residency program perspective.JB JS Open Access. 2020; 5: e00007Google Scholar]. Women and minorities are grossly underrepresented in society leadership and department chair positions [[5]Bi A.S. Fisher N. Blenitsky N. Rao N. Egol K. Karamitopoulos M. Representation of women in academic orthopaedic leadership: where are we now?.Clin Orthop Relat Res. 2022; 480: 45-56Crossref PubMed Scopus (1) Google Scholar]. We have far to go. Different orthopaedic societies have been formed to help support and mentor orthopaedic surgeons from all backgrounds. Ruth Jackson, MD, was the first female orthopaedic surgeon in the United States, completing her training in 1932. Named in her honor, The Ruth Jackson Orthopaedic Society was founded in 1983, to support and encourage mentorship and development of female orthopaedic surgeons. J Robert Gladden, MD, was the first board-certified African American orthopaedic surgeon, back in 1950. The J Robert Gladden Orthopaedic Society was founded in 1998 and now has over 450 members. The society is involved in initiatives to reduce health disparities in addition to its mentorship and career advancement for underrepresented minorities in orthopaedic surgery. In addition to the pioneering work of these societies, mentorship programs like the Perry Initiative and Nth dimensions work tirelessly to expose medical students and high-school students to orthopaedic surgery as a field [[6]Nth dimensions.http://www.nthdimensions.orgGoogle Scholar,[7]Perry initiative.https://perryinitiative.orgGoogle Scholar]. In 2018, the American Academy of Orthopaedic Surgeons announced a 5-year plan to increase diversity through initiatives in leader recruitment, selection, retention, and culture. The American Association of Hip and Knee Surgeons (AAHKS) is committed to expanding the diversity and is taking steps to understand the demographics of the membership through a Census, which is sponsored by the newly created Diversity Advisory Board [[8]Gaskin A. Hansen C. Cohen-Rosenblum A. Health disparities and diversity research presented at the American association of Hip and knee surgeons 2021 annual meeting.Arthroplasty Today. 2022; 15: 6-8https://doi.org/10.1016/j.artd.2022.02.020Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar]. The Women in Arthroplasty Committee was formed to support and mentor women AAHKS members. In this issue, Gaskin et al [[9]Diversity Advisory BoardAAHKS diversity advisory board. American Association of Hip and Knee Surgeons.https://www.aahks.org/diversity-advisory-boardDate: 2021Google Scholar] present a Viewpoint article summarizing the posters, presentations, and symposia that addressed topics of health disparity, gender, and race at the 2021 AAHKS annual meeting. We hope this review inspires our readers to continue and grow research into these topics. We at Arthroplasty Today have been making strides to improve diversity among our editorial board. We are also looking to diversify our pool of reviewers, and our publisher Elsevier is supporting this effort [[10]Inclusion and diversity.www.elsevier.comDate: 2022https://www.elsevier.com/about/inclusion-and-diversityGoogle Scholar]. We believe that Arthroplasty Today should strive to create opportunities for orthopaedic surgeons and to promote diversity throughout our specialty. Though we have far to go to create an orthopaedic workforce that reflects our population as a whole, increased awareness of the problem and steadfast commitment to correcting it are two important components of the path forward. G. Golladay receives royalties from Stryker, Inc., has received research support from KCI and Cerus, has received financial support from AAHKS, is on the editorial board for JOA and Arthroplasty Today, and is a committee member for the AAHKS and a board member of the Virginia Orthopaedic Society; A. Rosenblum is on the editorial board for Arthroplasty Today and Journal of Arthroplasty, has received financial support from the AAHKS, Elsevier, and the Journal of Bone and Joint Surgery, and is a committee member for the AAHKS and RJOS; A. Chen receives royalties from Stryker and SLACK Inc., is a paid consultant for Adaptive Phage Therapeutics, Avanos, BICMD, Convatec, Ethicon, GLG, Guidepoint, Heraeus, IrriMax, Pfizer, and UpToDate, has stock options with Hyalex, Irrimax, Joint Purification Systems, Sonoran, and IlluminOss, is on the editorial board of the JOA, CORR, JBJS, JBJI, and Arthroplasty Today, and is a committee member for the AAOS, AJRR, AAHKS, and MSIS. For full disclosure statements refer to https://doi.org/10.1016/j.artd.2022.05.007. 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