Impact of Program Characteristics on Diversity Representation in Orthopaedic Surgery Residency Websites.

Objectives: To examine how residency program characteristics, including program type, city population, region, program director/chair sex and ethnicity, and program size, influence the representation of diversity elements on orthopaedic surgery residency program websites.

Design: Cross-sectional study.

Setting: Orthopaedic surgery residency programs in the United States.

Participants: A total of 199 active nonmilitary orthopaedic surgery residency programs listed on the Electronic Residency Application Service (ERAS) and National Resident Matching Program (NRMP) directories in May 2023, with 198 programs included in the final analysis.

Results: The analysis of 198 programs showed an average of 4.32 ± 1.75 diversity elements per website. Large programs and university-affiliated programs were significantly more likely to feature 4 or more diversity elements (p < 0.001). Mississippi, New Hampshire, and Rhode Island had the highest mean diversity scores. The most common diversity elements were individual photographs of residents (87.37%) and faculty (81.82%), while the least common were community resources (24.24%) and nondiscrimination statements (13.64%). Program size and affiliation had significant associations with diversity representation, whereas the sex and ethnicity of program directors and chairs did not.

Conclusions: The study reveals that program size and affiliation significantly influence the presence of diversity elements on orthopaedic surgery residency program websites. It also underscores the urgent need for smaller and non-university programs to enhance their diversity and inclusion efforts. The findings suggest that other factors beyond leadership characteristics affect diversity representation. Improving nondiscrimination statements and DEI messages on websites could further support diversity in orthopaedic surgery residency programs.