Women in Orthopaedic Fellowships: What Is Their Match Rate, and What Specialties Do They Choose?

BACKGROUND: Orthopaedic fellowship training is a common step before becoming a practicing orthopaedic surgeon. In the past, fellowship decisions in orthopaedics were made early in the residency and without a formal match. The process was disorganized, often not fair to the applicants or fellowship programs. More recently, there has been an organized match process for nine different disciplines in orthopaedics. Although the numbers of women applicants into orthopaedic residency has been reported and is the target of efforts to continue to improve gender diversity in orthopaedics, the numbers regarding women in orthopaedic fellowships have not been known. Other details including if there is a difference in match rate between male and female fellowship applicants and what discipline they choose to pursue across orthopaedic surgery has not been reported. QUESTIONS/PURPOSES: (1) How have the numbers of women applying to orthopaedic fellowships changed over a 5-year period? (2) Is gender associated with fellowship match success? (3) Which subspecialties have greater proportions of female applicants?
METHODS: Available orthopaedic residency match data regarding number of applicants and number of female residents between 2010 and 2014 were obtained. For fellowship data, our method was a review of the applicants who submitted rank lists and the number of applicants who matched in all subspecialties through San Francisco Match and from the American Shoulder and Elbow Society from 2010 to 2014. For each year, the number of females versus males applying was abstracted. The total number of females versus males who matched was then obtained. For each subspecialty represented in this article, the number of female applicants and matches was compared with the male applicants and matches.
RESULTS: The proportion of fellowship applicants who are female ranged from 7% to 10% annually, and the percentage of matched female applicants ranged from 8% to 12%. Overall, combining results from 2010 to 2014, female fellowship applicants had a higher proportion of match success when compared with men (women: 320 of 335 [96%]; men: 2696 of 3325 [81%]; p < 0.001). Pediatric orthopaedic fellowships had the highest proportion of women (79 of 318 [25%] followed by foot and ankle (42 of 311 [14%]; spine had the lowest (15 of 525 [3%]).
CONCLUSIONS: Women applicants for advanced orthopaedic training matched at a higher proportion than men in fellowship training. Pediatrics has a higher proportion of women applicants and fellows. Orthopaedics should be a model for other surgical specialties by encouraging women to successfully pursue advanced training.