title: A 5-Year Update on the Uneven Distribution of Women in Orthopaedic Surgery Residency Training Programs in the United States.
abstract: BACKGROUND
  This study was undertaken to update our report from academic years 2004-2005 through 2008-2009, to include 5 additional years of the Association of American Medical Colleges GME Track data. This study will test the hypothesis that, when compared with the data from 2004-2005 through 2008-2009, there were no substantial changes from 2009-2010 through 2013-2014 in the distribution of orthopaedic surgery residency programs that train female residents and have been accredited by the Accreditation Council for Graduate Medical Education (ACGME).
  
  
  METHODS
  Data for all ACGME-accredited orthopaedic surgery residency training programs in the United States were analyzed for 2009-2010 through 2013-2014, in the same manner as our previous report analyzed data for 2004-2005 through 2008-2009. Programs were classified as having 0, 1, 2, or >2 women in training (i.e., for postgraduate year [PGY]-1 through PGY-5) for each of the 5 academic years. Programs were also analyzed for the percentage of female residents in training and were classified as being above the national average (>20%), similar to the national average (between 10% and 20%), or below the national average (<10%) for each of the 5 academic years.
  
  
  RESULTS
  During the time period of 2004 to 2009, the mean percentage of female trainees in U.S. orthopaedic surgery residency programs was 11.6%, and during the time period of 2009 to 2014, this mean percentage increased to 12.6%. Residency programs in the United States do not train women at an equal rate. In the 5 years examined (2009 to 2014), 30 programs had no female trainees and 49 programs had >20% women enrolled in at least 1 of the 5 years, 8 programs had no female trainees enrolled in any of the 5 years, and 9 programs had >20% women enrolled in each of the 5 years.
  
  
  CONCLUSIONS
  Female medical students continue to pursue orthopaedic surgery as a career at rates lagging behind all other surgical specialties. Not all residency programs train women at equal rates. The period of 2009-2010 through 2013-2014 showed a greater percentage of programs (68%) training ≥2 women than the period of 2004-2005 through 2008-2009 (61%). Obstacles to attracting women to orthopaedic surgery should continue to be identified and to be addressed.
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota vanhe003@umn.edu.
authors.forename: Ann E
authors.initials: AE
authors.lastname: Van Heest
authors.affiliation: Orthopaedics & Rehabilitation, Yale School of Medicine, New Haven, Connecticut felicity.fishman@yale.edu.
authors.forename: Felicity
authors.initials: F
authors.lastname: Fishman
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota agelx001@umn.edu.
authors.forename: Julie
authors.initials: J
authors.lastname: Agel
mesh_terms: D004503:Education, Medical, Graduate / Q000592:standards*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009985:Orthopedics / Q000193:education*; D017678:Sex Distribution; D014481:United States