by Edward Anthony Rankin, MD
Edward Anthony Rankin, MD, is an African-American orthopaedic surgeon who served on the Academy's Steering Committee on Musculoskeletal Education and the Future Role of Orthopaedic Surgeons. He also is a member of the Academy's Board of Directors.
A special Academy Steering Committee on Musculoskeletal Education and the Future Role of Orthopaedic Surgeons found that there are very few orthopaedic surgeons and orthopaedic residents who are members of minority groups even though the number of minorities in medicine has steadily increased in recent years.
In 1994, only 2.2 percent of all orthopaedic surgeons, including residents, were African-American. The same figure holds true for Hispanics. While these percentages have been relatively stable over the past decade, the Steering Committee found that the number of minorities accepted into medical school has increased from about 1,500 in 1988 to over 2,000 in 1994. That same year, the medical school acceptance rate for minorities was 42.9 percent compared to 37.6 percent for all other applicants. In 1994, minorities comprised 12.4 percent of all new medical school entrants.
The Steering Committee found that members of minority groups are more likely than other physicians to care for minority populations. Even though there has been an increase in the number of minority physicians over the last decade, the ratio of these physicians to their respective racial or ethnic populations is still lower than the ratio of other physicians to the overall population.
Since physicians who are members of minority groups are more likely than other physicians to care for minority populations, minority populations are generally underserved because there are still not adequate numbers of minority physicians. Given the extremely low number of minority orthopaedic surgeons and orthopaedic residents, the Steering Committee concluded that minority populations are experiencing a health care crisis in regard to their musculoskeletal needs.
The Steering Committee found a number of reasons for the low number of minority orthopaedic surgeons, starting with the way many minority medical students perceive orthopaedics and the competition for orthopaedic residency positions.
Most minority medical students overcame tremendous socioeconomic and educational disadvantages to perform well enough in their undergraduate college studies to be admitted to medical school. However, many minority medical students are not in the top medical schools and do not graduate at the top of their classes, in terms of grades and board examination scores. Therefore, they will not seriously consider orthopaedics for their medical careers, believing that it is an elitist specialty which they cannot hope to enter. Most of those that do apply for orthopaedic residencies fail to obtain them because they, like all applicants, are judged, primarily, on grades and board exam scores rather than other indicators.
The Steering Committee also found a number of other factors contributing to the low number of minority orthopaedic residents, including:
In order to adequately provide for the musculoskeletal health care needs of all Americans, the Steering Committee concluded that there must be adequate levels of ethnic and racial diversity among orthopaedists. In no other specialty is this more important than in orthopaedics because musculoskeletal injuries and disorders are such a common occurrence.
Among a number of recommendations, the Steering Committee called for the creation of a new Committee on Diversity to address minority issues in musculoskeletal education and orthopaedic practice. This new committee, which was approved by the Board of Directors at its December 1996 meeting, also would look at the problems associated with the low number of women in orthopaedics.