Diversity in Leadership at Musculoskeletal Oncology Fellowships in the United States

Musculoskeletal oncology fellowship directors (MOFDs) possess the unique ability to influence treatment paradigms in musculoskeletal oncology through teaching and research. Currently, the characteristics that define this important role including demographics, training characteristics, research activity, and grant funding are poorly defined. A list of musculoskeletal oncology fellowship programs was obtained from the American Association of Hip and Knee Surgeons and Musculoskeletal Oncology Fellowship Match. Bibliometric data including the h-index were abstracted from Scopus. Demographics, training, and federal grant characteristics were collected from academic websites. Comparisons were made using t-tests and data were presented as means ± SD. The average age at the appointment was 41±9 years and most were male (80%) and Caucasian (85%). Few had an additional graduate degree (10% MS, 5% PhD). The mean h-index was 23±15 resulting from 91±56 publications. There was a positive correlation between age and h-index (r=0.398, p=0.082). Four MOFDs (20%) had at least one National Institutes of Health research grant. Sex, race, additional graduate degree, and procurement of NIH funding were not associated with higher h-index values. Full professors had higher h-index values than assistant/associate professors (p=0.014). Women and racial minorities are underrepresented among leadership positions in musculoskeletal oncology fellowship programs. This study can help provide a benchmark for departments in orthopedic surgery and aspiring orthopedic surgeons for MOFD positions.