Abstract
Background: Fellowship directors are assumed to be distinguished in orthopedics, but the traits and training that have enabled them to achieve their leadership positions have not been assessed. Purpose: We sought to identify common demographics, research output, and educational trends of fellowship directors in orthopedics, with an emphasis on racial, ethnic, and gender diversity. Methods: We conducted a literature review to identify published studies on fellowship directors in orthopedic surgery and found 4 cross-sectional studies of fellowship directors in spine, arthroplasty, pediatrics, and sports medicine subspecialties. Another 4 accredited orthopedic subspecialties and their fellowship directors were identified using the American College of Graduate Medical Education Public Accreditation Data System for 2020-2021 and national fellowship directories. Data endpoints included race/ethnicity, age, sex, residency and fellowship training institutions, year of fellowship completion, year of hire at current institution, year of fellowship directors appointment, and h-index. The demographics and educational backgrounds for listed fellowship directors were collected from curricula vitae (CVs). Results: Of the 537 fellowship directors identified among 8 orthopedic subspecialties, the average age was 52.9 ± 2.2 years, 5.6% (N = 30) were women, 79.1% (N = 406) were white, 12.5% (N = 64) were Asian American, 3.7% (N = 19) were African American, 2.9% (N = 15) were Middle Eastern, and 1.7% (N = 9) were Hispanic/Latino. Oncology 20% (N = 4) had the highest percentage of female fellowship directors; 37.6% (N = 202) of fellowship directors were at the same institution they trained at for residency or fellowship. Their average h-index was 18.6 ± 3.7. Conclusion: This study of fellowship directors in orthopedics found that they have a high research output and a high level of institutional familiarity. We identified a need for greater diversity in these leadership positions in both gender and race/ethnicity.
Keywords: orthopedic fellowship, orthopedic leadership, orthopedic surgery, medical education
Introduction
Fellowship directors have the opportunity to mentor and educate the upcoming generation of orthopedic surgeons in their professional societies. However, the unique traits and training that have enabled these leaders to achieve this position have not been adequately assessed. Objective measures for assessing such skills are limited, which makes it difficult to determine who possesses leadership qualities and, ultimately, who will become leaders in the field. Prior studies assessing the factors associated with leadership in health care often cite effective communication, knowledge of group dynamics, and promotion of change and innovation as essential skills for physician leaders [25,38]. Research also suggests that leadership skills are not innate but teachable and can be developed through training [9,19].
We sought to analyze the various subspecialties within orthopedic surgery to understand the qualities and factors that have positioned fellowship directors into their prominent roles. Specifically, we aimed to identify fellowship directors’ demographics, research output, education, and employment; because orthopedic surgery has one of the lowest rates of women and minorities entering the field and working as practicing surgeons [22,24,27,29,30], we also sought to emphasize diversity.
Methods
We reviewed existing literature in May 2021 to identify studies published within the past 5 years on orthopedic surgery fellowship directors using the search terms “fellowship director” and “orthopaedic OR orthopedic surgery.” Articles were included if they reported trends of fellowship directors. We identified cross-sectional studies of leadership trends in 3 orthopedic subspecialties: spine, arthroplasty, and sports medicine [17,33,34]. In addition, 1 study assessing pediatric fellowship directors, which was in press at the time, was sent to us after contacting the program administrators [14]. These cross-sectional studies provided demographic information on fellowship directors in their respective subspecialties. We identified the remaining 4 subspecialties and their fellowship directors using 2 methods. First, we used the American College of Graduate Medical Education (ACGME) Public Accreditation Data System for 2020-2021. This system lists all ACGME-approved fellowship programs and their corresponding program directors by medical specialty. Second, non-ACGME accredited fellowships were identified through national orthopedic society directories including the Orthopaedic Trauma Association (OTA), American Orthopaedic Foot and Ankle Society (AOFAS), American Society for Surgery of the Hand (ASSH), and Musculoskeletal Tumor Society (MSTS) (accessed May 2021).
Demographic data were then collected by 2 research assistants (R.R, S.H.) using the previously identified program directors from the ACGME and fellowship directories. Primary data points included race/ethnicity, age, sex, residency, fellowship training institutions, year of fellowship completion, year of hire at current institution, year of appointment, and h-index. Demographics and educational backgrounds were collected from publicly available curricula vitae (CVs) through entities such as LinkedIn and academic profiles on institutional web pages. Data not available through CV review were gathered from institutional biographies, public profiles (Doximity, Healthgrades, Sharecare, Vitals), and direct calls or emails to institutional administrators. In total, 217 institutions were contacted for the remaining variables not found through web research, and 150 administrators replied to our queries.
Finally, the Scopus database was searched to record each fellowship director’s h-index for a given specialty. The h-index is a commonly accepted indicator of research productivity and the relative impact of an author [7,35]. Only descriptive statistics were performed using Microsoft Excel 2017.
Results
A total of 537 fellowship directors were identified among 8 orthopedic subspecialties and 498 programs (Table 1).
Table 1.
Orthopedic fellowship director demographics.
| Overall leadership | Total fellowship leaders | 537 |
| Total fellowship programs | 498 | |
| Co-fellowship leaders | 39 | |
| Age (N = 490) |
Mean ± SD | 52.9 ± 2.2 |
| Sex (N = 537) |
Men | 94.4% (507) |
| Women | 5.6% (30) | |
| Race/Ethnicity (N = 513) |
White | 79.1% (406) |
| Asian | 12.5% (64) | |
| African American | 3.7% (19) | |
| Hispanic/Latino | 1.7% (9) | |
| Middle Eastern | 2.9% (15) |
The following subspecialties are listed from largest to smallest by number of fellowship directors: spine (n = 103), arthroplasty (n = 94), sports (n = 88), hand (n = 73), trauma (n = 62), pediatrics (n = 49), foot and ankle (n = 48), and oncology (n = 20) (Table 2). The average age was 52.9 ± 2.2 years and 5.6% (N = 30) were women. Gender demographics revealed that with respect to subspecialties, oncology 20% (N = 4), pediatrics 14.3% (N = 7), and hand 11.0% (N = 8) had the highest percentage of women fellowship directors (Table 2). Fellowship directors were predominantly white 79.1% (N = 406), followed by Asian American 12.5% (N = 64), African American 3.7% (N = 19), Middle Eastern 2.9% (N = 15), and Hispanic/Latino 1.7% (N = 9) (Table 1). The 3 subspecialties with the highest rate of non-white directors were spine at 29.1% (N = 30), pediatrics at 28.6% (N = 14), and hand at 20.5% (N = 15).
Table 2.
Orthopedic fellowship director demographics by specialty.
| Specialty | Arthroplasty (N = 94) |
Hand (N = 73) |
Foot and Ankle (N = 48) |
Oncology (N = 20) |
Pediatrics (N = 49) |
Spine (N = 103) |
Sports (N = 88) |
Trauma (N = 62) |
|---|---|---|---|---|---|---|---|---|
| Total fellowship programs | 94 | 73 | 44 | 20 | 46 | 74 | 87 | 60 |
| Age, Mean ± SD |
52.6 ± 9.3 (n = 80) |
55.5 ± 9.9 (n = 68) | 50.7 ± 9.9 (n = 44) |
49.0 ± 8.1 (n = 18) |
50.4 ± 8.5 (n = 40) | 52.9 (n = 103) | 54.5 ± 9.0 (n = 81) | 52.4 ± 9.5 (n = 56) |
| Sex, % (n) | ||||||||
| Men | 100 (94) | 89.0 (65) | 93.8 (45) | 80 (16) | 85.7 (42) | 96.1 (99) | 98.9 (87) | 95.2 (59) |
| Women | 0 | 11.0 (8) | 6.3 (3) | 20 (4) | 14.3 (7) | 3.9 (4) | 1.1 (1) | 4.8 (3) |
| Race/Ethnicity, % (n) | ||||||||
| White | 80.7 (75) | 79.5 (58) | 89.6 (43) | 85.0 (17) | 71.4 (35) | 62.5 (50) | 85.2 (75) | 85.5 (53) |
| Asian | 12.9 (12) | 9.6 (7) | 4.2 (2) | 5.0 (1) | 20.4 (10) | 23.8 (19) | 6.8 (6) | 11.3 (7) |
| African American | 1.1 (1) | 5.5 (4) | 4.2 (2) | 10 (2) | 2.0 (1) | 6.3 (5) | 3.4 (3) | 1.6 (1) |
| Hispanic/Latino | 5.4 (5) | 0 | 0 | 0 | 4.1 (2) | 0 | 1.1 (1) | 1.6 (1) |
| Middle Eastern | 0 | 5.5 (4) | 2.1 (1) | 0 | 2.0 (1) | 7.5 (6) | 3.4 (3) | 0 |
The mean calendar year of fellowship graduation for all current fellowship directors was 2001.5 ± 2.1 (Table 3); the average time between graduation from a fellowship program and becoming a fellowship director was 9.8 years. Nearly 1/4 of fellowship directors, 24% (N = 129), trained at the same institution for residency compared with 19.2% (N = 103) who trained at the same institution for fellowship. 5.6% (N = 30) completed both a residency and fellowship at the institution where they are directors. Finally, the average h-index across all specialties was 18.6 ± 3.7 (Table 3). The highest h-index was seen in spine 23.8, followed by oncology 22.0 ± 13.9 (Table 4).
Table 3.
Education and employment progression of orthopedic Fellowship Directors (FDs).
| Education and employment | Mean ± SD (years) |
|---|---|
| Mean calendar year of fellowship graduation | 2001.5 ± 2.1 (n = 499) |
| Mean duration from fellowship graduation to earning position of FD | 9.8 ± 1.5 (n = 375) |
| Mean duration holding FD position | 8.8 ± 1.1 (n = 379) |
| Mean duration of employment at current institution | 15.1 ± 1.7 (n = 388) |
| Mean time between hire by current institution and appointment to FD | 6.1 ± 1.2 (n = 358) |
| Institutional loyalty | % (n) |
| Currently at same institution of residency training | 24.0% (129) |
| Currently at same institution of fellowship training | 19.2% (103) |
| Currently at same institution of residency or fellowship training | 37.6% (202) |
| Currently at same institution of residency and fellowship training | 5.6% (30) |
| Scopus h-indices | Mean ± SD |
| Average h-index | 18.6 ± 3.7 (n = 584) |
Table 4.
Education and employment progression of orthopedic FDs by specialty.
| Specialty | Arthroplasty (N = 94) |
Hand (N = 73) |
Foot and Ankle (N = 48) |
Oncology (N = 20) |
Pediatrics (N = 49) |
Spine (N = 103) |
Sports (N = 88) |
Trauma (N = 62) |
|---|---|---|---|---|---|---|---|---|
| Education and employment, mean ± SD (n), (years) | ||||||||
| Mean calendar year of fellowship graduation | 2001 ± 9.8 (74) | 1999.5 ± 9.9 (69) | 2003.5 ± 9.3 (44) | 2006 ± 8.6 (20) | 2003.8 ± 8.1 (45) | 2001 | 2000 ± 8.7 (83) | 2002.5 ± 9.3 (61) |
| Mean duration from fellowship graduation to earning position of FD | 9.6 ± 7.3 (53) | 12.5 ± 8.0 (38) | 10.4 ± 7.3 (27) | 8 ± 8.0 (20) | 9.0 ± 5.6 (30) | 8.6 | 11.4 ± 7.8 (66) | 9.1 ± 5.3 (38) |
| Mean duration holding FD position | 8.2 ± 6.5 (57) | 9.0 ± 8.0 (38) | 6.6 ± 4.7 (27) | 8 ± 7.9 (20) | 7.4 ± 8.1 (30) | 9.7 | 10 ± 9.2 (66) | 8.6 ± 6.1 (38) |
| Mean duration of employment at current institution | 14.1 ± 9.1 (57) | 17.6 ± 10.2 (42) | 12.5 ± 7.1 (29) | — | 15.2 ± 8.6 (39) | 14.4 | 16.7 ± 9.6 (71) | 15.1 ± 7.8 (47) |
| Mean time between hire by current institution and appointment to FD | 5.5 ± 7.0 (60) | 7.9 ± 7.6 (35) | 5.7 ± 4.9 (26) | — | 7.4 ± 5.4 (30) | 4.7 | 7.4 ± 7.3 (66) | 6.5 ± 5.0 (38) |
| Institutional loyalty, % (n) | ||||||||
| Currently at same institution of residency training | 24.0 (23) | 41.1 (30) | 25.0 (12) | 30 (6) | 22.4 (11) | 13.6 (14) | 22.7 (20) | 21.0 (13) |
| Currently at same institution of fellowship training | 14.0 (13) | 23.3 (17) | 20.8 (10) | 40 (8) | 22.4 (11) | 12.6 (13) | 26.1 (23) | 12.9 (8) |
| Currently at same institution of residency or fellowship training | 35.1 (33) | 50.7 (37) | 37.5 (18) | 60 (12) | 42.9 (21) | 23.3 (24) | 43.2 (38) | 30.6 (19) |
| Currently at same institution of residency and fellowship training | 3.0 (3) | 13.7 (10) | 8.3 (4) | 11.0 (2) | 2.0 (1) | 2.9 (3) | 5.7 (5) | 3.2 (2) |
| Scopus h-indices, mean ± SD, (n) | ||||||||
| Average h-index | 16.5 ± 14.5 (93) |
14.5 ± 9.5 (73) | 15.7 ± 9.9 (48) | 22.0 ± 13.9 (68) | 15.1 ± 11.8 (49) | 23.8 (103) | 22.3 ± 16.9 (88) | 17.0 ± 13.2 (62) |
FD Fellowship Director.
Discussion
This study provides a broad overview of fellowship directors across 8 subspecialties of orthopedics. We found that diversity in gender, race, and ethnicity varies greatly across subspecialties, but remains low compared with other medical and surgical specialties [4,5,27]. Orthopedic fellowship directors are prolific researchers, as evidenced by their high h-index, and 38% of fellowship directors completed either residency or fellowship training at the institution they currently lead.
While this study is broad and includes data from 8 subspecialties, it has limitations. We inferred race and ethnicity using CVs and other publicly available resources if program directors did not respond to our requests; therefore, our demographic data may contain inaccuracies. We did not gather data on specific institutions or geographic regions where fellowship directors trained, and thus no insight can be gained on training sites. Data were collected primarily from CVs, as well as from institutional biographies, public profiles, or directly calling or emailing institutional administrators; these platforms are susceptible to error. Considering the cross-sectional nature of this study, our findings offer no insight into changes in fellowship leadership over time, which may be an important area for future research. Despite these limitations, this study is novel in its presentation of 8 orthopedic subspecialties and provides a comprehensive overview of orthopedic fellowship directors and their associated attributes.
The importance of diversity in medicine and its leadership cannot be overstated, as the literature has repeatedly shown the value of a diverse health care staff [10,20,37,40,42]. Diversity in gender, race, beliefs, and culture not only enriches the practice of medicine and cultivates creativity [20] but also leads to improved patient outcomes [20]. Lack of health care diversity can lead to a limited perspective in patient care and result in miscommunication and mistreatment. Previous studies emphasize that staff diversity improves morale, individual motivation, and health care quality [20,40]. Furthermore, in the business sector mentors and sponsors often choose mentees who are of the same sex and race [15]. Similarly, in medicine women are more likely than men to indicate that a role model of the same sex or ethnicity influenced their decision to pursue a career in orthopedic surgery, further emphasizing the importance of diverse representation in leadership positions [12,23,26].
However, orthopedic surgery has been cited as one of the least diverse medical specialties [16,27,28]. As a whole, with respect to gender representation, the American Academy of Orthopedic Surgery (AAOS) 2018 census data show that only 7.6% of practicing surgeons are women and 84.7% are white (Supplemental Table 1). Additionally, compared with other surgical specialties, orthopedic surgery has the lowest rate of female or non-white members (Supplemental Table 2). (General surgery is the most diverse surgical field overall, according to the Association of American Medical Colleges (AAMC).)
We found a large gender disparity in fellowship directors, with almost 95% men. When this is compared with other areas of leadership within orthopedics, it is clear this is not an isolated phenomenon. A study by Bi et al of orthopedic residency programs revealed that as of 2020, there were only 3 female chairs, accounting for only 2% of all chairs [8]. Similarly, looking at advanced positions within orthopedic surgery, Shah et al found that as of 2017, orthopedic surgery had the lowest representation of women in senior or junior faculty positions [36]. Although the overall percentage of women of women in faculty positions increased from 8.51% in 1997 to 17.87% in 2017, the majority of women held junior positions (instructor or assistant professor) [36]. Meanwhile, other surgical specialties such general surgery and otolaryngology have increased female faculty representation by 13% or more over 20 years [36].
The most male-dominated fellowship director subspecialty in this study was arthroplasty, with 0 female directors, followed closely by sports medicine with only 1 female fellowship director. The subspecialties with the greatest representation of women as fellowship directors are pediatrics and oncology, with 14.3 and 20%, respectively. This is consistent with prior studies that show female representation is highest in hand, pediatrics, and oncology subspecialties [11,13,28,31]. While we did not investigate such effects, mentoring and diverse representation appear to be vital to attracting the next generation of orthopedic surgeons. In fact, a survey of orthopedic residents suggested that women believed more of their peers entered general surgery because of greater acceptance by senior faculty in that field [23]. With respect to fellowship choices, strong mentorship was the largest modifiable factor that affected the decision-making process [11]. Thus, to increase diversity within and across orthopedic subspecialties, outreach programs and early matching with role models may improve female interest in orthopedics and its subspecialties [41].
We found that African Americans make up 3.7% of fellowship directors, and Hispanic/Latino representation is 1.7%, comparable with the percentage of practicing orthopedic surgeons in the 2018 AAOS census that showed 1.9% were African American, 2.2% were Hispanic/Latino, and 6.7% were Asian American [1]. Yet, the racial and ethnic representation in orthopedic fellowship directors is considerably less diverse than in residency programs and medical schools [1,3,29]. Poon et al showed that diversity in orthopedic surgery residents had declined between 2006 and 2015, despite the AAOS prioritizing greater diversity [29]. However, more recent data from the AAMC suggests that as of 2020, diversity in the representation of minorities in orthopedic residency is increasing (24.2%) [6]. While the limited racial and ethnic diversity in orthopedic leadership may reflect the low diversity of the field itself, lower rates of promotion may also play a role. A study by Shah et al revealed that while underrepresented minorities (URM) in faculty positions increased from 4.0 to 6.1%, the majority of URM held junior faculty positions not senior roles [36]. With respect to fellowship trained physicians, there is reason for cautious optimism. The diversity of orthopedic ACGME accredited fellowships in 2019 to 2020 is greater than the diversity both of the 2018 AAOS membership and of fellowship directors [2,11]. As this class of fellows progress in their careers, perhaps their diversity will be reflected in future leadership positions. In addition, collaborative efforts to recruit URM residents and leaders through mentorship and early outreach must be emphasized [36].
Familiarity with an institution, defined as training there during residency or fellowship, appears to play a large role in the selection of fellowship directors. The present study revealed that 38% of directors had completed a residency or fellowship at the institution where they currently held the role of director. In orthopedic oncology, almost 75% of fellowship directors trained at the same institution where they direct the fellowship program. These results are comparable for both chair holders and program directors [8]. Roughly 20% of chair holders and 42% of program directors attended the same institution for residency where they currently reside. However, familiarity may influence individual decisions as well. In fact, research has suggested that geography plays a role in the selection and ranking of programs and preference for training [21,32].
There may also be a preference for selecting physicians with a penchant for research as well as education. The average h-index of fellowship directors was 18.9, roughly 14 points higher than the average academic orthopedic surgeon [21]. Ernat et al found that the mean publications by fellowship program were highest for oncology, shoulder and elbow, and spine [18]. This is consistent with our findings that fellowship directors with the highest research output are in spine, sports medicine, and oncology. It’s important to note that research comes with notoriety and the scholarly productivity of an institution is often used to determine its rank [39,43]. Similarly, it appears that high research output is a common trait among fellowship directors.
In conclusion, we found that research output is important to fellowship directors, as evidenced by their average h-index compared with other academic orthopedic surgeons. Institutional familiarity plays a large role, as over one-third of fellowship directors completed either their residency or fellowship at the same institution they were directing at the time of our study. Finally, this study also suggests a need for greater gender, racial, and ethnic diversity in these leadership positions.
Supplemental Material
Supplemental material, sj-pdf-1-hss-10.1177_15563316221091798 for Orthopedic Surgery Fellowship Directors: Trends in Demographics, Education, Employment, and Institutional Familiarity by Pramod N. Kamalapathy, Jon Raso, Rana Rahman, Sanjana Harihar, Santiago Lozano-Calderon and Hamid Hassanzadeh in HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery
Supplemental material, sj-pdf-2-hss-10.1177_15563316221091798 for Orthopedic Surgery Fellowship Directors: Trends in Demographics, Education, Employment, and Institutional Familiarity by Pramod N. Kamalapathy, Jon Raso, Rana Rahman, Sanjana Harihar, Santiago Lozano-Calderon and Hamid Hassanzadeh in HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery
Supplemental material, sj-pdf-3-hss-10.1177_15563316221091798 for Orthopedic Surgery Fellowship Directors: Trends in Demographics, Education, Employment, and Institutional Familiarity by Pramod N. Kamalapathy, Jon Raso, Rana Rahman, Sanjana Harihar, Santiago Lozano-Calderon and Hamid Hassanzadeh in HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery
Supplemental material, sj-pdf-4-hss-10.1177_15563316221091798 for Orthopedic Surgery Fellowship Directors: Trends in Demographics, Education, Employment, and Institutional Familiarity by Pramod N. Kamalapathy, Jon Raso, Rana Rahman, Sanjana Harihar, Santiago Lozano-Calderon and Hamid Hassanzadeh in HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery
Supplemental material, sj-pdf-5-hss-10.1177_15563316221091798 for Orthopedic Surgery Fellowship Directors: Trends in Demographics, Education, Employment, and Institutional Familiarity by Pramod N. Kamalapathy, Jon Raso, Rana Rahman, Sanjana Harihar, Santiago Lozano-Calderon and Hamid Hassanzadeh in HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery
Footnotes
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: P.N.K., BA, J.R., BS, R.R., BA, and S.H. declare no potential conflicts of interest. S.L.-C., MD, reports relationships with OKNOS, Amgen, Carbofix, and Daiichi Sankyo. H.H., MD, reports relationships with Orthofix, CSRS, Depuy, Nuvasive, Medtronic, Pfizer, Globus Medical, 4Web, Norvartis, and Pacira.
Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.
Human/Animal Rights: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2013.
Informed Consent: Informed consent was not obtained for this study.
Required Author Forms: Disclosure forms provided by the authors are available with the online version of this article as supplemental material.
Supplemental Material: Supplemental material for this article is available online.
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Supplementary Materials
Supplemental material, sj-pdf-1-hss-10.1177_15563316221091798 for Orthopedic Surgery Fellowship Directors: Trends in Demographics, Education, Employment, and Institutional Familiarity by Pramod N. Kamalapathy, Jon Raso, Rana Rahman, Sanjana Harihar, Santiago Lozano-Calderon and Hamid Hassanzadeh in HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery
Supplemental material, sj-pdf-2-hss-10.1177_15563316221091798 for Orthopedic Surgery Fellowship Directors: Trends in Demographics, Education, Employment, and Institutional Familiarity by Pramod N. Kamalapathy, Jon Raso, Rana Rahman, Sanjana Harihar, Santiago Lozano-Calderon and Hamid Hassanzadeh in HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery
Supplemental material, sj-pdf-3-hss-10.1177_15563316221091798 for Orthopedic Surgery Fellowship Directors: Trends in Demographics, Education, Employment, and Institutional Familiarity by Pramod N. Kamalapathy, Jon Raso, Rana Rahman, Sanjana Harihar, Santiago Lozano-Calderon and Hamid Hassanzadeh in HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery
Supplemental material, sj-pdf-4-hss-10.1177_15563316221091798 for Orthopedic Surgery Fellowship Directors: Trends in Demographics, Education, Employment, and Institutional Familiarity by Pramod N. Kamalapathy, Jon Raso, Rana Rahman, Sanjana Harihar, Santiago Lozano-Calderon and Hamid Hassanzadeh in HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery
Supplemental material, sj-pdf-5-hss-10.1177_15563316221091798 for Orthopedic Surgery Fellowship Directors: Trends in Demographics, Education, Employment, and Institutional Familiarity by Pramod N. Kamalapathy, Jon Raso, Rana Rahman, Sanjana Harihar, Santiago Lozano-Calderon and Hamid Hassanzadeh in HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery