Published 12/20/2023
Terry Stanton

The Diversity Advisory Board Takes Stock, Plans Events for the AAOS 2024 Annual Meeting in San Francisco

The AAOS Diversity Advisory Board (DAB) maintains a Diversity Dashboard, which tracks progress toward its goal of increasing diversity in the AAOS volunteer structure. At midyear, the DAB issued a progress update, informing members of accomplishments and initiatives.

Anthony E. “AJ” Johnson, MD, FAAOS, explained that the mission of the DAB is to serve as a resource for AAOS in its efforts “to (1) create a culture within the AAOS community that encourages and values diversity, and (2) build both a membership and a leadership of AAOS that are reflective of the communities that we represent, study, and care for.”

The DAB operates in alignment with AAOS’ 5-year Strategic Plan (now in year 5), specifically in support of goal 3—“Evolve the culture and governance of AAOS’ board and volunteer structure to become more strategic, innovative, and diverse”—via four main tactical touchpoints:

  • targeted and focused recruitment of underrepresented minorities (URMs) and women into AAOS committees, council membership, and leadership positions (expanded in 2020 to include underrepresented populations of first-generation, rural practice, and veteran orthopaedic surgeons)
  • transparency in the selection process for filling these positions
  • enhanced retention of women and URM volunteers with onboarding, mentoring, leadership development, and support
  • promotion of an orthopaedic culture that embraces diversity, equity, and inclusion—with the ultimate goal of belonging

The effort to transform the orthopaedic surgeon workforce from one that is still largely male and white to one that better reflects the overall population can be frustratingly slow for many, but efforts in this regard by AAOS leadership and the DAB have yielded some positive results, as enumerated in the progress report. “Organizational culture in an entrenched and, we can say, a highly successful culture otherwise takes time, persistence, and consistent invested leadership,” Dr. Johnson said.

In the recruitment category of the report—i.e., targeted and focused recruitment of URMs and women—the DAB cites several accomplishments. Notably, AAOS’ three top leaders met with the leadership of the liaison societies (J. Robert Gladden Orthopaedic Society, Ruth Jackson Society, and American Association of Latino Orthopaedic Surgeons), and the orthopaedic specialty societies promoted the current AAOS committee openings and membership benefits through their newsletters, emails, and word-of-mouth.

Under selection, the DAB lists three notable achievements: (1) It generated a Public Selection Report, posted online at aaos.org/diversity, an annual tally that reflects a 2018 to 2020 baseline and provides annual statistics on composition, selection, and engagement for AAOS diversity in governance. (2) It encouraged members to apply for Committee Appointment Program (CAP) positions via outreach through societies and individually. (3) It held an LGBTQ+ Networking Social at the 2023 Annual Meeting to promote diversity activities and CAP positions.

For retention, the DAB reported that leadership training continues through the AAOS Leadership Institute, with Level 3 and Level 4 applicants selected for the 2023 cycle. Also, the chair of the DAB began serving as an ex-officio member of the CAP Committee and provides direct feedback on diversity aspects of the CAP process, including the onboarding, selection, and evaluation process.

Under culture, the DAB implemented a Social Media Diversity Plan, including engagement of members and outreach. The DAB also noted that implicit bias, diversity, equity, and inclusion training continues for new chairs appointed to serve within the AAOS governance structure.

Finally, in additional efforts to support execution of diversity tactics and metrics, the AAOS IDEA Grant Program® opened applications for the second year of the grant program.

Within their mandate, Dr. Johnson and the members of the DAB primarily address issues of diversity as they apply to the organization of AAOS and its leadership and committee structures. As program director for Orthopaedic Surgery Residency at Dell Medical School at University of Texas at Austin, he is aware of the challenges involved in the effort to change the demographics of the profession overall—challenges made more fraught by the June U.S. Supreme Court ruling that severely limits, if not effectively forbids, the use of affirmative action in college admissions—with implications for admissions practices at professional programs, including medical schools and residency programs.

“The efforts that we take on are affected by both the recent Supreme Court decision regarding race-based criteria for admission and the transition away from numerically based or objective scores,” Dr. Johnson said. He noted that the United States Medical Licensing Examination is now a pass/fail assessment. “Most schools are now going to pass/fail” in their grading, he observed. “They’re not giving class rankings. The majority of medical schools are not doing honor societies like Alpha Omega Alpha, so the ability to determine if somebody is a ‘qualified candidate’ numerically—that’s gone. After the Supreme Court ruling, a lot of state-based schools are looking into how to achieve a diverse student body without using race as an admission criteria. No one has the answer yet because the ruling just happened.”

While Dr. Johnson and his colleagues wrestle with the legal landscape, balancing the goal of recruiting an inclusive class while complying with the new affirmative action restrictions, they will continue to advance their charter to foster an environment in orthopaedic surgery that welcomes all who aspire to enter the profession and extends tolerance, fairness, and civility to all.

To that end, the DAB has organized two events at the upcoming 2024 Annual Meeting on Feb. 12 to 16 in San Francisco. The first is a symposium, “Addressing Discrimination, Bullying, and Harassment in the Orthopaedic Workplace: What Is the AAOS Doing Now,” featuring the Academy president, first vice president, and past president, along with a diverse panel including department chairs, a fellowship director, and the chairs of the AAOS Communications Committee and Resident Assembly, as well as Dr. Johnson. These orthopaedic leaders will discuss potential solutions as they address the findings of the Academy’s 2022 Workplace and Environmental Culture Survey.

The symposium will take place on Feb. 12 and will be immediately followed by a Diversity Town Hall, chaired by Dr. Johnson. “We saw in the culture survey results a request for more leadership in combating bullying and harassment,” he said. “And the best way to do that would be to get the leaders to talk about it. We have the presidential line, plus department chairs from across the country, both underrepresented minority and women chairs, and organizational leaders to come together and discuss these issues, to get a perspective on how they are working on changing the culture across the spectrum.”

Terry Stanton is the senior medical writer for AAOS Now. He can be reached at tstanton@aaos.org.