Subspecialties and Characteristics of Leadership Position in Orthopaedic Surgery.

Objectives: The composition of department leadership, notably the Department Chair and Program Director, plays a pivotal role in "Match" decision making and further residency training. This study aims to examine the current landscape of subspecialties and other demographic characteristics of the Department Chairs and Program Directors of orthopaedic surgery residency programs across the United States. Methods: A list of Department Chairs and Program Directors of all 201 ACGME orthopaedic surgery residency programs was generated from the Orthopaedic Residency Information Network (ORIN) website. Demographic information, years of practice, research productivity (H-Index), and subspecialty for both Chairpersons and Program Directors were gathered. Information was available on 163/201 department chairs and 199/201 program directors. Results: Among the 163 Department Chairs, Sports (24.5%), Adult Reconstruction (16.6%), and Trauma (13.5%) emerged as the most prevalent subspecialties, while Shoulder and Elbow (5.5%), Pediatrics (3.7%), and General Orthopedics (1.8%) were the least represented. Among the 199 Program Directors, Trauma (22.1%), Sports (17.1%), and Hand and Upper Extremity (14.1%) were the most common, while Shoulder and Elbow (6.0%), Foot and Ankle (5.5%), and General Orthopedics (1.0%) were the least represented. Chairpersons exhibited notably higher mean years of practice, mean H-index, and were more commonly male compared to Program Directors. However, in the multivariable regression model predicting leadership position, only years of practice and H-index were found to be significant predictors. Conclusion: Sports, trauma, joint reconstruction, and hand were the most common subspecialities among those in positions of leadership explained by their higher prevalence among American-board orthopedic surgeons. Furthermore, H-index and years of practice were both predictors of being a chairperson.