Diversity Within Foot and Ankle Surgery: A Systematic Review

This systematic review summarizes the state of historically underrepresented minority and gender diversity in foot and ankle surgery (FA) at multiple levels, particularly leadership and research productivity. A literature search was performed following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Included studies presented demographics regarding diversity within FA and provided trends in rank, leadership, or research. Ten cross-sectional studies were included and assessed for quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) cross-sectional study checklist. Demographics on hundreds of FA applicants, attendings, fellowship directors, and researchers/research articles were collected. Results show disparity at each level, particularly in leadership with females accounting for one (5.5%) chair, three (15.8%) program directors, fi ve (9.8%) division chiefs, three (4.4%) fellowship directors, and one (0.9%) professor. Although there has been an increase from 12% to 14% females in FA from 2010 to 2019, parity is not met. Recognition of the lack of diversity within FA will allow for targeted approaches to an equitable workforce. (Journal of Surgical Orthopaedic Advances 34(2):062-068, 2025)

Key words: diversity, inclusion, fellowship director, minority, parity