LAUSR

Objectives: The purpose of this study was to evaluate the demographics of female representation among team physicians in the National Collegiate Athletic Association (NCAA) and professional sports organizations. We hypothesized that female team physicians are underrepresented at the collegiate and professional level despite controlling for the percentage of women in orthopaedics overall. Methods: Team physicians responsible for providing medical care to athletes in the “Power Five” conferences (Southeastern Conference [SEC], Atlantic Coast Conference [ACC], BIG-10, BIG-12, PAC-12) and select professional organizations [Major League Baseball(MLB), National Football League (NFL), National Basketball Association (NBA), Women’s National Basketball Association (WNBA)] were surveyed using the most current publicly available online information for both collegiate and professional organizations (range, 2012-2018). Demographic data was used to sort physicians by gender. Team physicians were further stratified into orthopaedic and primary care sports medicine (PCSM) categories. The proportion of females in each field was analyzed using univariate analysis, with statistical significance defined as p<0.05. Results: Analysis found that 100% of the teams in the NFL, NBA, and MLB as well as 82% of teams in the WNBA had male team physician representation, including either a male orthopaedic surgeon or male PCSM provider. Females (orthopaedic and PCSM) were represented among 13.3% of NBA teams, 55% of WNBA teams, 13.3% of MLB teams, and 6.3% of NFL teams. Specifically, female orthopaedic surgeons were represented in 3.33% of NBA, 45.45% of WNBA, 10% of MLB, and 3.13% of NFL teams. In the ”Power Five” conferences, female orthopaedic surgeons were represented in 7.14% of teams in the SEC, 8.33% in the ACC, 30.77% in the BIG-10, 0% in the BIG-12, and 50% in the PAC-12. The total number of male orthopaedic surgeons was significantly higher in the “Power Five” collegiate conferences, with team orthopaedic surgeons 1,483 times more likely to identify as male compared to female (p<0.001). The representation of female orthopaedic surgeons in the PAC 12 (p=0.004) and BIG 10 (p=0.005) was significantly higher as compared to female representation among physician members of the American Academy of Orthopaedic Surgeons (AAOS).The proportion of female orthopaedic surgeons in the AAOS was 5.4% (1568/28988) versus 94.6% male physicians (27420/28988) (AAOS 2016 Consensus Report). Conclusion: There is a paucity of data describing representation of female team physicians among major athletic organizations. This analysis found that male orthopaedic surgeons represent a significantly higher proportion of team or orthopaedic physicians in several Division I collegiate conferences and professional sports compared to female physicians. Interestingly, the overall representation of female orthopaedic surgeons in the PAC12 and BIG 10 conferences was higher than their representation in the AAOS. However, female representation among team physicians has not kept pace with increasing numbers of female participation in collegiate and professional athletics. Overall, female team physicians are underrepresented in sports medicine in the United States at both the collegiate and professional levels. Further exploration of educational pathways and hiring processes for team physicians may be warranted. Male Versus Female Orthopaedic Surgeons in the Power Five Conferences Power Five Conferences Male Orthopaedic Surgeons n (Total Male Physicians) Femlae Orthopaedic Surgeons, n (Total Female Physicians) Odds Ratio (95% CI) p-value Southeastern Conference (SEC) 50 (86) 1 (9) 11.1 (1.3-92.8) 0.007 BIG 12 33 (55) 0 (5) 0.048 PAC 12 58 (106) 9 (28) 2.6 (1.1-6.2) 0.03 BIG 10 41 (88) 7 (32) 3.1 (1.2-8.0) 0.01 Atlantic Coast Conference (ACC) 39 (71) 1 (13) 14.6 (1.8-118.6) 0.002 Total 221 (406) 18 (87) 1483.7 (852.3-2582.7) <0.001