Precocious Leadership in Military Orthopedic Surgery

Introduction Leadership skills are critical for success in both medicine and the military. Formal leadership training and early leadership experience are inherent in the career of military physicians. The aim of this study was to evaluate and compare the demographic characteristics of orthopedic surgery department chairs and residency program directors of military and civilian programs. We hypothesized that compared to civilian programs, military programs fill these roles with surgeons earlier in their careers and with proportionally more women. Materials and Methods A cross-sectional observational study was performed using publicly available demographic data for all civilian orthopedic surgery residency programs registered in the Association of American Medical Colleges Electronic Residency Application Service (AAMC ERAS) database and those military programs listed on the Society of Military Orthopaedic Surgeons (SOMOS) website. Institutional and professional websites (U.S. News and LinkedIn) were utilized to gather the year of residency graduation and sex of the orthopedic surgery department chairs and residency program directors for each program. The demographic information was compared between civilian and military orthopedic programs. Results A total of 162 civilian and 8 military orthopedic residency programs were included. For department chairs, the mean time since residency completion was longer for those at civilian programs compared to military programs (27.03 ± 7.72 vs. 10.57 ± 3.25) (P < .05). Similarly, for residency program directors, the mean time since residency completion was longer for those at civilian programs compared to military programs (19.01 ± 9.31 vs. 9.42 ± 1.81) (P < .05). Among civilian programs, 4.7% and 13% of chairs and programs directors were women. Among military programs, 14.3% and 28.6% of chairs and program directors were women. Conclusions Military orthopedic surgeons assume the leadership roles of department chair and residency program director significantly earlier in their careers than their civilian peers and exhibit modestly higher sex diversity. Structural and cultural aspects of military medicine likely contribute to these differences, offering a model for early leadership cultivation and highlighting the opportunity for early leadership experience in military orthopedics.