To The J. Robert Gladden Orthopaedic Society (JRGOS) Board of Directors,

Thank you for your thoughtful July 26th email regarding Black Orthopaedic Surgery Resident Attrition. The American Board of Orthopaedic Surgery (ABOS) staff and Board of Directors recognize the gravity of that issue and are committed to ensuring that the programs and processes of the ABOS are not contributing to that problem. More than that, the ABOS strives to be a leader in addressing the issues around the problem.

At our most recent fall meeting, the ABOS Board of Directors reviewed your email and the references that were attached. This was done jointly with leadership from the American Academy of Orthopaedic Surgeons (AAOS), the American Orthopaedic Association (AOA), and the Accreditation Council for Graduate Medical Education (ACGME). All of the organizations present recognized the magnitude and the importance of the situation and its complex, multifactorial etiology.

The ABOS recognizes that our profession has been behind in addressing the important topics around diversity, equity, and inclusion (DEI) and more granularly, the disparities in education, training, recruitment, and retention of African Americans in particular. While we recognize that by the time an individual avails themselves of ABOS Board Certification, many of the impactful developmental events have already occurred, we nonetheless remain committed to doing what we can from the perspectives that we can influence.

The commitment of the ABOS can be demonstrated in in several tangible ways. The Board has established a standing DEI Committee the evolved from a task force specifically convened to investigate and measure the equal and objective assessment of our Diplomates. That committee engaged a nationally respected diversity consultant with specific expertise in medical organizations to conduct a formal audit to evaluate all ABOS activities, programs, and processes and over that past two years, the ABOS had been systematically addressing all concerns that were identified.

Additionally, all ABOS examinations (both Computer-Based and Oral) are being reviewed for areas of potential bias in not only content but in delivery. To this end, the ABOS’s Written Examination Question Bank has been reviewed by a third party to identify and remove any questions that could be perceived as having bias. In addition, Bias training has been made available to all ABOS Oral Examiners over the past three years. That training has been so well received that it is being updated and extended to all ABOS Volunteers. Moreover, the ABOS Rules and Procedures have been adjusted to address areas that were identified as areas of potential concern to marginalized Diplomates. While this list is not an exhaustive one, it is being submitted to you as evidence of the commitment of the ABOS to addressing the very troubling and recalcitrant disparities highlighted in the articles that you submitted.

In closing, the ABOS would like to thank you for your leadership in this area. We would like to thank you for the courage demonstrated in drafting and sending your letter. Lastly, we would like to offer collaboration in the future as we attempt to confront the realities facing our minority surgeons.

Thank you.

Regards,

Kevin L. Garvin, MD, President ABOS

Wayne J. Sebastianelli, MD, Vice President ABOS

David F. Martin, MD, Executive Director ABOS

Michael S. Bednar, MD, Associate Executive Director ABOS