To compare the race and ethnicity diversity in Sports Medicine and Brain Injury Medicine (BIM) fellowships across five primary specialties with the U.S. Census population distribution using ACGME data from 2021-2022.

Diversity within medical training programs is crucial to ensuring equitable healthcare access and reducing disparities in patient outcomes. Prior studies have shown a lack of racial and ethnic diversity within subspecialty fellowships. This study aims to evaluate the underrepresentation of various racial/ethnic groups within Sports Medicine and BIM fellowships in relation to the U.S. population.

ACGME data from 2021-2022 were collected for Sports Medicine fellowships in Emergency Medicine, Orthopaedic Surgery, Pediatrics, Family Medicine, and PM&R, as well as BIM fellowships within PM&R and Neurology. The racial/ethnic distribution of fellows was compared to 2021-2022 U.S. Census data using a fellowship-to-census ratio for each group (American Indian/Alaskan Native, Asian, Black/African American, Hispanic/Latino, Multiple Races, Native Hawaiian/Pacific Islander, and White). Statistical significance was set at p < 0.05.

Black or African Americans and Hispanic/Latino individuals were significantly underrepresented in Sports Medicine fellowships in Orthopaedic Surgery (p < 0.001) and Family Medicine (p < 0.01). However, representation of Black or African Americans and Hispanic/Latino individuals was within the expected range in other fellowships such as Emergency Medicine and Pediatrics. American Indian or Alaskan Native and Native Hawaiian or Pacific Islander groups were completely absent in Sports Medicine fellowships across all specialties, including Emergency Medicine, Orthopaedic Surgery, Pediatrics, Family Medicine, and PM&R, as well as in BIM fellowships in PM&R and Neurology. 

There is substantial underrepresentation of racial and ethnic minorities in Sports Medicine and Brain Injury Medicine fellowships across multiple specialties, particularly within Orthopaedic Surgery, Family Medicine, and PM&R. These findings highlight the need for targeted efforts to improve diversity within these subspecialties to better reflect the U.S. population and address healthcare disparities.