Diversity in Hand Surgery Leadership: The Impact of Mentorship and Bias

Background: Diversity in leadership drives innovation. However, underrepresented minorities may face barriers. The aim of this study is to understand the impact of gender and race on the experience of leaders in hand surgery. Methods: An anonymous survey was sent to leaders in hand surgery who attained the position of national society president, head of a division/department, or hand fellowship director. The survey assessed demographic information, grit, mentorship, and bias. Results: One hundred twenty-one leaders responded for a response rate of 60.5%. Men represented 81.0% and women 19.0%. Most respondents were white (87.6%) with 7% Asian and 6% any other race. Ninety-one percent of female respondents lived in a dual career household, compared with 53.7% of male respondents (odds ratio [OR] 0.15, P = .017). Female respondents had significantly higher grit compared with male respondents (4.3 vs 4.0, P = .050). Male respondents were more likely to have a male mentor/sponsor than women (95% vs 76%, respectively, P = .001). White respondents were more likely to have a white mentor/sponsor than nonwhite respondents (91% vs 61%, respectively, P = .009). Ninety-five percent of women reported experiencing bias compared with 27% of men (P < .001). Specifically, women reported bias in salary, promotion, nomination, sponsorship, networking, and clinical resources. Nonwhite respondents were significantly more likely to experience bias in promotion (P = .006). Conclusions: Women and racial minorities face bias and barriers to leadership within hand surgery.