Ronald Navarro, MD, still remembers not matching into orthopedic surgery the first time he applied.
After graduating from medical school, he returned to Los Angeles and spent a year in general surgery, followed by two years doing research at the University of California Los Angeles before finally securing an orthopedic residency position at Torrance, Calif.-based Harbor-UCLA Medical Center, just miles from the neighborhood where he grew up.
“My story is one of rags to scalpels,” he said.
Today, Dr. Navarro is a shoulder and sports medicine surgeon with more than two decades of experience. He is also president of the American Association of Latino Orthopaedic Surgeons, and emeritus regional chief of orthopedic surgery for Pasadena-based Southern California Permanente Medical Group.
But even after years in leadership, research and national orthopedic organizations, he said the tension among merit, representation and opportunity remains one of the most complicated conversations in medicine.
A profession where half of applicants do not match
In his role as president of AALOS, Dr. Navarro has become increasingly focused on how Latino physicians are represented, mentored and supported within the specialty.
But he was careful to frame the issue in a way that reflected both pride and frustration.
“I have worked hard in my career to earn the podium based on my work and merit and not my skin color,” he said. For him, diversity efforts cannot be separated from the realities of orthopedic surgery itself, one of the most competitive specialties in medicine.
“There are about 900 orthopedic residency spots,” he said. “And almost 50% of the people who try to get into orthopedics don’t match.” That reality, he said, is why conversations around representation can sometimes lose nuance.
“Merit is not a four-letter word,” he said. Orthopedic surgery, he added, demands technical excellence, emotional resilience and years of sustained performance under pressure.
“It’s a hard job,” he said. “We don’t want lackluster people in the profession.”
At the same time, he believes Latino surgeons continue to face barriers that are often difficult to quantify, including unconscious bias, limited mentorship opportunities and the challenge of navigating professional spaces where few people share similar backgrounds.
Building legitimacy for Latino orthopedic surgeons
As president of AALOS, Dr. Navarro said one of his primary goals has been transforming the organization into what he describes as a more structured and nationally recognized professional society.
“For the first time in the history of the organization, we had a strategic plan meeting,” he said. Under his leadership, the organization has expanded fundraising efforts, developed formal bylaws and worked to strengthen relationships with larger orthopedic institutions, including the American Academy of Orthopaedic Surgeons. “We have to present ourselves as a professional organization if we want to be recognized as one,” he said.
His approach reflects a broader philosophy he frequently shares with students and mentees: representation alone is not enough.
Dr. Navarro said he often reminds students that success in orthopedic surgery ultimately depends on excellence, preparation and performance, not identity alone. That means excelling academically, building strong research portfolios and developing the interpersonal skills needed to succeed in highly demanding residency environments.
“You have to read the room,” he said.
Where disparities still exist
Much of Dr. Navarro’s research has focused on disparities in orthopedic care, particularly within large integrated systems.
At Oakland, Calif.-based Kaiser Permanente, he and his colleagues studied whether patients from different racial and ethnic backgrounds experienced different outcomes or access patterns after orthopedic procedures. By and large, he said, the system delivered relatively equal care. But the research also exposed subtler challenges.
Some patients, particularly in underserved communities, were less likely to return for follow-up care or seek help early when complications arose. In other cases, language barriers created misunderstandings around postoperative instructions and patient-reported outcomes.
“We’re finding that patients are getting information they can’t fully understand,” he said.
According to Dr. Navarro, many patient-facing materials are still written above recommended reading levels, while translated instructions often fail to account for cultural nuance or dialect differences. Even AI, which some health systems are beginning to test for translation support, has limitations.
In one study, Dr. Navarro and colleagues used AI to translate postoperative instructions into Spanish, then asked native Spanish speakers to review the results.
“AI was making it unintelligible at times,” he said.
Why representation still matters
Despite his emphasis on merit, Dr. Navarro believes representation still shapes patient experience in meaningful ways. In communities with large Black or Latino populations, he said, patients often feel more comfortable when treated by physicians who understand their background, language or lived experiences.
“It helps patients to see people like them,” he said.
He has also seen how diversity within leadership teams changes conversations internally. In his own department, he described a mix of physicians from Persian, Korean, Japanese, Jewish and Latino backgrounds, as well as women leaders in administrative roles.
“It adds a different touch,” he said.
Different perspectives, he said, can shape everything from communication styles to clinic operations to how physicians think about patient needs.
The balancing act facing the next generation
For younger Latino medical students, Dr. Navarro believes one of the biggest challenges is learning how to balance identity with professional navigation. “You can’t hold on to your ethnicity so much that it hurts your future,” he said.
That does not mean hiding cultural identity, he added. Rather, it means understanding how to navigate institutions, build relationships and lead effectively in environments that may not always feel naturally inclusive.
At times, he worries broader political polarization around diversity initiatives has made those conversations even harder. Still, he remains optimistic.
Even after decades in orthopedics, the same drive that carried him from a working-class Los Angeles neighborhood into surgery continues to shape how he mentors students and leads nationally.
For Dr. Navarro, the challenge is not choosing between identity and merit, but proving the two were never meant to be separated in the first place.
“That journey,” he said, “will always stay with me.”
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