Orthopaedic surgery, like many other medical specialties, suffers from a lack of representation in its professional ranks from groups other than Caucasian males. This not only has measurable impact on the quantity and quality of care delivered to underrepresented groups, but also affects research and policy decisions. Orthopaedic care as perceived by many in the African American community is primarily for salvage procedures such as amputations. Evolving the current system to produce more efficacious and fair healthcare delivery requires training more orthopaedic surgeons of African American extraction. Department chiefs of residency programs must be enlisted to achieve this goal.