Women in Orthopedics
One female surgeon’s perspective
By Angela W. Rowe, DO
When I started medical school in 1990, my freshmen class was made up of 40% women and 60% men. At the time, that was considered a high percentage for women entering medicine, yet very few women were going into orthopedic surgery. When looking at current medical school classes, the male to female ratio is nearly even, yet the numbers of females entering orthopedics continues to remain low. As a female orthopedic surgeon, I feel this is an important issue, and would like to share my insight as to why this is still the case.
Perhaps an important place to start is to examine how medical students get exposure to our specialty. As I am sure we would all agree, orthopedic surgery is a great specialty to work in. The patients are generally healthy, most injuries go on to heal, and we can make vast improvements to our patients’ lifestyles. That said, unless orthopedics is taken as an elective rotation, a student can actually navigate through four years of medical school and continue onto residency without any exposure to orthopedic surgery. I find this astounding, especially considering a large portion of family medicine and pediatrics involve musculoskeletal care. This lack of exposure may be one reason why many young women do not develop an interest in orthopedics early on.
Another important factor may be that orthopedic surgery has historically been seen as a male dominated field. Females traditionally have shied away from entering this field because they felt they weren’t strong enough or didn’t have an interest in sports. Women tend to pursue more family oriented fields such as family practice or pediatrics. Less than 10 percent of orthopedic surgical residents are women as noted at the AAOS Board of Councilors/Board of Specialty Societies meeting in 2007 . Plagued by negative stereotypes and misconceptions, orthopedics was felt to be part of the “old boys club”. As I have become proficient at using power tools and work out to maintain my strength, sadly, I still cannot bench press my own weight. Thankfully, while there remains a need for strength and proper technique, new technology, and specialty devices have made orthopedic work easier for the diminutive surgeon.
Another factor may be the scarcity of female teachers and role models in the educational system. As the only female orthopedic surgery resident in my training program, I was acutely aware of being the only woman in the group. While not a deterrent to pursing orthopedics, I felt I had to constantly prove myself. There were very few female orthopedic surgery residents and very little social interaction amongst us. More significantly, I did not have any female orthopedic surgeons that could have served as role models. This need for more women mentors likely has a big role in this dilemma, as lack of access to role models can directly affect the success of trying to attract more females into orthopedic residencies. This is a self perpetuating negative cycle that I believe is contributing to the ongoing status quo.
Last, as we are in the minority, women orthopedic surgeons naturally do not hold as many leadership positions. I feel this lack of representation is another obstacle in attracting more females to the field. Women tend to gravitate toward residency programs that already have women in leadership positions. It goes without saying that programs with few women tend not to get as many female applicants. There are organizations actively promoting leadership development in women orthopedic surgeons, such as the Ruth Jackson Orthopedic Society (RJOS-named after the first board certified female orthopedic surgeon in the U.S.).
The RJOS was formed to promote professional growth and leadership of female orthopedic surgeons. It includes resident and medical students as well as offers mentoring programs. It is the oldest surgical women’s organization in the U.S. Another program is the Perry Initiative, named after Dr. Jacqueline Perry. Its’ mission is to inspire young women to become leaders in orthopedic surgery and engineering by sponsoring hands on programs to high schools and medical students across the country. The key is to expose young women early on to peek their interest. The A.O.A.O. Female Orthopedic Group is yet another organization which provides support and a forum for osteopathic women orthopedic surgeons to network as well as mentor medical students and residents.
The AAOS, through the efforts of the Diversity Advisory Board, has initiated an awareness campaign to demystify preconceptions related to a career in orthopedics, as well as encourage medical students to pursue a career in this field. For the prospective female medical students choosing orthopedics, the proverbial question of how to raise a family and still have a successful career raises many questions. Many women traditionally have avoided the surgical specialties for what was perceived as better family and lifestyle choices in the medical fields. As is stands, many families nowadays have 2 working parents. Even in these difficult situations, working women surgeons have been able to juggle work and family successfully. Many female orthopedic surgeons have been able fit in family and home life with a successful full time working career. Practices such as sharing call within a larger group and utilizing physician extenders are two solutions that have increased productivity without having to sacrifice lifestyle choices.
According to the 2012 census data from the AAOS, women make up 4.8% of all practicing orthopedic surgeons in the United States. As our population continues to age, the need for orthopedic surgeons will increase. Currently, half of the incoming medical students are women. If our exciting and challenging field wants to do everything it can to attract the best and the brightest medical students into our training programs, it makes sense that every effort be made to assure orthopedic surgery be a specialty that is equally attractive to male and female students alike. If we succeed in this effort, our specialty will have improved cultural dynamics and diversity. My hope is that this dialogue, along with other discussion, will help us change the current mindset and increase the number of qualified women in orthopedic surgery. We will have better balance for requests that some may have for female physicians, and perhaps a better balance between male and female sensitivities in the delivery of musculoskeletal medicine. I believe this change would be welcomed and embraced by our patients.
Angela W. Rowe, D.O. is a board certified orthopedic surgeon in Altoona, PA. She has no financial disclosures.