Why Aren't There More Female Orthopaedic Surgeons?
While other medical specialites have increased gender diversity, orthpaedics has struggled to make real progress.
We’d like the challenge the specialty, and residency programs, to take a more deliberate and aggressive approach to solving this problem.
(Note- all of these issues/talking points and ideas, apply to diversity, generally, including all underrepresented groups.)
Orthopaedics – Almost No Progress
Women now constitute the majority in the ranks of younger doctors. A recent athenahealth survey revealed that more than 60% of physicians under 35 are female. The sad reality in orthoadics:
Females represent only 12-15% of orthopedic residents,16% full time academic faculty and 6% of AAOS members (2,3,6,9). This represents the lowest percentage of females across surgical disciplines.
The number of female trainees in orthopaedic surgery has remained stagnant over the past 5 years.
Looking at the 203 Orthopaedic Residency programs in the United States between 2009 to 2014, 30 programs had no female trainees. 49 programs had less than 20% women enrolled in at least 1 of the 5 years. Eight programs had no female trainees enrolled in any of the 5 years.
The number of female trainees in orthopaedic surgery has remained stagnant over the past 5 years...14%, the lowest percentage of famales across surgical disciplines...
We aren’t training enough female surgeons and there appears to be a failure to retain women as practicing orthopaedic surgeons as the number of women practicing in the profession, is not consistent with the number of women that we are training.
(Do female surgeons have better patient outcomes?)
The Causes?
A number of variables are contributing to the problem:
Research indicates there is no overt discrimination in selecting residents. Female applicants are as likely to match as male counterparts. Rather, female medical students simply aren’t applying to orthopaedic surgery residencies.
Women make up only 8% of full time orthopaedic faculty positions at academic Institutions – which means there aren’t an abundence of role models.
Are some women actually discouraged from entering the field – due to the perception that it is, indeed, dominated by men?
For a recent analysis of the reasons why women might not choose orthopaedics, see: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4965367/
Women make up only 8% of full time orthopaedic faculty positions at academic Institutions – which means there aren’t an abundance of female role models.
Challenges Facing Women in Medicine, Generally
The J3P team has explored the unique challenges facing women in medicine. In fact, we deployed a successful coaching program for female orthopaedic surgeons not too long ago and wrote about it, here: The Unique Challenges of Being a Female Physician – Notes from an Executive Coach.
Some observations from our work coaching women in medicine:
Most women have similar issues.
For many, it’s not IF they will have a hard time, be bullied or harassed - it’s WHEN.
When women in medicine do something great they often feel they are not only representing themselves, but theire entire gender.
Most women either feel guilty or are shamed for wanting to do a second shift at home.
The COVID-19 pandemic has brought more attention to the issue of childcare for physicians, women AND men.
It’ hard for women in male-dominaed specialties to rise to leadership. Many women feel dismissed and are afraid to speak up, stand in their power and take what is rightfully theirs.
Medicine, generally, has to face these issues. Orthopaedics, with these abysmal gender equity numbers, needs to lead the way.
Insights from Lisa Cannada, M.D.
We’ve been exploring ways to help orthopaedic residency programs take a more deliberate approach to this issue, in collaboration with Lisa Cannada, MD.
Dr. Cannada is an Orthopedic Trauma Surgeon from Jacksonville, FL., affiliated with the Hughston Clinic and Novant Health(Charlotte, NC). She’s served on the American Academy of Orthopaedic Surgeons BOD as the first female Chair of the Board of Specialty Societies. She’s also served as a president of the Ruth Jackson Orthopaedic Society (“RJOS”). She edited and produced the RJOS “Guide for Women in Orthopaedic Surgery” and is currently editing “Guide for Medical Students in Orthopaedic Surgery”.
Lisa Cannada, M.D.
Dr. Cannada’s high-level observations on the issue:
Most residency programs acknowledge the problem and indicate they’d like to increase the number of women in their programs – but few seem to have a clear plan.
Like anything else, it’s important to understand the barriers to achieving the goal, and then design and implement a plan to attack those barriers.
Programs need to challenge themselves to make sure they understand why diversity is important – so they can make it a priority.
There are some relatively straight-forward solutions we should be considering:
How can we allow for career advancement for women who have children?
We can be creative in finding flexible solutions AND still meeting the needs of the department and of patients.
Make sure that the profession is giving women the tools, resources, and support they need to have successful careers.
According to Dr. Cannada, “Some of the perceptions about the specialty, that might discourage women, are myths. But some are real, and we need to address them head-on because women make outstanding orthopaedic surgeons, and the profession needs their unique contributions. We need to do a better job getting women interested in the profession, and residency programs need to make it possible for them to succeed, and to feel valued and welcome.”
“Some of the perceptions about the specialty, that might discourage women, are myths. But some are real, and we need to address them head-on . . "
J3P’s Women in Numbers Program for Orthopaedic Residencies
In collaboration with Dr. Cannada, J3P will be rolling out a new program, Women in Numbers (“WIN”) designed to help residency programs take a more deliberate approach to attracting and supporting women.
The WIN program will provide an objective, expert analysis of the challenges facing residency programs and present a customized plan to increase gender diversity. Recommended interventions will address recruiting and selection, marketing, messaging, supporting female faculty, department training and coaching needs, and identifying practical, operational solutions.
The WIN program is working now with potential pilot sites. To learn more, contact Jena Jake at jenaj@j3phealthcaresolutions.com
Jena Jake, M.A., is J3P's Vice President of Coaching Programs. She works extensively with female physicians and is able to combine her expertise in individual and organizational behavioral science, with a practical understanding of the challenges facing women in medicine.
