Where are the women in orthopedics?


The orthopedic industry is ever-changing, with new robots and surgical techniques seemingly always around the corner. But one aspect of this vibrant industry hasn't changed much since its conception — the lack of women in the operating rooms.

Orthopedics has the least amount of female physicians when compared to other specialties, with just 10 percent of women making up the orthopedic workforce, according to Medscape's "Physician Compensation Report 2023," and that number shrinks when examining the number of women of color in the field. 

Five orthopedic surgeons from the Ruth Jackson Orthopaedic Society, a networking organization for female orthopedic surgeons, connected with Becker's to discuss why there are so few women in orthopedics. 

So why are there so few female orthopedic surgeons?

"It's definitely multifactorial," Mary Mulcahey, MD, division director of sports medicine at Loyola Medicine in Maywood, Ill., told Becker's. "Some of the many factors that contribute [to the lack of women in the field] are the low number of role models, the low number of women that are practicing [orthopedics] now and the [lack of] women that are in senior leadership roles that medical students and residents are seeing. By having so few women in those roles, some medical students don't even necessarily think about it or think that they can ultimately pursue that career because they don't see someone who looks like them."

In addition to scarce representation, a lack of exposure to orthopedics as a career option is another barrier that keeps women out of the field. 

Dr. Mulcahey said that the majority of male students who pursue orthopedics go into medical school already knowing they want to go into the specialty. However, for female medical students, the decision to go into orthopedics is typically made during medical school. Dr. Mulcahey said that early exposure, even at a college and high school level, to orthopedics is critical. 

Christen Russo, MD, president of the Ruth Jackson Orthopaedic Society, told Becker's, "In the past, maybe 30 to 40 years ago, more men were exposed to orthopedic surgery because they played more sports and they possibly had someone in their family that was an orthopedic surgeon and that person was probably a man. They just knew the field existed."

Dr. Russo said that over the past 20 years, there has been an increased focus on trying to increase the pool of competitive female orthopedic surgeon applicants by introducing them to the field early through pipeline programs such as the Perry Initiative, RJOS, mentoring workshops and webinars. 

The perception that orthopedic surgeons must have an exceptionally strong and large physique may also hold women back from joining the field.

"When you have a majority of men in the specialty, it's really difficult to see yourself doing this very physical surgery," Linda Suleiman, MD, associate dean for diversity and inclusion and assistant professor of orthopedic surgery and medical education at Northwestern University Feinberg School of Medicine in Chicago, told Becker's. "Historically people would say, 'Women don't want to do this because it's a very physical surgery,' and for those of us who are women in orthopedics, we have figured out how to make this surgery doable." 

So what happens to the women who are able to jump over these hurdles and actually become orthopedic surgeons? The barriers don't end when they become MDs.

In some settings, workplace culture issues have caused female orthopedic surgeons and students to face harassment, bullying, macro and microaggressions, and sexual harassment. 

"It's always challenging to be the only one or the only one of a few," Corinna Franklin, MD, chief of pediatric orthopedic surgery at New Haven, Conn.-based Yale School of Medicine, told Becker's. "I think one of the hardest things intellectually and emotionally is feeling like you represent all women. As a student or a resident you may think, 'If I don't know this or if I do this poorly, it reflects badly on everyone.' As one of the few, you do feel added pressure to be a good role model." 

Though female representation in orthopedics remains low, the women who are currently in the field are lighting the path for the next generation of orthopedic leaders. 

"We need to continue to chip away at an environment in which the world expects that orthopedic surgeons are going to be white men," Jennifer Weiss, MD, treasurer of RJOS and American Academy of Orthopaedic Surgeons communications chair, told Becker's. "As the world sees how beneficial it is to have people of different genders, races, ethnicities and economic backgrounds, our care is going to get better and our patients will appreciate having the option to be cared for by surgeons who get them a little bit better."

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