Abstract
Background:
American medical schools have gradually achieved balance in the sex of medical graduates over the past 4 decades. However, orthopaedic surgery has remained disproportionately male-dominated. Our aim was to quantify this discrepancy across surgical specialties at the residency training and academic faculty levels. We additionally sought to evaluate the prevalence of women in orthopaedic subspecialty and research societies. Methods: Publicly available data from the Association of American Medical Colleges (AAMC) and the Accreditation Council for Graduate Medical Education (ACGME) for the 2005-2006 to 2016-2017 academic years were pooled for analysis of sex in surgical residency programs. The AAMC 2016 Faculty Roster provided data on the sex composition of academic medical faculty, including rank. Current subspecialty and research society membership demographic characteristics were obtained by directly contacting each group.
Results:
Female orthopaedic surgery residents represented 0.92% of all female medical residents in the 2016-2017 academic year. Orthopaedic surgery remains the medical specialty with the lowest proportion of female residents at 14.0% in the 2016-2017 academic year, up from 11.0% in the 2005-2006 academic year. The percentage increase over this time period (27.3%) lags behind other male-dominated fields such as neurological surgery (56.8%) and thoracic surgery (111.2%). Women account for 17.8% of full-time orthopaedic surgery faculty at American medical schools, lower than all other medical specialties. In the 2015-2016 academic year, 1 orthopaedic surgery department chair and only 8.7% of professors of orthopaedic surgery were female. Women make up 6.5% of the American Academy of Orthopaedic Surgeons (AAOS) membership. The specialty societies with the fewest women are The Knee Society (0.5%),
The Hip Society (0.6%), and the Cervical Spine Research Society (1.5%).
Conclusions:
Orthopaedic surgery’s slow increase in the number of female residents and academic faculty lags behind that of other specialties. The lack of female orthopaedic surgeons in higher ranks within medical schools is detrimental to recruitment of female medical students to the field. Further efforts should be made toward increasing medical student exposure to orthopaedics and to female mentors in an effort to ensure that the field continues to attract the nation’s top medical graduates.
In an age of increasing female presence in the American work force, it is no surprise that physicians are following suit. American medical schools, composed of only 11.1% females in 1970, saw a staggering increase to 47.8% females by 2001. Over the same time course, orthopaedic surgery residencies increased from 0.6% to 9.0% female residents but remained the primary pool of women in medical schools rather than a larger proportion of female physicians choosing to practice orthopaedics.
“There appears to be no evidence that women are less suitable as orthopaedic trainees.”
From 1981 to 2001, the percentage of female medical school graduates entering a residency in orthopaedic surgery remained unchanged at 0.6%. Once engaged in orthopaedic surgery, female trainees perform well, with comparable faculty evaluations of core competencies and similar scores on the Orthopaedic In-Training Examination as well as Part I and Part II of the American Board of Orthopaedic Surgery (ABOS) credentialing examination. Additionally, female orthopaedic surgery fellowship applicants from 2000 through 2014 had a match rate of 96% compared with 81% for male applicants. Thus, there appears to be no evidence that women are less suitable as orthopaedic trainees. With the modest increase in female orthopaedic surgery trainees representing a recent trend, the overall orthopaedic community intuitively remains dominated by men. This presents a conundrum, as a lack of female mentors may hinder recruitment of female medical students into the field.
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Contributors:
Caitlin C. Chambers, MD, Stephanie B. Ihnow, MD, Emily J. Monroe, MD, and Linda I. Suleiman, MD
Disclosure: There was no source of external funding for this study. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/E885). COPYRIGHT 2018 BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED
Source: J Bone Joint Surg Am. 2018;100:e116(1-7) d http://dx.doi.org/10.2106/JBJS.17.01291
