Women in Orthopaedic Surgery: A Scoping Review on Challenges and Barriers

The purpose of this scoping review is to provide a broad overview on barriers facing women in orthopedic surgery both thematically and temporarily. A systematic search of EMBASE, PUBMED and MEDLINE identified relevant studies to the above objectives with the consultation of a librarian. The following search terms were used “orthopedics”, “women”, “gender inquity”, “gender diversity”, and “workforce”. Articles were then coded by theme by two reviewers. 281 articles were included in the final scoping review and read by the lead author. Articles were sorted in categories such as: workforce (24), leadership/academia (26), medical student perspective (17), gender bias and discrimination (48) and mentorship (4); representing considerations that may impact women during their training. Workforce articles summarized the demographic changes in orthopedic surgery with more women entering orthopedics as trainees, but still being the minority of orthopedic surgeons, despite other specialties improving gender parity more rapidly such as general surgery (1). Leadership and academia articles demonstrated the “glass ceiling”; women orthopedic surgeons often fail to reach the same academic ranks as men (ie: professorship) (2,3). The lack of women leaders in orthopedics further decreases lack of mentorship for aspiring orthopedic surgeon who are not men, which is a known factor on how students choose their speciality (4). Medical student perspectives showed that there are inherent stereotypes (ie: must be strong, play sports) that further deter women from considering orthopedics, which may decrease their exposure to the field (5). Gender bias articles further explored the “boys club” mentality women feel from medical school to staff-hood. Barriers in residency and staff-hood continue for women as they are often left out of informal networks because of conflicting family duties or interests (ie sports based) (5). Women face multiple barriers across training that can deter them from pursuing orthopaedics and thriving in the field. Not only may women not pursue orthopedics because of their perceptions of the field, but there is a further lack of exposure and mentorship. Once in residency and staff-hood, further difficulty reaching the same level of academic leadership and achievement as their gender counterparts due to gender bias. This scoping review summarizes the impact of gender when pursuing an orthopedic career in a temporal framework.