Residents’ Perceptions of Sex Diversity in Orthopaedic Surgery

BACKGROUND: Sex diversity in orthopaedic surgery lags behind other surgical specialties. Women comprise 13.2% of orthopaedic residents and 15% of full-time faculty, despite 47.8% of graduating medical students being women. The purposes of this study were to demonstrate how orthopaedic surgery has been less successful in recruiting women compared with general surgery and to identify the sex-specific factors that influenced orthopaedic surgery residents to choose their specialty. METHODS: A search of graduate medical data was performed to compare the recruitment of women into orthopaedic and general surgery. Next, a seven-question survey was e-mailed to 2629 orthopaedic residents by the American Academy of Orthopaedic Surgeons. Questions were formulated to detect why orthopaedic surgery residents chose their specialty. Data were collected over six weeks and responses were analyzed with use of one-tailed t tests to make comparisons of responses on the basis of sex. RESULTS: The historical data search showed that the percentage of female representation in both orthopaedic and general surgery has increased since 1968, but it has increased significantly faster in general surgery than in orthopaedic surgery (p < 0.0001). Five hundred and twenty-nine (20%) of the 2629 orthopaedic surgery residents who were contacted responded to the survey. Of the respondents, 114 (22%) were female and 415 (78%) were male. Several significant differences were found in the responses between the sexes. These include the timing of the decision to enter orthopaedic surgery and positive influences in choosing orthopaedic surgery as a specialty. Additionally, women, significantly more than men, believed that more of their peers entered general surgery because of greater acceptance by senior faculty in that field (p < 0.0001). CONCLUSIONS: To our knowledge, this study is the first to survey residents on their perceptions of orthopaedic surgery and to identify factors that may hinder the recruitment of women into orthopaedic surgery. Our data show that increased exposure to orthopaedic content during medical school and increased female mentorship may help recruit more women into the orthopaedic surgery workforce.