Orthopedic Surgery: An Evolving Field

There are fewer female orthopedists than there are male orthopedists in the U.S. Some in our field believe the reasons run deeper than the simple structural issues which affect the med school pipeline. One oft-cited explanation, for instance, is that practicing orthopedic surgery takes considerable strength:

“If you think about orthopedics, you think about hip and knee replacements, spine surgery, trauma, and some of those are bigger cases,“ says Kristy Weber, chief of Orthopaedic Oncology at the Perelman School of Medicine (PSOM). . . “Some of my work is physically significant, tiring I suppose, but I’ve never had a case where I felt that I wasn’t strong enough—and I’m not even that strong.”

Indeed, strength alone cannot possibly explain a 6:1 disparity, nor can it explain the great number of male orthopedists who are too old, weak, or injured to brace their full body weight against a stubborn hip flexor, yet somehow maintain a thriving practice.

The issue is almost certainly related to professional inertia, which is both good and bad. Good because inertia can be overcome with time, but bad because it suggests a deeply embedded issue:

The dearth of female residents correlates, of course, with the dearth of female orthopedic surgeons: Studies have shown the opportunity for same-sex role models to be a critical factor in women’s decisions about where to train and work, so if female medical students don’t see women in a specialty, they are less likely to pursue it themselves. Given that the threshold of visibility is 30 percent, the 5 percent of orthopedic surgeons who are women are not collectively visible enough to attract a critical mass of female residents.

As we move toward equity in our field as in medicine as a whole, I am encouraged to imagine of the emergence of true meritocracy, where the best orthopedic surgeons in San Diego rise to the top because of talent and experience alone.

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