Women in orthopaedics--way behind the number curve.

Background Women now constitute 49% of medical school matriculants. The percentage of women in orthopaedic surgery training programs has not kept pace with the increase in the number of women medical students. Although the number of female orthopaedic residents has increased and continues to do so slightly over time, the results of the 2008 American Academy of Orthopaedic Surgeons (AAOS) census reveal that only approximately 4% of orthopaedic surgeons responding to the survey are female. As of the year 2009, all other surgical subspecialties (with the exception of cardiothoracic surgery) had a higher percentage of women than orthopaedic surgery had. The factors that dissuade women from pursuing careers in orthopaedic surgery are not entirely clear. Several investigators have attempted to assess the factors that come into play when women choose a medical specialty career. In the past, lifestyle issues have been cited as a deterrent for women entering surgery and its subspecialties; however, while lifestyle choice may play some role, it is no longer a significant factor in the disparity. It has been noted by several authors that, with the current generation of medical students and residents, lifestyle alone is not more of a deterrent for women than it is for men when choosing a specialty. In fact, Saalwachter et al., in their study examining the needs of both male and female surgical trainees, found that male and female surgical residents, fellows, and trained surgeons identified almost identical training needs and priorities. Our report summarizes recent research on women in orthopaedic surgery. Women surgeons, in fact, appear to be very satisfied with their career choice; however; it is apparent that this information needs to be better conveyed to the medical students. Greater exposure to female surgical faculty would help. Neumayer et al. found that medical schools with more women surgical faculty send notably more female graduates to surgical residency programs. It has been postulated that an increase in the number of women on orthopaedic faculty would improve women medical students’ perceptions of orthopaedics and hence may increase interest in orthopaedics as a career. Exposure of medical students to women faculty, enthusiastic teaching, availability of female role models, mentoring, and increased involvement in the operating room have been recognized as important factors in career selection. Although perceptions about an ‘‘old boys club’’ culture and sexual discrimination may exist, we must work to convey the positive attributes of female orthopaedic surgeons as well as the satisfaction that can be gained from working in the field of orthopaedic surgery. As orthopaedic