Orthopaedic Faculty and Resident Sex Diversity Are Associated with the Orthopaedic Residency Application Rate of Female Medical Students

Abstract

Background: The representation of women in orthopaedics in the United States remains among the lowest in all fields of medicine, and prior research has suggested that this underrepresentation may stem from lower levels of interest among female medical students. Of the many proposed reasons for this lack of interest, the male-dominated nature of the field is one of the most commonly cited. The purpose of this study was to determine the degree to which the representation of women among orthopaedic faculty and residents influences female medical students at that institution to apply for a residency in orthopaedics. Methods: Using data provided by the Association of American Medical Colleges, we identified all U.S. medical schools that were affiliated with an orthopaedic surgery department and an orthopaedic surgery residency program (n = 107). For each institution, data on the representation of women among the orthopaedic faculty and residents from 2014 through 2016 were collected, as well as data on the proportion of female medical school graduates who applied to an orthopaedic residency program from 2015 through 2017. The association between institutional factors and the female medical student orthopaedic application rate was assessed. Results: Of 22,707 women who graduated from medical school during the 3-year study period, 449 (1.98%) applied to an orthopaedic surgery residency program. Women who attended medical school at institutions with high orthopaedic faculty sex diversity were more likely to apply for a residency in orthopaedics (odds ratio [OR], 1.30; 95% confidence interval [CI], 1.04 to 1.64; p = 0.023), as were women who attended medical school at institutions with high orthopaedic resident sex diversity (OR, 1.30; 95% CI, 1.05 to 1.61; p = 0.019). Conclusions: In this study, we found that increased sex diversity among orthopaedic faculty and residents was associated with a greater likelihood that female medical students at that institution would apply for an orthopaedic residency. These results suggest that at least some of the factors currently impeding female medical student interest in orthopaedics may be modifiable. These findings may have important implications for efforts to improve the sex diversity of the field of orthopaedics going forward.

A 15-Year Report on the Uneven Distribution of Women in Orthopaedic Surgery Residency Training Programs in the United States

“…Programs with more female faculty members and more women in leadership positions tend to have more female residents 40 . Similarly, women who attended medical schools with high faculty sex diversity and high resident sex diversity were more likely to apply for orthopaedics 41 . There is a strong correlation between the percentage of women in an orthopaedic subspecialty society and the percentage of women on the society's board of directors 42 .…”

Female Team Physician Representation in Professional and Collegiate Athletics

“…Previous literature has described multiple barriers to women pursuing the field of orthopaedic surgery, including lack of exposure to orthopaedics and/or female mentorship in training programs, different perceptions of expectations, work-life balance, perception of required physical strength, and the constraints of traditional sex-based roles. 3,13,16,20,22 The reasons for the lack of women as team physicians was not directly assessed in the current study but may similarly reflect the barriers of women entering orthopaedic surgery residencies. Team physicians work longer hours outside of clinical and surgical obligations, often requiring night and weekend time commitments, which may play a role.…”

“…3,10,13 However, in orthopaedic surgery, sex-based diversity is changing at a slower rate in comparison with other surgical fields, with women representing between 14% and 15% of orthopaedic surgery residents. 4,6,13,16,18,20,21 According to the most recent census data released by the American Academy of Orthopaedic Surgeons in 2016, women consist of 6.5% of the orthopaedic surgeon workforce in the United States. 2 Since the establishment of Title IX regulations allowing equal opportunity for athletic participation across sexes, the proportion of female athletes has increased exponentially in both collegiate and professional sports.…”

The Perry Initiative’s Impact on Gender Diversity Within Orthopedic Education

“…Through The Perry Initiative’s Perry Outreach Program and Medical School Outreach Program, a total of 12,483 women in high school and medical school have been reached during pivotal times in the decision to pursue a given career path. The match rate for MSOP participants is 20%, which is higher than the current percentage of women that are in orthopedic residencies [ 12 ]. This indicates that the women who participated in The Perry Initiative outreach programs have a rate of choosing orthopedic surgery that is higher than the national average of women choosing orthopedic surgery.…”