麻豆传媒

In a possible sign that the macho "ortho bro" stereotype still has jacked-up legs, orthopedic surgery remains by far the most male-dominated major specialty in American medical education despite a small recent increase in gender diversity, a new study found.

Only 20.5% of orthopedic faculty were women in 2020, and the percentages of women among applicants and residents were even lower, despite the fact that women make up more than half of medical school students overall.

"Orthopedic surgery has made progress with increasing gender diversity in the field, especially among applicants, but further efforts are necessary to recruit and support female trainees since gender diversity in orthopedic surgery lags behind all other specialties," study co-author Gokul Kalyanasundaram, a medical student at Albany Medical College in New York, told 麻豆传媒, discussing the study presented at the American Academy of Orthopaedic Surgeons annual meeting.

She and her colleagues tracked gender data for orthopedic surgery and other medical fields from 2016 to 2020 based on applicant and faculty data from the Association of American Medical Colleges (AAMC) and resident data published annually by JAMA.

The researchers found that although the percentages of female representation increased over the 4-year period among orthopedic applicants (14.7% to 19.7%), residents (14.8% to 16.0%), and faculty (18.2% to 20.5%), the percentages are still significantly lower than for any other major specialty (P<0.0001 for all).

, 55% of medical school applicants and 56% of medical students in 2020 were women.

On the orthopedic front, the difference between applicants and residents for 2020 was statistically significant, a finding that "suggests that female applicants may face difficulties in matching to orthopedic residency programs," Kalyanasundaram said. "The residency selection process may need to be updated as implicit bias may be affecting this process."

Lack of gender diversity in orthopedic surgery is a familiar problem that's been chronicled in the medical literature for years. Jennifer J. Beck, MD, an orthopedic surgeon at the University of California Los Angeles, who was not involved in the study, told 麻豆传媒 that the field also has notably low levels of ethnic minorities and LGBT representation.

"Other fields, such as neurosurgery, have similar tools, techniques, and training, yet have recruited diverse members at a faster rate than orthopedic surgery," she said.

According to the new study, more than 70% of pediatric residents in 2020 were women -- the highest percentage of the specialties examined -- and about 60% of dermatology residents were women. The lowest percentages in fields other than orthopedics were in radiation oncology, diagnostic radiology, and anesthesiology.

Why does the orthopedics field stand alone? Stereotypes of orthopedic surgeons being male play a major role, Beck said. In fact, it should be clear that there's no standard appearance for an orthopedic surgeon, she said, adding, "As a 5'7" female with an athletic frame, there are many men in orthopedics who are smaller than I am, and no one questions their abilities."

And, she noted, "it should be well understood that there is no need for strength. As I often tell my residents, surgery shouldn't be that physically hard. If you are straining, muscling, to do something, you are likely doing it wrong and should find a better way." However, while "the internal conversation within orthopedic surgeons has changed, it is those outside our specialty who are demoralizing students and perpetuating these stereotypes," Beck said.

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