It’s fairly common for folks to hear orthopaedic surgery and associate it with being a male-dominated field. According to the latest stats from the Association of American Medical Colleges, less than five percent of the nearly 20,000 active orthopaedic surgeons in the United States are female, and orthopaedic surgery residency has one of the lowest percentages of women, coming in at approximately 14 percent.
However, in recent years, there has been an uptick in the number of female residents and fellows in the United States – 398 in 2008, 447 in 2010 and 478 in 2013. Albeit a slow progression, the leaders in the Perelman School of Medicine at the University of Pennsylvania are helping to narrow that gap.
“If you want to know why there are so few women in ortho, you may be asking the wrong person,” said Kristy Weber, MD, chief of Orthopaedic-Oncology and director of the Sarcoma Program in the Abramson Cancer Center. “I love working in the field and have always been interested in it. What’s most ironic is that ortho is actually a great field for women because there is so much flexibility.”
In the Penn Orthopaedics residency program, the number of female residents has increased from one in 2013 to four – of eight spots available per year – in 2014. While the numbers may remain low for women matching in ortho programs across the country, the women at Penn continue to make strides to educate future generations of surgeons, advance the field of orthopaedics, and drive diversification in the industry.
“In orthopaedics, you can treat kids, geriatrics, athletes and just your average adult,” said Kathryn O’Connor, MD, MSPT, an assistant professor of Clinical Orthopaedic Surgery. “There are surgeries that use power tools that can practically cut the pelvis in half, and there are procedures so precise you have to use a microscope to sew nerves back together. And, the goal of every surgery to help improve people’s quality of life by providing better function or pain control. To me these don’t seem like gender-biased goals.”
More Residents, More Faculty
In 2015, under the leadership of L. Scott Levin, MD, FACS, chair of the Department of Orthopaedic Surgery, Penn Orthopaedics doubled its female faculty by hiring O’Connor and Kate Temme, MD, an assistant professor of Orthopaedic Surgery and Clinical Physical Medicine and Rehabilitation. These women, along with Wen Chao, MD, a professor of Orthopaedic Surgery and orthopaedic consultant for the Pennsylvania Ballet, handle everything from foot and ankle surgery to sports medicine and rehabilitation.
Building a strong female staff will likely be noticed by other institutions and physicians, the doctors agree – and may even pique the interest of the women in medical school who are still deciding on which direction to take their careers.
Said second year clinical orthopaedics resident, Blair Ashley, MD: “I love Penn Orthopaedics because while most of the residents have very impressive resumes, everyone is here to work and is willing to do whatever needs to be done to care for our patients – no matter what the task.”
Weber notes that in many medical school programs, students are not required to learn about the musculoskeletal system or to spend time in orthopaedics. And by nature, students often study primarily what they will be tested on, leaving ortho off of that list. However at Penn, students are required to spend some time on an orthopaedic rotation, which can provide early exposure to the field, she said.
“I rotated here as a medical student, and admired the residents for their impressive fund of knowledge, excellent operative skill and work ethic,” Ashley said. “I think that the most inspiring thing I see is how dedicated our attendings are to their patients. In some ways it has become more difficult for me to choose a specialty with each rotation I do.”
A Balancing Act
The women of Penn Orthopaedics have experienced medical school, residency and are now practicing orthopaedic surgeons. And they are the ones that can provide the best insight into what it’s like to be an orthopaedic surgeon.
“In the past there were many myths about orthopaedics – you had to be big and strong or it was so hectic that you couldn’t have a family and manage your career – but research studies and the experiences of more female surgeons have debunked these myths,” Weber said. “Now I think orthopaedics is one of the more flexible fields out there. You can decide the specialty or practice-type that fits your lifestyle, or the lifestyle you want to have.”
There are differences based on the subspecialty you choose, Weber points out.
“For instance, the life of an orthopaedic trauma surgeon can be unpredictable and hectic, but a private practice or outpatient surgeon can usually maintain a more typical daily schedule that doesn’t involve as much night or weekend inpatient work,” she said.
It’s all about balancing your career goals and your personal goals, a skill that most women employ with their careers, whether they’re a physician, an accountant, a lawyer, or a journalist, Weber said.
We may not know why some women avoid orthopaedics, as each person’s decision-making process is different, but we do have a sense of why some women did choose this path.
What’s Next
While there may be a small number of active female orthopaedic surgeons currently out there, those who are looking to enter the field – and even those on the fence about ortho as a specialty – should look to the women who have come before – leaders like Weber, Chao, Temme and O’Connor.
“Seek these women out, ask them about the field, and have a conversation,” O’Connor said. She added that even if orthopaedics isn’t the right fit – no matter what area of medicine is of interest – connecting with those who have had more practice, and who can speak directly from experience, can really be very helpful.
“If I was talking to a med student who was trying to decide their path, I wouldn’t tell them what to do. Instead, I would ask them questions,” Weber said. “And if they did have an interest in ortho, then I’d of course tell them all of the great things about it. But choosing a specialty isn’t something that can be forced.”
And the choice comes down to personal interest, goals, and what you want out of your career and your life, the doctors agree. Whether male or female, you have to have an interest in the specialty you choose.
In meantime, Weber says, “here at Penn Medicine, we welcome the opportunity to recruit female orthopaedic residents and female faculty members. In fact, right now in the field of orthopaedics, women are really rather sought after.”