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research-article2014

FAIXXX10.1177/1071100714534183Foot & Ankle InternationalBaumhauer and Pinzur

FootForum

Women in Orthopaedic Surgery

Foot & Ankle International® 2014, Vol. 35(9) 949­–950 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1071100714534183 fai.sagepub.com

Judith F. Baumhauer, MD, MPH1, and Michael S. Pinzur, MD2

Due to the multi-ethnic make-up of our surgical team, I sometimes comment that our operating room is like the United Nations. Much of the banter during surgery is about the cultural differences between the team members. This was not the case when I graduated from a medical school where 6 of my 60 graduating classmates were women. My residency class was composed of 37 white males, 2 Asian American males and 1 African American male. Data from the American Academy of Orthopaedic Surgeons Orthopaedic Practice in the United States survey demonstrated that women comprised only 2.7% of the orthopaedic surgery census in 2000 and only 5.1% in 2011. My current practice environment is very different. The co-medical directors of our Ambulatory Surgery Center are women from Kenya and Egypt. The hospitalists that comanage my inpatients are a white woman and an Indian male. I interact on a daily basis with an NIH-funded female endocrinologist. I see both ethnic and gender diversity every day in my academic medical center, yet my department is comprised of 20 white males and 2 women. Two years ago, we had 4 women out of 25 orthopaedic residents. When the last of these women graduate in June, we will have no female residents in spite of ranking a significant number of women in our top 10 residency match list over the past 10 years. The most recent medical school census data would suggest that women comprise between 48% and 50% of medical school graduating classes. In spite of the gender equality in medical school, women comprised only 13.6% of orthopaedic residents in 2011. We rank at the bottom of the historically male-dominated specialties. The 2011 census data demonstrated that women made up 37.1% of general surgery and 23.9% of urology residency positions. Even neurosurgery had a census of 15.4% women. I always thought the culture of the AOFAS was more accepting of youth and diversity. Our census numbers are, in fact, ahead of the curve. The percentage of female members of the AOFAS climbed from 7% in 2011 to 9% this year, 2014. Even more encouraging is the increase in female candidate members comprising 19% and fellow members rising to 27% in 2011.

Judith Baumhauer, MD, MPH, adds: There have been numerous surveys of women medical students asking the reasons why they may or may not have selected surgery as a specialty. Those who choose to become surgeons have had successful male and female role models and an interest in the intellectual and technical nature of the field. The primary deterrents are the lack of a role model, the perceived “toughness” of the field, the lack of flexibility with the workload, and thoughts that the lifestyle is not conducive to raising a family. Our job as faculty mentors is to be encouraging role models and put to rest these antiquated perceptions. In present day, there are examples of “job sharing” even in orthopaedic surgery. At the University of Rochester, the chairman had the foresight to allow two men to share a job. Their goal was to alternate being in the research lab and being on service as tumor surgeons. This collaboration resulted in more research productivity and NIH funding had they worked independently. These innovative job possibilities are supported by a positive business plan and common goals. A win-win for all.1-5 Currently at the University of Rochester we have 6 women faculty members out of 43 in orthopaedic surgery (14%). Of these women, 5 of 6 are married. Four of the 6 have children. A 2002 publication found that the choice of surgery as a profession was strongly associated with a higher proportion of women on the surgical faculty. There are often 4 to 6 medical students going into orthopaedics per year and 1 is a woman. The medical school class is approximately 100 students. You do the math; we need to do better.

It is clear to me that gender and ethnic diversity has greatly improved the culture of my medical center. What can we do to enhance the diversity of our profession? The FootForum would be interested in your thoughts on the roadblocks to diversity and what steps we can take to make 1

University of Rochester, Rochester, New York, USA Loyola University Health System, Orthopaedic Surgery, Maywood, Illinois, USA 2

Corresponding Author: Michael S. Pinzur, MD, Loyola University Health System, Orthopaedic Surgery, 2160 South First Avenue, Maywood, IL 60153, USA. Email: [email protected]

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Foot & Ankle International 35(9)

our profession more inclusive. Please email comments to [email protected]. Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding The author(s) received no financial support for the research, authorship, and/or publication of this article.

2.  Okike K, Utuk ME, White AA. Racial and ethnic diversity in orthopaedic surgery residency programs. J Bone Joint Surg Am. 2011;93(18):e107. 3. Sanfey HA, Saalwachter-Schulman AR, Nyhof-Young JM, Eidelson B, Mann BD. Influences on medical student career choice: gender or generation? Arch Surg. 2006;141(11): 1086-1094. 4.  Van Heest AE, Agel J. The uneven distribution of women in orthopaedic surgery resident training programs in the United States. J Bone Joint Surg Am. 2012;94(2):e9. 5.  Wirtzfeld DA. The history of women in surgery. Can J Surg. 2009;52(4):317-320.

References 1. Neumayer L, Kaiser S, Anderson K, et al. Perceptions of women medical students and their influence on career choice. Am J Surg. 2002;183(2):146-150.

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Women in orthopaedic surgery.

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