Gender Diversity in Orthopaedic Surgery – Estonian Perspective
By Katre Maasalu
Estonia is a small country on the eastern coast of the Baltic Sea in Northern Europe. It has a population of 1.3 million making it one of the least populous members of the European Union.
Estonia is a developed country with a high-income economy that has been among the fastest-growing in the EU. The country measures well in terms of civil liberties, education, and press freedom. Estonian citizens are provided with universal health care, free education, and the longest paid maternity leave in the OECD. One of the world's most digitally advanced societies, Estonia became the first state to hold elections over the internet in 2005 and the first to provide e-residency in 2014.
During the last five years 64% of medical graduates have been female and this has been stable for some decades. Although the majority of medical students are female, this representation is much lower in surgical specialties. The number of females entering surgery training has markedly increased during last decade. The same is true in orthopaedic surgery.
Currently in Estonia 46% of surgical and 36% of orthopaedic trainees are female. The increasing number of female orthopaedic trainees in the past decade is a reflection of more generous parental leave benefits, particularly as surgical residencies last 1-2 years longer and have less flexibility for those with family responsibilities than non-surgical residencies.
Among orthopaedic surgeons in Estonia, 26% are female and there is no unit without a female orthopaedic surgeon. Although the number of female orthopaedic surgeons has increased in the past decade, female orthopaedic surgeons have been working in Estonian hospitals since the 1950s and the first female orthopaedic head of department was appointed in 1964.
There are no professional organizations specifically for surgical women in Estonia. The Estonian Orthopaedic Society was founded in 1970 and the first secretary general was female. The president of the Estonian Orthopaedic Society has been female since 2015.
Estonian policies regarding pregnancy and maternity leave
In Estonia, maternity leave and all pregnancy policies are dictated by national laws and are universal regardless of employer or industry. Raising a child is supported through many benefits and it is common to stay at home at least until the child is 18 months old. However, it is possible to stay at home until the child turns 3 years without losing health insurance or position of employment.
- Reduction of workload is commonly accepted in Estonia, usually in the third trimester.
- Maternity leave can commence at 70 days prior to the estimated date of delivery.
- The maternity benefit is paid for up to a total of 140 days.
- The parental benefit paid guarantees the previous income, as a replacement income for a person raising a child.
- The right to the parental benefit begins when the maternity leave ends.
- The parental benefit is paid for a period of 435 days, or until the child is 18 months old.
- Until the child is 70 days old, only the mother is entitled to the parental benefit. After the child is 70 days old, either parent (but not both) is entitled to the parental benefit.
More information is available here.