United States Gender Diversity in Orthopaedic Surgery

By Kristy Weber 

US Diversity Data

The actual detailed data on gender among other demographic variables has been lacking until recently in the AAOS, thereby causing some variability in gender statistics over time. The following data is based on data from the American Academy of Orthopaedic Surgeons (AAOS). 

As of October 2019, there were 27,651 American Board of Orthopaedic Surgery (ABOS) certified U.S. orthopaedic surgeons in the AAOS. Of those, 1,673 were female (6%). There are 3,963 US residents and 610 are female (15.4%) based on 2018-19 data from the Association of American Medical Colleges (AAMC).

US history and current situation re/women in orthopaedics

The field of orthopaedic surgery in the US has been markedly male dominated since the founding of the AAOS in 1933. The gender disparity has persisted with the percentage of women residents training in orthopaedics, the lowest in all medical/surgical fields in the United States. There are currently <5 women chairs of major orthopaedic departments in the US. There have been few women orthopaedic surgeon leaders of national US orthopaedic organizations.

Initiatives to increase gender diversity in US

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There are numerous concurrent efforts in the United States related to improving gender diversity in orthopaedic surgery. Several are outlined below:

  1. The AAOS has prioritized diversity within its volunteer structure in its 2019-2023 Strategic Plan (https://www.aaos.org/strategicplan/). Specifically, Goal 3 of the plan is to ‘evolve the culture and governance of AAOS’ Board and volunteer structure to become more strategic, innovative, and diverse’. In 2019, the Diversity Advisory Board developed a five-year strategy to implement the diversity goal which was approved by the AAOS Board of Directors. That plan is formally rolling out in 2020 and involves a focused effort to engage more diverse individuals in the volunteer structure (race and gender prioritized). This will involve better education as to the application process, more transparency as to who is selected as a volunteer and why (and why others were not), and implicit bias training for all volunteers and staff related to the selection process for committees and other volunteer positions. The workplace survey that the AAOS conducted in 2018 (https://www5.aaos.org/aaosnow/2018/dec/youraaos/youraaos02/ ) identified concerning issues related to bullying, discrimination, and harassment and will be repeated over time after awareness initiatives are completed. There are clear objectives and metrics to measure progress and success in this initiative. In addition, the AAOS is starting a new inclusive leadership training program that will provide skills development critical for serving in the volunteer structure of the AAOS (strategic planning, understanding of governance, conflict management, running a meeting, understanding budgets, etc). The AAOS is led by its first woman president in 2019, and the AAOS Board of Directors will include 25% women in 2020. 
  2. The Ruth Jackson Orthopaedic Society (http://www.rjos.org/) is an organization that is advancing the science and practice of orthopaedic surgery among women. It was organized in 1983 and named after the first practicing female orthopaedic surgeon in the US. The group prioritizes mentoring and professional development of women in the field. 
  3. The Perry Initiative (https://perryinitiative.org/) is an organization named for an early pioneer in orthopaedic surgery. It was founded in 2009 by an orthopaedic surgeon and an engineer, both women, to increase the numbers of women in these fields. They focus on hands on programs for high school women students as well as programs for first and second year medical students.
  4. Nth Dimensions (http://www.nthdimensions.org/) is an organization which was founded in 2004 by orthopaedic surgeons working collaboratively with academic institutions, community surgeons, and industry to address the dearth of women and underrepresented minorities (URMs) in orthopaedic surgery. The overarching goal of Nth Dimensions is to address and eliminate healthcare disparities for all communities. The primary mission is to provide resources, expertise, and experience, through developing and implementing strategic pipeline initiatives. Nth Dimensions has a successful intensive summer clinical and research internship program where students are matched with a practicing surgeon in orthopaedics.