CORR Insights®: Are Women Proportionately Represented as Speakers at Orthopaedic Surgery Annual Meetings? A Cross-Sectional Analysis

Where Are We Now?

While approximately 50% of medical students now are women, the number of women residents in orthopaedics has only increased from 6% in 1995 to 14% in 2010, and has not increased further since that time [4, 8]. Indeed, the proportion of women in orthopaedic residencies is lower than all other medical subspecialties [4].

The most-common reasons cited by women physicians for choosing orthopaedic surgery have included enjoyment of manual tasks, professional satisfaction, and intellectual stimulation, while the most-common reasons identified for why women might not choose orthopaedics included perceived inability to have a good work/life balance, the perception that too much physical strength is required, and a lack of strong mentorship [9]. Strong mentorship has also been identified as a predominant factor in women orthopaedic surgeons’ decision to pursue a specific subspecialty [2]. However, the lower proportion of women in orthopaedic surgery and in academic roles may limit the access trainees have to mentorship from women. Unfortunately, men may also avoid participation in mentor models for women as a result of perceived concerns regarding the #Me Too movement [7]. In addition to lack of role models, a lack of peer support for women’s promotion through the academic ranks, implicit bias, and negative stereotypes have been suggested as factors contributing to gender disparity in academic medicine [1].

Once women enter orthopaedics, are we doing enough to promote women in leadership positions? The answer is a resounding no. But the answers to our specialty’s lack of gender diversity in leadership roles goes beyond simply offering more promotions for robust leadership roles, although that’s a start. Our leaders and mentors routinely take the podium to speak at annual conferences on a variety of topics. Importantly, the younger generation sees them on stage and may even look up to those speakers. Although the factors affecting women’s leadership in academic medicine have been studied extensively [1-3, 5, 9], recognition of gender disparity in the types of speaking roles at academic meetings does not appear to have been identified in previous studies.

Enter Gerull and colleagues [6], who found that although women are proportionally represented as annual meeting speakers, there are gender disparities favoring men in the types of speaking roles. These findings show that women participate in speaking roles that may be considered less prominent or not as important to specialty societies compared to the speaking roles performed by men. The study by Gerull and colleagues [6] suggests a subtle discriminatory pattern in the assignment of speaking roles at academic meetings which has not been revealed previously.

Where Do We Need To Go?

Prior studies of factors influencing women’s decisions to pursue a career in orthopaedic surgery or a specific orthopaedic specialty have relied on questionnaire surveys of women medical students and orthopaedic residents [2, 9]. Similar questionnaire studies of both women and men orthopaedic surgeons who are involved in academic roles and those who are not may provide more information on the factors that could influence any difference between genders in the motivation to pursue academics and potential barriers to advancement.

Prior studies have shown that the number of women in orthopaedic surgery as well as the number of women in leadership roles who can provide mentorship is stagnant [4, 8]. Since mentorship is an important factor for choosing a surgical subspecialty, one can conclude that a compelling method to increase gender diversity in orthopaedic surgery is for men to take a more active role in mentoring women who may be considering a career in our field. A better understanding of the perception or perceived barriers that male orthopaedic surgeons in leadership roles have regarding mentorship for women could provide valuable information to increase opportunities for women in orthopaedic surgery.

How Do We Get There?

While abstracts selected for presentations at orthopaedic scientific meetings are graded in a blinded fashion, there may be considerable variability in how subspecialty societies select invited speakers for their annual meeting and choose members for society leadership roles. Some societies may rely on a diverse group of committee members to determine meeting content or nominate their leaders, while others may rely more on individuals such as the program chair or past president to make these decisions. Analysis of the methods used by various orthopaedic subspecialty society program or planning committees to determine annual meeting content and criteria for nominating committees to establish society leadership positions may help determine the factors that could influence gender disparity in academic orthopaedic representation. Additional analysis of differences and similarities between academic programs that have and have not produced women in academic leadership roles may also be helpful to better understand the most-important factors women have encountered during their academic advancement.

Studies which analyze data relevant to the #MeToo movement such as the ratio of women mentored by men in various orthopaedic programs and any factors or differences in programs which may affect these numbers could also provide further insights into the perceived obstacles to male mentors for women in orthopaedic surgery.