Breaking Into Orthopaedics a Challenge for Female Surgeons

Women are better represented in the ranks of medicine than ever before. One need only look at the University of Miami Miller School of Medicine’s current first-year students — the Class of 2021 — in which a full 58 percent of the class is female.

But while the number of women in medicine continues to grow, one specialty in particular — orthopaedic surgery — continues to lag far behind all others in gender equality. According to the Association of American Medical Colleges, only 14.1 percent of all orthopaedic surgery residents nationwide are women.

Seeking ways to more quickly reverse the trend, Sheila A. Conway, M.D., associate professor of clinical orthopaedics and program director of the orthopaedic surgery residency program at the Miller School, recently organized a symposium to help balance today’s residency programs.

The event, “Being a Woman in Orthopaedics: Tips on Threading the Needle,” was held at the Donna E. Shalala Student Center on the University of Miami’s Coral Gables campus.

The symposium featured talks by three prominent female orthopaedic surgeons and a panel discussion with a group of Miller School physicians, residents, and fellows. It was made possible by SEEDS (Scientists and Engineers Expanding Diversity and Success), a University of Miami-wide program established to support and foster diversity and career development.

While the overall number of female orthopaedic surgeons has increased slightly in recent years, the increase is significantly lower than in most of the primary surgical fields — including general surgery, OB/GYN, ophthalmology and otolaryngology — which have traditionally attracted more women into their ranks.

Why the gender disparity? Historically, gender bias has been a major barrier in the field of orthopaedic surgery, which has long had a reputation for its male-oriented culture.

According to a study by Emily K. Miller, B.A., and Dawn M. LaPorte, M.D. of the Department of Orthopaedic Surgery at The Johns Hopkins University, overt bias plays less of a role now than it did in the past, yet unconscious bias persists. This results in fewer women being promoted to leadership roles, holding department chairs, or having papers accepted.

“Fewer women in leadership roles also means fewer role models and mentors for females entering the field,” said Conway, who sees this as the biggest problem. Conway herself was the only woman in the Miller School’s Department of Orthopaedic Surgery when she arrived in 2008.

“In addition to not having a lot of women in orthopaedics, they are not getting advanced and promoted to leadership positions,” Conway noted.

Positive changes are beginning to take place at the Miller School, said Conway, who now is joined by several other women in faculty and staff positions. There are also two female orthopaedic surgery residents, and the Class of 2021 has two women in the same residency year.

Conway, who also believes men need to play a role in bringing more women into the field, was pleased to see a diverse audience of both men and women at the symposium.

“Women talking to women isn’t going to change the culture,” she observed. “Men in orthopaedics need to be a part of the process and the solution.”

Frank J. Eismont, M.D., Leonard M. Miller Professor, chair of the Department of Orthopaedics, and George and Marla Bergmann Endowed Chair in Orthopaedics at the Miller School, agrees.

“We recognize that there’s a lack of gender equality in this field, and we’ve taken active steps to make our department more inclusive,” Eismont said. “We’re confident that bringing more women into our department will only make it better. Diversity in any category will benefit the University.”

Speakers at the symposium included Ann Ouellette, M.D., who spent 22 years at the Miller School and was orthopaedic chief of the hand surgery department, and Cynthia Emory, M.D., an orthopaedic surgeon in Winston-Salem, N.C.

Kristy Weber, M.D., Abramson Family Professor in Sarcoma Care Excellence in the Department of Orthopaedic Surgery at the University of Pennsylvania, also spoke.

Weber’s advice? “You’ve got to be good — not just in surgery or patient care, but in other areas, too,” she said. “Conflict management is critical for everyone, from residents to faculty members. You also need to learn how to negotiate. If you don’t ask, you don’t get.”

Next year, Weber will be installed as the first-ever female president of the American Academy of Orthopaedic Surgeons.

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