# Shattering the Glass Scalpel: Analyzing Female Representation in Orthopedic Surgery Across the United States

## TL;DR

This study examines the representation of women in orthopedic surgery residency programs across the U.S., highlighting regional differences and trends.

## Contribution

The study provides a detailed analysis of female participation in orthopedic surgery, including regional trends and website representation.

## Key findings

- Female residents comprised 23.7% of all orthopedic residents in the U.S., with the highest percentage in the West (27.0%).
- The Northeast region showed a significant upward trend in female residents from PGY5 to PGY1 years.
- Only 12.6% of programs had a dedicated section on their websites mentioning women or females.

## Abstract

Background

Orthopedic surgery has historically been a male-dominated field, with slower growth in female participation compared to other surgical specialties. The present study aims to assess the extent of this influence, examine whether the dynamic is changing, and further analyze female participation trends, focusing on various regions of the United States and including analyses of female residents.

Methodology

Orthopedic surgery residency programs were surveyed online. A list of 200 programs was sourced from the Association of American Medical Colleges, which provided details including the program names, cities, states, regions, and website links. The homepages of the residency program as well as the department of orthopedic surgery were surveyed for any mention of women or female in orthopedics, number of female residents, total number of residents (class of 2025-2029), number of female faculty operative orthopedic faculty, total number of operative orthopedic faculty physicians, specialty of the female orthopedic faculty, program director gender, assistant program director gender, and chair of the program gender. Data analyses were performed using SPSS Software version 28.0 (IBM Corp., Armonk, NY, USA) and Rstudio version 1.4.1106 (Boston, MA, USA).

Results

In total, 55 Midwest (28%), 53 Northeast (27%), 63 South (32%), and 27 West (14%) orthopedic surgery residency programs were included. Female orthopedic surgery residents comprised 23.7% of all orthopedic residents across the United States. When analyzed by geographic region, female residents comprised 22.7% of all residents in the Midwest, 24.3% in the Northeast, 22.5% in the South, and 27.0% in the West. In the Northeast region, there was a notable upward trend in the percentage of female residents across PGY5 to PGY1 years (τ = 1, p = 0.027). A total of 25 (12.6%) programs had a section in their residency program or orthopedic department website homepage that mentioned and/or was dedicated to women or females. There was a significant association between region and homepage mention of women (χ² (8, N = 198) = 105.7; p < 0.001). A total of 12.9% of all orthopedic residency program directors were female, while 21.2% of all associate program directors were female.

Conclusions

These findings underscore the importance of monitoring and addressing regional disparities in gender representation within orthopedic surgery residency programs. By identifying trends and disparities, healthcare institutions and policymakers can implement targeted interventions to promote gender equity and cultivate a diverse and inclusive workforce.