Although orthopaedic surgery is a popular, competitive field for medical students, it lags behind other surgical specialties attracting women. Nearly half of all medical students are female, but just 12 percent of orthopaedic residents are female, compared to nearly 35 percent of general surgery residents. One way to improve diversity in orthopaedics is to mentor female medical students.

The apprenticeship model used in surgical training is the historical root for mentoring. Surgical knowledge and ideas are passed from one generation to the next in a student-teacher model, which was formalized in the United States in the late 1800s.

Both male and female orthopaedic residents cite having a role model in orthopaedics as one of the major factors influencing their decision. However, more women than men indicate that having a role model of the same sex or ethnicity was a positive factor in their decision to enter orthopaedic surgery. Unfortunately, the current composition of the orthopaedic workforce lacks the diversity and number necessary to have interested female medical students mentored only by female orthopaedic surgeons.

Luckily, “women do not necessarily need female mentors to attract them to orthopaedic surgery. Many male orthopaedic surgeons can and do serve as outstanding mentors and role models,” according to Dawn LaPorte, MD, residency program director at the Johns Hopkins orthopaedic surgery training program.

I was first exposed to orthopaedic surgery as a patient with scoliosis. During my second year of medical school, I connected with Ann E. Van Heest, MD, via email. She graciously allowed me to shadow her in clinic and the operating room. It was beneficial to be at the University of Minnesota, which has a long tradition of educating female surgeons, and I was able to associate with many supportive staff and residents.

Mentoring opportunities
The AAOS—as well as organizations such as the Perry Initiative, a nonprofit organization aimed at recruiting young women to orthopaedic surgery; the J. Robert Gladden Orthopaedic Society; and the Ruth Jackson Orthopaedic Society—understands the need for mentors. All have established opportunities for high school and medical school students to learn more about orthopaedic surgery as a career.

But although these programs are invaluable, they do not reach a majority of students. Any orthopaedic surgeon, whether community- or academic-based, sees a diverse population of patients, both male and female. Orthopaedic surgeons also have access to students in their communities. They can use this access to initiate mentorships, as the following examples show:

• volunteering to speak at local high schools, colleges, or medical schools about an orthopaedic career choice and path
• speaking with local sports teams or with trainers to identify individuals with a possible interest in orthopaedic surgery
• allowing students to “shadow” them in the clinic or operating rooms
• providing advice for medical students on understanding a successful path to matching in orthopaedic surgery
• working with residents on career plans
• reaching out to groups that already have mentoring connections, such as the Perry Initiative

Even within orthopaedic residency programs, better mentorship models are needed. A 2008 survey of orthopaedic residents found that only about half had a mentorship system within their orthopaedic residency program. Regardless of whether the mentorship program was formal or informal, only 17 percent of those who responded were satisfied with the mentoring environment.

Although I initially sought out a female surgeon, I have had many wonderful mentors—both male and female—during my clinical rotations and residency. I happen to be the only female in my residency class, but having supportive peers and mentors enabled me to successfully complete residency and pursue a hand surgery fellowship. More importantly, I became involved with mentoring students at my medical school and through organizations such as the Perry Initiative.

Mentorship is beneficial to female students considering orthopaedic surgery as a career. Any orthopaedic surgeon may participate in effecting change by being a mentor or role model to females interested in orthopaedic surgery.

Jennifer Wozniczka, MD, recently completed residency at the University of Minnesota Medical School and is currently a hand fellow at Oregon Health & Science University.

Additional Information:
Perry Initiative
Ruth Jackson Orthopaedic Society
J. Robert Gladden Orthopaedic Society
Perry Initiative Leads the Way to Orthopaedics
Addressing Diversity with Nth Dimensions
Mentoring in Resident Education: How to Make it Work
Taking mentoring to the “Nth” degree
Recruiting minority medical students to orthopaedics
Find a Mentor – AAOS
Orthopaedic Summer Internship Program

References:

1. Bernstein J: Male practice: Gender inequality in orthopaedic surgery. Clin Orthop Relat Res 2013;471(6): 1754–1757. doi:10.1007/s11999-013-2978-7 [doi]
2. Day CS, Lage DE, Ahn CS: Diversity based on race, ethnicity, and sex between academic orthopaedic surgery and other specialties: A comparative study. J Bone Joint Surg Am 2010;92(13): 2328–2335. doi:10.2106/JBJS.I.01482 [doi]
3. Flint JH, Jahangir AA, Browner BD, Mehta S: The value of mentorship in orthopaedic surgery resident education: The residents’ perspective. J Bone Joint Surg Am 2009;91(4): 1017–1022. doi:10.2106/JBJS.H.00934 [doi]
4. Hill JF, Yule A, Zurakowski D, Day CS: Residents’ perceptions of sex diversity in orthopaedic surgery. J Bone Joint Surg Am 2013;95(19), e1441–e1446. doi:10.2106/JBJS.L.00666 [doi]
5. Levine WN, Braman JP, Gelberman RH, Black KP: Mentorship in orthopaedic surgery:Road map to success for the mentor and the mentee. AOA critical issues. J Bone Joint Surg Am 95(9), e591–e595. doi:10.2106/JBJS.L.01047 [doi]