EPOSNA photo highlights continuing progress in diversity
After many years of planning and collaboration, EPOSNA, a combined conference sponsored by the Pediatric Orthopaedic Society of North America (POSNA) and the European Paediatric Orthopaedic Society (EPOS), took place May 3-6, 2017, in Barcelona, Spain. With more than 2,000 attendees, the largest pediatric orthopaedic meeting in history fostered global pediatric orthopaedic education and scholarly exchange.

One memorable meeting event was influenced by the social media hashtag #ILookLikeASurgeon, promoting the image of women in surgery across the world. The social media campaign, and a comment to the meeting photographer, led to an iconic photograph that demonstrates the progress made by women surgeons in the male-dominated field of orthopaedics.

"I spoke to the photographer and said that I would like to make an announcement and have a few of the women get together for a photo," explained Jennifer M. Weiss, MD. "There was a small stairway that probably would have held 25 to 30 people, and I thought it would be great if we could fill the stairway. That was my goal.

"I asked the staff to send a push notification," she continued. "I also emailed all of the women that I knew. Steven L. Frick, MD, from the POSNA presidential line, who moderated the session prior to the photo, announced from the podium that some of us were going to get together for a picture."

Elsewhere at the meeting, Lori A. Karol, MD, received a text from Dr. Weiss.

"Dr. Weiss explained that she wanted to bring together women from the two societies for a quick photograph," said Dr. Karol. "I thought there would be about 50 of us—a small group and we would know everyone."

What does a surgeon look like?
Word of the gathering at the stairway spread quickly across the meeting. When the time came for the photograph to be taken, it was clear that the stairway was insufficient; only a stage could hold all the attendees who wanted to be involved.

"I walked toward the stage and I happened to bump into Deborah Eastwood, FRCS," said Dr. Karol. "Deborah was the first woman president of EPOS and I was the first woman president of POSNA. We thought it would be very symbolic to stand next to each other for the picture."

"I looked up and saw hundreds of women filing in, floating across the room, and making their way to the stage," said Dr. Weiss. "It was incredible. And I looked up and saw Drs. Eastwood and Karol in the corner of the stage, with their arms around one another, and I could see the look of amazement on their faces at the response."

"People were pouring onto the stage," said Dr. Karol, "with a line of women waiting their turn, and they kept coming and coming. There were women from Asia, the United States, Africa, and every country in Europe. There were women from all around the world standing on that stage. It became a really powerful moment for me."

The #ILookLikeASurgeon social media campaign was inspired by a similar program highlighting the contributions of women engineers. By April 2017, The New Yorker magazine featured a cover image of four women surgeons gathered in front of a set of operating room lights. The image went viral on social media, and women in surgery across the world recreated the image in their own operating rooms.

Both Dr. Weiss and Dr. Karol credit #ILookLikeASurgeon for helping to spur enthusiasm for the photograph.

Challenges and rewards
"I am very fortunate to have had a soft landing in the field of orthopaedic surgery," said Dr. Weiss. "My father was an orthopaedist, and I never felt that this was going to be a challenge. But I will admit, although I had some wonderful mentors, I had some definite challenges during residency, being the only woman and training in the South. Most women in a male-dominated specialty have two choices. One is to put your head down, dress generically, and just make it through without being called out. That's not how I chose to do it. I chose to celebrate what I could and build relationships with other women wherever I could."

Dr. Karol agrees that female orthopaedic residents face unique challenges. "When you're different from the other residents, there's a spotlight placed upon you. That spotlight can be both good and bad," she said. "If things are going well and you excel, you shine just a little brighter. On the other hand, if something isn't going well and you underperform, the spotlight is on you. I felt that there was a little more attention paid to me just because I was different, and perhaps a bit more pressure to perform up to and above standards, because I knew that it could have implications for women matching into my residency in the future."

When asked why she requested the photograph, Dr. Weiss said, "It can be difficult to rally women together because sometimes we just want to be orthopaedic surgeons and don't necessarily seek to be 'the women of orthopaedic surgery.' But in my experience, in more of a one-on-one level, women absolutely work together to mentor and help one another. There is a very great feeling amongst us, but often it's not very public. With the photograph, I wanted to celebrate that there were so many women together, and to dovetail with this social media phenomenon."

Dr. Karol added that when she selected orthopaedics as a specialty, she was in the extreme minority. "I was the only woman in my class, and the only woman in my program for most of my residency. It was me and the boys through all my training," she recalled. "Most women orthopaedic surgeons of my era didn't work with other women because we were so few and far between. To stand on that stage teeming with other women, I thought, 'How far we've come!'"

Erin Morrison is the communications coordinator for POSNA. She can be reached at morrison@aaos.org. Peter Pollack is the electronic content specialist for AAOS Now. He can be reached at ppollack@aaos.org.