Orthopedic Surgery's Diversity Problem: Most Arthroplasty Researchers Are Men

Despite efforts to improve diversity in orthopedic surgery, a study found that authors with high arthroplasty publication volume are still almost entirely male.

Orthopedic surgery remains a male-dominated field, significantly lacking behind other medical specialties. One study found that in 2018-19, among the top 10 specialties by residency size, orthopedic surgery had the lowest percentage of female residents, reporting just 15%. The second lowest specialty (radiology) reported 27%, illustrating a significant gap.

As efforts to spearhead diversity are brought to the forefront, one study evaluated gender disparities in leading authors of arthroplasty literature between 2002 and 2019.

PubMed was searched to identify articles from 12 academic journals that public orthopedic and arthroplasty research. The Genderize algorithm was used to determine author gender.

A total of 14,692 articles were eligible for inclusion, and genders for 23,626 unique authors were identifiable. Women, compared to men, were much less likely to publish an article five years after their publishing career began (adjusted odds ratio, 0.51; 95% confidence interval, 0.45–0.57; P<0.001). Nearly all of the top 100 authors were men (n=96), with only four women. The majority of the 100 top authors were orthopedic surgeons (n=93), most of whom were men (n=92), with only one woman. Of the top 10 male and female publishing authors, all 10 of the men were orthopedic surgeons, two of 10 women were physicians, and only one woman was an attending orthopedic surgeon.

The study was published in The Journal of Arthroplasty.

“While the majority of authors with high arthroplasty publication volume were orthopaedic surgeons, there were significant gender disparities among the leading researchers. We should continue working to increase gender representation and supporting the research careers of women in arthroplasty,” the study authors wrote in their conclusion.

Including more women in orthopedic surgery must be a concerted effort, according to an article published in AAOS Now.

“If we really want to improve gender equity and increase the number of women in orthopaedic surgery, we must devise plans and execute them at the local, state, and federal levels. We must continue to expose young women to orthopaedic surgery and encourage and mentor them, but that does not address the current lack of women in orthopaedics or the financial cost of becoming an orthopaedic surgeon,” according to the article.