Women in trauma and orthopaedics: are we losing them at the first hurdle?

Abstract

Introduction: Diversity in the healthcare workforce is associated with improved performance and patient-reported outcomes. Gender disparity in Trauma and Orthopaedics (T&O) is well recognised. The aim of this study was to compare factors that influence career choice in T&O between male and female final-year students. Furthermore, the trend of representation of women in T&O over the last decade was also compared with other surgical specialities.

Methods: An online survey of final-year students who attended nationally advertised T&O courses over a 2-year period was conducted. Data from NHS digital was obtained to assess gender diversity in T&O compared with other surgical specialities.

Results: A total of 414 students from 13 UK medical schools completed the questionnaire. Compared with male students (34.2%), a significantly higher proportion of women (65.8%) decided against a career in T&O, p<0.001. Factors that dissuaded a significantly higher percentage of women included gender bias, technical aspects of surgery, unsociable hours, on-call commitments, inadequate undergraduate training and interest in another specialty (p<0.05). Motivating factors for choosing a career in T&O were similar between both sexes. T&O was the surgical specialty with the lowest proportion of women at both consultant and trainee level over the last decade.

Conclusion: T&O remains an unpopular career choice among women. To enhance recruitment of women in T&O, future strategies should be directed toward medical students. Universities, orthopaedic departments and societies must work collaboratively to embed culture change, improve the delivery of the undergraduate curriculum, and facilitate students' exposure to operating theatres and female role models.

Keywords: Career choice; Diversity; Female representation; Gender parity; Orthopaedics.

Figure 1

Pie-chart demonstrating specialty choices among all final year medical students

Figure 2

Deterring factors among female (a) and male (b) students who decided against a career in T&O. CV = Curriculum vitae; T&O = Trauma and Orthopaedics

Figure 3

Motivating factors among female (a) and male (b) students who had chosen T&O as their future specialty. T&O = Trauma and Orthopaedics

Figure 4

Line graph demonstrating a comparison of the percentage female consultants among all surgical specialities in England between 2010 and 2020. (Data for vascular surgery available from 2014 onwards)

Figure 5

Line graph demonstrating a comparison of the percentage female trainees among all surgical specialities in England between 2010 and 2020. (Data for vascular surgery available from 2014 onwards)