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. 2025 Jun;22(3):e70078.
doi: 10.1111/tct.70078.

Medical Student Perceptions of the Barriers to Entering Orthopaedic Surgery Differ by Gender

Bahar Entezari  1 , Sarah Kerslake  2 , Steve Mann  1   3 , Jesse I Wolfstadt  4   5 , Wilma Hopman  1   6 , Peter C Ferguson  4   5 , Laurie A Hiemstra  2   7
Affiliations

Medical Student Perceptions of the Barriers to Entering Orthopaedic Surgery Differ by Gender

Bahar Entezari et al. Clin Teach. 2025 Jun.

Abstract

Background: The value of gender representation has been increasingly recognised in medicine, yet women represent only 13.6% of orthopaedic surgeons in Canada. The primary objective of this study was to determine barriers identified by medical students considering pursuing a career in orthopaedic surgery. The secondary objective was to assess for gender-based differences in barriers identified by medical students.

Methods: A cross-sectional mixed-methods survey was distributed to final-year students at a Canadian medical school. Descriptive analyses were calculated for the study population and gender subgroups. To compare responses between gender subgroups, chi-square or Fisher's exact tests were employed for binary data, and non-parametric Mann-Whitney U tests for ordinal data. Open-text responses were reviewed for descriptions of students' experiences in orthopaedics.

Results: Sixty-four medical students participated, representing a response rate of 59.3%. Male culture and the need for physical strength were identified as strong barriers to pursuing a career in orthopaedics. Additionally, women reported less exposure (p = 0.003), disproportionate constraints (i.e., scrutiny of performance based on gender, p = 0.001), less mentorship (p = 0.028), more concerns about verbal (p < 0.001) and sexual abuse (p = 0.013), and higher rates of direct discouragement from pursuing orthopaedics than men (p = 0.035). Open-text responses indicated that orthopaedics was not considered welcoming to all medical students.

Conclusions: This study is the first to characterise medical student perceptions of barriers to gender equity in orthopaedic surgery in Canada. Fostering a more equitable environment will necessitate a paradigm shift in the educational framework toward orthopaedic surgery.

Keywords: barriers; gender equity; medical students; orthopaedic surgery; survey.

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Conflict of interest statement

One of the authors certified that he (S.M.) has received or may receive payments or benefits, during the during the study period, in an amount of less than USD 10,000 from Depuy‐Synthes; in an amount of less than USD 10,000 from Stryker Inc.; and in an amount of less than USD 10,000 from Zimmer Bionet. One of the authors certified that he (J.I.W.) has received or may receive payments or benefits, during the during the study period, in an amount of less than USD 10,000 from Depuy‐Synthes; and in an amount of less than USD 10,000 from Microport Orthopaedics. One of the authors certifies that he (P.C.F.) has received or may receive payments or benefits, during the study period, in an amount of USD 10,000 to USD 100,000 from Stryker Inc. The other authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Sexual orientation of study participants.
FIGURE 2
FIGURE 2
Race of study participants.
See this image and copyright information in PMC

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