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Letters to the Editor   |    
Attracting Female Candidates to the Field of Orthopaedic Surgery
Beverly Stickles, MD; Susan A. Scherl, MD; Nicole Lively; Michael A. Simon, MD
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Center for Outcomes Research University of Massachusetts Medical School 365 Plantation Street, Suite 185 Worcester, MA 01605 E-mail address: beverly_stickles@hotmail.com
Corresponding author: Susan A. Scherl, MD Section of Orthopaedic Surgery and Rehabilitation Medicine Department of Surgery The University of Chicago 5841 South Maryland Avenue, MC 3079 Chicago, IL 60637 E-mail address: sscherl@surgery.bsd.uchicago.edu

J Bone Joint Surg Am, 2001 Jun 01;83(6):954-955
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To The Editor:
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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    J Sybil Biermann, M.D.
    Posted on July 19, 2001
    Re: Women in Orthopaedic Surgery: Experience in Veterinary Medicine
    University of Michigan, Department of Orthoapedic Surgery

    To the Editor:

    I was heartened to read the comments by Dr. Zachos regarding the success in recruiting women to the field of veterinary orthopaedic surgery, and could not agree more thoroughly with the comments regarding the importance of exposure of both women and men medical and premedical students to women surgeons.

    Dr. Zachos' comments regarding the importance of visibility of women orthopaedic surgeons and our responsibilities to medical students and premedical students are well taken. In my own practice at a teaching hospital I have, for several years, volunteered time in the first-year anatomy laboratories, and in career choice seminars for first year students---with the idea of imparting not only anatomic or career choice information, but also by providing early exposure to potential women orthopaedic surgeons. Many of my female orthopaedic colleagues have participated in similar activities.

    However, the "burden" Dr. Zachos describes--or the opportunity depending on how you look at it--lies not just with us, but with our male colleagues as well. Dr. Reginald Cooper, in his 1987 AAOS vice- presidential Address, rather pointedly referred to the orthopaedic physician with the pronoun "she, or he"-an unusual step even now, but especially fourteen years ago. (1). I, as a fourth year medical student waiting to hear NRMP match results and sitting in the audience at Moscone Center among a sea of male surgeons, noted that simple gesture. While many years later I cannot remember the rest of the address, I still remember to this day the inclusion that I felt by his words. Both men and women orthopaedic surgeons have the capability to make women feel included in our specialty.

    What difference can men make? Women on orthopaedic services as students sometimes relate that the male residents and attendings with whom they work do not seem to regard them as a potential future orthopods in the same collegial way that their male student counterparts are regarded. Taking women medical students and their potential interest in orthopaedic surgery seriously is a large first step. The avoidance of stereotyping in discussion of our specialty is another. Letting women students know about women orthopaedic surgeons (at other institutions if not one's own) is another-and the RJOS is available to help. Discouraging unenlightened male colleagues from making inappropriate remarks about the place of women in the field is invaluable; while it's no surprise to these individuals if women complain, if another man corrects them they may be more likely to reevaluate their thinking.

    Only about half of the graduating medical students are female. Orthopaedics matches approximately 93% men; if we continue to select the vast majority of our trainees from a subset of half the student population we will no longer be taking only the top students. All of us can work together to continue to keep the field more attractive to top students of both genders.

    Sincerely,

    J. Sybil Biermann, M.D. President, Ruth Jackson Orthopaedic Society

    1. Cooper RR. Grass roots, ivory towers, science, and The Academy. Journal of Bone & Joint Surgery - American Volume. 69(4):479-83, 1987

    Terri A. Zachos, DVM
    Posted on July 04, 2001
    Women in Orthopaedic Surgery: Experience in Veterinary Medicine
    Michigan State University, Laboratory for Comparative Orthopaedic Research

    I am writing in response to the reply by Dr. Scherl et al. 83-A:954- 955, June 2001) to Dr. Stickles' letter, "Attracting Female Candidates to the Field of Orthopaedic Surgery." The concern about the paucity of women entering orthopaedic surgery residency programs in the United States is one which has received much attention of late. Numerous viable theories have been proposed to explain the long-standing gender imbalance in this specialty.

    I strongly agree with Dr. Scherl's assertion that, "to attract female candidates, the field of orthopaedic surgery needs to have mentors and peers in place." While the efforts of the Ruth Jackson Orthopaedic Society (RJOS) have played a large role in this undertaking, prominent figures in the Society will need to take on the additional burden of increasing their visibility to medical students, as well as to undergraduates in pre-medical curricula.

    I propose the experience of women in veterinary orthopaedic surgery as an example of a group with excellent mentors. While there is no equivalent to the RJOS in veterinary medicine (likley because of the relatively small number of veterinarians, when compared with the number of physicians, in the United States), a small number of female orthopaedic surgeons who have been in the field for a number of years have paved the way for an increasingly large group of young surgeons. While the number of women in veterinary orthopaedic surgery remains small, it appears to be increasing relatively quickly in this small subspecialty of veterinary surgery, when compared with our colleagues in human orthopaedics. Prominent figures in our field include Gretchen L. Flo, DVM, MS at Michigan State University and Ann L. Johnson, DVM, MS at the University of Illinois. These individuals, have opened doors for a younger group of surgeons who are now becoming influential members of the veterinary and comparative orthopaedics communities. Among these younger surgeons are Nicole Ehrhart, DVM, MS at the University of Illinois, Amy Kapatkin, DVM at the University of Pennsylvania, and Sharon C. Kerwin, DVM, MS at Louisiana State University.

    Numerous explanations have been proposed for the increasing number of women in veterinary medicine, and specifically in veterinary surgery (a specialty traditionally dominated by men), in the past 15-20 years. Among these include the increasing flexibility for surgeons of both genders, to take family leave.

    I propose this comparison between the fields of veterinary and human orthopaedic surgery because the demands of residency programs in veterinary surgery are similar in terms of length of commitment, call schedule, and physical exertion. In our programs (which require four post -graduate years, rather than five), all residents are required to complete rotations in both orthopaedic and all facets of general surgery, for the duration of their programs.

    In summary, I agree strongly with Dr. Scherl that the field of orthopadic surgery is certainly not "'inhospitable' to women of childbearing age or to working mothers," and that "programs in orthopaedic surgery should make efforts to attract women by providing female mentors . . ." I propose the subspecialty of orthopaedic surgery in veterinary medicine as an example of successful mentorship, which has resulted in an increase in the number of women in this field.

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