Visual Element: A bar chart comparing "Percentage of Female Residents" across surgical specialties (OBGYN, General Surgery, ENT, Orthopaedics), highlighting Orthopaedics at the bottom (~14-18% depending on country).

The Last Frontier

Orthopaedic surgery has a reputation. The "Ortho Bro." The gym-goer. The rugby player. For decades, it was viewed as a trade requiring brute strength, inherently excluding women. While General Surgery, ENT, and Urology have seen rapid feminization, Orthopaedics lags behind. In the US, UK, and Australia, women make up over 50% of medical graduates but less than 15% of orthopaedic trainees and less than 6-8% of consultants.

This is not just a "social justice" issue; it is a talent issue. By failing to attract women, orthopaedics is effectively ignoring 50% of the potential talent pool.

The Myths That Hold Us Back

Myth 1: "You need to be strong."

Reality: Orthopaedics is physics, not weightlifting. Reducing a dislocated hip or nailing a femur requires leverage, technique, and understanding of soft tissue vectors. A 60kg surgeon using a lever correctly generates more force than a 100kg surgeon pulling inefficiently.

• Tech Tip: Power tools and reduction clamps are the great equalizers.

Myth 2: "The lifestyle is impossible for mothers."

Reality: Orthopaedics is actually more elective than General Surgery or OBGYN. While Trauma is unpredictable, subspecialties like Hand, Foot & Ankle, and Arthroplasty are largely elective, 9-5 practices. Many female surgeons successfully balance high-volume careers with motherhood.

Myth 3: "Radiation causes infertility."

Reality: The evidence does not support this. With proper lead protection (0.5mm lead equivalent), the fetal dose is well below the safety threshold (5 mSv) even for high-volume trauma surgeons. The risk is manageable with standard precautions.

The Real Barriers

If the strength myth is false, why are the numbers so low?

1. Lack of Role Models: "You cannot be what you cannot see." Medical students who never see a female orthopaedic surgeon assume it isn't an option.
2. The "Hidden Curriculum": The locker room banter, the "boys club" golf days, and the assumption that the female registrar is the nurse. These micro-aggressions accumulate ("Death by a thousand cuts").
3. Ergonomics: Surgical instruments are designed for the 95th percentile male hand size. Women (and smaller men) often struggle with grip span on rongeurs or power drills, leading to fatigue.
   • Solution: Industry is finally waking up to "inclusive design" for instruments.

Strategies for Success

1. Find Your Tribe

Organizations like WOrtho (Women in Orthopaedics), The Perry Initiative, and WOW (Women of Orthopaedics Worldwide) are essential. They provide:

• Mentorship.
• Advice on contract negotiation.
• Support during pregnancy/maternity leave.

2. Technique over Torque

Master the anatomy and the instruments.

• Use the patient's weight.
• Use reduction clamps early.
• Don't be afraid to ask for a "smaller handle" or a different retractor.

3. Be Visible

To the medical students and junior doctors: be the mentor you wish you had. Allow them to see that an orthopaedic surgeon can look like you.

The Male Ally's Role

Diversity is not just a "women's issue." Male surgeons must be allies.

• Call it out: If a patient or staff member assumes the female surgeon is a nurse, correct them politely but firmly.
• Sponsorship: actively advocate for female colleagues for podium presentations, awards, and leadership roles.
• Equipment: Ensure your hospital stocks lead gowns and gloves in smaller sizes.

Conclusion

The face of orthopaedics is changing. The modern orthopaedic surgeon is defined by their dexterity, their decision-making, and their empathy—not their bench press. To the female medical student reading this: We need you. We need your hands, your brain, and your perspective. The door is open.

References

1. Bucknall V, et al. "Women in orthopaedics: a UK perspective." Bone & Joint Journal. 2020.
2. Van Heest AE, et al. "Gender diversity in orthopedic surgery: we are missing half the talent." Clin Orthop Relat Res. 2021.
3. Cizmic Z, et al. "Radiation safety for the pregnant orthopaedic surgeon." JAAOS. 2017.