Gender diversity in orthopaedic surgery: Does the conversation require a new audience to find answers?

Background: Non-orthopaedic surgical specialties have demonstrated steady increases in female resident composition. Female participation in orthopaedics continues to lag behind. A survey of current female surgical residents across all specialties attempting to understand salient differences in pre-residency exposures and factors affecting specialty choice has not yet been conducted. Methods: A 38-item survey was developed with the following sub-sections: Demographics, Pre-Clinical Exposures, Attitudes Towards Surgical Environments, Factors Influencing Specialty Choice, Dissuaders to a Career in Orthopaedics, and Work Experiences Related to Gender. Surveys were disseminated to female surgical residents in Ohio during the 2022-2023 academic year. Continuous outcome measures were assessed using ANOVA. Categorical outcomes were compared using chi-square testing. Results: 76 surveys were included with a response rate of 23.5% (76/324), comprised of 30.3% orthopaedic residents, 43.4% general surgery residents, and 26.3% from other surgical subspecialties. Orthopaedic residents were more likely to attend medical schools that offered orthopaedics as an elective rotation during their third year and expressed more interest in the application of biomechanical principles. Low interest in orthopaedic conditions and surgeries was the most cited dissuader to pursuing orthopaedics while interest in surgical techniques and exposure to them in medical school were ranked as top factors influencing specialty choice. Conclusion: Lack of interest in orthopaedic pathology was a more salient dissuader than specialty culture. The option for a third-year orthopedic elective was significantly deficient amongst non-orthopaedic residents. Early exposure incorporated into the fabric of medical school curricula, may result in increased consideration of orthopaedics as a career.