MEDICAL STUDENT PERCEPTIONS OF BARRIERS TO ORTHOPAEDIC SURGERY DIFFER BY GENDER

Women have consistently comprised more than half of Canadian medical students since the 1990s, however, they represent only 13.6% of orthopaedic surgeons in Canada. To promote gender equity in the specialty, it is essential to understand and address the factors negatively affecting female medical students considering a career in orthopaedic surgery. The primary objective of this study was to determine the barriers identified by medical students when considering pursuing a career in orthopaedic surgery. The secondary objective was to assess whether there are gender-based differences in factors affecting medical students considering pursuing a career in orthopaedic surgery. A cross-sectional mixed-methods survey was distributed to all final-year students at a Canadian medical school. Quantitative survey responses were assessed using a five-point Likert scale or closed-ended questions. Descriptive analyses, including means and standard deviations, were calculated for the entire study population and gender subgroups. Chi-square or Fisher's exact tests were employed for binary data, and non-parametric Mann-Whitney U tests for ordinal data, to compare responses between gender subgroups. Illustrative excerpts from open-text responses were presented. Sixty-four medical students participated, representing a response rate of 59.3%. Forty-four respondents identified as women and 20 as men. Male privilege and physical strength were identified as strong barriers to pursuing a career in orthopaedic surgery by both women and the entire study population. Women additionally reported less exposure (p=0.003), less mentorship (p=0.028), disproportionate constraints (performance scrutinized differently, p=0.001), and concern about hostility (verbal abuse, p In this study, male privilege and physical strength were identified as strong barriers to pursuing a career in orthopaedic surgery. Lack of exposure, insufficient support, disproportionate constraints, and hostility were additional factors which were found to differentially affect women and men considering pursuing a career in orthopaedic surgery. These barriers are rooted in a culture of gender bias and stereotypes, perpetuating the underrepresentation of women in orthopaedic surgery. Breaking this cycle with require concerted, deliberate efforts at every step along the pipeline to orthopaedic surgery, from early exposure in medical school training to the creation of sustainable mentorship programs, to bias training for trainees and staff. Recognizing that gender diversity is just one aspect of promoting overall diversity, comprehensive interventions that address intersecting identities are necessary to foster true inclusivity and equity within the orthopaedic workforce.