Gender Trends in Orthopedic Surgical Residency Programs in Canada over 20 Years

Overview

Journal Can J Surg

Date 2025 Jan 17

PMID 39819509

Authors

Abigail Frazer

Silvio Ndoja

Holly S Howe

Supriya Singh

Affiliations

Soon will be listed here.

Abstract

Background: Gender disparities exist in several surgical specialties, particularly in orthopedic surgery. The purpose of this study was to determine the current trends in gender diversity among orthopedic surgical residents in Canada over the last 20 years.

Methods: We analyzed gender distribution data for orthopedic trainees from the Canadian Resident Matching Service (CaRMS) for 2013-2022 and the Canadian Post-MD Education Registry for 2000-2022 using linear and quadratic regressions.

Results: More male (4.7%) than female medical students (1.9%) applied to an orthopedics program ( < 0.001). The proportion of male applicants entering CaRMS who applied to orthopedics followed a quadratic (U-shaped) distribution over time ( = 0.01). The proportion of female applicants remained unchanged from 2013 to 2022 ( > 0.9). However, for matching results, among the applicants who applied to orthopedic surgery, there was no gender effect (men 56.1% matched, women 50.3% matched; = 0.3). The proportion of residency spots offered to female applicants remained at around 30%, without significant changes over time ( = 0.1). The number of female orthopedic graduates increased linearly from 2000 to 2021 ( < 0.001), projected to reach gender equalization (at 50%) by 2060. Female residents experienced higher attrition in residency (3.4%) than male residents (2.1%; = 0.05), and this gender difference is decreasing over time ( = 0.03).

Conclusion: Over 2 decades, women have shown consistently lower rates of application to orthopedic surgery programs than their male colleagues. Women who matched experienced higher attrition rates than men, although this appears to be improving over time.

References

Hiemstra L, Kerslake S, Clark M, Temple-Oberle C, Boynton E . Experiences of Canadian Female Orthopaedic Surgeons in the Workplace: Defining the Barriers to Gender Equity. J Bone Joint Surg Am. 2022; 104(16):1455-1461. DOI: 10.2106/JBJS.21.01462. View

Munger A, Heckmann N, McKnight B, Dusch M, Hatch 3rd G, Omid R . Revisiting the Gender Gap in Orthopaedic Surgery: Investigating the Relationship Between Orthopaedic Surgery Female Faculty and Female Residency Applicants. J Am Acad Orthop Surg. 2018; 27(8):295-300. DOI: 10.5435/JAAOS-D-17-00686. View

Wang J, Chang S, Nwachuku I, Hill W, Munger A, Suleiman L . Trends in Race and Sex Representation Among Entering Orthopaedic Surgery Residents: A Continued Call for Active Diversification Efforts. J Am Acad Orthop Surg. 2023; 31(12):e530-e539. DOI: 10.5435/JAAOS-D-22-01007. View

Brown A, Bonneville G, Glaze S . Nevertheless, They Persisted: How Women Experience Gender-Based Discrimination During Postgraduate Surgical Training. J Surg Educ. 2020; 78(1):17-34. DOI: 10.1016/j.jsurg.2020.06.027. View

Haffner M, Van B, Wick J, Le H . What is the Trend in Representation of Women and Under-represented Minorities in Orthopaedic Surgery Residency?. Clin Orthop Relat Res. 2021; 479(12):2610-2617. PMC: 8726541. DOI: 10.1097/CORR.0000000000001881. View

Van Heest A, Agel J, Balch Samora J . A 15-Year Report on the Uneven Distribution of Women in Orthopaedic Surgery Residency Training Programs in the United States. JB JS Open Access. 2021; 6(2). PMC: 8169074. DOI: 10.2106/JBJS.OA.20.00157. View

Day C, Lattanza L, Van Heest A, Templeton K, Fore J, Ode G . AOA Critical Issues: Gender Justice in Academic Medicine: What It Might Look Like in Orthopaedic Surgery. J Bone Joint Surg Am. 2023; 105(15):1214-1219. DOI: 10.2106/JBJS.22.01204. View

Lattanza L, Meszaros-Dearolf L, OConnor M, Ladd A, Bucha A, Trauth-Nare A . The Perry Initiative's Medical Student Outreach Program Recruits Women Into Orthopaedic Residency. Clin Orthop Relat Res. 2016; 474(9):1962-6. PMC: 4965379. DOI: 10.1007/s11999-016-4908-y. View

OConnor M . Medical School Experiences Shape Women Students' Interest in Orthopaedic Surgery. Clin Orthop Relat Res. 2016; 474(9):1967-72. PMC: 4965370. DOI: 10.1007/s11999-016-4830-3. View

10.

Okike K, Phillips D, Swart E, OConnor M . Orthopaedic Faculty and Resident Sex Diversity Are Associated with the Orthopaedic Residency Application Rate of Female Medical Students. J Bone Joint Surg Am. 2019; 101(12):e56. DOI: 10.2106/JBJS.18.00320. View

11.

Van Heest A, Fishman F, Agel J . A 5-Year Update on the Uneven Distribution of Women in Orthopaedic Surgery Residency Training Programs in the United States. J Bone Joint Surg Am. 2016; 98(15):e64. DOI: 10.2106/JBJS.15.00962. View

12.

Rohde R, Wolf J, Adams J . Where Are the Women in Orthopaedic Surgery?. Clin Orthop Relat Res. 2016; 474(9):1950-6. PMC: 4965367. DOI: 10.1007/s11999-016-4827-y. View

13.

Balch Samora J, Van Heest A, Weber K, Ross W, Huff T, Carter C . Harassment, Discrimination, and Bullying in Orthopaedics: A Work Environment and Culture Survey. J Am Acad Orthop Surg. 2020; 28(24):e1097-e1104. DOI: 10.5435/JAAOS-D-19-00822. View

14.

Blakemore L, Hall J, Biermann J . Women in surgical residency training programs. J Bone Joint Surg Am. 2003; 85(12):2477-80. DOI: 10.2106/00004623-200312000-00031. View

15.

Gargiulo D, Hyman N, Hebert J . Women in surgery: do we really understand the deterrents?. Arch Surg. 2006; 141(4):405-7. DOI: 10.1001/archsurg.141.4.405. View

16.

Mulcahey M, Waterman B, Hart R, Daniels A . The Role of Mentoring in the Development of Successful Orthopaedic Surgeons. J Am Acad Orthop Surg. 2018; 26(13):463-471. DOI: 10.5435/JAAOS-D-16-00665. View

17.

Hunter J, Grewal R, Nam D, Lefaivre K . Gender disparity in academic orthopedic programs in Canada: a cross-sectional study. Can J Surg. 2022; 65(2):E159-E169. PMC: 8916023. DOI: 10.1503/cjs.008920. View