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  • Item type:Publication,
    Gender Research Gap in Orthopaedics and Trauma Surgery: Gender-specific Disparities in Submission of Abstracts to the German Congress of Orthopaedic and Trauma Surgery from 2015 to 2024 Open PDF 
    (Georg Thieme Verlag KG, 2025-04-30)
    Vogel, Carolina
    ;
    Bertsch, Vera
    ;
    Rollmann, Mika F.
    ;
    Histing, Tina
    ;
    Braun, Benedikt J.
    Gender-specific differences also affect the subject of orthopaedics and trauma surgery (O&T). While the proportion of women studying medicine is steadily increasing, the proportion of female surgeons in O&T is only 18.6%. This underrepresentation affects not only clinics but also research and is reflected in participation in scientific annual meetings such as the German Congress for Orthopaedics and Trauma Surgery (DKOU).This retrospective study examined the gender differences in abstract submissions to the DKOU from 2015 to 2024. The anonymised data were subjected to examination regarding gender, role in submission and academic title.The overall participation of women in the 82,813 abstracts was 20%. The proportion of women among submitters was 23.3%, among presenters 24.5% and among co-authors 18.2%. In the analysis of the female cohort alone, women were more likely to be submitters and presenters than in the male cohort (p < 0.001). The proportion of female participation in abstract submissions increased by an average of 0.5% per year over the study period. However, women were significantly underrepresented at higher academic degrees, such as habilitations (7.4%), professorships (7.6%) and university professorships (5.2%).The results show that the proportion of women submitting abstracts to the DKOU largely corresponds to the percentage in the field of orthopaedics and trauma surgery (18.6% in 2022), reflecting the overall gender disparity in this specialty. If this trend analysis were applied to the general development of gender parity in orthopaedics and trauma surgery, gender-equitable staffing of medical positions could not be achieved before the year 2087. To accelerate this development, targeted measures to promote women in orthopaedics and trauma surgery are necessary. This includes dismantling structural barriers and implementing specific support programs for female surgeons pursuing academic careers.
  • Item type:Publication,
    Gender-Based Disparities in Academic Orthopaedic Surgery Physician Compensation in 2023 Open PDF 
    (Ovid Technologies (Wolters Kluwer Health), 2025-03-11)
    Chauhan, Dhun
    ;
    DeYoung, Joshua K.
    ;
    Goodrich, Ezra
    ;
    Templeton, Kimberly
    ;
    Day, Charles S.
    Background: Orthopaedic surgery remains one of the least diverse specialties in medicine. Parity in opportunity and recognition are key factors in attracting and retaining a diverse group of individuals in the field. The primary purpose of this study was to assess gender-based discrepancies in total salary compensation by rank for academic orthopaedic surgery faculty. Methods: Aggregate data were obtained from the Association of American Medical Colleges for fiscal year 2023. Mean compensation was compared for orthopaedic surgery faculty and total surgery faculty at all academic ranks based on gender and race. Results: Men received markedly higher total compensation for all ranks except chair within orthopaedic surgery. At the instructor level, men earned an average annual income of $554,245 while women received $229,204, demonstrating a significant pay gap (P = 0.0019). At the assistant professor (men: $628,346; women: $475,857), associate professor (men: $732,381; women: $575,877), and professor (men: $743,822; women: $472,140) levels, there existed significant pay disparities (P < 0.0001 for all three academic levels, respectively). At the chief position, men earned an average of $1,185,873 annually while women received $596,270 (P = 0.0006). Aggregate data for other surgical specialties demonstrated similar results, with women receiving lower total compensation at all ranks compared with men. Conclusion: This analysis of the 2023 American Medical Colleges Faculty Salary Report demonstrates a notable pay differential between men and women in orthopaedic surgery and surgical specialties, in general, across multiple academic levels including instructor, assistant professor, associate professor, professor, and chief of division. Although there has been increasing awareness of gender-based compensation disparities within surgical specialties, particularly in orthopaedic surgery, these disparities are still clearly present.
  • Item type:Publication,
    Revisiting the Gender Gap in Orthopaedic Surgery: Investigating the Relationship Between Orthopaedic Surgery Female Faculty and Female Residency Applicants. Open PDF 
    (2019)
    Munger, Alana M.
    ;
    Heckmann, Nathanael
    ;
    McKnight, Braden
    ;
    Dusch, Marie N.
    ;
    Hatch, George F. 3rd
    INTRODUCTION: Although women now constitute approximately half of all graduating medical students, orthopaedic surgery continues to lag behind in its ability to recruit female applicants. One hypothesis for this discrepancy is the lack of female faculty mentors at academic institutions. The three objectives of this study were the following: (1) to quantify the proportion of female orthopaedic surgery residency applicants, (2) to quantify the proportion of female orthopaedic surgery faculty, and (3) to investigate the relationship between female orthopaedic surgery faculty at an academic institution and the corresponding number of female orthopaedic surgery residency applicants. METHODS: Data from the Association of American Medical Colleges from 2005 to 2014 were used to calculate the number of medical school graduates, the number of orthopaedic surgery residency applicants, and the number of orthopaedic full-time faculty in the United States. Institutions were excluded if they had incomplete data. A Spearman rank correlation was used to assess for a correlation between the 9-year total number of female orthopaedic surgery applicants and the average number of female orthopaedic surgery faculty members. RESULTS: A total of 101 U.S. medical schools were included in the final analysis. During the period examined, women accounted for 48.7% of medical school graduates, 14.9% of orthopaedic surgery applicants, and 13.2% of full-time orthopaedic surgery faculty. The percentage of female residency applicants increased from 13.91% in 2005 to 2006 to 16.02% in 2013 to 2014 while the percentage of female faculty increased from 12.26% in 2005 to 2006 to 15.79% in 2013 to 2014. No correlation was found between the average number of female orthopaedic surgery faculty at an institution and the total number of female orthopaedic surgery applicants from that institution during the study period examined (Rho, 0.0176; P = 0.5957). CONCLUSIONS: The data presented in this study failed to demonstrate a relationship between the number of female faculty and the number of women who apply into orthopaedic surgery, which highlights the complex nature of this issue. More research is needed to examine factors influencing the recruitment of female medical students.
  • Item type:Publication,
    Gender Comparison of Scholarly Production in the Musculoskeletal Tumor Society Using the Hirsch Index Open PDF 
    (2015)
    Martinez, M.
    ;
    Lopez, S.
    ;
    Beebe, K.
    Objective Despite an increase in the proportion of female medical school graduates, the number of women in orthopedic surgery remains low. To examine the presence of gender disparities in scholarly production, the authors used the Hirsch index (h-index) to assess members of the Musculoskeletal Tumor Society (MSTS), a well-defined subspecialty of orthopedic surgery. Design Using the MSTS Membership Directory, the authors assessed those practicing at an academic institution in the United States. Members sex and rank was obtained from their department's website, and their h-index and years since initial publication was collected from the Scopus database. Setting Research was performed at New Jersey Medical School, an institution, using online databases. Participants A total of 247 members of the MSTS were eligible, of whom 125 practiced at a US academic medical center and were included in the study. Results The MSTS is composed of 247 members, 28 (11%) of whom are women. Within US academic medical centers, there are 125 members, including 17 (14%) women. Mean h-indices increased with rising academic rank from 5.42 for assistant professors to 19.28 for professors. Publication ranges showed an increase from 11.03 years for assistant professors to 29.52 years for professors. The h-index and publication years of chairpersons were nearly equal to those of professors. Using the h-index, it was found that men outproduce women - 13.4:7.9. Men outnumber women at every rank, increasingly so at higher ranks. The authors found that there was a significant difference in productivity between ranks (p < 0.01) and between sexes (p = 0.035), but not between sexes at the assistant professor, associate professor, or professor levels (p = 0.147, 0.581, and 0.263, respectively). Conclusions The h-index shows differing production among the sexes and ranks in the MSTS. No significant difference exists between the sexes when members are organized by academic title. © 2015 Association of Program Directors in Surgery.
  • Item type:Publication,
    What Are the Rates and Trends of Women Authors in Three High-impact Orthopaedic Journals from 2006-2017? Open PDF 
    (2020)
    Hiller, Kathryn P.
    ;
    Boulos, Alexandre
    ;
    Tran, Megan M.
    ;
    Cruz, Aristides I.
    BACKGROUND: The gender gap among authors publishing research in journals is narrowing in general medicine and various medical and surgical subspecialties. However, little is known regarding the gender gap among authors publishing research in orthopaedic journals. QUESTIONS/PURPOSES: (1) What is the proportion of women first and last authors of original research articles in three high-impact orthopaedic journals from 2006 to 2017? (2) What is the proportion women first authors of original research by orthopaedic subspecialty from 2006 to 2017? METHODS: A sample of original research publications from the even numbered months of issues of Clinical Orthopaedics and Related Research® (CORR®), the Journal of Bone and Joint Surgery, American volume (JBJS), and the American Journal of Sports Medicine (AJSM) were examined from 2006 to 2017. These journals were selected because of their clinical relevance, target audience, and relatively high impact factors. Over the studied period, a single author extracted and reviewed pertinent data, including the gender of the first and last authors and the primary subspecialty of the research article. The senior author refereed disputes regarding the primary subspecialty of each included article. The proportion of women first and last authors in each journal was compared between 2006 to 2017 using chi-square analysis. The proportion of women first authors according to orthopaedic subspecialty in which an article primarily focused its study was also compared between 2006 to 2017 using chi-square analysis. RESULTS: Data were collected from 6292 articles, 13% (800) of which were first-authored by women and 10% (604) of which were last-authored by women. From 2006 to 2017, the overall percentage of women first authors in the examined journals increased (from 11% in 2006 to 17% in 2017; odds ratio 1.6563 [95 % CI 1.4945 to 1.8356]; p < 0.001). Overall across the period studied, the percentage of women first authors in JBJS was 14% while 12% of first authors in CORR and AJSM were women. Regarding subspecialty, the percentage of women first authorship ranged from 9% in the shoulder subspecialty to 21% in pediatric orthopaedics across all three journals. CONCLUSIONS: There has been an increase in the percentage of women first authors in articles published in three high-impact orthopaedic journals from 2006 to 2017. This observed increase is encouraging in terms of promoting gender diversity in orthopaedics and may be reflective of a modest increase in the number of women entering the orthopaedic workforce. CLINICAL RELEVANCE: Between 2006 and 2017, the overall number of women first authors in CORR, JBJS, and AJSM modestly increased. This may suggest a nascent narrowing of the gender gap in orthopaedics. Although this is a welcome finding in terms of promoting and encouraging gender diversity in this man-dominated field, the overall percentage of women authorship remains modest, at best. Future investigations should examine whether the modest increase in women first authorship over time found in this study translates into an increased percentage of senior/last authorship in the future, as this may have implications for women orthopaedic workforce retention.
  • Item type:Publication,
    Sex Differences in Academic Productivity Across Academic Ranks and Specialties in Academic Medicine: A Systematic Review and Meta-analysis Open PDF 
    (2021)
    Ha, Giang L.
    ;
    Lehrer, Eric J.
    ;
    Wang, Ming
    ;
    Holliday, Emma
    ;
    Jagsi, Reshma
    Importance: Despite equal numbers of men and women entering medical school, women are underrepresented in the upper echelons of academic medicine and receive less compensation and research funding. Citation-related publication productivity metrics, such as the h-index, are increasingly used for hiring, salary, grants, retention, promotion, and tenure decisions. Exploring sex differences in these metrics across academic medicine provides deeper insight into why differences are observed in career outcomes. Objective: To systematically examine the available literature on sex differences in h-index of academic faculty physicians across all medical specialties and all levels of academic rank. Data Sources: Medical literature with the term h-index found in PubMed and published between January 1, 2009, and December 31, 2018, was used. Study Selection: A PICOS (Population, Intervention, Comparison, and Outcomes), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses), and MOOSE (Meta-analysis of Observational Studies in Epidemiology) selection protocol was used to find observational studies that published h-indexes for faculty physicians that were stratified by sex. Studies were excluded if they were review articles, retracted, or unavailable online. Ultimately, 14 of 786 studies (1.78%) met the inclusion criteria. Data Extraction and Synthesis: Data from 9 studies across 16 specialties were examined using weighted random-effects meta-analyses. Five studies were excluded because of overlapping specialties with another study or because they were missing appropriate statistics for the meta-analysis. Four of these studies were included in qualitative synthesis to bring the total to 13 studies. Main Outcomes and Measures: The primary study outcome was the h-index. Results: The meta-analysis included 10 665 North American unique academic physicians across 9 different studies from the years 2009 to 2018. Of the 10 665 physicians, 2655 (24.89%) were women. Summary effect sizes for mean h-indexes of men and women and mean h-index difference between men and women were determined for all faculty physicians and at each academic rank. Overall, female faculty had lower h-indexes than male faculty (mean difference, -4.09; 95% CI, -5.44 to -2.73; P < .001). When adjusting for academic rank, female faculty still had lower h-indexes than male faculty at the ranks of assistant professor (mean difference, -1.3; 95% CI, -1.90 to -0.72; P < .001), associate professor (mean difference, -2.09; 95% CI, -3.40 to -0.78; P = .002), and professor (mean difference, -3.41; 95% CI, -6.24 to -0.58; P = .02). Conclusions and Relevance: In this systematic review and meta-analysis, women had lower h-indexes than men across most specialties and at all academic ranks, but it is unclear why these differences exist. These findings suggest that future investigation should be conducted regarding the causes of lower h-indexes in women and that interventions should be developed to provide a more equitable environment for all physicians regardless of sex.
  • Item type:Publication,
    How Well Represented Are Women Orthopaedic Surgeons and Residents on Major Orthopaedic Editorial Boards and Publications? Open PDF 
    (2020)
    Rynecki, Nicole D.
    ;
    Krell, Ethan S.
    ;
    Potter, James S.
    ;
    Ranpura, Akash
    ;
    Beebe, Kathleen S.
    BACKGROUND: Recent studies indicate that women are substantially underrepresented as orthopaedic surgeons and residents compared with other specialties in medicine and medical school. The reasons for this are multifactorial and not completely understood, but previous studies suggest that women may be attracted to fields in which they have female role models. Given that women interested in academia and research may use female editorship and authorship as a proxy for female representation in orthopaedic surgery, we wanted to examine the proportion of women represented in orthopaedic journals and determine if it reflects the distribution of women in orthopaedic surgery as a field. We further wanted to understand if this representation has changed over time in the setting of a slowly shifting gender landscape within orthopaedic surgery. QUESTIONS/PURPOSES: (1) How are women orthopaedic surgeons and residents represented in orthopaedic journals compared with men? (2) Have these proportions changed in the past two decades in light of relatively new efforts to recruit women to the field of orthopaedic surgery? METHODS: The gender composition of editorial boards and first and last authors were obtained from the 1997, 2007, and 2017 volumes of the following journals: The Journal of Bone & Joint Surgery (JBJS), the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), and Clinical Orthopaedics and Related Research® (CORR®). Gender neutral names were searched to obtain a picture to ensure proper tallies. RESULTS: The total combined amount of women first and last authors increased from 88 of 1450 (6%) in 1997 to 152 of 1912 (8%) in 2007 to 723 of 5391 (13%) in 2017. Similarly, three of 113 (3%) editorial board members were women in 1997, three of 105 (3%) were women in 2007 and 10 of 107 (9%) editors were women in 2017. Of note, 0 out of 9 editors-in-chief were women. CONCLUSIONS: Based on the current percentage of women orthopaedic surgeons and residents, women are represented equally or in greater numbers as editors and authors in JAAOS, JBJS, and CORR. This may be in part due to women orthopaedic surgeons entering academic medicine at a greater rate than males. CLINICAL RELEVANCE: Orthopaedic surgeons serving as mentors to prospective female applicants can cite female representation on editorial boards and as authors as an example of gender parity in the field. Additionally, active orthopaedic surgeons who are women interested in these leadership positions should be encouraged that these opportunities exist, regardless of gender.
  • Item type:Publication,
    Despite Growing Number of Women Surgeons, Authorship Gender Disparity in Orthopaedic Literature Persists Over 30 Years Open PDF 
    (2020)
    Brown, Meghan A.
    ;
    Erdman, Mary Kate
    ;
    Munger, Alana M.
    ;
    Miller, Anna N.
    BACKGROUND: The most recent demographic data reveal that only 6.5% of practicing orthopaedic surgeons are women, and as far as we know, only two women have held chair positions in academic orthopaedic programs in the United States. Furthermore, orthopaedic surgery is the least gender-diverse speciality recognized by the Accreditation Council for Graduate Medical Education. The factors that contribute to the lack of gender diversity in orthopaedics remain ill-defined. A lag in publication productivity may be a barrier to career advancement for women orthopaedic surgeons, but this has not been well studied. QUESTIONS/PURPOSES: (1) What is the proportion of orthopaedic studies published in six major orthopaedic journals by women first or senior authors from 1987 to 2017? (2) Did men and women orthopaedic surgeons publish in equal proportions during the study period (measured in 5-year intervals)? (3) Are there differences in the characteristics (such as study type or subject focus) of orthopaedic publications authored by women and those authored by men? (4) Has the increased proportion of practicing women orthopaedic surgeons been matched by an equal increase in authorship by women orthopaedic surgeons during the study timeframe? METHODS: A cross-sectional analysis was designed to characterize trends in authorship of orthopaedic studies by women over time. All publications from the first issue of each of six major orthopaedic journals were evaluated at seven time points (1987, 1992, 1997, 2002, 2007, 2012, and 2017). Characteristics of each first and senior author (including gender, academic degree, and specialty), and study category of each publication were collected. Articles for which this information was not available were excluded (35 of 1073, or 3.3% of published studies, no difference in proportion of excluded studies between journals). The proportions of women and men authors were compared at the seven time points and for six study categories (basic science, case report/technique article, clinical medicine, economics/practice management, editorial content [including true editorials, letters to the editor, commentaries, and book reviews] and review/meta-analysis) using a Fisher's exact test or chi-squared analysis. We compared the rates of change of women authorship, practicing women orthopaedic surgeons, and women orthopaedic residents during the study period using an ANOVA and Tukey's honestly significant difference (HSD) post-hoc test with Cohen's D measure of effect size. RESULTS: From 1987 to 2017, only 1.7% (15 of 880) of senior authors and 4.4% (46 of 1038) of first authors of orthopaedic publications were women orthopaedic surgeons. Based on population proportions (that is, percent of practicing women orthopaedic surgeons compared with men), the proportion of women senior authors was less than would be expected at each time point after 1987 compared with men. There were no differences between the types of studies authored by women or men. Finally, during the study period, the rate of growth of women senior authorship was less than the rates of growth of both practicing women orthopaedic surgeons (d = 5.3, 95% CI, 4.8-5.6; p = 0.023) and women first authorship (d = -4.3, 95% CI -4.6 to -3.6, p = 0.030; estimated mean 3.3, p = 0.013). CONCLUSIONS: Women orthopaedic surgeons published a small proportion of academic orthopaedic research from 1987 to 2017, and women senior authors consistently published less than would be expected based on their population proportion compared with men orthopaedic surgeons. Furthermore, the growth of practicing women orthopaedic surgeons has not been matched by growth in senior authorship by women over the same timeframe. CLINICAL RELEVANCE: This discrepancy warrants further exploration because a low rate of publication may negatively impact the career advancement of women orthopaedic surgeons and contribute to the overall lack of gender diversity in orthopaedics. We suggest that journals and publishers review their editorial processes to ensure blinding of author names during peer review and editorial decision-making, and to disclose those review processes to authors. We also suggest that institutions encourage women trainees and junior faculty to participate in mentorship programs and specialty societies that promote academic productivity.