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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,
    Sex and Gender Considerations in Orthopaedic Research Open PDF 
    (Ovid Technologies (Wolters Kluwer Health), 2024-10-08)
    Bechtold, Joan E.
    ;
    Bauer, Thomas W.
    ;
    Clayton, Janine
    ;
    Foucher, Kharma C.
    ;
    Graves, Leland
    JBJS convened a symposium to discuss the reporting of sex and gender in research studies as an imperative to improve research methods and results to benefit all patients. Barriers to improved reporting include a lack of societal and cultural acceptance of its need; a lack of education regarding appropriate terminology and appropriate statistical methods and efficient study designs; a need for increased research funding to support larger group sizes; unknown concordance of cell and animal models with humans to reflect biologic variables such as sex; and a lack of understanding of key considerations of gender, race, and other social determinants of health and how these factors intersect. Attention to developing and disseminating best-practice statistical methods and to educating investigators (at all career levels), reviewers, funders, editors, and staff in their proper implementation will aid reporting. Concomitantly, well-designed studies with sufficient rigor and adequate resources are essential to enable meaningful and reproducible research. Existing recommendations, such as the Sex and Gender Equity in Research (SAGER) guidelines, provide valuable guidance that can be applied across the research ecosystem. Academic institutions and private foundations are likely groups to assist in scientific and institutional review board guidance and study recruitment and pilot funding to generate meaningful power estimates, and to serve as sources for additional funding and presentation of workshops, educational events, and seminars. All of this needs to be conducted on an ongoing basis to ensure that sex and gender are considered in scientific analyses, where relevant.
  • 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,
    Sex Bias in Hand Surgery Research Open PDF 
    (2018)
    Kalliainen, Loree K.
    ;
    Wisecarver, Ian
    ;
    Cummings, Allison
    ;
    Stone, Jennifer
    It has been long recognized that sex-based biases related to participant inclusion exist in research. To help address inequities in research participation, the National Institutes of Health Revitalization Act was passed into law in 1993. Although this act was primarily designed to increase inclusion of females and minorities in research funded by National Institutes of Health, it has also helped raise global awareness of the value of routinely including females and minority groups in research. Subsequent work has demonstrated a continued gap in inclusion of females in medical and surgical research and female animals and cell lines in basic science research. Hand surgeons have recognized that certain conditions have greater incidence in one sex over the other, but there has been no widespread discussion on whether, when, and how sex should be used as an outcomes variable. This review investigated the recent hand surgery literature to assess for equity in inclusion of both sexes in research as well as whether outcomes were analyzed based on sex.
  • Item type:Publication,
    Trend of female first authorship in Journal of Orthopaedic Science, the official journal of the Japanese orthopaedic association from 2001 to 2021: An observational study Open PDF 
    (2023)
    Saka, N.
    ;
    Chiang, C.-M.
    ;
    Ogawa, T.
    ;
    Pendleton, A.A.
    ;
    Tsuihiji, K.
    Background: Women are underrepresented in orthopaedic surgery, especially in Japan. Authorship is associated with representation and career advancement, but the academic representation of women in Japanese orthopaedic surgery has not been elucidated. This study aimed to elucidate the proportion of female first authorship and its associating factors, as well as trends in the Journal of Orthopaedic Science (JOS), the official journal of the Japanese Orthopaedic Association. Methods: The study reviewed original articles published in JOS from 2002 to 2021 using data from PubMed on March 16, 2022. The gender of the first and last authors was determined using genderize. io, an online gender detection tool and manual search. The study used multivariable logistic regression to identify the factors associated with female first authorship and visualized the trend of predicted probability using restricted cubic spline curve. Results: Among 2272 original articles, 148 (6.5%) and 79 (3.5%) had female first and last authors, respectively. Compared with 2002–2006, female first authorship significantly increased in 2012–2016 (adjusted odds ratio [aOR], 2.04; 95% confidence interval [CI], 1.09–4.05; p = 0.03) and 2017–2021 (aOR, 2.72; 95% CI, 1.46–5.276; p = 0.002). Affiliation with an institution in Japan (aOR, 0.51; 95% CI, 0.35–0.74; p < 0.001) and affiliation in orthopaedics (aOR, 0.16; 95% CI, 0.11–0.23; p < 0.001) were negatively associated with female first authorship. Around 2020, the trend showed a gradual then rapid increase in women with non-orthopaedic affiliations. Only a very small increase was observed in women with an orthopaedic affiliation. Conclusions: Female first authorship in JOS has been increasing. However, the proportion of female authors remains low. Authors outside of Japan and not affiliated with orthopaedics largely affect female authorship statistics. The results indicate the persistent gender gap in the academic representation of women in Japanese orthopaedic publications. © 2023 The Japanese Orthopaedic Association
  • Item type:Publication,
    Evolution and Trends in Male Versus Female Authorship of Articles in Flagship Orthopaedic Journals From 1995 to 2020 Open PDF 
    (2022)
    Powell, Sarah N.
    ;
    Hunting, John C.
    ;
    Frazier, Landon P.
    ;
    Keeling, Laura E.
    ;
    Janowski, Jessie
    INTRODUCTION: The gender disparity in orthopaedic surgery has been recognized for many years. Because research affects promotions, this study investigates trends in female authorship in three journals over the past 25 years for both first and senior authors. METHODS: All articles from Journal of Bone and Joint Surgery, Journal of the American Academy of Orthopaedic Surgeons, and Clinical Orthopaedics and Related Research from 1995 to 2020 in 5-year intervals were downloaded, and the data for first and senior authors were extracted. The sex of the first and senior authors was determined using the validated Genderize algorithm. The demographics of the first and senior author cohorts were analyzed using chi square tests. The trends in female authorship controlling for year and journal were assessed with logistic regression models. RESULTS: Within the studied journals, 5,636 individuals were identified as first authors and 4,572 as senior authors. Sex was determined for 82.59% of the authors. Female first authorship increased significantly from 1995 to 2020 (6.70% to 15.37%, P < 0.001). Similarly, female senior authorship increased significantly from 1995 to 2020 (8.22% to 13.65%, P < 0.001). Overall, there was no significant difference in gender composition of authors between journals (P = 0.700 first author and P = 0.098 senior author). Women were much more likely to publish as first or senior author in later years, regardless of the journal (P < 0.001 first author and P < 0.001 senior author). DISCUSSION: Female authorship in prominent orthopaedic journals has increased markedly from 1995 to 2020 with interjournal differences in senior author gender disparity. Although female orthopaedic surgeons publish at rates equal to or greater than their representation in the specialty, additional research is needed into the persistence of gender disparities in orthopaedics.
  • Item type:Publication,
    Potential Sex Bias Exists in Orthopaedic Basic Science and Translational Research Open PDF 
    (2018)
    Bryant, Jessica
    ;
    Yi, Paul
    ;
    Miller, Liane
    ;
    Peek, Kacy
    ;
    Lee, Daniel
    BACKGROUND: Potential sex bias has been shown in general surgery basic science and translational research, with unequal representation of male and female specimens. Because basic science research forms the foundation for clinical studies on which patient care is based, it is important that this research equally consider both sexes. The purpose of this study was to determine if potential sex bias exists in the basic science and translational orthopaedic literature. METHODS: A systematic review was conducted of all articles published in 2014 in The Journal of Bone & Joint Surgery, Clinical Orthopaedics and Related Research, The Bone & Joint Journal, and the Journal of Orthopaedic Research (JOR). All original research articles utilizing animals, cells, or cadavers were included. The data abstracted included study type, sex of specimen studied, and presence of sex-based reporting of data. A second review was performed of all basic science articles published in JOR in 1994, 2004, and 2014 to compare sex bias trends across 3 decades. Distributions of variables were compared using the Fisher exact test, with significance defined as p < 0.05. RESULTS: Of 1,693 articles reviewed, 250 (15%) were included: 122 animal-based studies (49%), 71 cell-based studies (28%), and 57 human cadaver-based studies (23%). Overall, authors in 88 studies (35%) did not report the sex of animals, cells, or cadavers used. Of 162 studies in which the authors did report sex, 69 (43%) utilized male only, 40 (25%) utilized female only, and 53 (33%) utilized both sexes. Of those studies that used both sexes, authors in only 7 studies (13%) reported sex-based results. A subanalysis of JOR articles across 3 decades revealed a significant increase in studies specifying sex (p = 0.01) from 2004 to 2014. CONCLUSIONS: Potential sex bias exists in orthopaedic surgery basic science and translational research, with an overrepresentation of male specimens. CLINICAL RELEVANCE: Inequality in sex representation must be addressed as basic science and translational research creates the foundation for subsequent clinical research, which ultimately informs clinical care.