DIVERSITY & INCLUSION
A BRIEF AND PERSONAL ORTHOPEDIC HERSTORY AUTHOR Star L . Nixon , MD / MPH , FAAOS , ABOS-certified
When I was applying to medical
school , I had no intention of being an orthopedic surgeon . I was going to be an OB-GYN like my mother and my late stepfather . I knew early on in medical school that I wanted to do a procedure-based specialty after I was allowed to participate in a case to reverse a volvulus in a young child . Having hurdled the first step of my career - choosing surgery versus medicine - I thought for sure I would follow in my family members ’ footsteps in caring for women with high-risk pregnancies . However , it was during our musculoskeletal curriculum in second year when the chair of orthopedics said that the treatment of their patients boiled down to “ decreasing pain and improving function .” And then it all clicked . In my personal life , I had seen orthopedic surgeons do this very thing in helping friends and family resume normal activities again after surgery for arthritis . The realization that orthopedists could make such a big difference in a patient ’ s quality of life ( and in a relatively short period of time ) changed the course of my career path .
Orthopedic surgery has been practiced for millennia . One of the oldest examples of orthopedic surgery , unearthed in a 7,000-year-old stone age skeleton , was the discovery of a well-healed trans-humeral amputation . 1 Splinting materials and crutches have even been excavated from Egyptian tombs . However , it wasn ’ t until 1741 when Nicolas Andry de Bois-Regard coined the term “ Orthopaedics ” ( which is derived from a combination of Greek words that essentially mean “ straight children ”) that the specialty got a name . And , since then , the specialty has grown tremendously from a field that mostly dealt with treating injuries and pediatric deformities to one
that treats complex conditions involving the entire musculoskeletal system . What has not grown along with the breadth of the field itself is the participation of women in modern orthopedic surgery . While the numbers of women entering medical school have nearly equalized those of men , the same cannot be said of women entering orthopedic training programs .
Unlike many other women who are contemplating a career in medicine or choosing a specialty , I was privileged to have had early exposure to musculoskeletal medicine in medical school , supportive clinical faculty during my surgery clerkship and a role model in my family . During third year , I was allowed to do orthopedics as part of my surgery clerkship , and I sought mentorship from our orthopedic faculty . For the most part , they were very welcoming , but none of them were women and I definitely steered clear of the ones who were rumored to believe “ women didn ’ t belong in orthopedics .” According to a survey of members of the Ruth Jackson Orthopedic Society ( an association of women orthopedists named after the first female member of the American Academy of Orthopaedic Surgeons ), one of the most common potential deterrents to considering a career in orthopedics is the lack of early exposure to the specialty , as well as lack of suitable mentors . I witnessed firsthand my mom juggling a busy and successful career in obstetrics while rearing children , so I was able to more easily envision myself being a busy surgeon while having a family and a “ real life ” outside of medicine . However , I certainly believe that not having these positive experiences would be a significant deterrent for other candidates . A recent paper defined the concept of “ paradigmatic trajectories ” to describe how medical trainees may or may not envision a particular career path due to the presence ( or lack ) of role modeling , community examples , social expectations and so forth . 2 This concept is applicable to women in orthopedics as well as underrepresented minorities . 3
8 LOUISVILLE MEDICINE