104 - A Comparative Analysis of Factors Influencing Women's Specialty Choice in Orthopaedics versus Physical Medicine and Rehabilitation

Objectives: Efforts to boost gender diversity in medicine saw women comprising 50.6% of 2021 U.S. medical school graduates. This representation sharply drops within orthopaedic surgery where only 18.3% of residents and 5.6% of active orthopaedic surgeons in 2021 were women. This is contrasted to physical medicine and rehabilitation (PM&R), where 34.3% of residents and 35.8% of active physiatrists in 2021 were women. This study compares factors impacting women’s decision to pursue their respective fields to identify opportunities for systemically promoting fair representation.

Design: A 48-question survey was distributed to women practicing orthopaedics and a 51-question survey was distributed to women practicing PM&R. Questions included close-ended, open-ended, and identifiers on a 4-point modified Likert scale. Study data were collected using REDCap electronic data capture tools.

Results: There were 299 responses to the orthopaedics survey and 102 responses to the PM&R survey. Regarding negative experiences, 7.3% of PM&R respondents versus 28.2% of orthopaedics respondents reported experiencing sexual harassment. 11.5% of PM&R respondents versus 79.2% of orthopaedics respondents reported witnessing sexist comments or behaviors. Furthermore, 13.7% of PM&R respondents versus 60.6% of orthopaedics respondents reported an unwelcoming environment. Regarding positive experiences, 68.6% of PM&R respondents versus 71.6% of orthopaedics respondents found exposure to the field encouraging. 69.6% of PM&R respondents versus 87.4% of orthopaedics respondents reported that having a mentor in the field was encouraging.

Conclusions: Stark differences were reported especially with sexist behaviors or comments, illustrating a dichotomous environment between orthopaedic surgery and PM&R, despite both being predominantly male-dominated fields. This high degree of pervasive behavior readily experienced within orthopaedics is not present within other specialties, necessitating further investigation into the toxicities which discourage and prevent women from entering the field.