The lack of gender diversity in orthopaedics may be old news, but an article published in 2018 in The Journal of Bone & Joint Surgery offered a view by specialty society. The data may be sobering to subspecialties, but initiatives undertaken by the American Orthopaedic Foot & Ankle Society (AOFAS) offer a model that other societies and organizations may emulate to engage women and support them in leadership roles.
Several events at the most recent AOFAS Annual Meeting were designed to celebrate and connect women in the subspecialty. The Women’s Reception has been an ongoing event for three years. Additionally, Judith F. Baumhauer, MD, MS, MPH, and Kelly C. Stéfani, MD, PhD, were honored as recipients of the 2019 AOFAS Women’s Leadership Awards.
Dr. Baumhauer, clinical professor, foot and ankle fellowship director, associate chair of academic affairs, and Patient-reported Outcomes Measurement Information System medical director at the University of Rochester Medical School, said of winning the award: “[This] is a highlight of my career, to be recognized for a leadership award by my peers. It doesn’t get any better than this.”
Dr. Baumhauer is a recognized front-runner in patient-reported outcomes as well as general foot and ankle research. She was the first female president of AOFAS in 2011–2012, she is a past president of the American Board of Orthopaedic Surgery and the Eastern Orthopaedic Association, and she continues to be actively involved in many aspects of AOFAS.
The leadership award was developed during the 2016–2017 AOFAS presidency of Thomas Lee, MD, who shared his motivation and perspectives to engage women in AOFAS during a recent interview. Dr. Lee emigrated with his family from China when he was six years old. Cultural assimilation as a minority in Columbus, Ohio, taught him to “find pride in who you are and celebrate it.” That ethos directs Dr. Lee’s respect for the women in his world, personally as the father of daughters and professionally in his work with female surgeons.
Inspired by an AAOS Now article on gender diversity, the hallmark of his presidency revolved around an open discussion on opportunities for women in AOFAS. Topics included bringing women into society leadership roles and addressing the absence of women at the podium for meetings and courses. “As orthopaedic surgeons, we are always in a position of leadership,” said Dr. Lee. He believed that formally recognizing the women who have pushed boundaries in the field of foot and ankle was a way to motivate other women to follow the leadership example. Further, an international leadership award gives gender diversity an even larger exposure.
This coincided with efforts of A. Holly Johnson, MD, and Rebecca Cerrato, MD, to better understand the goals and potential barriers of the female membership of AOFAS in light of underrepresentation of women at the podium and in leadership positions. In a survey distributed to the 228 female members, respondents expressed overall positivity but acknowledged a lack of transparency in the leadership process within the society. Dr. Lee and the AOFAS Board responded in full force: They actively backed a more prominent Women’s Reception at the AOFAS Annual Meeting and helped establish the Women’s Leadership Task Force, initially including Drs. Johnson, Cerrato, and Lee, as well as Foundation President Scott Ellis, MD, and AOFAS Executive Director Elaine Leighton. The role of the task force is to identify and act on ways the society can support, acknowledge, and promote women within AOFAS.
Dr. Baumhauer believes that the task force and leadership awards have been crucial to motivate and celebrate women who “want it all.” She stated, “Often, we give lip service to diversity, … [but] Dr. Lee, the initiator of the award, along with other women, men, and industry [sponsors], certainly highlight women in [this] field … and put women’s leadership in the spotlight.”
In 2018, two inaugural AOFAS leadership awards were presented: Su-Young Bae, MD, PhD, of the Inje University Sanggye Paik Hospital in South Korea, received the International Leadership Award. Dr. Bae is the only female foot and ankle orthopaedic educator in South Korea. Ruth Thomas, MD, clinical professor of orthopaedics at the University of Arkansas, was honored with the domestic Leadership Award. She has been actively involved in AOFAS committees, leadership positions, and overseas humanitarian missions throughout her more than 25-year career. In addition, she has directed the Perry Initiative in Arkansas and led the foot and ankle program at the University of Arkansas for Medical Sciences for more than 20 years. As an early leader in her field, Dr. Thomas now believes that “the door is finally opening wide for women to assume leadership roles in the world of orthopaedics.” She said she is very proud to have helped “in some small way to pave the way.”
AOFAS has developed other ways to promote gender and racial diversity. As part of the Physician Wellness Webinar Series, AOFAS has partnered with experts from the Ruth Jackson Orthopaedic Society (RJOS) and J. Robert Gladden Orthopaedic Society. Christen Russo, MD, chair of the RJOS Mentoring Committee, moderated “Mentoring in a Diverse Workforce,” during which faculty addressed the importance of early exposure and mentoring and training of candidate surgeons who might be overlooked. Intersectionality was discussed, as was the interconnectedness of overlapping social categorizations, with suggestions for strategies to identify and address the various dimensions of diversity.
Another webinar, moderated by Sandra Klein, MD, addressed work-life balance and burnout. Faculty members provided specific examples and solutions to help all surgeons facing these challenges, with a focus on how women may be specifically impacted.
Seeking additional ways to better facilitate inclusiveness and increase female applicants, AOFAS recently changed the upper age limit for the AOFAS Traveling Fellowship from 45 years to 49 years. Of 79 participants in the prestigious two-week fellowship, only five have been women since its inception in 2005. Many women and men are unable to take extended time away if they have young children. The Awards and Scholarship Committee believes that the increased age limit may help surgeons feel more comfortable leaving home responsibilities during the fellowship, leading to a more diverse applicant pool.
With strong leadership support, AOFAS has implemented programs to encourage and support women in the subspecialty. Other orthopaedic societies and organizations seeking to attract women may consider similar methods.
A. Holly Johnson, MD, currently serves as a member-at-large on the AOFAS Board of Directors. She specializes in foot and ankle at the Hospital for Special Surgery in New York, N.Y.
Alexandra Page, MD, FAAOS, is immediate past president of RJOS and secretary-elect of the AAOS Board of Specialties. An AOFAS member, she has a foot and ankle private practice in San Diego.
- Chambers CC, Ihnow SB, Monroe EJ, et al: More women in orthopaedic surgery: population trends in trainees and practicing surgeons. J Bone Joint Surg Am 2018;100:e116.