Orthopedic surgery has the lowest percentage of women of any major medical specialty in the United States. Only 6% of actively practicing orthopedic surgeons are women, and women make up just 12.1% of academic orthopedic faculty nationally. The gap starts early, persists through training, and is reinforced by a cycle of cultural and structural barriers that compound at every stage of a surgeon’s career.
The Numbers at Every Level
Women account for roughly half of all medical school graduates in the U.S., yet they represent only about 17% of applicants to orthopedic residency programs. That’s a striking drop-off compared to other surgical specialties, where women’s representation is significantly higher. Among those who do enter orthopedic training, women made up 19% of residents in allopathic programs during the 2021-2022 academic year, a modest increase from the 10.9% to 14.4% range seen between 2006 and 2014.
At the faculty level, the picture narrows further. Of 4,303 faculty members associated with orthopedic residency programs, only 524 (12.1%) were women. And at the very top, the number of female orthopedic department chairs in U.S. medical schools only reached double digits for the first time in the 2023-2024 academic year, up from a single chair in 2015-2016.
The Strength Myth Still Matters
One of the most persistent stereotypes about orthopedic surgery is that it requires extraordinary physical strength, that it’s a specialty for athletes who can muscle through procedures involving bones, joints, and power tools. This perception discourages many women from considering the field in the first place, even though it’s largely outdated. Modern orthopedic surgery relies heavily on refined techniques, specialized instruments, and biomechanical tools that reduce the physical demands of procedures. Mental precision, spatial reasoning, and technical skill matter far more than brute force.
Still, the image sticks. Medical students form impressions of specialties early in their training, often during clinical rotations where they observe and absorb the culture. If orthopedics is presented or perceived as physically grueling in a way that implicitly excludes women, fewer women explore it further.
Too Few Mentors, Too Much Demand
Mentorship is one of the strongest predictors of specialty choice. Among orthopedic residents who had a mentor during medical school, 84% said that mentor influenced their decision to pursue orthopedics. Medical students consistently rank “exposure to orthopedic role models” as one of the most important functions of mentorship when considering the field.
This creates a self-reinforcing problem. With so few women in orthopedic faculty positions, the small number of female surgeons who are available get stretched thin. As one female resident described it: “Because there are so few female attendings, they do their best to be available for students but tend to be frequently sought out by students and residents of all genders.” The mentors who could most effectively recruit women into the field are also the most overburdened.
Interestingly, gender concordance in mentorship (having a mentor of the same gender) mattered most to trainees, the people at the exact point of deciding whether to enter orthopedics. This suggests that the presence of even a few more women in visible faculty and leadership roles could shift the pipeline meaningfully. Orthopedic program directors themselves most frequently cite the lack of diversity in their departments as the primary barrier to recruiting students from underrepresented groups.
Women Leave Training at Higher Rates
Getting into an orthopedic residency is only part of the challenge. Between 2001 and 2018, female orthopedic residents left their training programs at more than double the rate of male residents: 5.96% compared to 2.79%. Even when looking only at unintended attrition (residents who didn’t choose to leave voluntarily), women’s rate was twice as high, at 2.09% versus 1.01%.
To put it another way, women averaged 12.9% of all orthopedic residents during that period but accounted for 24% of those who left. The reasons behind this disparity are complex and likely include workplace culture, isolation as a gender minority, lack of support systems, and the difficulty of navigating a demanding surgical residency without many peers or mentors who share your experience.
Pregnancy and Radiation Concerns
Orthopedic surgery involves frequent use of fluoroscopy, a type of real-time X-ray imaging used during many procedures. For surgeons who become pregnant, this raises legitimate safety questions about radiation exposure to the developing fetus. Regulations in the U.S., U.K., and Europe allow pregnant surgeons to choose their level of participation in fluoroscopic procedures, and specific dose limits apply to protect both the pregnant worker and the unborn child.
In practice, this means a pregnant orthopedic surgeon may need to step back from certain cases or take additional protective measures, which can affect her caseload, training progression, and standing among colleagues. While the actual radiation doses from common orthopedic procedures can be managed safely, the perception that pregnancy is incompatible with orthopedic practice adds another layer of deterrence. In a specialty where residency alone lasts five years, with fellowship often adding another one or two, the overlap between peak training years and childbearing years is nearly unavoidable.
Programs That Are Making a Difference
The Perry Initiative, a nonprofit founded in 2009, was designed specifically to break this cycle. The organization runs hands-on outreach programs for high school and medical school women, giving them direct exposure to orthopedic surgery techniques, mentorship from women in the field, and a chance to challenge the stereotypes that keep many from considering the specialty. Since its founding, The Perry Initiative has reached over 12,000 women through its various programs.
The results are notable. Among participants in the Medical Student Outreach Program who were eligible to match into residency, 20% matched into orthopedic surgery, a rate higher than the current national percentage of women in orthopedic residencies. Survey data also shows the program positively shifted participants’ perceptions of and interest in orthopedics. The core approach is straightforward: give women early exposure, connect them with role models, and directly counter the myths about who belongs in the field.
Why the Gap Persists
No single factor explains the gender disparity in orthopedic surgery. Instead, it’s a series of barriers that layer on top of each other. The strength myth discourages interest early on. The scarcity of female mentors means fewer women get recruited into the pipeline. Those who do enter training face higher attrition rates and a culture where they are a distinct minority. Pregnancy and family planning concerns add practical complications that disproportionately affect women. And the tiny number of women in leadership positions means there are few people with the authority to change department culture from the top.
The trend lines are moving in the right direction. Women now make up 19% of orthopedic residents, up from around 11% a decade and a half ago. But at that pace, parity is still decades away. The field is starting from a deeper deficit than nearly any other medical specialty, and closing the gap will require sustained effort at every stage, from who sees orthopedics as a possibility to who stays long enough to become the next generation of mentors.