TRUE STORIES & WISDOM

Since Drs. Marian Henrietta Frauenthal Sloane,  Ruth Jackson and Barbara Stimson began practicing orthopaedic surgery in the 1930’s, the number of women in the field has grown, albeit slowly(1).  Today, women account for 6.5% of all orthopaedic surgeons. Within that 6.5%, 79.10% are Caucasian, 9.03% are Asian, 3.09% are African American, 3.09% are Hispanic/Latino, 2.61% Multi-racial, 2.61% Other and 0.48% Native American (2).  The total percentage of female orthopaedic surgeons may now be closer to 7.4% based on additional information (1a).

Male orthopaedists are more likely to be Caucasian than female orthopaedists.  Therefore, the population of women in the field is slightly more diverse.

An on-line survey of women who belong to the Ruth Jackson Orthopaedic Society (42% of female AAOS fellows) and women who are members of the private FaceBook group “Women of Orthopaedics” (includes orthopaedic residents) reveals the following:  76.4% are married, 67.6 % have children, 66.5% were collegiate athletes, 82% had no female orthopaedic surgery mentors in undergraduate years or in medical school and 26.5% had no female orthopaedic surgery mentors during training.

The same survey  revealed that 85.5% of women consider themselves a specialist within orthopaedic surgery, 10.2%, an orthopaedic generalist with an area of specialty interest and 4.3%,  orthopaedic generalists.  The declared specialties are as follows:  Hand 25.7%, Peds 21.7%, Sports 19.6%, Trauma 11%, Foot and Ankle 9.4%, Arthroplasty 8%, Shoulder and Elbow 8%, Oncology 4.3%, Spine, adult 3.2%, Spine peds 2.1% (2).

Another survey of Ruth Jackson Orthopaedic Society  candidate and resident members asked why they chose orthopaedic surgery.  Answers were: enjoyment of manual tasks, professional satisfaction and intellectual stimulation.  When asked for reasons that might deter the choice of orthopaedic surgery, responses were:  inability to have a good work-life balance, too much physical strength required and lack of strong orthopaedic mentorship in medical school or earlier (3).

 A role model of the same gender has been reported to be a much more important influence for women, compared to men, when choosing a career (4).

From 2001 to 2018, female orthopaedic residents increased from 8.77% to 15.54% of the residency pool.   Among female residents, the overall attrition (any reason for not finishing residency) and unintended attrition (dismissal and withdrawl) rates were 5.96% and 2.09% compared with 2.79% and 1.01%, respectively in male residents.  Black/African American female residents had high attrition rates at 3.6% and 6.74% respectively.  Black/African American males also had high attrition and unintended attrition rates at 3.77% and 7.16% .  While recruitment has been the primary focus of diversity, equity and inclusion efforts, these numbers suggest that resident retention through appropriately supporting residents during training is equally critical.  Of note, 9 programs  out of 189 or 4.76%, had no female residents over the study period from 2001 – 2018 (4a).  On a very positive note, the Ruth Jackson Orthopaedic Society and the Orthopaedic Research and Education Foundation have recently awarded a research grant to Dr. Jaysson T. Brooks for his project, Understanding Factors Influencing Attrition in Orthopaedic Surgical Training (4b).

Currently, 16% of orthopaedic  surgery residents are women, the lowest percentage of all surgical specialties. If the rate of training women remains consistent and is projected over time, the percentage of female orthopaedic residents will not reach 30% until 2060! (5)

Assuming that the growth rate in the proportion of female orthopaedic surgeons remains the same as that of the 2010 to 2019 period, it will take a projected 217 years for orthopaedic surgeons to achieve gender parity with the overall medical profession (6).

It must be stated that orthopaedic mentoring and pipeline programs are now available for girls and women in their high school, colleagate and medical school years in many parts of the country.  These create exposure to female orthopaedic surgeons and an opportunity to use power tools and orthopaedic instruments with their own hands rather than to simply watch others or read about them.  These programs are described on the Creations page.  We watch with great enthusiasm to see if the trajectory of the numbers mentioned above, shifts as we go forward in time.

There have been many triumphs achieved by women in the field of orthopaedic surgery which were almost unimaginable when the Ruth Jackson Orthopaedic Society had its inaugural meeting in 1983. Women have been elected to the presidency of the American Board of Orthopaedic Surgery, the American Orthopaedic Association, and the American Academy of Orthopaedic Surgeons including its subspecialty societies. Women practice in all the orthopaedic subspecialty areas, head residency training programs, are selected for traveling fellowships and as their “godmothers”, chair academic and community orthopaedic departments, command military hospitals, initiate pipeline programs to encourage more females to pursue careers in orthopaedic surgery, do international orthopaedic service work, serve as team physicians for local, national & international sporting events, conduct research which contributes to the orthopaedic literature, and teach about musculoskeletal health using social media. Most importantly, they offer culturally competent orthopaedic care to patients as they seek to further diversify their numbers.

Statistics demonstrate that female surgeons are sued less often than their male counterparts (7). Patients treated by female surgeons had lower rates of adverse postoperative outcomes, including death and major medical complications, at 90 days and one year compared with those treated by male surgeons (8).  Female arthroplasty surgeons are significantly undercompensated versus male surgeons and surgical volume is the biggest predictor of compensation (8a).

How would the pioneering women in the field react to these facts? We will never know.  Drs. Jackson, Sloane and Stimson have passed away as have Drs. Jacquelin Perry, Liebe Diamond, Anna Brady (no photo available), Mary Sherman, Mary Williams Clark (no photo available), Roshen Irani, Francesca Thompson, Alexandra Kirkley, and Mary Morden (9, 10, 11, 12). We can no longer look to them for their wisdom & insights.  To learn more about the thoughts of these remarkable women, visit the TRIBUTE CIRCLE page where they are discussed by colleagues, friends and mentees.

Due to the excellent memory of Dr. Alice Martinson, Anna M. Brady, MD has been added to the list above.  Dr Brady is rarely mentioned as a pioneering orthopaedic surgeon.  A nurse who administered to the wounded on Normandy Beach in World War II and later became an orthopaedic surgeon, she commanded the 305th Medical Detachment in Viet Nam.  She was later promoted to full colonel in the Reserve upon her retirement.  She was the first woman admitted to the Veterans of Foreign Wars organization.  No photographs are yet available (13).

Dr. Barbara Stimson, an American, had a fascinating career and served as an orthopaedic surgeon in the British Royal Army Medical Corps during World War II.  As a woman she was prohibited from serving in that capacity in the United States military.  For her outstanding work in England, North Africa and Italy, King George VI named her a Member of the Order of the British Empire, the first American woman to recive such an honor.  In addition, she was the first woman to become board certified by the American Board of Surgery in contradistinction to the American Board of Orthopaedic Surgery.  Orthopaedic surgery once was considered a part of the field of general surgery.  Dr. Stimson’s amazing story is chronicled in a 2025 issue of The Smithsonian magazine (14, 14a, 14b).

Dr. Marian Frauenthal Sloane, the first woman licensed to practice orthopaedic surgery in New York State, has been largely forgotten as she died an untimely death from breast cancer at age 36 in 1940.  She did her internship and residency at the Hospital for Joint Diseases which was founded by her father and uncle in 1906 as the Jewish Hospital for Deformities and Joint Diseases.  She married another orthopaedic resident and together they co-authored 2 peer-reviewed articles, both of which were published in the Journal of Bone and Joint Surgery in 1936 and 1937.  This gave her the distinction of being the first US female orthopaedist to publish a scholarly article (1).  In addition there is an award presented annually in her name at NYU Langone Orthopaedic Hospital.  It is for an original clinical research paper submitted by an orthopaedic resident or recent graduate (1, 15).

Mary Stults Sherman, MD was the first American woman to pursue an academic career in orthopaedic surgery as well as being elected to membership in the American Orthopaedic Association.  She remained the first and only woman in the Orthopaedic Surgery Division of the Department of Surgery at the University of Chicago.  Despite her continued advancement in orthopaedic oncology research, she was never granted tenure.  She left the University in 1952 and moved to the Ochsner Clinic Medical Foundation in New Orleans.  She became a faculty member at Tulane University.  Among her other “firsts”, she was  the first woman to receive the Kappa Delta/OREF Clinical Research Award in 1963, was the only female charter member of the Orthopaedic Research Society and was the first woman to become an American Board of Orthopaedic Surgery oral examiner.  Her life came to a premature end when she was murdered in 1964.  The crime has never been solved.  We salute her accomplishments and memory (1, 16, 16a).

Dr. Roshen Irani was born in Iran and raised in India.  Her father, a physician, encouraged her to pursue a medical career.  She attended medical school in India and traveled to DC General Children’s Hospital of Philadelphia for her residency in orthopaedic surgery.  She won the 1963 Kappa Delta Award/OREF Clinical Research award along with her mentor, Dr. Mary Sherman.  The subject of their work was the pathologic anatomy of club foot.  She was among the first female pediatric orthopaedists in the United States (17).

Dr. Mary Powell Lewis became board certified in Orthopaedic Surgery in 1963, the 13th woman in the United Stated to do so (18).  See her obituary in Legendary Photos section.

Mary L Morden, MD was one of the Ruth Jackson Society Founding Members in 1983.  The Society was later renamed as the Ruth Jackson Orthopaedic Society.  See obituary in Legendary Photos section.

Dr. Lorraine Day focused her early career on developing the subspecialty of orthopaedic trauma.  As one of the first women in orthopaedic trauma, she promoted the foundation of the Orthopaedic Trauma Association.  She later became controversial as a result of her views on AIDS, the Holocaust and alternative cancer care (19).

Other surgeons who have passed away and should be acknowledged include Drs:  Rosamond Kane (20) and Diana Carr (21).

Drs. Helen Horstmann, Catherine Hawthorne, Laura Tosi, Jo Hannafin,  Mary O’Connor and Kristy Weber are also living pioneers and role models who have demonstrated to us that women do have a place in orthopaedic surgery.  They have served as clinicians, educators, leaders, authors, and researchers.   We are eternally grateful for their inspiration, resilience, dedication and grit.  Please refer to the LEGENDARY PHOTO section on the Menu bar to see photos of these women and many others who are also “legendary.”

Our gratitude is also extended to the female leaders, teachers, researchers, and clinicians who are not individually named here but who advocate for patient-centered care and advancement of underrepresented minorities within the profession.  You know who you are and we honor you for what you do every day.

Special recognition goes to the women and organizations who are dedicated to creating transparency in orthopaedic training programs and practice settings in order to create a more equitable and congenial workplace in which all orthopaedic surgeons can thrive.  You are beginning to alter the culture.

To capture the thoughts, words of wisdom, inspiration, unique experiences, and cautionary tales of present-day women who do orthopaedic surgery, the Accounts from the Boneyard Project was launched in 2023. It is aimed at collecting narratives from female orthopaedic surgeons, whether they be retired, actively practicing, or in their training years.

The present-day women whose stories are documented on this site, were contacted individually or through orthopaedic societies and asked to volunteer for a 60-minute video interview. They were asked to tell one true story from their practice or training years; specifically, the one that first “bubbled up” to their awareness when they thought back. Each interview was condensed into a narrative by the editor and then sent to the interviewee for additions and/or corrections. The goals were to capture the essence of what was said and to keep the storyteller anonymous. Each narrative was approved by the subject prior to posting.

The interviewees were also asked to state what they learned from their ACCOUNTS, how the information may benefit other female orthopedists, and what advice they would give to other women regarding their careers.

Volume I, containing the first 52 accounts, has been completed and is included on this site. Volume II is being published progressively over time.   Some of the Accounts are protected in a vault as they contain sensitive information.  The vault can be be accessed only by using a special password.  Each “account” is also categorized into when the event/story occurred.  See the DECADES section for the listing.

A special section, entitled TRIBUTE CIRCLES, is evolving and features women who moved the profession forward before passing away.  Together, the Accounts and Tribute Circles sections help construct a unique mosaic of women’s orthopaedic experiences and provide snapshots of orthopaedic culture at various points in time.

Finally, a new menu category entitled CREATIONS is under production.  It contains a listing and description of orthopaedic organizations created by and for women.  The breath of focus and work accomplished by these groups is immense and spectacular.  Mission statements are included along with comments about the organizations from their leadership.

The final new addition is called ORTHO FAMILIES where videos of parent/child/children orthopaedic surgeon combinations are highlighted.  The wisdom and insights gained through having family members in the profession can be invaluable and will be shared here for listeners to enjoy.  Production is now underway.

If, after reading the accounts, you are inspired to provide your own, please submit your information in the CONTACT section.

REFERENCES:

[1] Hooper JM, Santiestaban L, Levin A, Lajam CM. What’s Important: Women Trailblazers in Orthopaedics. The Orthopaedic Forum. J Bone Joint Surg Am. 2019;101:1037-38.

[1a] Peterman NJ, et al.  Gender Representation in Orthopaedic Surgery: A Geospatial Analysis from 2015-2022. Cureus. 2022 July 26;14(7)e2705. doi:107759/cureus.27305.

[2] Gardner, EC, Cheng R, Moran J, Summer LC, Emsbo, CB, Gallagher, RG, Gong, J, Fishman, FF.  Describing the women of orthopaedic surgery.  Bone Jt Open. 2024 May 20;5(5):419-425.  doi: 10.1302/2633.1462.55.BJO-2023-0073.R1.

[3] Rohde, RS, Wolf, JM, Adams, J. Where are the Women in Orthopaedic Surgery? Clin Orthop Relat Res. 2016 April 18;474(9):1950-1956.  doi: 10.1007/s11999-016-4827-y.

[4] Hill JF et al.  Resident’s perceptions of sexual diversity in orthopaedic surgery.  J Bone Joint Surgery Am. 2013; 95-A (19): e1441-6.  doi: 10.2106/JBJS.L.

[4a]  Haruno, LS, Chen X, Metzger, M, Lin, CA, Little, MTM, Kanim, LEA, Poon, SC.  Racial and Sex Disparities in Resident Attrition in Orthopaedic Surgery.

[4b] Ruth Jackson Orthopaedic Spotlight:  Dr. Jaysson T. Brooks.  Spring, 2025.

[5] Van Heest AE, Agel J, Samora JB. A 15-year report on the uneven distribution of women in orthopaedic surgery residency training programs in the United States. JBJS Open Access. 2021 May 28. doi: 10.2106/JBJS.OA.20.00157

[6] Acuna, et al. How long will it take to reach gender parity in Orthopaedic Surgery in the United States?  An analysis of National Provider Identifier Registry.  Clin Orthopedic Relat Res. 2021;479(6):1179-1189.  doi: 10.1097/CORR.0000000000001724.

[7] Guardado JR. Policy Research Perspectives: Medical liability claim frequency among U.S. physicians. American Medical Association, 2022.

[8] Wallis CJD, Jerath A, Aminoltejari K, et al. Surgeon sex and long-term post-operative outcomes among patients undergoing common surgeries. JAMA SURG. 2023;158(11):1185-1194. Doi:10.1001/jamasurg.2023.3744.

[8a] Deen JT et al. Paper 76. Presented at:  American Academy of Orthopaedic Surgeons Annual Meeting; March 10-14, 2025; San Diego.

[9] Dib AG, Lowenstein NA, LaPorte DM, Samora JB, Matzkin EG. The pioneering women of orthopaedic surgery. The Orthopaedic Forum. J Bone Joint Surg Am. 2022;00:e1(1-6).

[10] https://www.legacy.com/us/obituaries/baltimoresun/name/liebe-diamond-obituary?id=16765581

[11]  Zillmer, DA:  Ruth Jackson, MD:  A Woman of Determination and Accomplishment.  The Iowa Orthopaedic Journal, 2001;21:x-xii.

[12] Jackson, Patsy Mayes:  Ruth Jackson, MD: A Life on the Leading Edge.  BookSurge Publishing, 2007.  Also see Ruth Jackson, MD Wikipedia page.

[13] Philadelphia Inquirer Archive:  Obituary of Anna M. Brady, 86, retired surgeon.  March 7,1998; Page B4.

[14]  https://vcencyclopedia.vassar.edu/distinguished-alumna/barbara-stimson/.

[14a] Musemeche, C: Major Barbara’s War.  Smithsonian, March 2025: 38 – 45.

[14b] Haisley, KR et al:  Major Barbara Stimson, A Historical Perspective on the American Board of Surgery Through the Accomplishments of the First Woman to Achieve Board Certification.  Annals of Surgery 267(6):p 1000-1006, June 2018.

[15] https://med.nyu.edu  Marian Frauenthal Sloane Clinical Research Award.

[16] https://aoassn.org. AOA Pillar of the Orthopaedic Profession 2021; Mary S. Sherman, MD.

[16a] See Dr. Mary Sherman Wikipedia page.

[17]  https://posna@posna.org   In Memoriam to Roshen N. Irani, MD, 2007.

[18] Philadelphia Inquirer Archive:  Obituary of Dr. Mary Powell Lewis, pioneering orthopaedic surgeon, role model, mentor and tree farmer.  2024.

[19] Theodore Miclau, MD:  Acknowledgement of passing of Lorraine J. Day, MD.  https://orthosurgery.ucsf.edu.

[19a] See Lorraine Day Wikipedia page.

[20]  https://www.nytimes.com/1989/07/29/obituaries/rosamond-kane-62-orthopedic-surgeon.html

[21] https://www.legacy.com/obituaries/name/dr-diana-carr-obituary?pid=190568968

[22]  Thomas, CL (2007).  God Spare Life:  An autobiography.  Rochester, NY, WME Books.

[22a]. See Dr. Claudia Thomas Wikipedia page.