Women in Spinal Surgery: dispelling myths and improving opportunities

Women in Orthopaedics

Women make up more than 50% of medical students in the UK, few go on to become orthopaedic or neurosurgical registrars and there are very few female spinal surgeons in the UK. 

In the USA between 12-13 % of the orthopaedic and neurosurgical trainees are female². BOTA (British Orthopaedic Trainees Association) state that women make up approximately 25% of orthopaedic trainees in the UK. The attrition rate of these trainees is approximately 3% in both neurosurgery and orthopaedic surgery³

The same potential dissuaders for women going into orthopaedic surgery (a perception of poor work life balance, a perception that too much physical strength is required and a lack of mentorship¹ ) exist also for spinal surgery. In addition there are other factors that put off orthopaedic trainees from the profession including a perception of the low success rate of spinal surgery, the psychological and psychosocial aspects with spinal disorders and the high level of litigation⁴.

Can you do it?

YES YOU CAN ! As one of the few female spine surgeons in the UK, I have come to know most of the other female colleagues in our community. When asked about how they came to spinal surgery as a career, almost all had had spinal surgeon consultant mentors who had supported them and guided them in their aspirations, and many of them had been exposed to spinal surgery at a pre-registrar  level. This was also my experience, and I feel strongly that exposure to spinal surgery is essential to develop an interest in the field. Once that interest is nurtured then any perceived ‘block’ to the entering the profession can be overcome with support and encouragement.

In order for more women to think of spinal surgery as an achievable career, we should encourage female junior doctors and medical students to come to spinal surgery cases, in equal proportion to the male junior doctors and medical students. Discussion about what is required to become a spinal surgeon should be brought to the fore and myths about the strength required to perform the surgery or that the surgery is too complex for women should be dispelled. Rather, we need to show that spinal surgery should appeal to those who display excellent manual dexterity and intellect that knows no gender boundary. 

As a community, we must support female trainees that wish to take maternity leave or work part time. This support must be visible and promoted to make the specialty attractive to women who want to be able to balance work and family life. 

Are you interested in spines - We can support you?

Finally, any female spinal surgeons should be encouraged to be visible role models in spinal societies and medical education where they can inspire new generations of female spinal surgeons.

The British Orthopaedic Association and the British Association of Spinal Surgeons consider this an important issue, and have created diversity action groups to bring these issues to the fore and to encourage minority groups, of which women make up the smallest, to join, contribute, and have their voices heard. 

If you wish to join the Diversity Inclusion Group of Spine Surgeons or wish to talk about any of these issues, please email: diversity@spinesurgeons.ac.uk

Hui-Ling Kerr, FRCS, MSc Med Ed (hons), Consultant Spinal Surgeon, Gloucestershire

January 2021

1)    Rohde RS. Wolf JM. Adam JE. Where are the women in orthopaedic surgery? Clin Orthop Relat Res 2016: 474: 1950-1956

2)    Renfrow JJ. Rodriguez A. Liu A. Pilitsis JG. Samadani U. Ganju A. Germano I. Benzil D. Wolfe SQ. Positive trends in neurosurgery enrollment and attrition: analysis of the 2000-2009 female neurosurgery resident cohort. J Neurosurg 2016: 124: 834-839

3)    Hampton T. Greenhalgh R. Ryan D. Das-Purkayastha. Female surgical trainee attrition. RCS The Bulletin. 2016: 98: 134-137

4)    Conn KS. Sharp DJ. Gardner AD. Orthopaedic Specialist Registrar training and attitudes to spine surgery in the United Kingdom: reasons for poor recruitment and suggestions for improvement