More women are joining the medical field every day. In fact, more women are now in medical school than men. But equitable gender representation continues to be an uphill battle in orthopedics, which has the lowest percentage of women in any surgical specialty. At the current rate of change, it will take more than 200 years for orthopedic surgery to achieve gender parity with the overall medical profession, according to a study published in Clinical Orthopaedics and Related Research.
Only 8% of orthopedic surgeons are women, and Texas Orthopedics is proud to have two female orthopedic surgeons on our team – Dr. Barbara Bergin and Dr. Kelly Cline – alongside female physical medicine and rehabilitation specialist – Dr. Ai Mukai.
In honor of International Women’s Day, they reflect on their journey as female physicians and share their hope for future generations of women in medicine.
What is the biggest obstacle you’ve had to overcome in your career?
Mukai: Being a first-generation doctor from an immigrant family with a single mother, I did not have anyone in my family to guide me throughout the process. Luckily, I had many amazing mentors who took me under their wings and got me to where I am today. I only hope to pay it forward by mentoring my residents and students the same way.
Bergin: Needless to say, I struggled in my training. There were no other female residents and certainly no attendings with whom to establish a mentorship. The surgeons lounge was never a place of peace for me. I was more comfortable in the nurses’ lounge, or the internal medicine call room, than the surgery lounge or call room. Some of that has not changed much. Let’s face it. The guys prefer to talk shop with the guys. When I’m scrubbing my hands for surgery, it’s rare for a male surgeon to come up and start a conversation. It’s just not in their comfort zone. I’m taller than most of them, and that’s scary.
Raising a family was complicated, to say the least. For some reason, most women surgeons are married to career-oriented husbands, so there’s no one to “stay-at-home” with children. We all have to rely on family or nannies. It’s that way for all working women. We’re torn between kids and work…always. Male surgeons have little empathy. They think, “I had kids too. What’s the big deal.” It should go without saying that it’s different. And yet, it has to be said.
For a female orthopedic surgeon, a capable partner who is totally and naturally inclined* to divide and conquer the duties of a household, is paramount to the well-being of the family and the woman’s medical practice. I’ve been fortunate there.
Cline: One of the bigger obstacles being in a male-dominated field like orthopedics has been trying to avoid feelings of isolation and imposter syndrome. When you constantly work in a field where there are very few people around who look like you and are similar, it can be a lonely feeling. But above feeling a little left out of the “boys club”, it can also make you start to doubt your abilities. There have been many (many) times when I have had to shake imposter syndrome and remind myself that I completed the same amount of training, earned the same accolades, and now do the same surgeries as my male counterparts.
How have you seen women’s representation and equity grow in your field over your time in practice?
Mukai: The current president of the AAPM&R (the American Academy of PM&R) is a woman – Dr. Deb Venessy. We have had several female presidents and the Academy has been great about making sure there is representation and inclusion of physiatrists of all backgrounds.
Bergin: There’s been a huge push to encourage women to enter the field of orthopedics, simply because it’s been the last specialty to field the expected increases in female applicants, lagging way behind the numbers of women applying to medical school. And the push has worked. In the past few years, we’ve seen a dramatic increase in female applicants to orthopedic surgery residencies. The face of orthopedic surgery is slowly but surely changing.
Cline: I am still newer in the field, but I do have hopes about women’s representation increasing in orthopedics! While women are still very under-represented, we have now had the first female president of the American Academy of Orthopedic Surgeons, which is a huge accomplishment. I am hopeful that we can continue to recruit more women into the field, and also hope that I can be a small part of recruiting!
What barriers still exist for women in your field?
Mukai: Women in medicine do have the difficult task of trying to balance personal/family obligations with their careers. It can also be exhausting to be a caregiver in personal life as well as in professional life and burnout and exhaustion can be intensified, especially with the impact of COVID-19. I am lucky to have found a group of men and women in my group who are generally supportive and respectful of each other. I think the tone and culture of our group was influenced by the fact that Dr. Bergin, a female orthopedic surgeon, was one of the founding partners.
Bergin: I believe there are few to no barriers for women in orthopedics. There is no reason a woman should not consider orthopedic surgery as a viable career. But, to be honest, the full-time practice of medicine and having a family remains complicated. Many female physicians feel the need to work part-time, take sabbaticals, or leave clinical practice. Surgical practice introduces another level of complexity because it is necessary to develop and maintain surgical skills. It’s almost impossible to do surgery part-time or take an extended break while raising children.
Cline: One of the barriers that is still very prevalent for women in orthopedics is conveying to patients and families that you are, in fact… the actual surgeon! I will get through an entire pre-surgery visit, explain in very significant detail the procedures, explain all of the post-surgical care, and get to the very end of an appointment just to have the patient and family ask “when are we going to get to meet the surgeon??” It’s becoming more and more common to hear that question, and less and less surprising now when I get asked… but hopefully people will start to realize that orthopedic surgeons come in all different shapes and sizes!!
What advice do you share with other female physicians and/or those interested in your field?
Mukai: Understand that your priorities and goals will evolve and change over time. Be ready to have options and be adaptable.
Bergin: I mainly enjoy sharing the many wonderful aspects of a career in orthopedic surgery. Women naturally make great, caring docs, and it’s no different for orthopedic surgeons. I tell them they can do it all; have a wonderful, fulfilling career, and a family. We are the child-bearers. We can do it all.
I tell them not to waste time with potential partners they have to take care of too. Their partners must come into the relationship with an egalitarian approach to the woman’s position in the workplace and family. Otherwise, it will never work out. It’s wonderful to be at the end of an amazing career and have two wonderful kids and a wonderful hubby (nephrologist).
Cline: If you have a passion for something, you can do it!! When it comes to orthopedics, don’t let someone tell you that you’re not strong enough. Don’t let someone tell you you’re not tough enough. Don’t let someone convince you that you can’t do it. YOU CAN! If I would have listened to the many naysayers during my training and education, there is no way I could be doing what I do now. You just have to block out the negativity and stay close to the mentors and positive influences in your life that are right there alongside you telling you “you can do it!!!”
Drs. Bergin, Cline and Mukai all agree that diversity plays an important role in patient care and the doctor-patient relationship. When a patient has the opportunity to see a physician that looks like them, or speaks their native language, it helps build a trust that is integral in helping patients heal and get back to the activities they enjoy.