SICOT

Women in Orthopaedics: Sweden

Anna Ekman   Stockholm, Sweden

During medical school, I decided quite early to specialise in surgery. Back then I did not realise that Orthopaedic surgery was its own speciality. I thought it was a subspeciality to general surgery. So I started doing general surgery in a smaller hospital in Sweden, where you during calls also did orthopaedic surgery (fractures). I did general surgery for three years, thinking that the bone part of it was the best. It never occurred to me that I could become an orthopaedic surgeon. Maybe it was because I had never seen a female orthopaedic surgeon, I do not know. On the other hand, I had heard about one female general surgeon. One day the Head of the orthopaedic section asked me if I wanted to become an orthopaedic surgeon, because he liked the fracture surgery I had done during calls. I guess that if I had not been invited, I would still be doing ileuses. I think that one difference between genders, in this sense, is that as a young female surgeon you are even more dependent on goodwill and acceptance. 

I went on to a university hospital and eventually I became a trauma surgeon, and I am now the head of the trauma department. I think that my situation, being a Swedish female orthopaedic surgeon, has been much easier than for women in many other countries, Sweden being a country with a rather high equality of opportunity between women and men. I have four children, and I have always worked full time, and that would have been impossible without the day nursery system that we have.

During my training, it happened quite often that patients mistook me for a nurse, it actually still happens, but you get so used to it that it becomes no big deal. I have never met a patient who refused to be treated by a woman, not that I can remember. When I started doing fracture surgery, my boss back then automatically thought that I was the one who was going to do foot and ankle or upper limb, but I was more interested in lower limb, and that was the first time that I realised I had actually hit the glass roof. I ignored his wish and went on predominantly with lower limb.

I think that asking a senior female orthopaedic surgeon about the situation for female orthopaedic surgeons in general today, there might be a problem with “selection bias”, at least when I think of myself. This is partly because I have almost become a priviliged “silver wolf” myself, and I am afraid that I no longer see obvious drawbacks around me. I also believe that for a woman to have chosen orthopaedic surgery back then, it took a certain kind of personality with a somewhat thicker skin, and also a short memory.

I am a national, regional and international AO faculty member, and going abroad to congresses and meetings is nowadays the only occasion when I always feel somewhat inferior. I have never been asked for advice by an international colleague during a break or a dinner. They ask another man or the other men in the group and talk to me about their summer holiday or their kids.

Sweden has 2,267 orthopaedic surgeons and 288 of them are women (13%). I do not know how many of them are doing hospital bound surgery, paediatric surgery, arthroscopic surgery, etc. The share is rising though. In my hospital, the head of the orthopaedic department is a female professor and we have quite a lot of female residents who are very talented and I hope they will be interested in trauma.

It always strikes me as a little bit odd that I am supposed to have some kind of answer to the question why there are so few female orthopaedic surgeons, or why women do not stay in orthopaedic surgery. I do not think that that is a question for me, but rather a question that the male majority of orthopaedic surgeons should pose themselves.