Daniels Christopher M, Dworak Theodora C, Anderson Ashley B, Brelin Alaina M, Nesti Leon J, McKay Patricia L, Gwinn David E
Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889.
Mil Med. 2018 Jan 1;183(1-2):e162-e166. doi: 10.1093/milmed/usx061.
Women account for approximately 15% of the active duty US Army, and studies show that women may be at an increased risk of musculoskeletal injury during sport and military training. Nationally, the field of orthopedic surgery comprises 14% women, lagging behind other surgical fields. Demographics for US Military orthopedic surgeons are not readily available. Similarly, demographic data of graduating medical students entering Military Medicine are not reported. We hypothesize that a gender disparity within military orthopedics will be apparent. We will compare the demographic profile of providers to our patients and hypothesize that the two groups are dissimilar. Secondarily, we examine the demographics of military medical students potentially entering orthopedics from the Uniformed Services University of the Health Sciences (USUHS) or the Health Professions Scholarship Program.
A census was formed of all US Army active duty orthopedic surgeons to include staff surgeons and residents, as well as US Army medical student graduates and orthopedic patients.
There are 252 Army orthopedic surgeons and trainees; 26 (10.3%) are women and 226 (89.7%) are men. There were no significant demographic differences between residents and staff. Between 2014 and 2017, the 672 members of the USUHS graduating classes included 246 Army graduates. Of those, 62 (25%) were female. Army Health Professions Scholarship Program graduated 1,072 medical students, with women comprising 300 (28%) of the group. No statistical trends were seen over the 4 yr at USUHS or in Health Professions Scholarship Program. In total, 2,993 orthopedic clinic visits during the study period were by Army service members, 23.6% were women.
There exists a gender disparity among US Army orthopedic surgeons, similar to that seen in civilian orthopedics. Gender equity is also lacking among medical students who feed into Army graduate medical education programs. The gender profile of our patient population is not reflected by that of providers. Because patients prefer providers of the same gender, this is a limitation to patient satisfaction and access to care for musculoskeletal injuries. Further study is underway to identify perceptions and potential causes of these disparities, including the critical perspective of our patients. In addition to the inherent benefits offered by diversity (e.g., expanding the talent pool and more perspectives for decision-making), ultimately it affords a greater ability to maintain a fit and ready force.
女性约占美国现役陆军的15%，研究表明，女性在体育和军事训练期间发生肌肉骨骼损伤的风险可能更高。在全国范围内，整形外科领域女性占14%，落后于其他外科领域。美国军队整形外科医生的人口统计学数据不易获取。同样，进入军事医学领域的毕业医学生的人口统计学数据也未被报道。我们假设军事整形外科领域存在性别差异。我们将比较医疗服务提供者和患者的人口统计学特征，并假设这两组人群存在差异。其次，我们研究了可能从健康科学统一服务大学（USUHS）或卫生专业奖学金计划进入整形外科的军事医学生的人口统计学特征。
对所有美国陆军现役整形外科医生进行普查，包括外科医生和住院医师，以及美国陆军医学生毕业生和整形外科患者。
有252名陆军整形外科医生和学员；26名（10.3%）为女性，226名（89.7%）为男性。住院医师和外科医生之间在人口统计学上没有显著差异。2014年至2017年期间，USUHS毕业班的672名成员中有246名陆军毕业生。其中，62名（25%）为女性。陆军卫生专业奖学金计划培养了1072名医学生，其中女性占300名（28%）。在USUHS或卫生专业奖学金计划的4年期间未观察到统计趋势。在研究期间，陆军现役军人共进行了2993次整形外科门诊就诊，其中23.6%为女性。
美国陆军整形外科医生中存在性别差异，与民用整形外科领域的情况类似。进入陆军毕业后医学教育项目的医学生中也缺乏性别平等。我们患者群体的性别特征并未在医疗服务提供者中得到体现。由于患者更喜欢同性别的医疗服务提供者，这对患者满意度和肌肉骨骼损伤护理的可及性构成了限制。正在进行进一步研究，以确定这些差异的认知和潜在原因，包括我们患者的关键观点。除了多样性带来的固有好处（例如，扩大人才库和为决策提供更多观点）之外，最终它还能提供更强的能力来维持一支健康且随时待命的部队。
