JTO
02 Mar 2020

JTO - March 2020

Volume 8 Issue 1

From the Executive Editor

Now go back and look at the front cover. Who is scrubbing up? Man or woman? If a man, did you presume them to be a surgeon or a nurse? If a woman, a surgeon or a nurse?

Now look at ourselves; the T&O establishment does not exhibit great diversity. Currently the BOA has no women elected trustees (we believe there have only ever been three), the FRCS (T&O) has few women examiners, at the Congress in 2019 the number of ‘Manels’ (men only panels) was noted and criticised. Whilst there is change in our world of T&O practice, this is gradual. Much of this issue is themed to tie in with International Women’s Day, and to celebrate and champion female surgeons across the globe. We debated how to encourage readers to actually read the section on diversity, and in particular what to put on the front cover. A collage of women surgeons, whilst straightforward, would I feared (as a grey haired white male) appeal primarily to the converted. Whereas ‘the anonymous person scrubbing’ was placed front and centre to entice all of us to briefly consider our own assumptions and then perhaps, be persuaded to read the many relevant articles in this issue. We cannot control everything, but all of us can and should aim to play our part in creating an environment where medical students, juniors and consultants have no barriers, either real or perceived to a full career in T&O Surgery, apart from the need to demonstrate sufficient ability, aptitude and enthusiasm.

However diverse the T&O workforce may be it will have to comes to terms with and negotiate a changing landscape. The changes for the requirements of a trainee are introduced in ‘Implementation of the new T&O curriculum’ (page 24). The article on the National Orthopaedic Alliance (page 29) gives background to an organisation of which we may have heard and indeed which affects us but of which most of us have little or no understanding. We are not just affected by our own parochial organisational changes but those to the law in general, John de Bono asks ‘What is consent?’, and so should we. Whilst
this article relates primarily to elective practice the awkward issue of consent in non-elective work will be dealt with in a future issue.

The issue includes a letter to the editor on page 23, in this case relating to supracondylar fractures. We do not get many letters, I am hoping this is because they have not been encouraged rather than a lack of interest. However, with an online facility for the JTO we are in a position to publish a precis in the printed version and the full letter online; correspondence is now welcome.

This issue of JTO and a significant component of the agenda outlined by Don McBride in his ‘From the President’ relates to diversity. How this is manifest in opportunities for women is often used as a barometer for diversity in general as this is readily measured. However, career progress based on ability, aptitude and enthusiasm should apply to all.

Bob Handley, Vice President Elect

 

Subspecialty Section

References

Should women do orthopaedics? A topic explored at the Future Women of Orthopaedics event at St George’s University of London

1.         Miller EK, LaPorte DM. Barriers to Women Entering the Field of Orthopedic Surgery. Orthopedics. 2015;38(9):530-3.

2.         Rohde RS, Wolf JM, Adams JE. Where Are the Women in Orthopaedic Surgery? Clin Orthop Relat Res. 2016;474(9):1950-6.

3.         Bellini MI, Graham Y, Hayes C, Zakeri R, Parks R, Papalois V. A woman's place is in theatre: women's perceptions and experiences of working in surgery from the Association of Surgeons of Great Britain and Ireland women in surgery working group. BMJ Open. 2019;9(1):e024349.

4.         O'Connor MI. Medical School Experiences Shape Women Students' Interest in Orthopaedic Surgery. Clin Orthop Relat Res. 2016;474(9):1967-72.

5.         Harrington MA, Rankin EA, Ladd AL, Mason BS. The Orthopaedic Workforce Is Not as Diverse as the Population It Serves: Where Are the Minorities and the Women?: AOA Critical Issues Symposium. J Bone Joint Surg Am. 2019;101(8):e31.

6.         Moberly T. Number of women entering medical school rises after decade of decline. BMJ. 2018;360:k254.

7.         NHS Digital (2019). HCHS doctors by specialty group, specialty, grade and gender, Sept 2009 to March 2019 AH2736. Available from: https://digital.nhs.uk/data-and-information/find-data-and-publications/supplementary-information/2019-supplementary-information-files/hchs-doctors-by-specialty-grade-and-gender-sept-2009-to-march-2019-ah2736. Accessed February 2020.

8.         Neumayer L, Freischlag J, Levinson W. Demographics of today's woman surgeon. Bull Am Coll Surg. 1994;79(2):28-33.

9.         Hill JF, Yule A, Zurakowski D, Day CS. Residents' perceptions of sex diversity in orthopaedic surgery. J Bone Joint Surg Am. 2013;95(19):e1441-6.

10.        Meredyth N. Cute Little Hands. Ann Surg. 2019;270(6).

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Improving the undergraduate Trauma and Orthopaedic experience. Adoption of a modern teaching approach

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Less than full time training: Being a parent and an orthopaedic trainee

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  2. Conference of Postgraduate Medical Deans (2018). The Gold Guide - A Reference Guide for Postgraduate Specialty Training in the UK. 7th ed. Available at: https://www.copmed.org.uk/images/docs/gold_guide_7th_edition/The_Gold_Guide_7th_Edition_January__2018.pdf. Accessed February 2020.
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Supporting orthopaedic trainees returning to training after taking time out of programme

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  2. S Williams, VA Bowbrick, S Chan. Return to work for higher surgical trainees: a deanery perspective. Bulletin of the Royal College of Surgeons, 2020.
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  4. NHS Health Education England (2016). Enhancing Junior Doctor’s Working Lives - A progress report Available at: https://www.hee.nhs.uk/sites/default/files/documents/Enhancing%20junior%20doctors%20working%20lives%20-%20a%20progress%20report.pdf. Accessed February 2020.
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  7. NHS Health Education England (2018). Supported Return to Training. Available at: https://www.hee.nhs.uk/sites/default/files/documents/Supported%20Return%20to%20Training.pdf

Diversity: Women in orthopaedic surgery – a perspective from the International Orthopaedic Diversity Alliance

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