Gender Representation Among Foot & Ankle Conference Presenters and Research Authors: A 10-Year Analysis (2012-2022)

Introduction/Purpose: Today women are over 50% of medical school matriculants but remain underrepresented in orthopaedic surgery (~15% of residents and < 6% of practicing surgeons). Moreover, despite different and sometimes controversial reports, the rate of female society memberships and national and international meeting speakers as well as their contribution to leadership positions including moderating sessions, podiums, and symposiums are believed to be low. The objective of this study was to assess whether there is a gap in female representation among invited speakers at American Orthopaedic Foot & Ankle Society (AOFAS) national meetings relative to research productivity as reflected by article authorship in Foot & Ankle International journal (FAI). Methods: Programs for AOFAS specialty days and annual meetings and FAI articles from January 2012 to December 2022 were obtained. Industry-hosted programs were excluded. Gender was identified through personal acquaintance or online search on the biographies of the authors. Presentations and articles were categorized as “technical” or “non-technical”, where technical was defined as relating to basic science or the clinical practice of orthopaedics. Comparisons were done using the Chi-Square Test (significance level= p< 0.05). Results: 1,020 AOFAS presentations and 2,230 FAI articles were analyzed. Gender was unavailable for 0.19% of AOFAS speakers, 4.48% of FAI first authors and 4.13% of FAI senior authors. 11.08% of AOFAS invited national meeting speakers, 15.18% of FAI first authors and 7.40% of FAI senior authors were female. Overall, the proportion of female speakers was significantly lower than female first authors (p= 0.0036), and significantly higher than female senior authors (p < 0.001). In 2018 and 2019, women were more likely to have given “non-technical” AOFAS presentations. There was no significant difference in other years or among FAI articles. The average annual change was +2.00% female AOFAS presenters, +0.31% FAI female first authors and -0.37% FAI female senior authors per year. Conclusion: Women represented 15.16% of first authors in FAI between 2012 and 2022 but 11.08% of invited speakers at AOFAS meetings. Meanwhile, the percentage of female AOFAS membership in the organization as a whole increased from 7.5% to 13%. Thus, despite historically low rates of representation, female Foot & Ankle surgeons were proportionally represented in 2021 and 2022 among invited national conference presentations and research compared to female society membership and female research publications in FAI. There is still room to increase representation of deserving historically under-represented groups, however the increase in female AOFAS presenters demonstrates a positive trend. Figure 1. Percentage of AOFAS Female Podium Speakers and FAI Female 1st Authors, 2012 - 2022