How should we intervene to increase the number of female spine surgeons? A preliminary survey of trainees in Japan from medical school through spine fellowship

抄録

Background:Women account for 23.6% of physicians in Japan yet account for only 5% of orthopedic surgeons and <1% of board-certified spine surgeons. We identified points along the training pathway where women perceive barriers to pursuing spine surgery. Methods:In this sequential explanatory mixed-methods study, we surveyed all 5th- and 6th-year medical students at our institution and postgraduate year-1–2 residents and received responses from 62 trainees (29 women, 33 men). Counts, percentages, and χ2 or Fisher exact tests were used to compare the groups. We thematically analyzed the semi-structured e-mail interviews conducted with 10 female orthopedic trainees (4 residents, 1 non-spine surgeon, and 5 spine fellows). Results:Interest in orthopedics was reported by 45% of women and 64% of men (p=0.22);within that subgroup interest in spine surgery was similar (31% vs. 33%;p=1.00). From the interviews, four categories of barriers to choosing spine surgery as a subspecialty emerged:(1) physical limitations, (2) radiation exposure, (3) demanding working hours/on‑call, and (4) a gender‑imbalanced environment. Conclusions:Many early-career women already express interest in orthopedics. However, translating that interest into careers as spine surgeons will require sustained mentorship plus the adoption of assistive technologies, ergonomic instruments, and team-based shift schedules—interventions that could benefit the entire surgical workforce. J. Med. Invest. 72 : 425-429, August, 2025