Effects of a Mandatory Orthopaedic Surgery Rotation on Medical Student Perceptions of the Field.

Abstract

Exposure to orthopaedics has been shown to positively influence medical student perceptions of the field; however, fewer than half of medical schools require or even offer an orthopaedic rotation as part of the core clinical curriculum. We hypothesized that a mandatory rotation during the clerkship year would counteract stereotypes about the field. Therefore, we sought to characterize the perceptions of orthopaedic surgery before and after such a clinical rotation at our institution. Over a 2-year period, we administered an anonymous survey to all 320 medical students completing our mandatory 1-week orthopaedic surgery rotation. We received 267 prerotation and 153 postrotation survey responses. Students were asked for their sex, age, race/ethnicity, and "three words that describe your perception of orthopaedic surgery." These words were categorized according to theme and positive/negative connotation by the study team and evaluated for association with medical student demographics. The most frequent prerotation words were "bones" (10.1% of words), "intense" (6.5% of words), and "bros" (6.4% of words). The most frequent postrotation words were "bones" (6.2% of words), "fun" (5.9% of words), and "intense" (2.9% of words). The percentage of negative and neutral words decreased after the rotation (negative: 27.5% to 14.1%; P < 0.001; neutral: 50.2% to 38.3%; P < 0.001), whereas the percentage of positive words increased (21.3% to 47.4%; P < 0.001). Positive words increased postrotation for both men (23.4% to 54.7%; P < 0.001) and women (20.9% to 40.5%; P < 0.001), whereas negative words decreased for both men (20.1% to 10.4%; P < 0.001) and women (34.2% to 17.6%; P < 0.001). This study demonstrates that initially negative perceptions of orthopaedic surgery, particularly those related to its reputation as a male-dominated "bro" culture, markedly improved following a clinical rotation. This suggests that a mandatory orthopaedic surgery rotation may counteract stereotypes about the field, particularly among women students.