Winner — Belinda Ong
Give a girl a hammer and you give her an opportunity. One that ranges from simply learning a technical skill to embarking on a fulfilling career pathway. Despite women accounting for more than 50 per cent of medical school graduates, only five per cent of orthopaedic surgeons in Australia are female[1]. Give a girl a hammer and, statistically speaking, that opportunity is likely to be declined. This choice is influenced by a plethora of factors and it is only by scrutinising them that we can find ways to address them.
Give a girl a hammer, and she’ll be told, “that’s for boys”. Orthopaedic surgery’s reputation as a boy’s club severely impinges its appeal to women. The natural habitat of the orthopaedic theatre, one where conversations about golf and fishing are ubiquitous and size XXL gowns remain the status quo, can prove unsuitable and even hostile to the development of future female surgeons. Similarly, the notion that orthopaedics is all brawn and brute strength is another misconception, and one that diminishes the delicacies of the vocation so integral to its success. When confronted, women are faced with a choice: to come as they are and remain outside the traditional structures of surgery, or shed a part of themselves so intrinsic to their identity in order to be embraced as “one of the boys”[2].This is no easy choice to make.
Give a girl a hammer, and she will turn to the person next to her to show her how to use it. The guidance of a mentor – someone that can be trusted and that mentees can relate to – has the potential to motivate and inspire. Given the lack of female surgeons, however, it is easy to understand why some may find it difficult to picture themselves as such: you can’t be what you can’t see. Diversity in the workplace, whether that be gender, ethnicity or social background, should reflect the general population. It is this diversity of experiences that results in a diversity of ideas, and consequently better health outcomes[3]. Thus, diversity is not only invaluable to the advancement of orthopaedic surgery, it is necessary for its survival.
Give a girl a hammer, and she will be surprised by its weight. Modest in its design, the sturdiness of a solid stainless-steel hammer can be intimidating. In a similar way, orthopaedics as a career can also seem daunting – the substantial work and hours required may contribute heavily to one’s decision, no matter how shiny the goal is. In the hands of a confident operator, however, a hammer can be wielded in such a way that the simple transfer of energy and momentum has the ability to fix broken bones. By the same token, the decision for a woman to pursue orthopaedics, when supported by a system that encourages her, has the ability to save lives.
The question then arises as to how to address these barriers, and to that end, it requires both women and men to make conscious, mindful choices when it comes to being inclusive. The choice to discuss last weekend’s netball game over golf. The choice to stock extra S/M gowns in theatre. The choice to seek and encourage diversity in trainee applicants. The choice to have systems in place that support women who want to have children during training. To give a girl a hammer is to celebrate women and embrace all the challenges that come with it for the good of patients and their health.
Change requires bravery but it does not have to be bold – in fact it is the small instances, the subtle moments gone unnoticed in the humdrum of everyday life, that have the potential to have the biggest impact. A kind word on ward round, a reassuring nod at clinic, or a quiet offer to use a hammer in theatre. Give a girl a hammer and you give her a seat at the proverbial table. Give a girl a hammer, and one day she’ll build the future of orthopaedics… one nail at a time.
References
1. Diversity in healthcare – why are we still talking about it? Australia: Australian Orthopaedic Association [Available from: https://www.aoa.org.au/for-patients/articles-and-galleries/articles/article-diversity-in-healthcare.]
2. Liang R, Dornan T, Nestel D. Why do women leave surgical training? A qualitative and feminist study. Lancet. 2019 Feb 9;393(10171):541-549. doi: 10.1016/S0140-6736(18)32612-6. PMID: 30739689.
3. Gomez LE, Bernet P. Diversity improves performance and outcomes. J Natl Med Assoc. 2019;111(4):383-92.
Runner-up — Annabel Fraser
Give a girl a hammer
She’ll show you what she can do
A simple tool, the hammer, the catalyst for what will ensue
She’ll start with an idea – from initial experiences and impressions this will form But only with positive interactions, understanding and role models
Will thoughts about a career in orthopaedics become the norm
From a simple idea the thought needs to come to fruition
She’ll need to lay the foundations that will support her ongoing ambition This starts in medical school and residency
Where positive experiences qualm any hesitancy
Yet, unfortunately for some young women and surgeons to be
The opportunity to hold a hammer is a chance they might not see
Where women comprise 4% of consultants and 15% of Orthopaedic making a training application (1)
This currently reflects a lack of female representation
Deterred early, some prior to any placement or residency term
Due to discouragement about the difficulty and barriers that some hold firm
A RACS survey has found poor culture, gendered advice and a lack of flexibility
To be limiting factors for a career in surgery that medical students and junior doctors see (2)
Why should we address this discrepancy of those using a hammer some might ask Increasing the number of women and cultural diversity is a difficult task
It has been well documented, particularly in the in the corporate space
That diversity improves productivity and profitability within the workplace (3)
There are approaches aimed at improving this parity
So that the number of women holding a hammer is not a rarity
It includes experiences with supportive culture and leadership
Alongside positive encouraging role models and ongoing senior mentorship
It empowers women to envision a balanced career and family life they might uphold
Instead of believing their gender, priorities and hopes do not fit the traditional mould
Thus, with a growing feeling within the specialty of inclusion
Her plan of embarking within the specialty will no longer be a delusion
So, she launches towards an Orthopaedic career
Learning the craft with as much effort as she can commandeer
Once you give a girl a hammer
She’ll show you what she can do
With time she’ll start to show you she has gained further competencies too
Throughout her career she will transition
Demonstrating medical and technical expertise with innate cognition (4)
Furthered by the provision of opportunities to improve orthopaedic finesse
And attributes of decision making, advocacy and collaboration that allow her to progress (4)
Definitely give a girl a hammer, a K wire and perhaps a drill
To improve the care and outcomes of her patients that are ill By providing her with the right knowledge and tools
She can use logic and expertise to excel in bone schools
With time, study and proficiency she will reach her fellowship
Aided by the guidance, support and progressive culture of collegiate mentorship
Now specialist consultant with numerous qualifications
She will continue to inspire more girls of imminent generations
So please, give a girl a hammer She’ll show you what she can do
What she can build might surprise a few
Overall, it will allow her to establish a career and future in orthopaedic surgery too
Not so much an essay as a bit of a rhyme – written for my one-year-old daughter Maggie and her sister on the inside.
Give a girl a hammer – and see what she can do. She will know what it’s for – it’s hardly a new tool in our evolutionary repertoire. She will strike with force and precision – and more consideration than her brother by far.
Give a girl a hammer – and see what she can do. She will build, as well as break, and rebuild anew. She will use it to create, along with other tools, things you never thought of and didn’t think she knew.
Give a girl a hammer – and see what she can do. While she’s still brave enough to use it – and doesn’t recoil, ‘Eww! – That’s a toy for boys, I’m not sure what to do’.
For the truth is she will need it – time and time again – to build bridges on her way and smash the ceilings in. The world is still not geared to value her equal part – it will often consider her too weak to wield a hammer, too concerned with matters of the heart.
It may not be her most useful tool – reliant on force alone. Her life will require negotiations of give and take – for equal pay, for equal say, for equal support to name a few.
And then at the end of the day there’s home – always busy, whether full of family or on her own. The negotiations continue there – in her mind, her relationships too; has she given her family, partner, kids and friends all the time they’re due?
Give a girl a hammer – they’ve been around three million years. They’ve seen it all – from Thor to Floyd – a great remedy to her fears.
Give a girl a hammer – let it amplify her force. Let it express her rage at this frustrating stage, build her confidence – but not too much, of course…
Give a girl a hammer – there’s plenty to go round. She will do more than you to build up those around her, without making much of a sound.
Give a girl a hammer – what is there to lose? Only the creativity and strength of half the planet, if
‘nah’ is the answer you choose.
Why not give a girl a hammer? You don’t think it’s something she needs? Should she be getting on with more feminine pursuits, or undertaking lighter deeds?
Give a girl a hammer – controversial if you please? That idea that this warrants discussion does show far we’ve come – by our leaders no less, an authority, not just by anyone. Progress no doubt, with good intent and responses aimed to ease – but that aside, in this day and age, bloody brings me to my knees.
Dr Sophie West Orthopaedic PHO
Mother of one, with another to go