OWL Essay 2025 winner and runners-up


Topic: 'Redefining strength and resilience in orthopaedics' 

Congratulations to OWL Essay 2025 winner Sarah Gray

We also extend congratulations to highly commended entries from Charlotte Collier, Nandini Karthikeyan and Nathalie Tan.

Winner — Sarah Gray

PGY7, SA

Redefining strength and resilience in Orthopaedics: “Breaking Surgical Norms Without Breaking Myself.”
Orthopaedics has long conjured images of brute strength, muscles, endurance, and a certain stoicism — usually male, usually silent, and rarely questioned. But I’ve come to believe strength doesn’t always roar.

Sometimes, it walks vivaciously into theatre in a pink unicorn scrub cap, visibly pregnant.

Sometimes, it wears high heels down the hospital corridor or speaks softly but with conviction in a room full of louder male voices. Sometimes, it stays late for a patient while texting the nanny as a single parent. And sometimes, it shows up — tattoos uncovered, coloured hair and piercings on show, unapologetically vibrant — in a space that whispers, You don’t quite belong.

I’m a 36-year-old orthopaedic registrar, currently pregnant, and inching closer to my long-held dream of becoming a consultant surgeon. I didn’t take the well-trodden path.

I was raised in a small country town and made my way to medicine through a rural pathway as a mature aged entry — open access learning, public schooling, no shortcuts. I didn’t inherit a legacy name that opened doors. I earned my place through late nights, relentless study, and a quiet, stubborn belief that the juice would be worth the squeeze.

Four years into my role as a service registrar, I’ve seen glimpses of progress — but orthopaedics still clings tightly to tradition.
I know I stand out. My appearance doesn’t fit the usual surgical silhouette.

I’ve had comments, looks, and dismissals. But I wear who I am on the outside because I’ve spent too long hiding it. Every tattoo, every piercing, every shade of my hair is a piece of my story

– and when I scrub in, I do so knowing my difference doesn’t weaken my skill. It deepens it.

Some of the strongest parts of me were forged far from the hospital. I left a marriage scarred by domestic violence and addiction. I became a single mother, holding my son with one arm and surgical textbooks in the other. I passed my primaries alone — no partner cheering me on, no mentor guiding me, just the quiet echo of resolve at 2 a.m., coffee cold, pounding heart. Those years carved me open — but they also filled me with something unbreakable.

For too long, orthopaedic strength has been measured by physicality, detachment, and the ability to go without rest. But what about the strength it takes to keep your humanity intact? To be vulnerable in a field that sees that as weakness?

I believe we need a new definition — one that celebrates empathy, adaptability, and the courage to be different. One that makes room for mothers, for dreamers, for those who dare to show up fully as themselves.

Pregnancy, too, has taught me a new kind of grit. It’s one thing to hold a retractor through a six- hour case; it’s another to do it while managing carpal tunnel from pregnancy, swollen legs, and a baby thumping against your ribs.

There are moments — standing for hours, scrubbed in, sweat running down my back — when I catch a glimpse of myself in the reflection of an overhead light and think: This is what strength looks like, too. Anything you can do, I can do — pregnant, and yes, still in heels.

Resilience, to me, isn’t just survival. It’s not becoming bitter when you’ve earned the right to be.

It’s staying soft in a system that rewards hardness. It’s letting your story shine, rather than
 
burying it for the comfort of others. It’s knowing that you are not less because you are different

– you are more, and that difference is deeply, urgently needed.

I’ve seen change begin to ripple through the ranks, like a pebble in a pond. More women entering surgery. Open conversations about burnout, identity, and sexism. But the work isn’t done.

For those of us building space in a world not designed for us, every small act of presence is a rebellion — and much needed seed of change.

To the orthopaedic hopefuls who feel like they don’t fit: maybe that’s your power. Maybe you’re here to shift the shape of things. Bring your scars, your laughter, your lipstick, your child in tow

– and know that you are not alone. You can be a domestic violence survivor, a mother, a misfit

– and still be extraordinary. You don’t need to hide your story to belong. You just need to own it.

Orthopaedics needs more stories like mine. Not because they’re rare — but because they’ve been kept quiet for too long. It’s time to expand what strength means. What resilience looks like. And who belongs in theatre.

Size 6.5 hands. Open and caring hearts. Swollen feet. We are here. First one in, last to leave. We will not be silenced, and we’re not going anywhere.

Highly commended — Charlotte Collier

Medical student, ACT

Her Own Tempo: A Symphony of Strength and Resilience
Prelude (preparation): The Quiet Before the Cut
In the stillness of morning, she arrives unseen,
Her hands steady, her mind tuned to the score ahead.
She lays out her instruments, checks the lights,
Not for the applause, not for the glory,
But because every note matters to the music yet to come.
Strength lives here,
In quiet preparation, in relentless practice,
In choosing to run her own race.
Even when the whispers question if she belongs,
And the XXL gowns don’t fit her,
She shows up anyway,
Because she knows the stage is as much hers as theirs.

Allegro (incision): Choosing Her Own Path
The blade meets skin and all eyes turn,
But she stays at her post, calm, composed,
Guiding the rhythm, holding the tempo steady.
Others wield the hammer and saw,
Too often assuming strength is only muscle and noise,
But she, she wields resolve.
She cuts through the theatre’s boys’ club bravado,
Refusing to let old myths about brute force and swagger
Drown out her quiet power.
Strength is not the loudest strike or the boldest move,
But the quiet certainty of a conductor who knows the piece by heart,
And refuses to let it falter.

Andante (exploration and dissection): Adapting to the Unexpected
Once inside, the anatomy reveals its challenges.
Tendons tight where they should glide,
Bones fragile where they should be strong.
Her path is no different:
Colleagues who underestimate her,
Pay gaps she must cross,
And ambitions that jostle against family,
In a system that wasn’t built for her.
She adjusts, reorients and guides her team through discord.
Like an orchestra meeting an unexpected key change,
She adapts and endures.
Her strength lies in not clinging to the old score,
But rewriting it with grace.

Scherzo (fixation and repair): Mending More Than Bone
Plates and screws lock fractured bones,
While wires and rods restore the frame.
But her true craft lies beyond the table,
In mending the culture’s rigid scaffolding.
She builds more than bone:
Spaces where voices rise, not falter,
Where gowns fit every shape,
And conversations include all stories.

Strength is choosing to challenge the familiar,
To rewrite the rules of who belongs here,
To steady hands not only with tools,
But with empathy, courage, and humility.
She fixes and repairs not just bodies, but barriers,
Laying foundations where resilience grows.

Finale (closure): Threads of Strength, Woven Together
At the end, the suture pulls tight,
A single thread joining flesh, fragile but sure.
But true strength comes in numbers,
Many sutures working in harmony,
People from every corner of healthcare,
Nurses, doctors, mentors, allies,
Joining hands to weave change.
Her fingers move like a conductor’s baton,
Guiding, steadying, creating strength.
Together they mend more than skin and bone,
Building resilience that outlasts the theatre’s light,
So the next girl with a scalpel,
Can rise supported, whole and unencumbered.

Encore (post-op): Leaving a Quiet Legacy
When the case is over, her work is not yet done,
Teaching and guiding, lifting others to their potential.
Her strength endures beyond the theatre walls:
In the dancer who now dares to leap,
In the young surgeon who feels she belongs,
In the patient who walks again.
She redefines strength:
Not by wielding the hammer,
Not by standing in the spotlight,
But by being the steady hand,
The quiet symphony behind every curtain call.

Give her the stage, the baton, the cue,
And watch strength and resilience take form.
Not as a solo, but as a chorus of many,
As a symphony of grace.

Highly commended — Nandini Karthikeyan

Medical student, VIC

Redefining Strength and Resilience in Orthopaedics 

L1: Exposure 
The sterile lights sing softly above, washing us in its glow. Draped in the legacy blue of the surgeons before me, I watch as the scalpel glides through skin, fat then fascia. I admire its course as the spine reveals itself. A structure made to brace life, to twist, bend and stabilise, suddenly still before me. There is something powerful in this first step, not in the cut itself, but in what it represents. 

Strength in orthopaedics has long been equated with dominance: loud, objective and forceful. But here, I am reminded that true strength lies in exposure. It is the courage of vulnerability. The ability to welcome it with quiet compassion and gentle grace. The spine exemplifies this as it bends and adapts to avoid breaking. In practice, it is not the rigidity of perfection, but the flexibility to acknowledge uncertainty and to respond with integrity that defines resilience. We must have the courage to lay bare what is tired and worn, whether it be our bodies, our systems or our minds. Refining archaic practice, recognising burnout or confronting biases, strength lies in exposure and transparency. Just as we expose the joint to repair it, we must be willing to examine the profession to improve it. 

L2: Unity 
The lamina is resected to reveal the dura pulsating gently beneath. The surgeon’s hands are deliberate, precise. I marvel at the orchestration: scrub nurse, anaesthetist, radiographer, scrub scout, all moving in silent synchrony. Resilience, I reflect, is not a solitary pursuit. In orthopaedics, it is forged by the hands of many for the whole is greater than the sum of its parts.

No fracture is reduced by one; no fusion held by a single screw. It is the shared burden that allows us to endure. Resilience must be redefined as collective, the sum of many minds and hands, concerted in purpose. Orthopaedic surgeons train not only in bone and blade, but in collaboration and unity. To ask for help, to debrief after failure, to learn from colleagues, these connections define strength. 

L3: Adaptation  
We decorticate the facet joints and prepare the endplates for graft. Bone once rigid and unyielding, now a fine dust that consumes the air. I think of the past, of Harrington rods and traction beds, of history left long behind. Strength, I now understand, is not clinging to tradition for comfort, but daring to evolve. 

Innovation is not the enemy of experience; it is its natural extension. Strength is the curiosity to question practice and the humility to embrace change. Our resilience lies not in rigid protocol, but in its adaptive application, in our willingness to remain students from graduation to retirement. In orthopaedics, we must welcome this not as disruption, but as opportunity. 

This lesson extends far beyond the operative field. It envelopes the unique embrace of working in remote settings and addressing the needs of culturally diverse patients. Strength is being responsive to difference and resilient enough to evolve, as surgeons, as systems and as a profession. 

L4: Reflection 
As we tamp the interbody device into place, I feel the weight of the xray gown on my shoulders. Sinking into its heaviness, my eyes catch the gleam of the x-ray machine, watching as it floats out of theatre. Cumbersome yet humble, it gifts us a moment of stillness. Resilience lies in having the courage to pause. A chance to clarify, confirm and conquer. We assess. Are the screws stable? Are they in the right position? The answer never immediate, it demands review, reflection and revision. 

This moment reflects a deeper truth: resilience in orthopaedics must encompass continual review of both practice and culture. Whether in clinical audit, research or cultural reform, we must reflect on our be humble enough to adapt when they fall short. Resilience is not endurance without reflection - it is reflection that fuels evolution. 

L5: Sustainability 
With pressure and precision, rigid screws once foreign immerse to become part of the patient for a lifetime. In orthopaedics, we must redefine strength as longevity - not just of implants, but of culture and profession. Orthopaedics must confront its culture of silence, stress and stoicism. We must redefine strength not as sacrifice, but as sustainability - the ability to commit to one’s own health, identity and purpose alongside our commitment to the profession. Creating systems that are sustainable. Training that nurtures, rather than isolates. Departments where diversity is valued, and inclusion is practised. A culture that promotes seeking help as wise, not weak. To build a resilient workforce, we must build sustainable careers that last as long as our prostheses.

Highly commended — Nathalie Tan

Medical student, QLD

'Redefining strength and resilience in orthopaedics'
From steel to titanium – The changing mettle of orthopaedic surgeons
Do I have what it takes to be an orthopaedic surgeon?

I am at the dawn of my medical career. In the crucible that is medicine, I am liquid metal – my final characteristics have not yet been defined. Occasionally, I see ripples of the future in that shiny surface. A nod of approval as I tie my first hand tie in theatre. A simple message of encouragement. I know the properties desirable for metals used in fracture reduction and fixation: strength – to bear the load of the body, resilience – to withstand step, after step, after step. This will be a journey, I think. One where over time  I will have to mould, temper and forge myself; looking to those who have already defined and redefined the kind of mettle it takes to be an orthopaedic surgeon.

First, we were steel.

Steel is defined by its high modulus of elasticity. This means that it can withstand large amounts of stress, with relatively small amounts of strain or deformation. Steel is hard and strong. In the most literal sense, orthopaedic surgeons are known for their physical strength. Lifting limbs, reducing fractures, hammering femoral nails. Even today the stereotype remains that orthopaedic surgeons are the brawn of medicine – tall, strong, male.

I am strong, but am I strong enough?

Another property: steely resilience. Orthopaedic surgeons appear infatiguable as they clock in for early morning ward rounds and out, late nights, and long hours spent in the operating theatre. They too have been tempered by the culture that came before them. The expectation of stoicism in the face of on-call shifts and missed dinners has forged doctors with cool, hard exteriors. They do what is needed, no questions asked.

But sometimes steel is too rigid. Research suggests that stainless steel plates used to fix femur fractures are so stiff, they shield the bone from the stress it needs to stimulate healthy healing.1 In some cases, this can result in bony non-union and implant fatigue failure. Are we not the same? A culture of stoicism has proven itself to be unsustainable with up to 53% of Australian orthopaedic trainees experiencing symptoms of burnout such as emotional exhaustion or depersonalisation.Masculine ideals of strength and competence have forced women in the field to work harder to achieve the same level of recognition as their male counterparts. 3If we force ourselves to be too strong, we risk becoming brittle. These issues reflect more than individual strain. Just as stress shielding weakens bone, the unyielding standards we uphold for ourselves ultimately threatens to weaken the system we strive to protect, as we perpetuate it in those that follow.

Then, we were titanium.

Titanium is softer than steel. Its modulus of elasticity is comparable to that of bone, meaning that the titanium metal plate shares its load with the fractured bone. Paradoxically, it is this relative softness that is titanium’s greatest strength. In a loadbearing site, this modicum of flexibility promotes better bony healing and reduces risk of non-union.In layman’s terms, rigidity is not the sole determinant of success. The strongest doctors do not try to carry the full burden alone, but collaborate within a diverse team. They utilise the strengths and expertise of the individual and in turn foster the best outcomes for their patients.

And what about the resilience of titanium? Its intrinsic properties create a robust corrosive resistant layer that protects it from harsh environments. In an unforgiving environment like orthopaedics, the gender disparity is amplified. We see this in the over-representation of men in consultancy and leadership roles.3 By embracing a culture of collaboration and support, we can prevent the disproportionate attrition of female doctors, in every step of the orthopaedics pipeline.

What of the future?

Another silvery, titanium ripple. The stories generously shared by women in orthopaedics shine hot and bright within me. The mentorship they received from male and female colleagues alike. Collaboration. An overwhelming consensus that the attitudes toward part-time training and leave are shifting. Flexibility. A moment when they realised that a patient needed empathy and reassurance, more than they needed a surgery for their spine. Humanity. I can see firsthand this new kind of strength, galvanised by the needs of breaking system.
So – do I have what it takes to be an orthopaedic surgeon?

Possibly not yet.

And that’s okay. I am still liquid. Still being formed. Still learning what strength and resilience will mean for me. But perhaps, in time, I might just become the mettle orthopaedics needs next.


1Lujan, T. J., Henderson, C. E., Madey, S. M., Fitzpatrick, D. C., Marsh, J. L., & Bottlang, M. (2010). Locked . plating of distal femur fractures leads to inconsistent and asymmetric callus formationJournal of orthopaedic trauma, 24(3), 156–162. https://doi.org/10.1097/BOT.0b013e3181be6720

2Arora M, Diwan AD, Harris IA. Prevalence and Factors of Burnout among Australian Orthopaedic Trainees: A Cross-Sectional Study. Journal of Orthopaedic Surgery. 2014;22(3):374-377. doi:10.1177/230949901402200322

3Clark, M., Kerslake, S., Bøe, B., & Hiemstra, L. A. (2024). Being a Woman and an Orthopaedic Surgeon - A Primer on the Challenges We Face. Journal of ISAKOS, 9(3), 449. https://doi.org/10.1016/j.jisako.2024.05.008

4Barber, C. C., Burnham, M., Ojameruaye, O., & McKee, M. D. (2021). A systematic review of the use of titanium versus stainless steel implants for fracture fixation. OTA international : the open access journal of orthopaedic trauma, 4(3), e138. https://doi.org/10.1097/OI9.0000000000000138