The ongoing gender disparity in orthopedic surgery is rooted in reasons that range from antiquated to mythical. Among these is the idea that women aren’t physically strong enough to practice orthopedic surgery.

“If you think about orthopedics, you think about hip and knee replacements, spine surgery, trauma, and some of those are bigger cases,“ says Kristy Weber, chief of Orthopaedic Oncology at the Perelman School of Medicine (PSOM), who is also vice-chair of faculty affairs in the Department of Orthopaedic Surgery, director of the Abramson Cancer Center’s Sarcoma Program, and the Abramson Family Professor in Sarcoma Care Excellence. “Some of my work is physically significant, tiring I suppose, but I’ve never had a case where I felt that I wasn’t strong enough—and I’m not even that strong.”

Another myth that Weber debunks is the idea that a career in orthopedics is too hectic to balance with family life. On the contrary, she says, “orthopedics offers a lot of flexibility. You can be an outpatient surgeon that works 8-5, for example. You can do research. There are so many options in the field to tailor to your lifestyle.”

When Weber entered her residency training in 1991, she was among the five percent of orthopedic residents across the country who were women.

“But the field has changed significantly since I started,” says Weber. “I’ve seen a really positive change.” Although women now constitute 14.2 percent of orthopedic residents, the percentage still places orthopedics among the fields with the least female representation. “But when you’re talking about a whole field,” she says, “it may take a few more years.”

The dearth of female residents correlates, of course, with the dearth of female orthopedic surgeons: Studies have shown the opportunity for same-sex role models to be a critical factor in women’s decisions about where to train and work, so if female medical students don’t see women in a specialty, they are less likely to pursue it themselves. Given that the threshold of visibility is 30 percent, the 5 percent of orthopedic surgeons who are women are not collectively visible enough to attract a critical mass of female residents.

Case in point is second-year orthopedic surgery resident Nicki Zelenski.

“[Gender bias] definitely impacted my choice to do my residency at Penn,” Zelenski says. “Some programs don’t have any women residents at all, and some don’t have any female faculty. My class here is half women, and I think Dr. Weber probably had a large part to play in that, in recruiting us here and making us feel welcome.”

Weber sees recruiting and mentoring female residents as a critical part of her leadership role in a specialty where women are so distinctly under-represented—and part and parcel of PSOM’s larger culture of inclusivity and excellence.

“Some of the women residents we’ve had have been the best residents in the program. The women in Nicki’s class are just really outstanding. And I don’t find any Penn orthopedic surgeons who are not favorable to women,” Weber says. “So I think it’s a good culture here with equal expectations of men and women. It is a culture of hard work that’s set from the top: the Department of Orthopaedic Surgery chairperson, L. Scott Levin, is a really hard worker.”

Weber notes that over the last few years, Levin has strongly emphasized the importance of diversity in their program, and how much they value women and underrepresented minorities (minority orthopaedic surgeons are even scarcer than women, making up just three percent). “He’s tried hard to put that message out there,” says Weber. “And I have that message on our website for orthopedics.”

When asked what advice she gives to her female residents, she says, “I tell young women to learn where they’re going to draw the line in the sand in terms of what they’re going to stand for. I’ve never been afraid to do that.”

But mostly, Weber says, she gives the same advice to women and men alike: “Work hard and be nice. At the end of the day, if you work really hard, and if you take care of patients really well, people are going to notice—even people who may be biased against women in the field. I mean, that’s why we’re here. If you do a great job as a doctor, how can they not notice that?”