What Women Want: A Call for Ergonomic, Equitable and Inclusive Orthopaedic Surgical Practice.

Background: Despite gender parity in medical school enrolment, women remain underrepresented in orthopaedic surgery in India. Whilst structural barriers and implicit biases are increasingly acknowledged, less is known about the lived experiences and priorities of women navigating this field. This study seeks to capture the perspectives of female orthopaedic surgeons in India-their challenges, choices, and what they value in training and practice. Materials and Methods: A cross-sectional survey was conducted amongst 102 female orthopaedic surgeons across India, ranging from residents to senior consultants. A 43-item questionnaire assessed demographics, residency experience, intraoperative ergonomics, occupational health, psychosocial challenges, and perceived gender bias. Quantitative data were analysed descriptively; qualitative responses were thematically coded. Agreement between self- and peer-perceived difficulty in trauma procedures was evaluated using Cohen's Kappa. Results: Only 24.5% reported no gender-based differences during training, whilst 71.8% felt seniors and peers lacked confidence in their surgical ability. Intraoperative difficulties such as poorly fitting lead aprons (64.7%) and radiation exposure (27%) were common. Occupational health issues like back (31.7%) and neck pain (27.6%) were frequently reported. Although trauma was of interest to many, 91.2% reported being discouraged from pursuing it, with key deterrents including work-life imbalance, radiation concerns, and lack of mentorship. Respondents also expressed a need for equitable surgical opportunities, institutional support, and gender-sensitive design in equipment and training environments. Conclusion: The findings reveal what female orthopaedic surgeons value in their professional journeys-supportive mentorship, equal access to operative roles, safe working conditions, and recognition as capable surgeons. Addressing these needs is critical to creating a more inclusive and forward-looking orthopaedic community.