Voices for Change: Celebrating diversity within the AO

My AO Access journey: Urs Rüetschi

Backed by his 23-year career in AO leadership, Urs Rüetschi has a unique perspective on the organization’s history and the role diversity, inclusion, and mentorship can play in the AO’s future. Rüetschi, who retired from the AO in May 2025 and today works as an independent consultant, advisor, and coach with a keen interest in contributing to meaningful projects and initiatives, was an AO Access Steering Committee member from the program’s 2020 beginning.

Rüetschi joined the AO as head of AO Publishing in 2002, bringing with him a solid background in both conventional print publishing and new media, including his pioneering implementation of the first Internet-accessible, daily Swiss newspaper, Tages-Anzeiger, as head of interactive media with TX Group. From 2008 to 2023, Rüetschi was executive director of education development and director of the AO Education Institute (AO EI) and a member of the AO Executive Committee (AO EC). During his long AO tenure, Rüetschi established the AO EI in 2012 as a leading global postgraduate medical education organization and led a multicultural team of 35 nonmedical experts working across a vast range of areas, from academically sound curriculum development and medical education research to faculty development, creation of educational platforms, resources, and products, as well as use of innovative technology in education and communication.

This long history with a deep understanding of the AO informs Rüetschi’s perspective on the role diversity, inclusion, and mentorship can play in the organization’s future.

“The AO was a pretty diverse organization from the beginning. On one hand, the organization engaged internationally and in developing countries very early on,” Rüetschi said. “The surgeon leaders really cared about spreading their concepts including to groups that normally no one else would have considered.” 

He pointed out that the AO culture was never political.

“We brought together people from countries that had been in conflicts with one another, for example. I remember that we had discussions about Taiwan and China, and the AO leadership, the surgeons at the time said, ‘We will work with whoever has patients and whoever is interested in the AO concepts,’” Rüetschi explained. “So that mindset was really very open compared to industry, which was my professional background. The fact that the AO leadership was primarily male and not that democratic was just given by the times.”

"In my early days at the AO, the way to get into the organization was through the alumni association based on a certain level of knowledge and skills based on proving that you had done cases and so on."


Urs Rüetschi

‘A closed circle’

The organization boasted a spirit of volunteerism and camaraderie, he said, but at the same time was something of a closed circle.

“In my early days at the AO, the way to get into the organization was through the alumni association based on a certain level of knowledge and skills based on proving that you had done cases and so on,” said Rüetschi. “The only exclusion criterion was when the leadership felt that a surgeon was working with a competitor of the AO’s industrial partners. Stealing ideas, thinking commercially, or wanting to make money out of the AO was a no-go.”

Rüetschi believes surgeons’ desire to contribute to the AO mission of promoting excellence in patient care and outcomes in trauma and musculoskeletal disorders led to AO Access’ precursor, the Opportunity, Diversity, and Inclusion Initiative (ODII)—in 2018.

“Surgeons were and according to our data, are saying, ‘I would like to contribute, but I cannot get into the organization’,” he recalled, “and this created the perception that the AO was ‘an old boys’ club.’”

Creating opportunities 

That perception wasn’t surprising, Rüetschi said. 
 
“The number of opportunities to volunteer were always limited. And if you look at the AO today, we aren’t growing in terms of opportunities to volunteer,” he said, noting that volunteer opportunities in the AO are primarily serving as faculty and in leadership roles at the country, regional, and international levels. “There are fewer faculty opportunities because the AO has reduced the number of pure face-to-face educational events.” 
 
As director of the AO EI, Rüetschi and his team had always looked at the demographics of the AO Faculty as well as the recruiting process. 
 
“We realized that our faculty pool was actually rather old and white and not that diverse, and we realized we might have a problem by not really representing the surgeon community of the future, nor the diverse patient population surgeons serve because we knew the people coming in were just mirroring the faculty, which is always ten to 15 years older than the surgeons they’re educating,” Rüetschi said. “It’s a generational thing as well, but you can react to that.” 

He said hospital-based education, preferably in the operating room, is one way the AO could create new pathways into the organization. This approach would scale up AO involvement in hospitals and create volunteer opportunities for existing, talented surgeon educators as well as the next generation to become part of an increasingly vibrant and diverse AO community.

 

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