Abstract
Access to surgical care in low- and middle-income countries (LMICs) remains deficient without an adequate workforce. There is limited understanding of the gender gap in surgical trainees in LMICs. In Rwanda, females fill only one of 20 positions available. Understanding surgeons’ experiences and perceptions of surgical careers may help facilitate support for females to contribute to the global surgical workforce. We performed qualitative analysis on perceptions of surgical careers through semi-structured interviews of all female surgeons (n = 6) and corresponding male surgeons (n = 6) who are training or have trained at University of Rwanda. Transcripts were analyzed with code structure formed through an integrated approach. Question categories formed the deductive framework, while theoretical saturation was reached through inductive grounded theory. Themes were organized within two key points of the career timeline. First, for developing interest in surgery, three main themes were identified: role models, patient case encounters, and exposure to surgery. Second, for selecting and sustaining surgical careers, four main themes emerged: social expectations about roles within the family, physical and mental challenges, professional and personal support, and finances. All female surgeons emphasized gender assumptions and surgical working culture as obstacles, with a corresponding strong sense of self-confidence and internal motivation that drew them to select and maintain careers in surgery. Family, time, and physical endurance were cited as persistent challenges for female participants. Our study reveals concepts for further exploration about gendered perceptions of surgical careers. Efforts to improve support for female surgical careers as a strategy for shaping surgical work culture and professional development in Rwanda should be considered. Such strategies may be beneficial for improving the global surgical workforce.
Highlights
Inadequate workforce is a fundamental challenge to addressing the disproportionate burden of surgical diseases in low- and middle-income countries.[1][2] The Lancet Commission on Global Surgery recommends a density of 20 surgeon, anesthesiologist, and obstetrician (SAO) providers per 100,000 population as a conservative benchmark correlated with improved
Our study examines the experiences of both female surgeons and their male counterparts in Rwanda to provide a window into critical decision points that shape career paths
2012, the Rwandan Ministry of Health partnered with a consortium of US academic institutions to create the Human Resources for Health (HRH) Program to increase the quantity and quality of providers in Rwanda.[17]
Summary
Inadequate workforce is a fundamental challenge to addressing the disproportionate burden of surgical diseases in low- and middle-income countries.[1][2] The Lancet Commission on Global Surgery recommends a density of 20 surgeon, anesthesiologist, and obstetrician (SAO) providers per 100,000 population as a conservative benchmark correlated with improved. Transcriptions are inextricably linked to the participants, as the content reflects their experience training in Rwanda so far and cannot be de-identified appropriately without removing most of the data. The Institutional Review Board approved a data collection, security, and storage procedure in which the original transcriptions must be erased and destroyed upon completion of the written work for this research
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