A survey of gender-based barriers and misconceptions in surgery

Abstract

• This study explores the relationship between gender and personal/professional life. • Women in surgery perceive more external gender-based barriers compared to men. • Women in surgery have similar internal desires for family and professional success. • Our findings motivate the need for intervention to improve gender equity in surgery. Women are the majority of U.S. medical school matriculants, and women physicians have been associated with lower mortality and readmission rates. Yet gender-based barriers—such as social deterrents, lack of formal parental leave policies, and lower rates of academic promotion—continue to limit women physicians. This study aimed to elucidate gender-based barriers in surgery. An online survey was emailed to 5,875 residency coordinators of Accreditation Council for Graduate Medical Education (ACGME) programs requesting distribution to faculty, fellows, residents, and medical students. Specialties were grouped into surgical (surgery, ophthalmology, urology) vs non-surgical (dermatology, emergency medicine, family medicine, internal medicine, obstetrics/gynecology, pediatrics). Likert-type scales were used to measure agreement with each of 80 survey items exploring the relationship between gender and personal/professional life. Data was analyzed with ordinal logistic regression. An analysis was done using the 205 participants from surgical fields (98 women and 107 men), a subset of the total 1,014 complete obtained responses. Compared to men, women were more likely to agree with statements identifying gender-based disparities related to specialty choice, perceived competency, experience with racial/sexual harassment, social behavior, and family impact, as well as statements identifying gender-based barriers to research and academic success, despite similar interest in professional advancement. Despite no gender-based difference in preference for being the primary caregiver, women were more likely to perceive greater expectations regarding familial responsibility. Our study counters notions that gender disparities in surgery are due to women's preferences to prioritize family responsibilities or lack of interest in professional advancement. We suggest potential interventions to promote gender equity.