Abstract
IntroductionAlthough gender discrimination and bias (GD/bias) experienced by female surgeons in the developed world has received much attention, GD/bias in lower-middle-income countries like Pakistan remains unexplored. Thus, our study explores how GD/bias is perceived and reported by surgeons in Pakistan. MethodA single-center cross-sectional anonymous online survey was sent to all surgeons practicing/training at a tertiary care hospital in Pakistan. The survey explored the frequency, source and impact of GD/bias among surgeons. Results98/194 surgeons (52.4%) responded to the survey, of which 68.4% were males and 66.3% were trainees. Only 19.4% of women surgeons reported ‘significant’ frequency of GD/bias during residency. A higher percentage of women reported ‘insignificant’ frequency of GD/bias during residency, as compared to males (61.3% vs. 32.8%; p = 0.004). However, more women surgeons reported facing GD/bias in various aspects of their career/training, including differences in mentorship (80.6% vs. 26.9%; p < 0.005) and differences in operating room opportunities (77.4% vs. 32.8%; p < 0.005). The source was most frequently reported to be co-residents of the opposite gender. Additionally, a high percentage of female surgeons reported that their experience of GD/bias had had a significant negative impact on their career/training progression, respect/value in the surgical team, job satisfaction and selection of specialty. ConclusionAlthough GD/bias has widespread impacts on the training/career of female surgeons in Pakistan, most females fail to recognize this GD/bias as “significant”. Our results highlight a worrying lack of recognition of GD/bias by female surgeons, representing a major barrier to gender equity in surgery in Pakistan and emphasizing the need for future research.
Highlights
Gender discrimination and bias (GD/bias) experienced by female surgeons in the developed world has received much attention, gender discrimination and bias (GD/bias) in lower-middle-income countries like Pakistan remains unexplored
A 2017 study looking at women as department chairs and full professors showed dismal results, with few women making it beyond the rank of instructor and assistant professor, and even fewer making it to full professor and department chair [7]
We aimed to examine the incidence and the overall experience of gender discrimination and bias (GD/bias) experienced by practicing surgeons and surgeons in-training at our institution
Summary
Gender discrimination and bias (GD/bias) experienced by female surgeons in the developed world has received much attention, GD/bias in lower-middle-income countries like Pakistan remains unexplored. 19.4% of women surgeons reported ‘significant’ frequency of GD/bias during residency. More women surgeons reported facing GD/bias in various aspects of their career/training, including differences in mentorship (80.6% vs 26.9%; p < 0.005) and differences in operating room opportunities (77.4% vs 32.8%; p < 0.005). A high percentage of female surgeons reported that their experience of GD/bias had had a significant negative impact on their career/training progression, respect/value in the surgical team, job satisfaction and selection of specialty. Due to an increasing spotlight, gender discrimination and bias (GD/ bias) is identified and reported in many aspects of surgical training and practice in the developed world [1,2]. Similar statistics are seen in other developed nations such as Great Britain and Japan, where Kyoto University noted no female associate or full professors in Surgery from 2009 to 2013 [8], and the Society of British Neurological Surgeons noted that out of 315 neurological surgeons, all 16 full professors were men [9]
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