Practice patterns and work environments that influence gender inequality among academic surgeons

Abstract

BackgroundPractice pattern and work environment differences may impact career advancement opportunities and contribute to the gender gap within highly competitive surgical specialties. MethodsUsing a 2000–2015 New York statewide dataset, we compared board-certified pediatric surgeons by specialist case volume and Herfindahl-Hirschman Index (HHI), which quantifies surgeon focus within specialist case mix. Results51 pediatric surgeons were analyzed for 461 surgeon-years. Female surgeons had lower case volume (159 cases/year versus 214, p < 0.01), lower shares of specialist cases (14.1% versus 16.7%, p = 0.04), and less focused practices (HHI 0.16 versus 0.20, p = 0.03). Female surgeons’ networks had fewer colleagues (7.2 versus 12.1, p < 0.01), and lower annual total (388 versus 726, p < 0.01) and specialist case volume (83 versus 159, p < 0.01), even after accounting for career length. However, female surgeons performed more cases within their networks (49% versus 36%, p = 0.04) and worked at major teaching hospitals as often as men (76% versus 76%, p = 0.97). ConclusionThe challenges that female surgeons face may be reflective of organizational inequities that necessitate intentional scrutiny and change.