Resident Perspectives on the Role of Gender in Operative Experience During General Surgery Residency Training: A Mixed-Methods Study

Abstract

BackgroundIt remains unclear why female general surgery residents perform fewer cases than male peers. This exploratory study investigated possible contributors to gender-based disparities and solutions for improving equity in operative experience. MethodsSurveys, including Likert scale and free-text questions, were distributed to 21 accredited general surgery residency programs. ResultsThere were 96 respondents, of whom 69% were female. 22% of females personally experienced barriers to operative experience versus 13% of males (p=0.41), while 52% of female residents believed operative training was affected by gender (p=0.004). Inductive analysis revealed the most common barrier to operating room participation was floor work/clinical tasks. The most common barrier for female residents was perceived sexism/gender bias, with subthemes of “misidentification,” “feeling unwelcome,” and “poor trust/autonomy.” To improve parity, residents proposed structured program-level review, feedback, and transparent expectations about case assignments. ConclusionFemale general surgery residents believe gender bias impacts training. Further mixed-methods research is crucial to determine the cause of gender-based disparities in operative experience.