Surgical Workforce Research Articles

Pathways to effective surgical coverage in a lower-middle-income country: A multiple methods study of the family physician-led generalist surgical team in rural Nepal.

The Lancet Commission on Global Surgery (LCoGS) recommends using specialist surgical workforce density as one of 6 core indicators for monitoring universal access to safe, affordable surgical and anaesthesia care. Using Nepal as a case study, we explored the capacity of a generalist workforce (led by a family physician or MD general practitioner and non-physician anaesthetist) to enable effective surgical delivery through task-shifting. Using a multiple-methods approach, we retrospectively mapped essential surgical care and the enabling environment for surgery in 39 hospitals in 25 remote districts in Nepal and compared it with LCoGS indicators. All 25 districts performed surgery, 21 performed Caesarean section (CS), and 5 met at least 50% of district CS needs. Generalist surgical teams performed CS, the essential major operation at the district level, and very few laparotomies, but no operative orthopaedics. The density of specialist Surgeon/Anaesthesiologist/Obstetrician (SAO) was 0·4/100,000; that of Generalist teams (gSAO) led by a family physician (MD General Practitioners-MDGP) supported by non-physician anaesthetists was eight times higher at 3·1/100,000. gSAO presence was positively associated with a two-fold increase in CS availability. All surgical rates were well below LCoGS targets. 46% of hospitals had adequate enabling environments for surgery, 28% had functioning anaesthesia machines, and 75% had blood transfusion services. Despite very low SAO density, and often inadequate enabling environment, surgery can be done in remote districts. gSAO teams led by family physicians are providing essential surgery, with CS the commonest major operation. gSAO density is eight times higher than specialists and they can undertake more complex operations than just CS alone. These family physician-led functional teams are providing a pathway to effective surgical coverage in remote Nepal.

Examining the diversity of MRCS examiners

BackgroundMRCS examiners are the face of the Royal College of Surgeons for early-career surgeons and should therefore represent the workforce they are examining as not to marginalise or negatively impact on the assessment experience of candidates from minoritised groups. This study aimed to explore the diversity of MRCS examiners and whether they represent the demographics of the MRCS candidates. MethodsA retrospective observational study including all active examiners and examination candidates who attempted MRCS Part A or Part B between January 2020 and July 2021. Self-declared demographic data collected by the Intercollegiate Committee for Basic Surgical Examinations (ICBSE) included gender, sexual orientation, disability status and ethnicity. Following data anonymisation, total group response frequencies were made available to the research team for statistical analysis. ResultsChi-squared analyses showed statistically significant differences in the representation of gender, disability and ethnicity between candidates and examiners (all p < 0.001). Men (83.9% (n = 1121) vs 70.9% (n = 6017) respectively), individuals without disability (98.7% (n = 917) vs 96.1% (n = 6847)) and individuals of White ethnicity (36.6% (n = 346) vs 20.4% (n = 1223)) were significantly overrepresented in the examiners compared to the examination candidates. There was no statistically significant difference in sexual orientation between examiners and candidates (p = 0.712). ConclusionsBroadly speaking, the socio-demographic profile of MRCS examiners reflects that seen in senior and leadership positions in surgery in the UK – that is, predominantly male and White - but not that seen in early-career surgeons. Positive action is now required in examiner recruitment by the Royal Colleges to ensure that the cohort of MRCS examiners reflects the modern surgical workforce.

The impact of Covid-19 pandemic on Italian surgeons: a national survey

Background: During the Covid-19 pandemic many surgeons found themselves in unfamiliar settings, trying to combine the increased workload with family duties. We hypothesized that female surgeons might have been subjected to higher stress levels and work-life tensions compared to their male counterpart. The aim of this study was to assess the psychological impact of the pandemic on Italian surgeons and investigate possible gender differences. Materials and Methods: A 47-items-questionnaire was distributed from February 7th to March 31st 2022 among Italian surgeons. Stress levels, mental health status, work-life tensions, gender equity, personal and professional satisfaction were explored. Results: A total of 869 responders were included in the analysis. Most responders were female (64%) with a median age significantly lower than the male counterparts (36 versus 45, p<0.001). The academic position was most often held by male surgeons (17%), while most of women were non-academic faculty (66%) or surgeon in-training (28%) (p<0.001). Even if male surgeons reported a higher number of dependent children and elder relatives (p<0.05), female surgeons perceived an increased burden related to their care-giving role (p=0.042). Being younger, in training and without an academic position was associated with higher stress levels, mostly occurring among women surgeons (p<0.05). Conclusions: Female surgeons, during the second peak of Covid-19 pandemic, experienced higher stress levels compared to men. Designed interventions are needed to support the female surgical workforce also in a post-pandemic setting.

Timely Access to Essential Surgery, Surgical Workforce, and Surgical Volume: Global Surgery Indicators in Mexico.

The Lancet Commission on Global Surgery seeks to improve surgical care outcomes and equity for the world population through 6 indicators outlined in its 2030 Global Surgery Report. Our study aimed to estimate the percentage of the Mexican population with access to surgical care within the 2-hour distance range (indicator 1), the surgical workforce density (indicator 2), and the number of surgical procedures performed per 100,000 inhabitants (indicator 3) during the year 2020. Knowing these indicators can help to design and implement policies to increase surgical care access coverage and equity in our country. Data related to population distribution, local referral hospitals, and surgical volume were obtained from the 2020 Mexican National Census. Information relating to hospital characteristics and surgical specialists was collected from the Secretariat of Health's public records. We calculated travel time between health care facilities and municipalities using the TrueWay Matrix API and R Studio. Taking into consideration the health care system affiliation, the proportion of the Mexican population with timely access to essential surgery was 81.7%, with 29.3 specialists per 100,000 inhabitants and 726.9 annual procedures performed per 100,000 inhabitants. We identified clusters of municipalities where a low proportion of the population has timely access to essential surgery. These findings illustrate that changes in Mexican policy are required to facilitate more equitable and timely access to essential surgical care among the population.

Geospatial Analysis of Accessibility to Surgical Care, a Brazilian Local Perspective.

Surgical care has been neglected and recently discussed by the World Health Organization as a necessary component of health care. Situations that distance individuals and medical services are of particular concern. We aim to estimate the distance a patient who lives in a municipality without a general surgeon would have to travel to access surgical care; and to describe the geographical distribution of the surgical workforce. We obtained the surgical data from DATASUS, from IBGE, the information regarding the classification of each municipality and its location, and FEPAM, the road network. We performed the geoprocessing analysis on QGIS and the statistical analysis on SPSS. The Rio Grande do Sul state had 496 municipalities, of which 69.4% were rural, with a mean of 9.19 general surgeons per overall municipality. A total of 237 cities had no general surgeons, of which 89.45% were in rural ones. There was a significant difference in the number of surgeons per municipality between rural and urban ones. We found a mean of 22.09 surgeons per 100,000 population. The mean distance traveled by a patient to a municipality with general surgeons available was 30.25km, with a minimum of 2.46km and a maximum of 268.22km. Disparities are associated with the geospatial distribution of surgical care in the Rio Grande do Sul state. The surgical workforce and the distance a patient travels are irregular geographically. This study is the start of inspiring other similar studies about geospatial surgical analysis.

Examining need and capacity for the development of a pediatric liver transplantation program in Kenya.

In Africa, pediatric liver transplantation (PLT) is currently only performed in Egypt and South Africa, leaving those who require treatment in Kenya to travel abroad. The aim of this study was to determine whether sufficient capacity and need exists in Kenya to establish a safe and sustainable PLT program. A descriptive analysis of the intensive care unit (ICU) beds, surgical workforce, current hepatobiliary volume, and estimated prevalence of pediatric liver disease (PLD) was conducted across 17 hospitals in Kenya between July and September 2020. Data were collected from medical superintendents, directors of surgical departments, or nominated proxies at Kenyan Level 5 and 6 hospitals via a web-based survey. A total of 165 ICU beds were reported at 17 facilities, with 15 facilities reporting five or more beds. About 39% of general surgeons at responding hospitals performed hepatobiliary procedures, and 30% performed pediatric surgeries. Only 10% of surgeons had pediatric training. Over half (57%) of hospitals performed hepatobiliary procedures; at the maximum, 1-5 cases were performed per week including cholecystectomy to Kasai portoenterostomy and hepatectomy. Across 13 hospitals, there were an estimated 192-570 cases of PLD seen per month. The most common PLDs were hepatitis B, neonatal hepatitis, cirrhosis, and acute hepatic failure. Overall, two hospitals possessed the minimum workforce and resources to attempt PLT. In Kenya, ICU bed availability, pediatric surgical training, and hepatobiliary volume are limited. However, the high prevalence of PLD demonstrated a significant need for PLT across all Kenyan hospitals.

First-trimester surgical abortion practice in Canada in 2012

To evaluate practices among first-trimester surgical abortion facilities and providers in Canada in 2012 and examine the characteristics of the surgical abortion work force. Self-administered paper or electronic survey adapted from a survey previously fielded in the United States. Canada. Facility administrators and physicians. Descriptive statistics on reported first-trimester surgical abortion practice and provider demographic characteristics. Eighty-three percent of identified facilities (78 of 94) and 178 physicians responded. Of the respondents, 99% of facilities and 96% of physicians provided first-trimester surgical abortions. Responding facilities provided 68,154 first-trimester surgical abortions in 2012. This represented 96% of their reported total (combined medical and surgical) first-trimester abortions. More than half (55%) of responding facilities were community based, while 45% were hospital affiliated. Most physician providers were female (68%) and were family doctors (59%). Preoperatively, 96% of physicians routinely used ultrasound and 89% gave perioperative antibiotics. Almost half (48%) used manual vacuum aspiration, but less than 35% did so beyond 9 weeks after the last menstrual period. At most facilities, most procedures were performed under combined local anesthesia and intravenous sedation (73%); only 7% indicated deep sedation or general anesthesia were used exclusively. Postoperatively, 81% of physicians performed immediate tissue examination and 96% offered postabortion contraception on the same day as the abortion. Other assessed outcomes included medication regimens and cervical preparation, with a high degree of consistency among facilities and physicians. First-trimester surgical abortion providers are mostly family physicians and most are female. Practices across Canada were mostly uniform and followed evidence-based guidelines. Uptake of the most recent Canadian practice guidelines may help further standardize patient care and improve routine perioperative antibiotic use and immediate tissue examination.

Delays in care for hydrocephalus and spina bifida at a tertiary hospital in Somaliland

BackgroundChildhood neurosurgical conditions such as hydrocephalus and spina bifida represent a significant burden of death and disability worldwide, particularly in low and middle-income countries. However, there are limited data on...

The unmet surgical needs of global refugee populations: A perspective review.

The global refugee community, including those forced to flee due to persecution, conflict, or violence, faces significant challenges in accessing healthcare, resulting in a higher prevalence of surgical disease. These challenges have a profound impact on morbidity and mortality rates, particularly in low- and middle-income countries where many immigrants seek refuge. Limited availability of medical facilities, an inadequate surgical workforce, financial constraints and linguistic and cultural barriers all contribute to reduced access to healthcare. Limited access to competent healthcare leads to poor health outcomes, increased morbidity and mortality rates and suboptimal surgical results for refugees. To address these challenges, a multifaceted approach is necessary. This includes increased funding for healthcare initiatives, workforce recruitment and training and improved coordination between aid organisations and local healthcare systems. Strategies for managing surgical conditions in the global refugee community encompass the development of targeted public health programmes, removing legal barriers, establishing healthcare facilities to enhance surgical access and prioritising disease prevention among refugees.

Will Artificial Intelligence Eventually Supplant Surgeons?

Abstract: This systematic review paper examines the current state of research on the potential for artificial intelligence (AI) to supplant surgeons. It covers a range of topics, including the capabilities of AI in surgical tasks, the ethical implications of using AI in surgery, and the potential impact on the surgical workforce. The result and analysis of the paper will evaluate the potential impact of AI on the field of surgery, including possible improvements in efficiency, accuracy, and patient outcomes. The conclusion will summarize the study's findings and discuss the potential for AI to supplant surgeons in specific procedures eventually.

The Surgical Sisterhood - The Experiences of wāhine Māori and Pasifika Aspiring Surgeons.

The establishment of a culturally diverse surgical workforce, largely on the basis of gender, has been highly promoted in Australasia in the last decade. Despite this, discussions of gender diversity in surgery have largely excluded Indigenous women. This study presents the experiences of wāhine Māori and Pasifika doctors in Aotearoa, who formed a surgical sisterhood to support them towards applying for advanced surgical training. Utilising mana wāhine and Masi methodologies, semi-structured interpersonal interviews were undertaken with five wāhine who formed the surgical sisterhood. Following transcription and analysis of all interviews, four key themes were identified. These were mana wāhine, unity, our why and change on the horizon. These themes illustrate the complex and varied experiences of wāhine Māori and Pasifika and how they have navigated their surgical pathways amidst multiple layers of discrimination towards being in a position to apply for advanced surgical training.

Geographical Inequalities in Access to Bellwether Procedures in Brazil.

Brazil is a middle-income country that aims to provide universal health coverage, but its surgical system's efficiency has rarely been analyzed. In an effort to strengthen surgical national systems, the Lancet Commission on Global Surgery proposed bellwether procedures as quality indicators of surgical workforces. This study aims to evaluate regional inequalities in access to bellwether procedures and their associated mortality across the five Brazilian geographical regions. Using DATASUS, Brazil's national healthcare database, data were collected on the total amount of performed bellwether procedures-cesarean section, laparotomy, and open fracture management-and their associated mortality, by geographical region. We evaluated the years 2018-2020, both in emergent and elective conditions. Statistical analysis was performed by one-way ANOVA test and Tukey's multiple comparisons test. During this period, DATASUS registered 2,687,179 cesarean sections, 1,036,841 laparotomies, and 648,961 open fracture treatments. The access and associated mortality related to these procedures were homogeneous between the regions in elective care. There were significant geographical inequalities in access and associated mortality in emergency care (p < 0.05, 95% CI) for all bellwether procedures. The Southeast, the most economically developed region of the country, was the region with the lowest amount of bellwether procedures per 100,000 inhabitants. Brazil's public surgical system is competent at promoting elective surgical care, but more effort is needed to fortify emergency care services. Public policies should encourage equity in the geographic allocation of the surgical workforce.

Surgical capacity, productivity and efficiency at the district level in Sub-Saharan Africa: A three-country study.

Efficient utilisation of surgical resources is essential when providing surgical care in low-resources settings. Countries are developing plans to scale up surgery, though insufficiently based on empirical evidence. This paper investigates the determinants of hospital efficiency in district hospitals in three African countries. Three-month data, comprising surgical capacity indicators and volumes of major surgical procedures collected from 61 district-level hospitals in Malawi, Tanzania, and Zambia, were analysed. Data envelopment analysis was used to calculate average hospital efficiency scores (max. = 1) for each country. Quantile regression analysis was selected to estimate the relationship between surgical volume and production factors. Two-stage bootstrap regression analysis was used to estimate the determinants of hospital efficiency. Average hospital efficiency scores were 0.77 in Tanzania, 0.70 in Malawi and 0.41 in Zambia. Hospitals with high efficiency scores had significantly more surgical staff compared with low efficiency hospitals (DEA score<1). Hospitals that scored high on the most commonly utilised surgical capacity index were not the ones with high surgical volumes or high efficiency. The number of surgical team members, which was lowest in Zambia, was strongly, positively correlated with surgical productivity and efficiency. Hospital efficiency, combining capacity measures and surgical outputs, is a better indicator of surgical performance than capacity measures, which could be misleading if used alone for surgical planning. Investment in the surgical workforce, in particular, is critical to improving district hospital surgical productivity and efficiency.

Evolution of a Transplant Surgery Advanced Practice Provider Practice Model in the Care of High-Acuity Liver Transplant Recipients: A Single-Center Experience

The role of advanced practice providers (APPs) in an academic transplant surgical acute care setting remains to be defined. We sought to evaluate the impact of a transplant surgeon-APP (TSAPP) practice model on patient access and outcomes in the care of critically ill patients with end-stage liver disease (ESLD) in an academic transplant center. A retrospective analysis evaluated the effect of practice model evolution over an 11-year period on hospital access of patients with ESLD to an academic liver transplantation center and survival outcomes. We compared 3 practice models: era 1 (transplant surgeon-general surgery resident; January 2009 to Sept 2012): vs era 2 ( transition transplant surgeon-general surgery resident to TSAPP; October 2012 to December 2016): vs era 3 (TSAPP; January 2017 to December 2020). Patient access to hospitalization and inpatient service census increased significantly over time with TSAPP model (P < .01). At the time of liver transplant, the median Model for End-Stage Liver Disease scores for era 1 (25), era 2 (33), and era 3 (34), P < .01, and patient requirement for intensive care unit for era 1 (7.1%), era 2 (44.8%), and era 3 (56.4%), P < .01, have increased. The overall 1-year patient survival rates remained comparable across all eras: era 1 (93.88%), era 2 (93.11%), and era 3 (94.06%), P=.77 CONCLUSIONS: The APPs play an integral role in clinical transplantation practice. The integration of APPs into the transplant surgical workforce increased access of high-acuity patients with ESLD to the transplantation center. In addition, it provided excellent patient and graft survival outcomes after liver transplant.

Monitoring Indicators of Universal Access to Accessible and Safe Anesthetic and Surgical Care in a Peruvian Region: An Ambispective Study

IntroductionThe Lancet Commission on Global Surgery indicators for monitoring anesthetic and surgical care allow the identification of access barriers, evaluate the safety of surgeries, facilitate planning, and assess changes over time. The primary objective was to measure these indicators in all health facilities of a Peruvian region in 2020. MethodsThis was an ambispective observational study to measure the anesthetic and surgical care indicators in Piura, a region in Peru, between January 2020 and June 2021. Public and private health facilities in the Piura region that performed surgical care or had specialists from any surgical specialty participated in the study. Data were collected from all regional health facilities that provided surgical care to estimate the density of surgical workforce. Likewise, the percentage of the population with access to an operating room within 2 h was estimated using georeferenced tools. Finally, a public database was accessed to determine the surgical volume, the percentage of the regional population protected with health insurance. ResultsIn 2020, 88.4% of the inhabitants of this Peruvian region had access to timely essential surgery. There were 18.4 surgical specialists and 1174 surgeries per 100,000 populations, and 91% of the population had health insurance. In addition, there was a rate of 2.1 working operating rooms per 100,000 inhabitants in 2021. ConclusionsThis Peruvian region presented an increasing trend with respect to the population's access to essential and timely surgical care, and health insurance coverage. However, the workforce distribution was inequitable among the provinces of the region, the surgical volume was reduced, and timely access was hindered because of the SARS-CoV-2 pandemic.

Cultural Diversity, Bias, and Patient Safety: A Case-Based Discussion

BackgroundSocial and cultural bias on the part of both patients and health care workers is common in the surgical setting. When bias generates behavior that influences patient care strategies or disrupts operational flow, quality suffers and patient safety is threatened. MethodsA subgroup composed of members of The Society of Thoracic Surgeons Workforce on Patient Safety and the Workforce on Diversity, Equity, and Inclusion joined to create and discuss clinical scenarios where patient or provider bias and oppression compromised patient safety. A transcript of the first video discussion is included, along with a brief discussion. ResultsDiscussants agreed that cultural diversity needs to improve within the cardiothoracic surgical specialty. Whereas all agreed that bias and oppression have the potential to impair patient safety and that the clinical result was of primary importance, opinions differed regarding the most effective verbal response to a biased patient. ConclusionsCultural and gender bias in clinical cardiothoracic surgical practice has the very real potential to compromise patient safety. As cultural and gender diversity in the cardiothoracic surgical workforce is improving, patients are expected to accept and embrace a more diverse surgical team.

Situation and the need of specialist surgeons working in provincial and district hospitals by ecological regions throughout Vietnam

Abstract Introduction: Surgical pathologies account for 28-32% of the global disease burden, however human resource in surgery (surgical workforce) is still not good enough. The study aimed to describe the current situation and the need of specialist surgeons for working in provincial and district hospitals by representation of ecological regions (ecoregions). Patients and methods: A cross-sectional study has conducted in 7 provinces/cities with 27 hospitals. Results: The current number of surgeons was mostly distributed for the Coastal and Southern Central regions accounted for 23.3%; in Red River Delta was 22.3%. The need for surgeons for the Central Coast and South-Central region (30.6%) was the highest, but its lowest in the Central Highlands region for 2025. The distribution of surgical workforce according to the hospital classification categories showed that the surgeons commonly work in provincial level (81.1%). The need for surgeons for provincial hospitals was the highest as 78.4%. Conclusion: The distribution of surgical workforce was unbalanced among ecoregions, especially there was a shortage of specialist surgeons such as neurosurgeons, cardiovascular and pediatric surgeons. It is recommended to support in-depth training in professional knowledge and skills and prioritize short-term, more practical types. Keywords: Human resource situation, human resource needs, demand for doctors, surgeons

The History of the National Clinicians Scholars Program and Surgery: A New Inlet to the Surgical Workforce Pipeline of Diversity, Equity, and Inclusion.

The History of the National Clinicians Scholars Program and Surgery: A New Inlet to the Surgical Workforce Pipeline of Diversity, Equity, and Inclusion.

Current Status of National Institutes of Health Research Funding for Women Surgeon-Scientists

Women have made substantial advancements in academic surgery, but research funding disparities continue to hamper their progress, and current literature on the status of National Institutes of Health (NIH) funding awarded to women surgeon-scientists appears to be conflicting. To examine gender-based differences in NIH funding awarded to surgeon-scientists by comparing total grant amounts awarded and the distribution of grants by gender and research type. This cross-sectional study was performed using a previously created database of NIH-funded surgeons from 2010 to 2020. Active physician data from the Association of American Medical Colleges were used to calculate total surgeon populations. This study was performed at the NIH using the NIH internal data platform, iSearch Grants. A total of 715 men and women surgeon-scientists funded by the NIH in 2010 and 1031 funded in 2020 were included in the analysis. The main outcome was the number of women among the total number of surgeons who received NIH grants and the total grant amounts awarded to them. Bivariate χ2 analyses were performed using population totals and substantiated by z tests of population proportions. This study included 715 physicians (n = 579 men [81.0%]) in 2010 and 1031 physicians (n = 769 men [74.6%]) in 2020. In 2020, women comprised 27.4% of the surgical workforce and 25.4% of surgeons with research funding in the US, but they received only 21.7% of total NIH research funding awarded to all surgeons. The number of funded women surgeon-scientists, however, significantly increased from 2010 to 2020 (262 [25.4%] in 2020 vs 136 [19.0%] in 2010; P < .001) as did their funding ($189.7 million [21.7%] in 2020 vs $75.9 million [12.3%] in 2010; P < .001). Furthermore, the proportion of US women surgeons overall with NIH funding significantly increased in 2020 vs 2010 (0.7% vs 0.5%; P < .001). Basic science, clinical outcomes, and clinical trial R01 grants also increased among women surgeon-scientists. Women and men K grant holders had a similar mean (SD) number of R01 application attempts before success (2.7 [3.01] vs 2.3 [3.15]; P = .60) and similar K-to-R award conversion rates (23.5% vs 26.7%; P = .55). This cross-sectional study found an increasing number of women surgeon-scientists receiving NIH funding in 2020 vs 2010 as well as increases in the median grant amounts awarded. Although these results are promising, a discrepancy remains in the proportion of women in the surgical workforce compared with those funded by the NIH and the total grant amounts awarded to them.

Will Female Surgeon-Scientists Save Academic Surgery?

INTRODUCTION: Gender equity among surgeon-scientists is critical for diverse and equitable clinical innovation. However, little is known about trends in gender diversity among surgeon-scientists. With the increasing number of women entering surgery, we hypothesized that women would make up an increasing proportion of surgeon-scientists. METHODS: NIH-funded surgeons (“surgeon-scientists”) were identified from NIH RePORTER from 1995 to 2020. Academic surgeons’ data were retrieved from the Association of American Medical Colleges Physician Masterfile. Academic surgeons were defined as MD, or MD-PhD faculty with board certification in any surgical specialty. Gender was determined by pronouns and image on institutional and Doximity profiles. RESULTS: Surgeon-scientists had less growth in number compared with academic surgeons (1.6-fold vs 2.3-fold; p < 0.001), and the percentage of surgeon-scientists decreased from 6.09% to 4.40% (Fig. 1A). The number of male surgeon-scientists increased 1.4-fold from 280 to 393, compared with a 2.3-fold increase in male academic surgeons, from 4,820 to 10,989 (Fig. 1B)). During the same years, the number of female surgeon-scientists increased 6.5-fold (14 to 91, Fig. 1C)), which was greater than the increase for female academic surgeons (2.7-fold, 792 to 4,055). Among surgeon-scientists, women increased at an annual rate of 0.54% (Fig. 1D)). In 2020, women comprised 17.3% of surgeon-scientists, compared with 27.5% of academic surgeons.CONCLUSION: Although the proportion of surgeon-scientists is decreasing among academic surgeons, female surgeon-scientists increased 4-fold compared with men, yet only represented 36.9% of the academic workforce. Structural support for women surgeon-scientists at the institutional and national level is needed to achieve gender equity in the surgical research workforce.