Women In Academic Surgery Research Articles

Negotiation and Career Advancement: How Can We Continue to Advance Women in Academic Surgery, What Are the Barriers They Are Facing, and What Can We Do to Overcome Them?

Despite increasing female representation in U.S. medical schools, women remain underrepresented in academic surgery departments across the country. Even as the gap narrows in academic surgery, female surgeons' professional advancement does not parallel that of their male counterparts. This article explores how to continue to advance women in academic surgery, first by considering the barriers women surgeons face, then offering actionable steps-on the individual, interpersonal, and systems levels-to overcome these barriers and work toward gender equity.

Overcoming COVID-19: Strategies to Mitigate the Perpetuated Gender Achievement Gap.

Sex inequity in academic achievement was well documented before the COVID-19 pandemic, and evolving data suggest that women in academic surgery are disproportionately disadvantaged by the pandemic. This perspective piece reviews currently accepted solutions to the sex achievement gap, with their associated shortcomings. We also propose innovative strategies to overcoming barriers to sex equity in academic medicine that broadly fall into three categories: strategies to mitigate inequitable caregiving responsibilities, strategies to reduce cognitive load, and strategies to value uncompensated, impactful work. These approaches address inequities at the system-level, as opposed to the individual-level, lifting the burden of changing the system from women.

Maxillofacial Female Surgeons: Perspectives and Obstacles

There are many challenges and many barriers to the maxillofacial profession for female surgeons, particularly the beginners of their career. The reported analysis data revealed that this is not concentrated in developing countries, but it is unexpectedly found in many developed and high-income countries. The continued progress of women in academic surgery depends on addressing such issues and trying to solve these challenging problems.

Maxillofacial Female Surgeons: Perspectives and Obstacles

There are many challenges and many barriers to the maxillofacial profession for female surgeons, particularly the beginners of their career. The reported analysis data revealed that this is not concentrated in developing countries, but it is unexpectedly found in many developed and high-income countries. The continued progress of women in academic surgery depends on addressing such issues and trying to solve these challenging problems.

Women in academic surgery over the last four decades.

As the number of female medical students and surgical residents increases, the increasing number of female academic surgeons has been disproportionate. The purpose of this brief report is to evaluate the AAMC data from 1969 to 2018 to compare the level of female academic faculty representation for surgical specialties over the past four decades. The number of women as a percentage of the total surgeons per year were recorded for each year from 1969-2018, the most recent year available. Descriptive statistics were performed. Poisson regression examined the percentage of women in each field as the outcome of interest with the year and specialty (using general surgery as a reference) as two predictor variables. Data from the American Association of Medical Colleges (AAMC). All full-time academic faculty physicians in the specialties of obstetrics and gynecology (OB/GYN), general surgery, ophthalmology, otolaryngology (ENT), plastic surgery, plastic surgery, urology, neurosurgery, orthopaedic surgery and cardiothoracic surgery as per AAMC records. The percentage of women in surgery for all specialties evaluated increased from 1969 to 2018 (OR 1.04, p<0.001). Compared with general surgery, the rate of yearly percentage change increased more slowly in neurosurgery (OR 0.84; P = .004), orthopaedic surgery (OR 0.82; P = .002), urology (OR 0.59; P < .001), and cardiothoracic surgery (OR 0.38; P < .001). There was no significant difference in the rate of yearly percentage change for plastic surgery (OR 1.01; P = .840). The rate of yearly percentage change increased more rapidly in OB/GYN (OR 2.86; P < .001), ophthalmology (OR 1.79; P < .001) and ENT (OR 1.70; P < .001). Representation of women in academic surgery is increasing overall but is increasing more slowly in orthopaedic surgery, neurosurgery, cardiothoracic surgery and urology compared with that in general surgery. These data may be used to inform and further the discussion of how mentorship and sponsorship of female students and trainees interested in surgical careers may improve gender equity in the future.

Women in Academic Surgery: A Double-Edged Scalpel.

Women continue to be underrepresented in academic surgery, especially at the leadership level. Surgical culture has been historically male dominated and recently received negative attention for higher rates of mistreatment, sexual harassment, and attrition of women compared with other medical specialties. The authors examine factors that contribute to challenges in academic surgery, making it a potentially difficult environment for women and underrepresented minorities; these include surgical culture, work-life balance, and historic promotion timelines. Efforts to change social norms and structural biases are critical to improving gender parity in academic surgery.

A Call to Action: Black/African American Women Surgeon Scientists, Where are They?

To determine the representation of Black/AA women surgeons in academic medicine among U.S. medical school faculty and to assess the number of NIH grants awarded to Black/AA women surgeon-scientists over the past 2 decades. Despite increasing ethnic/racial and sex diversity in U.S. medical schools and residencies, Black/AA women have historically been underrepresented in academic surgery. A retrospective review of the Association of American Medical Colleges 2017 Faculty Roster was performed and the number of grants awarded to surgeons from the NIH (1998-2017) was obtained. Data from the Association of American Medical Colleges included the total number of medical school surgery faculty, academic rank, tenure status, and department Chair roles. Descriptive statistics were performed. Of the 15,671 U.S. medical school surgical faculty, 123 (0.79%) were Black/AA women surgeons with only 11 (0.54%) being tenured faculty. When stratified by academic rank, 15 (12%) Black/AA women surgeons were instructors, 73 (59%) were assistant professors, 19 (15%) were associate professors, and 10 (8%) were full professors of surgery. Of the 372 U.S. department Chairs of surgery, none were Black/AA women. Of the 9139 NIH grants awarded to academic surgeons from 1998 and 2017, 31 (0.34%) grants were awarded to fewer than 12 Black/AA women surgeons. A significant disparity in the number of Black/AA women in academic surgery exists with few attaining promotion to the rank of professor with tenure and none ascending to the role of department Chair of surgery. Identifying and removing structural barriers to promotion, NIH grant funding, and academic advancement of Black/AA women as leaders and surgeon-scientists is needed.

Knowing Better and Doing Better to Advance Women in Academic Surgery

Knowing Better and Doing Better to Advance Women in Academic Surgery

Defining Barriers and Facilitators to Advancement for Women in Academic Surgery

Sex equity is elusive in academic surgery departments across the United States. Persistent inequities remain a considerable problem and inhibit professional advancement for female surgeons. Identifying the factors that promulgate sex discrepancies may provide a framework for institutional growth and personal progress for women. To identify barriers and facilitators to success at the individual and organizational level to develop evidence-based interventions designed to close the sex gap in surgery. This qualitative study included 26 female participants who were current and former surgical faculty employed by Michigan Medicine, the health system of the University of Michigan, between 2000 and 2017. Semistructured personal interviews were conducted from June 28 to September 29, 2017, via telephone. Each interview lasted 45 minutes to 1 hour. Interviews were recorded and then transcribed for analysis. The interview included 7 questions referring to the surgeon's experience with the Michigan Medicine Department of Surgery and 7 questions referring to nonspecific areas of interest. The 26 participants in this study ranged in age from 32 to 64 years, with faculty experience ranging from 3 to 22 years. Thematic analysis was used to locate, analyze, and report patterns within the data related to barriers and facilitators for women in academic medicine. Three major themes were identified by researchers. Participants reported that (1) organizational culture and institutional policies affect opportunities for advancement; (2) relational interactions with leadership, mentors, colleagues, and staff affect promotion and attrition; and (3) individual characteristics mediate the perception of professional and personal success. In this qualitative study of 26 female academic surgeons, a complex matrix of organizational and individual factors were found to contribute to sex inequities in academic surgery. This research may provide insight into the sex biases that inhibit advancement, may inform strategies that facilitate progress, and may inspire interventions that could help eliminate institutional and individual barriers to the academic success of women.

Barriers to careers identified by women in academic surgery: A grounded theory model

BackgroundFaculty attrition has been widely acknowledged and poorly understood throughout academic medicine. To date, barriers to career advancement in academic surgery have been identified and described in a limited fashion using only survey data. The authors sought to characterize career barriers for women academic surgeons using grounded theory methodology. MethodsAuthors conducted semi-structured interviews with 15 mid-career and senior female academic surgeons in the United States. Data were drawn together using grounded theory analysis of interview transcripts to develop a conceptual model. ResultsInterviewees identified barriers constituting two intersecting categories: (1) obstacles within the system of academic surgery and (2) impediments based in broader culture and its power structures. Interviewees’ robust description of the challenges of integrating clinical and non-clinical professional responsibilities is novel. ConclusionsCareer barriers identified by women in academic surgery are complex and include cultural factors from within and outside of the profession. Identifying and dismantling barriers, particularly those that negatively impact perceptions of belonging, is imperative to creating a culture of sustained excellence in academic surgery. SummaryThe authors used grounded theory method to develop a conceptual model of barriers to careers in academic surgery as described by successful female academic surgeons. The authors identified intersecting cultural barriers specific to academic surgery and derived from cultural power differentials.

Glass Ceilings and Sticky Floors: Defining Barriers and Facilitators to Advancement for Women in Academic Surgery

Thompson-Burdine, Julie A.; Dombrowski, Janet C. BSN, MHSA; Telem, Dana MD, MPH; Waljee, Jennifer F. MD, FACS; Newman, Erika A. MD, FACS; Coleman, Dawn M. MD; Stoll, Hadley; Sandhu, Gurjit PhD Author Information

Does Sex Influence Publication Productivity Among Colorectal Surgeons Participating in Fellowship Training Programs?

Underrepresentation of highly ranked women in academic surgery is recognized. Our objective was to examine whether sex differences exist in faculty representation, academic rank, and publication productivity among colorectal faculty in fellowship programs. American Society of Colon and Rectal Surgeons fellowship program faculty were identified. Bibliometric data were obtained for each faculty member, including Hirsch index, the Hirsch index divided by research career duration, and number of publications. Linear mixed-effect regression models were constructed to determine the association between the Hirsch index and the Hirsch index divided by research career duration and sex, when controlling for institutional measures. A subset analysis of academic faculty examined the association between academic rank, sex, and Hirsch index and the Hirsch index divided by research career duration. Colorectal fellowship programs, defined as academic, satellite-academic, and nonacademic, were evaluated. Three hundred fifty-eight faculty members were examined across 55 training programs; 22% (n = 77) were women and 78% (n = 281) were men. Sixty-one percent (n = 220) practiced in an academic setting, 23% (n = 84) in a satellite-academic setting, and 15% (n = 54) in a nonacademic setting. There was no difference in median number of publications between sexes (15 vs 10, p = 0.33); men, however, had longer careers (18 vs 11 years, p < 0.001). When controlling for confounders, there was no difference in the Hirsch index (p = 0.42) or the Hirsch index divided by research career duration (p = 0.73) between sexes. Academic rank was significantly associated with Hirsch index and the Hirsch index divided by research career duration (p < 0.001) after controlling for sex. Our assessment of association between publication productivity and academic rank was only possible in the subset of academic faculty. In addition, this study is limited by its retrospective nature. We found no difference in median number of publications between men and women. When controlling for possible confounders, sex was not a significant predictor of a faculty member's publication productivity, as measured by the Hirsch index or the Hirsch index divided by research career duration; academic rank, however, was.

The Female Pediatric Surgeon

AbstractIn medical schools throughout Europe, women make up an increasing proportion of graduates entering the medical profession. Even though this phenomenon is also found in the surgical profession, women are still clearly underrepresented. However, it has been demonstrated that women are equally qualified as men, and are as eager as men to aim for a surgical career.In general, a career in surgery has significant lifestyle implications for both men and women. In particular, women meet challenges such as pregnancy, maternity, and responsibility for childcare that compete with pressures of time and expectations of productivity. Further complicating the situation, there is a huge complexity of national legislation dealing with maternity and parental leave within Europe. Owing to this legal inconsistency, a strong demand on targeted policies and guidelines has increased particularly among the surgical staff.The scarcity of female role models and mentors has also been discussed as a possible explanation for the underrepresentation of women in academic surgery. Even in the 21st century, the advancement of women into leading positions of academic surgery and major surgical societies is still limited. An updated view of leadership development, the promotion of female surgeons in academic surgery, and identifying barriers to women entering this field are crucial to correcting the existing gender inequities.This contribution aims to highlight the current situation of women in academic surgery, outline findings on gender disparities, and define persistent obstacles to the advancement of women in surgery. In addition, this review presents new possibilities and provides approaches to overcome the underrepresentation of female surgeons. In current literature, there is only little information concerning the situation of female pediatric surgeons. Therefore, this article mainly relies on available data on the female surgeon in general.

Women in academic surgery: why is the playing field still not level?

BackgroundThe purpose of this study was to explore career satisfaction and advancement for women in academic surgery. MethodsA 48-item web-based survey was emailed to women surgeons in academic centers across Canada, exploring career advancement, family planning, mentorship, discrimination, and career satisfaction. ResultsThe survey response rate was 38% (81 of 212); 18% of participants felt they experienced gender discrimination in medical school, 36% in residency, 12% in fellowship, and 41% as staff surgeons. More than half felt that their gender had played a role in the career challenges they faced. Responses to open-ended questions suggested that many surgeons struggled to balance their academic careers with family life. Despite this, participants rated their career satisfaction very highly. ConclusionsThere remain ongoing challenges for women in academic surgery including lack of gender equality, appropriate mentorship, and accommodations for surgeons with families. Continued advancement of women in academic surgery is dependent on addressing these concerns.

Breaking Down the Walls: Removing Structural Barriers for Women in Academic Surgery

<i>Breaking Down the Walls: Removing Structural Barriers for Women in Academic Surgery</i>

Women in Academic Surgery: The Pipeline Is Busted

This investigation examined the trends for gender-based advancement in academic surgery by performing a comparative analysis of the rate of change in the percentage of medical students, surgery residents, and full professors of surgery who are women. All available Women in Medicine Annual Reports were obtained from the American Association of Medical Colleges (AAMC). The gender compositions of medical graduates, surgery residents, and full professors were plotted. Binomial and linear trendlines were calculated to estimate the year when 50% of surgery full professors would be women. Additionally, the percentage distribution of men and women at each professorial rank was determined from 1995 to 2009 using these reports to demonstrate the rate of academic advancement of each gender. The slope of the line of increase for women full professors is significantly less than for female medical students and for female general surgery residents (0.36, compared with 0.75 and 0.99, respectively). This predicts that the earliest time that females will account for 50% of full professors in surgery is the year 2096. When comparing women and men in academic ranks, we find that women are much less likely than men to be full professors. The percentage of full professors in surgery who are women is increasing at a rate disproportionately slower than the increases in female medical students and surgery residents. The rates of increase in female medical students and surgery residents are similar. The disproportionately slow rate of increase in the number of female full professors suggests that multiple factors may be responsible for this discrepancy.

Is There Still a Glass Ceiling for Women in Academic Surgery?

Despite the dramatically increased entry of women into general surgery and surgical subspecialties, traditionally male-dominated fields, there remains a gross under-representation of women in the leadership positions of these departments. Women begin their careers with fewer academic resources and tend to progress through the ranks slower than men. Female surgeons also receive significantly lower salaries than their male counterparts and are more vulnerable to discrimination, both obvious and covert. Although some argue that female surgeons tend to choose their families over careers, studies have actually shown that women are as eager as men to assume leadership positions, are equally qualified for these positions as men, and are as good as men at leadership tasks.Three major constraints contribute to the glass-ceiling phenomenon: traditional gender roles, manifestations of sexism in the medical environment, and lack of effective mentors. Gender roles contribute to unconscious assumptions that have little to do with actual knowledge and abilities of an individuals and they negatively influence decision-making when it comes to promotions. Sexism has many forms, from subtle to explicit forms, and some studies show that far more women report being discriminately against than do men. There is a lack of same-sex mentors and role models for women in academic surgery, thereby isolating female academicians further. This review summarizes the manifestation of the glass-ceiling phenomenon, identifies some causes of these inequalities, and proposes different strategies for continuing the advancement of women in academic surgery and to shatter the glass ceiling.

Women's Career Development

I n “Is There Still a Glass Ceiling for Women in Academic Surgery?”, Drs Zhuge, Kaufman, and Velazquez demonstrate that women’s increasing representation is not achieving hoped-for advances in gender equity. One might counter that great strides forward have been made in the short space of 2 generations; women now outnumber men in entering classes at most universities and many medical schools, and most young women now take educational opportunities for granted. Furthermore, is it not simply likely that women who do not climb the ranks just prefer to devote more of themselves to their families or lack the necessary appetite for competition? The situation for men is not so great these days either. Besides, haven’t we heard enough about this topic already? There is some truth to the joke that the problem is not a glass ceiling—just a very dense layer of men. While men may not intend for their traditional dominance to inhibit the career development of women, gendered features of the culture are impeding women’s reaching their potential.

Scientific Impact of Women in Academic Surgery

To evaluate the scientific impact of women in the surgical literature. Gender of the principal investigator of every abstract presented at the 2002, 2003, and 2004 annual meetings of the Association for Academic Surgery and Society of University Surgeons was identified by internet search. Resulting publications were identified using PubMed. Journal impact factor and number of article citations were determined using ISI Web of Knowledge. The principal investigator's gender was identified for 649 (98.8%) of the 657 abstracts presented at the 2002--2004 AAS meetings. Women authored 9.1% of abstracts and 11.8% of total resulting publications. The publication rate of abstracts by women was significantly higher than that of men (69.5% versus 52.4%, P = 0.0132). There was a trend toward higher average impact factors of journals in which female authors published (3.265 versus 2.673, P = 0.0626). There was no significant difference in mean number of citations per publication. The principal investigator's gender was identified for all 337 (100%) abstracts presented at the 2002--2004 SUS meetings. Women authored 11.0% of abstracts and 11.2% of resulting publications. Publication rates and average citation numbers were similar for female and male authors. The average impact factors of journals in which women published were significantly higher (4.741 versus 3.348, P = 0.0082). Although women comprise a small proportion of principal investigators on abstracts presented at these conferences, the quality of their presented work is equal to or better than those of their male counterparts.

22. Scientific Impact of Women in Academic Surgery

22. Scientific Impact of Women in Academic Surgery