From surviving to thriving: How can female surgeons overcome barriers in the male-dominated specialty?
Key Takeaways
In the US in 2022, only 23% of general surgeons and 11% of orthopedic surgeons were female.
Women in surgery face many challenges, including lack of representation, gender discrimination, bias by referring physicians, lower pay, and discouragement from pursuing motherhood.
Only the right policies and cultural changes can ensure that women have an equal opportunity to excel in surgery.
Gender inequality remains a persistent problem for women in the American workforce, especially within the field of surgical medicine. According to a national statistic, only 23% of general surgeons in the United States were female.[]
This low representation of women in surgery is partly due to the discouragement women receive from pursuing a career in surgery—sometimes even at the hands of their male colleagues. Women who specialize in surgery often struggle to advance their careers.
They are more likely to quit surgical residencies and less likely to become board-certified surgeons than men.
What is behind the under-representation of women in surgery?
A Lancet study confirms the high attrition rates among female surgical trainees.[] Reasons given include long working hours, fatigue and sleep deprivation, unpredictable lifestyle, impact on relationships, lack of learning opportunities, and bullying, along with the impacts of pregnancy, childbirth, and childrearing.
Insufficient role models and the unsupportive attitudes of colleagues and superiors also exacerbate the problem.
The lack of role models can be critical. Research by the Royal College of Surgeons has found that many junior trainees do not determine a surgical career to be suitable for them due to the absence of "identity fit."[] This is obvious, given the fact that, as of 2020, only 28 of 354 academic chairs of surgical departments in the US were female.[] Although some women have been encouraged and inspired by positive mentors and sponsors, there is still a long way to go before true equality can be achieved.
Parenthood disproportionally affects female’s careers
Time and again, pregnancy has been singled out as a barrier to career development. Since women in medicine receive inadequate maternity leave and limited support for childcare, they often delay having children.[]
They are also twice as likely to experience miscarriages as women in the general population.
Surgery is a physically taxing job, requiring doctors to stand for hours and work an unpredictable schedule, including night shifts, which has been associated with a higher risk of miscarriage in females.
Gender discrimination
Research shows that female surgical residents experience gender discrimination and sexual harassment during training.
According to a report published in JAMA Surgery, a staggering 80% of female surgical residents in the United States reported experiencing gender-based discrimination.[] These forms of discrimination can range from being misidentified as a nonphysician by patients to more subtle forms of exclusion and marginalization.
Approximately 43% of female surgical residents also reported experiencing sexual harassment involving distasteful, belittling, or explicit comments. These comments are commonplace from “the old boys’ club.”
Patient referrals and compensation
Female surgeons lose out on referrals, too, receiving 5.4 fewer new patient referrals per month than their male counterparts—a disparity believed to arise from the bias by referring physicians.[] Moreover, female surgeons perform fewer complex procedures than male surgeons—not the result of incompetence or lack of training, but due to this bias.
All of this amounts to lower compensation and diminished career advancement opportunities for female surgeons.
Potential solutions
Innovative hospital policies, such as providing more maternity leave and flexible scheduling, are needed to create equal employment opportunities. However, this just scratches the surface of needed changes. The prevailing belief that surgeons need to be challenging, stoic, and willing to prioritize work over personal life must change. And this paradigm shift can only take place by a systematic policy change.
Organizations like the Association of Women Surgeons and the Society of Black Academic Surgeons are working to create more inclusive and supportive environments for underrepresented groups. These organizations provide mentorship, networking opportunities, and advocacy for the advancement of women and people of color in surgery.
What this means for you
Gender disparity continues to afflict the healthcare workforce, including the field of surgery. Many gender-based beliefs adverse to women are well-entrenched in surgical training and practice, and present obstacles to equality of opportunity for women. Healthcare professionals, regardless of their gender, should acknowledge and honor their accomplishments while striving for a more equitable and supportive environment for all surgeons. Gender must never impede the acquisition and exercise of surgical competence, and every member of the surgical team ought to be valued and recognized for their expertise.