Key Points Question What are the perceived barriers and facilitators to promotion and professional success for women in academic surgery? Findings In this qualitative study of 26 female academic surgeons, a complex matrix of organizational and individual factors was found to contribute to sex inequities for the professional advancement of women in academic surgery. Meaning This research may provide insight into the sex biases that inhibit advancement, may inform strategies that can facilitate progress, and may inspire interventions that could help eliminate institutional and individual barriers to the academic success of women.

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