Comparison of Male and Female Surgeons’ Experiences With Gender Across 5 Qualitative/Quantitative Domains

Abstract

ImportanceA growing body of literature has been developed with the goal of attempting to understand the experiences of female surgeons. While it has helped to address inequities and promote important programmatic improvements, work remains to be done.ObjectiveTo explore how practicing male and female surgeons’ experiences with gender compare across 5 qualitative/quantitative domains: career aspirations, gender-based discrimination, mentor-mentee relationships, perceived barriers, and recommendations for change.Design, Setting, and ParticipantsThis national concurrent mixed-methods survey of Fellows of the American College of Surgeons (FACS) compared differences between male and female FACS. Differences between female FACS and female members of the Association of Women Surgeons (AWS) were also explored. A randomly selected 3:1 sample of US-based male and female FACS was surveyed between January and June 2020. Female AWS members were surveyed in May 2020.ExposureSelf-reported gender.Main Outcomes and MeasuresSelf-reported experiences with career aspirations (quantitative), gender-based discrimination (quantitative), mentor-mentee relationships (quantitative), perceived barriers (qualitative), and recommendations for change (qualitative).ResultsA total of 2860 male FACS (response rate: 38.1% [2860 of 7500]) and 1070 female FACS (response rate: 42.8% [1070 of 2500]) were included, in addition to 536 female AWS members. Demographic characteristics were similar between randomly selected male and female FACS, with the notable exception that female FACS were less likely to be married (720 [67.3%] vs 2561 [89.5%]; nonresponse-weighted P < .001) and have children (660 [61.7%] vs 2600 [90.9%]; P < .001). Compared with female FACS, female AWS members were more likely to be younger and hold additional graduate degrees (320 [59.7%] were married; 238 [44.4%] had children). FACS of both genders acknowledged positive and negative aspects of dealing with gender in a professional setting, including shared experiences of gender-based harassment, discrimination, and blame. Female FACS were less likely to have had gender-concordant mentors. They were more likely to emphasize the importance of gender when determining career aspirations and prioritizing future mentor-mentee relationships. Moving forward, female FACS emphasized the importance of avoiding competition among female surgeons. They encouraged male surgeons to acknowledge gender bias and admit their potential role. Male FACS encouraged male and female surgeons to treat everyone the same.Conclusions and RelevanceExperiences with gender are not limited to supportive female surgeons. The results of this study emphasize the importance of recognizing the voices of all stakeholders involved when striving to promote workforce diversity and the related need to develop quality improvement/surgical education initiatives that enhance inclusion through open, honest discourse.

Gender Disparity in National Institutes of Health Funding Among Surgeon-Scientists From 1995 to 2020

“…Women surgeons often lack the critical mentorship necessary for advancement . Women surgery trainees are more likely to experience burnout and mistreatment compared with their men counterparts, resulting in higher attrition from surgical training . In addition, lack of support surrounding childcare and motherhood may also increase the risk of attrition from surgical training .…”

Queen Bee Phenomenon—Repairing the Hive in Surgery

“…Their results highlight the disparities in gender experiences in surgery, with women surgeons reporting higher levels of gender-based disparities (47.3% vs 96.3% FACS and 94.8% AWS; P < .001) and lower rates of gender-concordant mentors (57.5% vs 92.3%; P < .001) . Their qualitative findings were particularly interesting.…”

“…However, compared with the general body of medicine, the increase in the number of women surgeons has been disproportionately stagnant, with even fewer women in positions of leadership . In this issue of JAMA Surgery , Zogg and colleagues used a survey-based assessment of Fellows of the American College of Surgeons (FACS) and Association of Women Surgeons (AWS) members to explore the role of surgeon gender in career aspirations, gender-based discrimination, mentor-mentee relationships, perceived barriers, and recommendations for change.…”

“…Their qualitative findings were particularly interesting. When participants were surveyed on how women surgeons may best improve the female surgeon experience, the most common response identified was to “Support each other and stop creating competition,” followed closely by “Do not ignore disparities or implicit bias,” and “Be a mentor/sponsor to other women surgeons.”…”

Seeing Gender Bias Through a Corrected Lens

“…It is not a surprise to see that male surgeons also perceive themselves as affected by gender-biased discrimination and that their hesitancy or even fear to take on these issues may lead to a worsening disengagement or a "culture of fear," as referred to by the authors. 1 The most important points of this article can be drawn from the recommendations for change. Female surgeons' suggestions provide an important message of male allyship.…”