Gender imbalance amongst promotion and leadership in academic surgical programs in Canada: A cross-sectional Investigation

Abstract

Background Women are underrepresented at higher levels of promotion or leadership despite the increasing number of women physicians. In surgery, this has been compounded by historical underrepresentation. With a nation-wide focus on the importance of diversity, our aim was to provide a current snapshot of gender representation in Canadian universities. Methods This cross-sectional online website review assessed the current faculty listings for 17 university-affiliated academic surgical training departments across Canada in the 2019/2020 academic year. Gender diversity of academic surgical faculty was assessed across surgical disciplines. Additionally, gender diversity in career advancement, as described by published leadership roles, promotion and faculty appointment, was analyzed. Results Women surgeons are underrepresented across Canadian surgical specialties (totals: 2,689 men versus 531 women). There are significant differences in the gender representation of surgeons between specialties and between universities, regardless of specialty. Women surgeons had a much lower likelihood of being at the highest levels of promotion (OR: 0.269, 95% CI: 0.179–0.405). Men surgeons were statistically more likely to hold academic leadership positions than women (p = 0.0002). Women surgeons had a much lower likelihood of being at the highest levels of leadership (OR: 0.372, 95% CI: 0.216–0.641). Discussion This study demonstrates that women surgeons are significantly underrepresented at the highest levels of academic promotion and leadership in Canada. Our findings allow for a direct comparison between Canadian surgical subspecialties and universities. Individual institutions can use these data to critically appraise diversity policies already in place, assess their workforce and apply a metric from which change can be measured.

Rates of Burnout in Female Orthopaedic Surgeons Correlate with Barriers to Gender Equity

“…That domain refers to the constraints that professional women experience compared with their male counterparts 11 . One consequence of these disproportionate constraints is the decreasing numbers of women in leadership roles, particularly as academic rank proceeds 34 . The distinct lack of gender diversity in leadership continues to propagate the power gap between male and female surgeons and leads to a "persistent opportunity gap between the genders."…”

“…That domain refers to the constraints that professional women experience compared with their male counterparts 11 . One consequence of these disproportionate constraints is the decreasing numbers of women in leadership roles, particularly as academic rank proceeds 34 . The distinct lack of gender diversity in leadership continues to propagate the power gap between male and female surgeons and leads to a “persistent opportunity gap between the genders.” 34 Previous research has indicated that the difference in the rate of burnout between genders was attenuated when adjusted for academic rank, suggesting that the ability to break the glass ceiling may mitigate burnout 33 .…”

“…The distinct lack of gender diversity in leadership continues to propagate the power gap between male and female surgeons and leads to a "persistent opportunity gap between the genders." 34 Previous research has indicated that the difference in the rate of burnout between genders was attenuated when adjusted for academic rank, suggesting that the ability to break the glass ceiling may mitigate burnout 33 .…”

“…Identification of gendered barriers provides an opportunity to test solutions that can mitigate distress, including modifying call schedules, building peer-to-peer networks, providing adequate mental health supports, minimizing attrition from surgical programs, and recruiting and supporting female mentors and leaders 4,35 . Gender inequities appear to be partly responsible for the limited increase in women entering the specialty, the higher rate of attrition of female trainees and surgeons, and deleterious impacts on the health and well-being of female orthopaedic surgeons 34 . The identified barriers are resolvable, and well-researched solutions have the potential to benefit all members of the profession.…”

Let's Have Some Clarity on Academic Parity

“…Across the pond, the General Medical Council Medical School Annual Return found that 52.5% of medical students were female in the 5 medical schools in London, United Kingdom, for the academic year 2017/2018 (2). Despite this, women have lagged behind entering positions that are traditionally dominated by men such as surgery (3) or to take up academic leadership positions, and this phenomenon has persisted for several decades (4). In 2019, 18% of US medical school deans and 19% of clinical department chairs were women (1).…”