Opportunity Costs of Internal Promotions in Plastic Surgery: Are Women Given a Fair Shot?

Abstract

Background: Academic advancement in plastic surgery necessitates creation of opportunities for rising faculty, which are pivotal for women in their efforts to close prominent gender gaps in higher ranks. We study positions of academic prestige that benefit from internal nomination as surrogates for opportunities afforded to men and women seeking leadership roles. Methods: We collected the following datapoints: authors of invited discussions published in Plastic and Reconstructive Surgery from 2010 to 2019; current editorial board members of representative plastic surgery journals; recipients of societysponsored traveling fellowships; and directors of the American Board of Plastic Surgery. Public profiles for all authors and surgeons were referenced to confirm gender identification. Results: Seven-hundred ninety-seven plastic and reconstructive surgery discussions were included, 18% of which included female first or senior authorship. Seventyone (9%) discussions listed a female senior author. Male and female senior authors were equally as likely to collaborate with a female first co-author (25% and 26%, respectively). Only 17% of invited authors contributed to 55% of discussion articles. Women occupied 19% of journal editorial board positions, though none were editors-in-chief. American Society of Reconstructive Microsurgery, American Society of Maxiliofacial Surgeons, American Society for Surgery of the Hand, and Plastic Surgery Foundation traveling fellowships were awarded to one (3%), four (7%), five (13%), and 141 (15%) female plastic surgeons, respectively. Women comprise 26% of directors of American Board of Plastic Surgery. Conclusions: Female representation in plastic surgery is rising, but it is not mirrored across appointed positions in academia. We should strive to support advancements that allow selected prestigious positions to more accurately reflect the gender distribution within the plastic surgery community.

Diversity, Equity, and Inclusion in Plastic Surgery

“…Butler is Chair of the American Society of Plastic Surgery's Diversity and Inclusion Committee. 81 He is also Yale University's inaugural Vice Chair of Diversity, Equity, and Inclusion.…”

“…Three authors were frequently cited as author or coauthor (Amanda Gosman, 15; Paris Butler, 15; and Meera Reghunathan, 12). Butler is Chair of the American Society of Plastic Surgery's Diversity and Inclusion Committee 81 . He is also Yale University's inaugural Vice Chair of Diversity, Equity, and Inclusion.…”

“…A total of 138 publications were identified 3–140 Figure 1. demonstrates the number of publications appearing annually in the 6 journals from January 2018 to September 2023.…”

The Annual ASCFS Whitaker Lecture: Breaking Through to Bold

“…Since most chairs/chiefs of plastic surgery are internal hires, retention can thrust females into leadership positions. 20 It could also be a number of other issues. Ask the female surgeons and then be brave as you ask your fellow colleagues to help fix these issues that they have likely never considered.…”

“…The social science literature strongly supports a positive relationship between satisfaction and workplace performance. 20 Providing both structural and personal support in the perinatal period when females are still continuing to further their career is a vital way to help retention and promote satisfaction. 27 And remember, when that colleague describes a hardship that may seem minor, irrelevant, or just plain silly, the leader can take solace in the fact that it is likely much more difficult for their colleague to bring the issue up, and it is probably more important than it seems.…”