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Women in Surgery: Do We Really Understand the Deterrents?

Debra A. Gargiulo, Neil H. Hyman, James C. Hebert
University of Vermont College of Medicine, Burlington, VT

Objective: To test the hypothesis that women are deterred from a career in surgery owing to a lack of role models, rather than lifestyle considerations.
Design: Survey
Setting: University teaching hospital
Participants: Surgery and OB/GYN attendings, residents and medical students
Main Outcome Measures: Potential deterrents to a surgical career amongst men and women
Results: Men and women had a similar interest in a surgical career before their surgical rotation (64% vs 53%, p=0.68) .A similar percentage developed a mentor (40.0% vs 45.9%, p=0.4). Women were far more likely to perceive gender discrimination (46.7% vs 20.4%, p=0.002), most often from male attendings (33.3%) or residents (31.1%). Women were less likely to be deterred by diminishing rewards (4.4% vs 21.6%, p=0.003) or workload considerations (28.9% vs 49.0%, p=.014). They were also less likely to cite family concerns as a deterrent (47.8% vs 66.7%, p=0.02) and equally likely to be deterred by lifestyle during residency (83.3% vs 76.5%, p=0.2). However, women were more likely to be deterred by their perceptions of the surgical personality (40% vs 21.6%, p=.026) and the perception of surgery as an “old boys club” (22.2% vs 3.9%, p=0.002).
Conclusions: Men and women are very similar in what they consider important in deciding on a surgical career. Women are not more likely to be deterred by lifestyle, workload issues or the lack of access to role models. However, the perceived “surgical personality” and surgical “culture” is a gender-specific deterrence to a career in surgery for women.

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