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Factors Affecting Women Surgeons’ Careers in Low–Middle-Income Countries: An International Survey

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Abstract

Background

Despite increasing numbers of women surgeons globally, barriers to career advancement persist. While these barriers have been extensively discussed in high-income countries (HICs), the topic has received minimal attention in lower–middle-income countries (LMICs) like Pakistan.

Methods

The Association of Women Surgeons of Pakistan (AWSP)—an organization in Pakistan consisting of female surgeons and trainees—carried out this international cross-sectional study over July–Sept 2019. An anonymous online survey was disseminated via social media platforms and various institutions across Pakistan and internationally.

Results

A total of 218 female surgeons responded to the survey, with 146 (67%) from Pakistan and 72 (33%) from HICs. While HIC surgeons were more likely to report gender discrimination/bias (GD/bias) during residency (29.2% vs 11.6%; p = 0.001), more Pakistani surgeons reported that GD/bias negatively affected their job satisfaction (80.7% vs. 64.9%; p = 0.024). GD/bias manifested most commonly as differences in mentoring relationships (72%). A higher percentage Pakistani surgeons reported having experienced a family-related interruption in their career (24.7% vs. 11.1%; p = 0.019). The vast majority (95%) felt that surgery was perceived as a masculine field, and the majority (56.4%) of respondents reported having been told that they could not be a surgeon because of their gender.

Conclusion

Our study highlights keys factors that must be addressed to provide equal career opportunities to women surgeons. It is the responsibility of surgical educators, policy makers, and healthcare organizations to facilitate women surgeons’ career progression by developing systems that support equitable career growth for women surgeons.

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Notes

  1. The CPSP publishes the list of fellows who have passed the qualifying examination for the Fellow of College of Physicians and Surgeons (FCPS). This number does not include surgeons who have completed their training and certification outside of Pakistan. https://www.cpsp.edu.pk/online-directories.php

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Acknowledgements

The authors of this study wish to acknowledge the members of the AWSP for their assistance with the creation, piloting, and dissemination of this survey at the national level. The results from this study will be used by AWSP as a framework towards developing policies and strategies for the advancement and equitable representation of females in the field of surgery throughout Pakistan.

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Authors and Affiliations

  1. Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan

    Mahim Malik, Hina Inam, Nida Zahid, Sadaf Khan, Abida K. Sattar & Syed Ather Enam

  2. Aga Khan University, Stadium Road, Karachi, 74800, Pakistan

    Mahin B. N. Janjua

  3. Medical Student, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan

    Russell S. Martins

  4. Medical College, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan

    Adil H. Haider

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  1. Mahim Malik
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  2. Hina Inam
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  3. Mahin B. N. Janjua
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  4. Russell S. Martins
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  5. Nida Zahid
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  6. Sadaf Khan
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  7. Abida K. Sattar
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  9. Syed Ather Enam
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Correspondence to Mahim Malik.

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Malik, M., Inam, H., Janjua, M.B.N. et al. Factors Affecting Women Surgeons’ Careers in Low–Middle-Income Countries: An International Survey. World J Surg 45, 362–368 (2021). https://doi.org/10.1007/s00268-020-05811-9

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