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Gender and Surgery

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Diversity, Equity and Inclusion

Part of the book series: Success in Academic Surgery ((SIAS))

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Abstract

A significant gender achievement gap exists in surgery. Women remain outnumbered by men in surgical specialties (https://www.ama-assn.org/residents-students/specialty-profiles/these-medical-specialties-have-biggest-gender-imbalances) and in positions of surgical leadership. The decreased representation of women in higher academic ranks despite an increased presence in surgical training suggests the persistence of a “glass ceiling” for women in surgery. This chapter reviews factors influencing the gender achievement gap in surgery, including implicit gender bias and subsequent differences in recruitment, retention, burnout, promotion, and pay. We summarize a number of actionable interventions that have been proposed to mitigate the impact of gender discrimination in surgery, such as: encouraging amplification of female voices, identifying and addressing implicit bias and microaggressions, recruiting leaders who promote gender equity, instituting objective metrics for unbiased resident recruitment and faculty promotion, and enforcing transparent policies to extinguish the gender pay gap. This chapter aims to promote awareness of key issues of gender in surgery to effect both personal and systemic interventions that can lead to meaningful change.

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References

  1. Murphy B. These medical specialties have the biggest gender imbalances. 2019. https://www.ama-assn.org/residents-students/specialty-profiles/these-medical-specialties-have-biggest-gender-imbalances. Accessed 4 Dec 2019.

  2. Zhuge Y, Kaufman J, Simeone DM, Chen H, Velazquez OC. Is there still a glass ceiling for women in academic surgery? Ann Surg. 2011;253:637–43. https://doi.org/10.1097/SLA.0b013e3182111120.

    Article  PubMed  Google Scholar 

  3. Greenberg CC. Association for Academic Surgery presidential address: sticky floors and glass ceilings. J Surg Res. 2017;219:ix–xviii. https://doi.org/10.1016/j.jss.2017.09.006.

    Article  PubMed  Google Scholar 

  4. Else-Quest NM, Hyde JS, Linn MC. Cross-national patterns of gender differences in mathematics: a meta-analysis. Psychol Bull. 2010;136:103–27. https://doi.org/10.1037/a0018053.

    Article  PubMed  Google Scholar 

  5. Lindberg SM, Hyde JS, Petersen JL, Linn MC. New trends in gender and mathematics performance: a meta-analysis. Psychol Bull. 2010;136:1123–35. https://doi.org/10.1037/a0021276.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Szymanowicz A, Furnham A. Gender and gender role differences in self- and other-estimates of multiple intelligences. J Soc Psychol. 2013;153:399–423. https://doi.org/10.1080/00224545.2012.754397.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Chafetz JS, Valian V. Why so slow? Adv Women Contemp Sociol. 1999;28:42. https://doi.org/10.2307/2653855.

    Article  Google Scholar 

  8. Bickel J. How men can excel as mentors of women. Acad Med. 2014;89:1100–2. https://doi.org/10.1097/ACM.0000000000000313.

    Article  PubMed  Google Scholar 

  9. Okimoto TG, Brescoll VL. The price of power: power seeking and backlash against female politicians. Personal Soc Psychol Bull. 2010;36(7):923–36. https://doi.org/10.1177/0146167210371949.

    Article  Google Scholar 

  10. Phillips NA, Tannan SC, Kalliainen LK. Understanding and overcoming implicit gender bias in plastic surgery. Plast Reconstr Surg. 2016;138:1111–6. https://doi.org/10.1097/PRS.0000000000002668.

    Article  CAS  PubMed  Google Scholar 

  11. Hu Y-Y, Ellis RJ, Hewitt DB, Yang AD, Cheung EO, Moskowitz JT, et al. Discrimination, abuse, harassment, and burnout in surgical residency training. N Engl J Med. 2019;381(18):1741–52. https://doi.org/10.1056/NEJMsa1903759.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ruzycki SM, Freeman G, Bharwani A, Brown A. Association of Physician characteristics with perceptions and experiences of gender equity in an Academic Internal Medicine Department. JAMA Netw Open. 2019;2(11):1915165. https://doi.org/10.1001/jamanetworkopen.2019.15165.

    Article  Google Scholar 

  13. Sanfey H, Crandall M, Shaughnessy E, Stein SL, Cochran A, Parangi S, Laronga C. Strategies for identifying and closing the gender salary gap in surgery. J Am Coll Surg. 2017;225(2):333–8. https://doi.org/10.1016/j.jamcollsurg.2017.03.018.

    Article  PubMed  Google Scholar 

  14. Bruce AN, Battista A, Plankey MW, Johnson LB, Blair Marshall M. Perceptions of gender-based discrimination during surgical training and practice. Med Educ Online. 2015;20:25923. https://doi.org/10.3402/meo.v20.25923.

    Article  PubMed  Google Scholar 

  15. Gargiulo DA, Hyman NH, Hebert JC, Kirton O, Gawande A, Tseng J, et al. Women in surgery: do we really understand the deterrents? Arch Surg. 2006;141:405. https://doi.org/10.1001/archsurg.141.4.405.

    Article  PubMed  Google Scholar 

  16. Giantini Larsen AM, Pories S, Parangi S, Robertson FC. Barriers to pursuing a career in surgery: an Institutional Survey of Harvard Medical School Students. Ann Surg. 2019. Publish Ah. https://journals.lww.com/annalsofsurgery/Fulltext/publishahead/Barriers_to_Pursing_a_Career_in_Surgery__An.94856.aspx.

  17. Moss-Racusin CA, Dovidio JF, Brescoll VL, Graham MJ, Handelsman J. Science faculty’s subtle gender biases favor male students. Proc Natl Acad Sci U S A. 2012;109:16474–9. https://doi.org/10.1073/pnas.1211286109.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Madera JM, Hebl MR, Martin RC. Gender and letters of recommendation for academia: agentic and communal differences. J Appl Psychol. 2009;94:1591–9. https://doi.org/10.1037/a0016539.

    Article  PubMed  Google Scholar 

  19. Trix F, Psenka C. Exploring the color of glass: letters of recommendation for female and male medical faculty. Discourse Soc. 2003;14:191–220. https://doi.org/10.1177/0957926503014002277.

    Article  Google Scholar 

  20. Gene Hern H, Alter HJ, Wills CP, Snoey ER, Simon BC. How prevalent are potentially illegal questions during residency interviews. Acad Med. 2013;88:1116–21. https://doi.org/10.1097/ACM.0b013e318299eecc.

    Article  PubMed  Google Scholar 

  21. O’Connor MI. Medical school experiences shape women students’ interest in orthopaedic surgery. Clin Orthop Relat Res. 2016;474:1967–72. https://doi.org/10.1007/s11999-016-4830-3.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Meyerson SL, Sternbach JM, Zwischenberger JB, Bender EM. The effect of gender on resident autonomy in the operating room. J Surg Educ. 2017;74:e111–8. https://doi.org/10.1016/j.jsurg.2017.06.014.

    Article  PubMed  Google Scholar 

  23. Ban KA, Chung JW, Matulewicz RS, Kelz RR, Shea JA, Dahlke AR, et al. Gender-based differences in surgical residents’ perceptions of patient safety, continuity of care, and well-being: an analysis from the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial. J Am Coll Surg. 2017;224:126–136.e2. https://doi.org/10.1016/j.jamcollsurg.2016.10.043.

    Article  PubMed  Google Scholar 

  24. Elmore LC, Jeffe DB, Jin L, Awad MM, Turnbull IR. National survey of burnout among US General Surgery Residents. J Am Coll Surg. 2016;223(3):440–51. https://doi.org/10.1016/J.JAMCOLLSURG.2016.05.014.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Emamaullee JA, Lyons MV, Berdan E, Bazzarelli A. Women leaders in surgery: past, present, and future. Bull Am Coll Surg. 2012;97(8):24–29.

    Google Scholar 

  26. Andriole DA, Jeffe DB. Certification by the American Board of Surgery among US Medical School Graduates. J Am Coll Surg. 2012;214(5):806–15. https://doi.org/10.1016/J.JAMCOLLSURG.2012.01.049.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Jena AB, Khullar D, Ho O, Olenski AR, Blumenthal DM. Sex differences in academic rank in US Medical Schools in 2014. JAMA. 2015;314(11):1149–58. https://doi.org/10.1001/jama.2015.10680.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Yeo HL, Dolan PT, Mao J, Sosa JA. Association of Demographic and Program Factors with American Board of Surgery Qualifying and Certifying Examinations Pass Rates. JAMA Surg. 2019;155:22. https://doi.org/10.1001/jamasurg.2019.4081.

    Article  PubMed Central  Google Scholar 

  29. Lachish S, Svirko E, Goldacre MJ, Lambert T. Factors associated with less-than-full-time working in medical practice: results of surveys of five cohorts of UK doctors, 10 years after graduation. Hum Resour Health. 2016;14(1):62. https://doi.org/10.1186/s12960-016-0162-3.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Peckham C. Medscape General Surgeon Compensation 2016. 2018. https://www.medscape.com/slideshow/2018-compensation-surgeon-6009657. Accessed 4 Dec 2019.

  31. Mueller C, Wright R, Girod S. The publication gender gap in US academic surgery. BMC Surg. 2017;17(1):16. https://doi.org/10.1186/s12893-017-0211-4.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Gray K, Neville AL, Kaji AH, Wolfe MM, Calhoun KE, Amersi F, et al. Career goals, salary expectations, and salary negotiation: a comparison between male and female general surgery residents. J Am Coll Surg. 2018;227:S215. https://doi.org/10.1016/j.jamcollsurg.2018.07.471.

    Article  Google Scholar 

  33. Jagsi R, Griffith KA, Stewart A, Sambuco D, DeCastro R, Ubel PA. Gender differences in the salaries of physician researchers. JAMA. 2012;307:2410–7. https://doi.org/10.1001/jama.2012.6183.

    Article  CAS  PubMed  Google Scholar 

  34. Jena AB, Olenski AR, Blumenthal DM. Sex differences in physician salary in US Public Medical Schools. JAMA Intern Med. 2016;176:1294–304. https://doi.org/10.1001/jamainternmed.2016.3284.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Laura K. Krecko, Caprice C. Greenberg & Jacob A. Greenberg

Authors
  1. Laura K. Krecko
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  2. Caprice C. Greenberg
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  3. Jacob A. Greenberg
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Corresponding author

Correspondence to Caprice C. Greenberg .

Editor information

Editors and Affiliations

  1. Ann Arbor, MI, USA

    Dana A. Telem

  2. Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA

    Colin A. Martin

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Krecko, L.K., Greenberg, C.C., Greenberg, J.A. (2021). Gender and Surgery. In: Telem, D.A., Martin, C.A. (eds) Diversity, Equity and Inclusion. Success in Academic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-55655-6_9

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  • DOI: https://doi.org/10.1007/978-3-030-55655-6_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-55654-9

  • Online ISBN: 978-3-030-55655-6

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