Survey: Perceptions of male culture may deter women from a career in surgery

Even though men and women are similar in factors they consider important in deciding on a career in surgery, the perception of surgery as an "old boys' club" and negative perceptions of the surgical personality may deter women from choosing the field, according to results of a small survey published in the April issue of Archives of Surgery, one of the JAMA/Archives journals.

Recent analyses have suggested that more general surgeons will be needed in the future, but fewer medical students are entering surgery residencies, according to background information in the article. About half of all entering medical students are women, who have historically been less likely to choose surgery as a career.

Debra A. Gargiulo, M.D., and colleagues at the University of Vermont, Burlington surveyed 298 Vermont physicians and medical students. Of the 141 who completed the survey, there were 90 women and 60 men, including 31 attending physicians (16 general surgeons and 15 obstetrician/gynecologists), 16 residents and 94 medical students. Sixty-four percent of men and 53 percent of women indicated that were interested in a surgery career before their surgical rotation. Respondents were asked to select their top three deterrents to a surgical career. Findings included:

  • 46.7 percent of female medical students vs. 20.4 percent of males perceived sex discrimination in surgery
  • Among all respondents, 21.6 percent of men and 4.4 percent of women were deterred by the diminishing rewards of surgery
  • 49 percent of men and 28.0 percent of women cited workload considerations
  • 66.7 percent of men vs. 47.8 percent of women chose family concerns
  • 83.3 percent of women and 76.5 percent of men worried about lifestyle during residency
  • 40 percent of women and 21.6 percent of men were deterred by their view of the "surgical personality"
  • 22.2 percent of women and 3.9 percent of men were discouraged by the perception of surgery as an "old boys' club"

The results suggest that lifestyle concerns should be addressed to attract both men and women to surgery, the authors write. "However, our results also suggest that there exists a male culture in surgery that needs to be confronted because it is a significant factor deterring women from a career in surgery … Surgery remains a 'macho field'," they conclude. "Surgeons need to critically assess the nature of their interactions with students and provide an environment more conducive to women."

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(Arch Surg. 2006;141:405-408. Available pre-embargo to the media at www.jamamedia.org.)


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