Discrimination Toward Women Surgeons in the Workplace Through an Intersectional Lens

Abstract

I n the prioritization and advancement of diversity, equity, and inclusion (DEI) within the surgical workforce, to ensure that our institutions, hospitals, and organizations are reflective of the diverse patient population to whom we serve, we must also assess the institutional readiness for diversity and implement measures of accountability for workplace discrimination and bias. The manuscript entitled ''Discrimination toward women in surgery: a systematic scoping review,'' articulates and thoroughly describes the various forms of discrimination women surgeons have historically faced and continue to endure in the workplace including sexual harassment, implicit/explicit sex bias, and microaggressions. 1 More specifically, the authors describe studies showing the discrimination faced by women in authorship, research productivity, and grant funding; discrimination in the advancement of women to leadership roles; discrimination in representation in roles such as moderators, discussants, and keynote speakers at scientific conferences; discrimination in academic promotions to full professorships; and discrimination in pay. Women surgeons face a large salary disparity at $2.5 million over a simulated 40-year career with data showing that the annual salary for women in general surgery was on average, $40,000 less than men surgeons. 2 When applying an intersectional lens to the discrimination endured by women surgeons, the disparities are more prevalent for under-represented in medicine (URiM) women surgeons and starts early in their careers.Yuce et al 3 evaluated the national prevalence and sources of discrimination based on race/ ethnicity in US general surgery residency programs and identified factors associated with discrimination. The overall prevalence of racial/ethnic discrimination was 24% but when stratified by race, Black trainees had an overwhelmingly higher prevalence of discrimination at 70% followed by Asians at 48% and Hispanics at 25%. The most common sources of discrimination included different standards of evaluations, denied opportunities, being mistaken for a non-physician, slurs and/or hurtful comments, being socially isolated, and being mistaken for another person of the same race. The most common source of discrimination came from attending physicians, patients and their families, colleagues, and nurses/staff. Thus, if URiM trainees particularly URiM women trainees are being subjected to an environment deeply rooted in discrimination, hostility, and bias, it is no surprise that the attrition of URiM surgical residents is disproportionately higher when compared to non-URiM trainees. In fact, per the ACGME, Black surgical residents are six times more likely to be dismissed from their residency training program when compared to non-Black surgical residents.In moving along the surgical pathway to the faculty level, the data clearly shows the effects of discrimination, bias, and structural racism. In evaluating the 2017 AAMC faculty roster, Black and Hispanic women faculty represented 0.78% (123/15,671)...