Testing for Implicit Gender Bias among Plastic Surgeons

Abstract

Background: The aim of this study was to examine for the presence of implicit bias within the field of plastic surgery using a gender-specific Implicit Association Test (IAT), specifically looking at gender and career stereotypes. Methods: A Gender-Career/Family Implicit Association Test was developed and distributed to the international plastic surgery community. Mean scores were calculated. Respondents were provided with an automated summary interpretation of their results, categorizing association for a particular grouping of gender and career/family as a little or no, slight, moderate, or strong. Respondents were also asked a series of demographic and post-IAT questions. Results: Ninety-five responses were available for analysis. Overall, respondents showed a moderate-to-strong association of male + career / female + family compared with the reverse, which was statistically significant. Nearly half of the respondents thought they might have an implicit gender-related bias; however, 50% post-test would not change their behavior based on results, while 9.5% would. Conclusions: Plastics surgeons may have an unconscious tendency to associate men with a career and women with a family. Further steps must be taken to increase awareness and mitigate the impact of implicit gender bias.

Diversity, Equity, and Inclusion in Plastic Surgery

“…A common theme is greater recognition of women's needs during residency, including maternity leave and time for nursing. This specialty choice fits with the general perception that, overall (and by no means for all women), women tend to think of families because they usually assume more family responsibilities than men 13,17,32,59,60,121,137 …”

“…This specialty choice fits with the general perception that, overall (and by no means for all women), women tend to think of families because they usually assume more family responsibilities than men. 13,17,32,59,60,121,137 Many specialties in which women physicians make up the majority focus on children, women, and families, including pediatrics, obstetrics and gynecology, pediatric hematology/oncology, child and adolescent psychiatry, and neonatal-perinatal medicine. 143 Women may select these careers as a matter of personal choice, 60 and not because of perceived obstacles to their advancement in plastic surgery.…”

“…142 The recent emphasis on diversity coincides with the introduction of new terminology. In addition to diversity, equity, and inclusion, new catchwords and phrases include antiracism, 19,60 implicit bias, 19,59,77,128 race concordance, 10,27,28,47,79,86,118,124,125 cultural competency, 10,14,18,19,61,77,89,90,110,117 cultural humility, 19 intersectionality, 11,41,53,114 microaggressions, 19,23,62,69,79,83 White privilege, 19 allyship, 19 toxic mentorship, 67 and hypermasculinity. 67 The word "merit" infrequently appears.…”

The West Coast Plastic Surgery Mentorship Program

“…Many of these students may be discouraged during medical school from pursuing a surgical career and never make it to the point of applying to plastic surgery. Those who do apply face reduced access to mentorship, implicit bias, and financial barriers that make their journey wrought with difficulty 3,6,13 …”

“…Those who do apply face reduced access to mentorship, implicit bias, and financial barriers that make their journey wrought with difficulty. 3,6,13 With students participating in multiple visiting subinternships as well as one or multiple research year, the hidden costs of being a plastic surgery applicant continue to rise. Students unable to shoulder these costs stand to face a disadvantage before they even begin the interview process.…”