The unspoken reality of gender bias in surgery: A qualitative systematic review

Abstract

Objective This study was conducted to better understand the pervasive gender barriers obstructing the progression of women in surgery by synthesising the perspectives of both female surgical trainees and surgeons. Methods Five electronic databases, including Medline, Embase, PsycINFO, CINAHL and Web of Science Core Collection, were searched for relevant articles. Following a full-text review by three authors, qualitative data was synthesized thematically according to the Thomas and Harden methodology and quality assessment was conducted by two authors reaching a consensus. Results Fourteen articles were included, with unfavorable work environments, male-dominated culture and societal pressures being major themes. Females in surgery lacked support, faced harassment, and had unequal opportunities, which were often exacerbated by sex-blindness by their male counterparts. Mothers were especially affected, struggling to achieve a work-life balance while facing strong criticism. However, with increasing recognition of the unique professional traits of female surgeons, there is progress towards gender quality which requires continued and sustained efforts. Conclusion This systematic review sheds light on the numerous gender barriers that continue to stand in the way of female surgeons despite progress towards gender equality over the years. As the global agenda towards equality progresses, this review serves as a call-to-action to increase collective effort towards gender inclusivity which will significantly improve future health outcomes.

The perspectives of health professionals and patients on racism in healthcare: A qualitative systematic review

“…There is an urgent need for more concrete and actionable anti-racism programs like incorporating bias curriculum early into medical education and training [ 68 ], to signal the strong commitment of institutions to tackle racism and close racial disparities in the healthcare setting, spearheading a paradigm shift. Additionally, approaches should be aimed at promoting interracial understanding through dialogue sessions or feedback channels for minority patients [ 69 , 70 ], where difficult conversations on a sensitive topic can take place safely. Improving interracial understanding would eliminate the various assumptions of minority patients that result in poorer medical treatment and service.…”

Current challenges for women in orthopaedics

“…‘Gender blindness’ in some male surgeons has further heightened these issues and the true extent of gender inequality is likely to be underestimated. 29 Departmental strategies, such as team case-based discussion and training in implicit bias, can be employed to create a culture that is responsive to microaggression. 30 Creating a culture of ‘microaffirmations’ develops a sense of belonging.…”

“… 41 Female surgeons who had familial duties were perceived to be “less committed by their seniors”, especially when working part-time. 29 These attitudes are likely to have an effect on the number of women entering orthopaedics. Deaneries across the UK are more active in ensuring that pregnant trainees are not disadvantaged, and attitudes are changing slowly.…”

Gender distribution among transplant journal editorial members: a call to empower women in academic medicine

“…Among all transplantation journals, Transplant International leads the way with a near-perfect gender balance in their editorial board [8]. Nevertheless, it is crucial to acknowledge the substantial underrepresentation of women and the multifactorial barriers into higher academia positions including gender-based discrimination, male-dominated culture, and lack of women mentors [9,10]. Beyond increasing the transparency of selection criteria of editorial board members and using objective tools including competitive and merit-based invitations, transplantation journals should actively connect qualified women faculty to available editorial board positions [11].…”