Underemployment of Female Surgeons?

Abstract

Objective: To compare the complexity of operations performed by female versus male surgeons. Background: Prior literature has suggested that female surgeons are relatively underemployed when compared to male surgeons, with regards to operative case volume and specialization. Methods: Operative case records from a large academic medical center from 1997 to 2018 were evaluated. The primary end point was work relative value unit (wRVU) for each case with a secondary end point of total wRVU per month for each surgeon. Multivariate linear analysis was performed, adjusting for surgeon race, calendar year, seniority, and clinical subspecialty. Results: A total of 551,047 records were analyzed, from 131 surgeons and 13,666 surgeon-months. Among them, 104,424 (19.0%) of cases were performed by female surgeons, who make up 20.6% (n = 27) of the surgeon population, and 2879 (21.1%) of the surgeon months. On adjusted analysis, male surgeons earned an additional 1.65 wRVU per case, compared to female surgeons (95% confidence interval 1.57–1.74). Subset analyses found that sex disparity increased with surgeon seniority, and did not improve over the 20-year study period. Conclusions: Female surgeons perform less complex cases than their male peers, even after accounting for subspecialty and seniority. These sex differences are not due to availability from competing professional or familial obligations. Future work should focus on determining the cause and mitigating this underemployment of female surgeons.

Autonomy in the Operating Room: A Multicenter Study of Gender Disparities During Surgical Training

“…For example, if female trainees feel they have lower levels of operative autonomy during residency or fellowship, they might feel less prepared to perform more difficult procedures after graduation, a hypothesis supported by a recent study in which female attending general surgeons performed less complex cases than male colleagues even when controlling for subspecialty and seniority. 22 Lastly, we found that female trainees logged fewer complex cases than their male colleagues, which warrants further exploration and possible intervention. If female trainees were actually performing fewer difficult cases because they were assigned to or volunteered for them, programs should increase oversight to ensure even allocation of complex cases.…”

Underrepresentation of women in computer systems research

“…Even within well-paid occupations, there are gender gaps that can be partially explained by the prestige and gendered social expectations of each subfield. For example, despite the increase in the number of female doctors overall, relatively few women still practice surgery, especially complex surgery [82].…”

Raising Up Gender Equity Voices: Report from an International Virtual Assembly in Global Surgery

“…The gender variable has been associated with adverse implications while choosing the surgical eld, training for residency programs, and daily working in medical practice [13][14][15]. When appraising the intersections with minorities based on race, sexuality, and socioeconomic class, the gap expands [14,16,17]. In this sense, GEIGS general assembly had capacity-building as a core value for its members and external participants.…”

“…For example, existing supportive bene ts, like parental leave, and mechanisms to report discrimination play a vital role in retaining these groups in the SOA elds [15]. Along with these strategies, promoting diversity and putting women and non-binary people in leadership helps to mitigate the pipeline effect [16,18]. The "leaky pipeline" effect describes a precipitous decline in women compared with men at each progressive step in the academic ladder, in which women occupy less leadership roles such as faculty, division chiefs, full professors, department chairs, and deans [18,19].…”