The new surgical workforce: recruiting and developing women surgeons

Barbara Lee Bass M.D.
Professor of Surgery, Associate Chair for Research and Academic Affairs, University of Maryland School of Medicine

What is the current status of women in surgery?

  • Only 5-6% of the surgical workforce (excluding OB) is female, despite the fact that 50% of graduating students are female
  • In 2000, 23% of residents in surgery were women, compared to 13% in 1989

Triple barrier to increasing surgical workforce among women:

  • Less initial interest
  • Likely to lose interest
  • Less likely to gain interest


  • 96% of women students (but 0% of men) at Johns Hopkins perceive surgery to be unfavorable to their gender
  • 92% of women (but 0% of men) at Johns Hopkins feel out of place in surgical clerkship, even though women outperformed men in the clerkship
  • Life-style decisions keep women out of surgery; few role models

What do women look for in residency?

  • Successful women faculty (88% of women students choosing surgery as career come from schools with >40% of women faculty
  • Equity in training program (call scheduling, mentoring, etc.)
  • Geography
  • Work hours
  • Pregnancy/parenting accommodations/policy

Issues in training programs that influence choices

  • Professionalism
  • Equity
  • Geographically remote rotations requiring living away from home for extended periods
  • Gender-exclusive social activities
  • Successful women role models

Transition from residency to practice

  • Attrition rate during training same for men and women (~20-25%)
  • Fewer women do fellowship training (45% vs 69% men)
  • Women tend to go into private practice rather than academic medical careers
  • Women less likely to join professional organizations (can lead to professional isolation)

Overall result: women don't feel they belong to the community of surgeons

Starting a career in academic surgery

  • Pick your academic goal-requires mentoring during residency
  • Commit to clinical excellence
  • Pick your mentor-must share similar vision of success, must be willing to be your advocate and nominator, must like each other, must be open and frank, must like each other

Building a career in academic surgery

  • Learn the rules
    • Compensation
    • Promotion
    • Leave policies
    • Professional assignments
  • Understand the price you may have to pay
    • Spouse, parents, children
    • Personal sanity

Achieving success in academic surgery

  • Go to work
  • Operate
  • Write
  • Present at national meetings
  • Do only a fair share of no reward tasks
  • Don't be afraid to create a new pathway
  • Know your personal infrastructure limits

Vital transition point: Promotion to Associate Professor

Developing women surgical faculty

  • Active recruitment of women-from within/retain
  • Establish effective mentoring (clinical/cultural/scholarly realms)
  • Create an environment for success-institutional leaders should:
  • Reward professionalism (no tolerance for unprofessional behavior)
  • Responsive to suggestions for remedying problems
  • Recognize in a visible way the value of successful women faculty
  • Ensure equity-compensation, startup, opportunity for success
  • Support creative pathways
  • Flexible pathways for promotion
  • Family leave policies
  • Alternative work schedules
  • Creative compensation arrangement

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