Importance: Despite women composing half of current medical school classes, surgical specialties still struggle to attract and retain women. Even after successful recruitment into training, women surgeons continue to face gender bias and various obstacles to career advancement, including lower rates of surgical residency completion, board certification, and professional advancement. Gender inequality in medicine has drawn attention; particular consideration regarding the status of women in surgery is warranted. We review research delineating disparities and investigating the causes underlying such issues, and most importantly, we propose recommended action.
Observations: Recruitment of women into surgery is increasing as more women are visible in the specialty, and forthcoming measures to encourage mentorship and rectify issues related to pregnancy and burnout will likely improve this. However, obstacles to career development for women surgeons, including residency/fellowship support, mentorship/sponsorship, leadership, work-life balance, and pay equity remain. More importantly, gender discrimination continues, originating from conscious and unconscious bias, which is remedied only by recognition and deliberate correction. Several organizations have proactively recommended measures to cultivate gender equity for women surgeons, which require implementation to effect meaningful change. While the first step is recognition of the issues and underlying etiologies, further action is needed in combating such disparities and establishing a culture of equity for women in surgery.
Conclusions and relevance: Opportunities for women in surgery have improved, although much work remains to make the surgical workplace supportive of women, empowering them to optimally contribute. These efforts will benefit organizations, the community, future generations of surgeons, and most importantly, profoundly and positively affect the care of patients.