Women in academic surgery: the pipeline is busted

Abstract

Purpose: This investigation examined the trends for gender-based advancement in academic surgery by performing a comparative analysis of the rate of change in the percentage of medical students, surgery residents, and full professors of surgery who are women.

Methods: All available Women in Medicine Annual Reports were obtained from the American Association of Medical Colleges (AAMC). The gender compositions of medical graduates, surgery residents, and full professors were plotted. Binomial and linear trendlines were calculated to estimate the year when 50% of surgery full professors would be women. Additionally, the percentage distribution of men and women at each professorial rank was determined from 1995 to 2009 using these reports to demonstrate the rate of academic advancement of each gender.

Results: The slope of the line of increase for women full professors is significantly less than for female medical students and for female general surgery residents (0.36, compared with 0.75 and 0.99, respectively). This predicts that the earliest time that females will account for 50% of full professors in surgery is the year 2096. When comparing women and men in academic ranks, we find that women are much less likely than men to be full professors.

Conclusions: The percentage of full professors in surgery who are women is increasing at a rate disproportionately slower than the increases in female medical students and surgery residents. The rates of increase in female medical students and surgery residents are similar. The disproportionately slow rate of increase in the number of female full professors suggests that multiple factors may be responsible for this discrepancy.

FIGURE 1

Gender in academic medicine survey.

FIGURE 1

Gender in academic medicine survey.

FIGURE 2

Gender composition trends for medical graduates, surgical residents, and surgical professors. The graph represents how the gender compositions of graduating medical student classes, surgery residents, and full professorship have changed from 1965 to 2009. Pink delineates women and blue delineates men. Using data lines with the best fit, this graph suggests that the gender composition of surgery residents and full professors of surgery could be 50% women by the year 2028 and 2096, respectively.

FIGURE 3

Advancement in academic surgery. The data compiled for the years 1995, 2000, 2005, and 2009 from the AAMC show the gender and rank composition of surgical faculty. There are more assistant professors than either associate or full professors among both men and women. Among men, full professors outnumber associate professors. Conversely, among women, both assistant and associate professors outnumber full professors.

FIGURE 4

Annual number of professors of surgery in the United States. Graphical comparison of the number of male and female full professors of surgery in the United States.

FIGURE 5

Advancement in academic surgery at VUMC. These data show gender differences similar to those shown in Fig. 3. In particular, full professors outnumber associate professors among men but not among women.

FIGURE 6

Female surgical faculty and residents report that gender limits promotion. An 11-question survey sent to all faculty in the section of Surgical Sciences and to all general surgery residents yielded one statistically significant difference in responses between men and women (men, n = 32; women, n = 16; response rate, λ = 0.625; p = 0.01).