The WTS report on the current status of women in cardiothoracic surgery

Abstract

Background: The purpose of this work was to assess career demographics, professional activities, and career satisfaction of board-certified female cardiothoracic surgeons in the United States, 50 years after certification of the first women diplomats by the American Board of Thoracic Surgery (ABTS).

Methods: All ABTS-certified women were surveyed anonymously in December 2010, using surveymonkey.com. Questions were in five categories: demographics, training, practice activities, activities of nonpracticing cardiothoracic surgeons, and career satisfaction. Respondents were grouped by year of certification: group 1 (1961 to 1999) and group 2 (2000 to 2010). Broad comparisons to the entire thoracic surgery workforce were based on The Society of Thoracic Surgeons and American Association for Thoracic Surgery 2009 practice survey.

Results: Of the 204 living female diplomats, 190 were surveyed, as 14 (7%) were unavailable owing to lack of contact information. Survey response rate was 64% (121 of 190). Mean respondent's age was 48 years (range, 35 to 74), with the majority being Caucasian (94 of 121). Women spent a mean of 9.1 years in training, and 56% (68 of 121) reported non-Accreditation Council for Graduate Medical Education training time. Duration of training and resultant debt has increased over time, as respondents in group 1 (n=52) reported training for 8.5 years versus 9.5 years in group 2 (n=68; p=0.01), and a doubling of graduates with educational debt more than $100,000 from 19% to 41%, respectively (p=0.003). The average number of years in practice was 8 (range, 1 to 30), with the majority working in urban setting (65 of 106), in group practices of 2 to 10 surgeons (82 of 106), and as the sole female surgeon in their group (84 of 106). Of the 54 women with academic appointments, more than 60% (33 of 54) are at the instructor or assistant professor level, but 18% (10 of 54) are full professors. Nearly a third (16 of 54) have secured research funding, and 20% (11 of 54) have protected research time. Job satisfaction is high, with 64% (76 of 118) reporting being always or almost always satisfied with their career, and fewer than 9% (11 of 118) would choose a different career. Although demand on time is the greatest source of dissatisfaction, workplace politics for group 1 and lack of support for group 2 are significant issues. Only 12 respondents are no longer practicing, with the majority leaving because of retirement, health issues, or career advancement.

Conclusions: Women represent a minority of cardiothoracic surgeons in the United States. The numbers in academic versus private practice are roughly equal, with high levels of job satisfaction in both. Importantly, 90% of surveyed women remain in practice and are academically productive; 50% entered the profession in the past 10 years. The exponential increase in the number of women in the field over the past 10 years provides optimism for continued recruitment.