Women in Leadership and Their Influence on the Gender Diversity of Academic Plastic Surgery Programs

Abstract

Background: Women seldom reach the highest leadership positions in academic plastic surgery. Contributing factors include lack of female role models/mentors and lack of gender diversity. Studies show that female role models and mentors are critical for recruiting and retaining female surgeons and that gender diversity within organizations more strongly influences women's career choices. The authors therefore sought to determine the current gender diversity of academic plastic surgery programs and investigate influences of gender and leadership on program gender composition.

Methods: A cross-sectional study of U.S. plastic surgery residency programs was performed in December of 2018. Genders of the leadership were collected, including medical school dean, department of surgery chair, department/division of plastic surgery chair/chief, plastic surgery program director, plastic surgery faculty, and plastic surgery residents. Gender relationships among these groups were analyzed.

Results: Ninety-nine residency programs were identified (79 integrated with or without independent and 20 independent). Women represented a smaller proportion of academic plastic surgeons in more senior positions (38 percent residents, 20 percent faculty, 13 percent program directors, and 8 percent chairs). Plastic surgery chair gender was significantly correlated with program director gender, and plastic surgery faculty gender was significantly associated with plastic surgery resident gender. Although not statistically significant, female plastic surgery chair gender was associated with a 45 percent relative increase in female plastic surgery residents.

Conclusions: Women in leadership and gender diversity influence the composition of academic plastic surgery programs. Gender disparity exists at all levels, worsening up the academic ladder. Recruitment, retention, and promotion of women is critical, as such diversity is required for continued progress in innovation and problem-solving within plastic surgery.

Figure 1.

Relationships hypothesized to be influenced by gender. Arrows point from positions of higher to lower rank within academic surgery, with the gender of the former hypothesized to influence the gender of latter. Significant associations are represented with blue arrows. No association is represented with black arrows, however the effect size of PRS Chair on PRS residents is 45%. The grey arrows represent hypothetical gender associations that were unable to be addressed in our study. The relationship between Dept of Surgery Chair and PRS Chair/Chief or PRS faculty were only investigated if Plastic Surgery was not a separate department. Dept = Department, PD = Program Director, PRS = Plastic and Reconstructive Surgery.

Figure 2.

A. The gender makeup of Plastic Surgery faculty is positively correlated with the gender makeup of the residents. The linear regression model y = 0.28 + 0.41x is shown in blue. This model demonstrates the significantly positive impact that proportion of total female faculty (x) has on the proportion of female residents (y). The upper and lower bounds of the 95% CI for the regression are shown in red. B. The gender of the PRS chair is associated with the gender of the program director (PD); a female PRS chair is associated with significantly higher appointments of female PDs. PD = Program Director, PRS = Plastic and Reconstructive Surgery.