Association of Women Surgeons
The erasure of gender in academic surgery: a qualitative study

https://doi.org/10.1016/j.amjsurg.2016.06.006Get rights and content

Abstract

Background

The number of women in surgery has steadily increased, yet their numbers in academic surgery positions and in high-ranking leadership roles remain low. To create strategies to address and improve this problem, it is essential to examine how gender plays into the advancement of a woman's career in academic surgery.

Methods

Focus group (1) and one-on-one qualitative interviews (8) were conducted with women academic surgeons from various subspecialties in a large university setting. Interviews examined women surgeons' accounts of their experiences as women in surgery. Audio-recorded data were transcribed verbatim and coded thematically. NVivo10 software was used for cross-referencing of data and categorization of data into themes.

Results

Focus group data suggested that gender discrimination was pervasive in academic surgery. However, in interviews, most interviewees strongly disavowed the possibility that their gender had any bearing on their professional lives. These surgeons attempted to distance themselves from the possibility of discrimination by suggesting that differences in men and women surgeons' experiences are due to personality issues and personal choices. However, their narratives highlighted deep contradiction; they both affirmed and denied the relevance of gender for their experience as surgeons.

Conclusions

As overt acts of discrimination become less acceptable in society, it does not necessarily disappear but rather manifests itself in covert forms. By disavowing and distancing themselves from discrimination, these women exposed the degree to which these issues continue to be pervasive in surgery. Women surgeons' ability to both identify and resist discrimination was hobbled by narratives of individualism, gender equality, and normative ideas of gender difference.

Section snippets

Methods

This study used a generic qualitative methodology informed by critical feminist theory.12 Our team originally planned to collect data through several focus groups, guided by a semi-structured interview guide. However, due to the busy practices of our participants, we were only able to schedule one focus group with 4 surgeons (from 2 subspecialties). We therefore used what we had learned from the focus group to inform an interview guide for semi-structured key informant interviews, which were

Findings

We report first on the focus group data. The conversation we engaged in during the focus group was candid, and the women participants shared a series of accounts from their lives during medical training and practice that ranged from overt harassment and bullying to feeling pressured to having to adopt certain rigid roles in relation to their male mentors. Statements such as the following were typical from the focus group data:

My gender poses challenges for my work on a daily basis. When medical

Comments

Our findings support a growing body of evidence that indicates people—especially women—are often unwilling to identify as victims of discrimination or inequity.14, 15, 16, 17, 18, 19 This may be especially true in our population of successful academic surgeons. Although our participants deny any possibility of gender differences in their workplace, their accounts of their experiences instead suggest that surgery remains a gendered profession. However, several women surgeons argued that because

Conclusion

As overt acts of discrimination become less acceptable in mainstream society, discrimination does not necessarily disappear but rather manifests itself in ambiguous and covert forms. This has the effect of rendering gender issues difficult to identify and address. An irony of our study is that through disavowing and distancing themselves from gender discrimination, these women ultimately exposed the degree to which these issues continue to be pervasive in surgery. It is encouraging to find that

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    The authors declare no conflicts of interest.

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