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Do We Really Understand the Deterrents?

Debra A. Gargiulo, MD; Neil H. Hyman, MD; James C. Hebert, MD

Arch Surg. 2006;141:405-408.

Hypothesis  Women are deterred from a surgical career owing to a lack of role models rather than lifestyle considerations.

Design  Survey.

Setting  University teaching hospital.

Participants  Surgery and obstetrics/gynecology attending physicians, residents, and medical students.

Intervention  Questionnaire.

Main Outcome Measures  Potential deterrents to a surgical career.

Results  Men and women had a similar interest in a surgical career before their surgical rotation (64% vs 53%, P = .68). A similar percentage developed a mentor (40.0% vs 45.9%, P = .40). Women were far more likely to perceive sex discrimination (46.7% vs 20.4%, P = .002), most often from male attending physicians (33.3%) or residents (31.1%). Women were less likely to be deterred by diminishing rewards (4.4% vs 21.6%, P = .003) or workload considerations (28.9% vs 49.0%, P = .02). They were also less likely to cite family concerns as a deterrent (47.8% vs 66.7%, P = .02) and equally likely to be deterred by lifestyle during residency (83.3% vs 76.5%, P = .22). However, women were more likely to be deterred by perceptions of the "surgical personality" (40.0% vs 21.6%, P = .03) and the perception of surgery as an "old boys' club" (22.2% vs 3.9%, P = .002).

Conclusions  Men and women are very similar in what they consider important in deciding on a surgical career. Women are not more likely to be deterred by lifestyle, workload issues, or lack of role models. However, the perceived surgical personality and surgical culture is a sex-specific deterrence to a career in surgery for women.

Author Affiliations: Department of Surgery, University of Vermont, Burlington.

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