Congenital: Education
Impact of gender in congenital heart surgery: Results from a national survey

https://doi.org/10.1016/j.jtcvs.2022.06.005Get rights and content

Abstract

Objective

There are limited data regarding the impact of gender within congenital heart surgery. Our aim was to assess gender-related experiences by surgeons in this field.

Methods

A cross-sectional survey was emailed to practicing congenital heart surgeons to ascertain the perception of gender in 5 domains: training, professional career, clinical practice, personal life, and career outlook.

Results

The survey response rate was 94% (17/18) for women and 44% (112/257) for men. More than half of women (53%) were discouraged from pursuing congenital heart surgery (P < .001) and reported a negative impact of gender in attaining their first congenital heart surgery job (P < .001) compared with men. Despite similar demographics, women reported lower starting annual salaries ($150K-$250K vs $250K-$400K), lower current annual salaries ($500K-$750K vs $750K-$1M), lower academic ranks (clinical instructor 6% vs 4% [P = .045], assistant professor 35% vs 19% [P = .19], associate professor 41% vs 25% [P = .24], and professor 6% vs 41% [P = .005]) along with lower annual salaries at the associate professor ($500K-$750K vs $1M-$1.25M) and professor levels ($1M-$1.25M vs >$1.5M) compared with men. Sexual harassment was experienced more frequently by women both in training (65% vs 6%, P < .001) and in practice (65% and 4%, P < .001).

Conclusions

This survey highlights many areas of gender-related differences: discouragement due to gender to pursue congenital heart surgery, sexual harassment in training and practice, salary and academic rank differentials, negative gender perception at work, and lower career satisfaction for women. Despite various differences between both genders, the majority in each group would choose to enter this profession again as well as encourage others to do so.

Section snippets

Materials and Methods

A cross-sectional survey was designed by 2 female congenital heart surgeons and received Institutional Review Board approval (20-123 CCMC, 1.21.2021). The survey (Online Data Supplement) was sent electronically via REDCap in December 2020 to a list of women (group 1) practicing CHS in the United States. The list of female surgeons was created on the basis of professional affiliations and publicly available hospital websites. A subsequent list of male congenital heart surgeons (group 2) was

Results

A total of 18 women and 257 men were identified per the inclusion criteria with 94% (n = 17) and 44% (n = 112) of women and men completing the surveys, respectively. A summary of results is listed in Table 1 (demographics), Table 2 (gender issues), and Table 3 (salaries by academic rank).

Discussion

Women constitute not only half of the medical school graduates but also half of the potential CHS workforce. Although there has been a focus on decreasing the gender gap in thoracic surgery, the subspecialty of congenital warrants individual focus because of its unique characteristics: additional training and board certification beyond general surgery residency + cardiothoracic (CT) surgery fellowship or integrated CT surgery residency, an extraordinarily competitive and well-saturated job

Conclusions

Addressing the lack of gender equity in thoracic surgery (including within each of its branches) is of paramount importance for a multitude of reasons, including the projected thoracic surgeon workforce deficit and the association between female physician gender and better clinical outcomes.20 Women's progress appears to be stunted because of disparities in “academic progression” and lack of reportedly healthy and supportive work environments focused on professional development (Figure 5).

Cited by (3)

Read at the 102nd Annual Meeting of The American Association for Thoracic Surgery, Boston, Massachusetts, May 14-17, 2022.

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