Women in surgery - Do we really understand the deterrents?

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 deter-red 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.