The Glaring Gender Bias in the Operating Room: A Qualitative Study of Factors Influencing Career Selection for First-Year Medical Students

OBJECTIVE: Despite greater female than male-identifying Canadian medical graduates, women continued to be underrepresented in surgical specialties. The aim of this study was to explore the role of lifestyle challenges and gender-specific considerations in career selection for first-year medical students following early exposure to surgery through an immersive surgical program. DESIGN: A single institution, qualitative study consisting of structured focus groups before and after completion of a 2 week surgical program was used to explore medical student perceptions of surgery. The program consisted of shadowing, surgeon-led talks, and surgical skills workshops in all direct-entry surgical specialties within the Department of Surgery at the University of Toronto. Six entry and exit interviews were conducted by 2 authors. Interviews were recorded, transcribed, and coded for thematic analysis. SETTING: Teaching hospitals affiliated with the University of Toronto, Canada PARTICIPANTS: Thirty first-year medical students with interest in surgery participated in the program and the focus groups. RESULTS: Four prominent themes emerged: gender imbalances in the work environment, the importance of female mentors, gender-specific challenges of parenting, and the importance of flexible work hours for both male and female students. Greater exposure to female surgeons improved the outlook of medical students on work-life balance. Medical students are concerned with the challenges of pregnancy in a surgical profession. Both male and female students consider parenting, supportive partners, and flexibility of work hours in their career selection. CONCLUSION: This study demonstrates the prevalence of gender bias in surgical specialties, raising gender-specific challenges that impact career selection for first-year medical students. In an effort to address these perceptions, this study supports efforts to implement formalized mentorship programs for women in surgery early in medical education. Furthermore, concerns surrounding childbearing further support the need for well-established parental leave policies in the Canadian postgraduate medical education system. (J Surg Ed 78:1516-1523. (c) 2021 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)