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    1 Comment for this article
    Biases in our profession
    Frederick Rivara, MD, MPH | University of Washington
    This is another in a series of articles that have been published in JAMA Network Open on the discrimination and difficulties of women in medicine. While this one is on surgeons, such issues have been found across academic medicine. We all must take a role in ensuring that there is equity for all members.
    CONFLICT OF INTEREST: Editor in Chief, JAMA Network Open
    Original Investigation
    Surgery
    August 30, 2019

    Defining Barriers and Facilitators to Advancement for Women in Academic Surgery

    Author Affiliations
    • 1Department of Surgery, Michigan Medicine, Ann Arbor
    JAMA Netw Open. 2019;2(8):e1910228. doi:10.1001/jamanetworkopen.2019.10228
    Key Points español 中文 (chinese)

    Question  What are the perceived barriers and facilitators to promotion and professional success for women in academic surgery?

    Findings  In this qualitative study of 26 female academic surgeons, a complex matrix of organizational and individual factors was found to contribute to sex inequities for the professional advancement of women in academic surgery.

    Meaning  This research may provide insight into the sex biases that inhibit advancement, may inform strategies that can facilitate progress, and may inspire interventions that could help eliminate institutional and individual barriers to the academic success of women.

    Abstract

    Importance  Sex equity is elusive in academic surgery departments across the United States. Persistent inequities remain a considerable problem and inhibit professional advancement for female surgeons. Identifying the factors that promulgate sex discrepancies may provide a framework for institutional growth and personal progress for women.

    Objective  To identify barriers and facilitators to success at the individual and organizational level to develop evidence-based interventions designed to close the sex gap in surgery.

    Design, Setting, and Participants  This qualitative study included 26 female participants who were current and former surgical faculty employed by Michigan Medicine, the health system of the University of Michigan, between 2000 and 2017. Semistructured personal interviews were conducted from June 28 to September 29, 2017, via telephone. Each interview lasted 45 minutes to 1 hour. Interviews were recorded and then transcribed for analysis.

    Main Outcomes and Measures  The interview included 7 questions referring to the surgeon’s experience with the Michigan Medicine Department of Surgery and 7 questions referring to nonspecific areas of interest.

    Results  The 26 participants in this study ranged in age from 32 to 64 years, with faculty experience ranging from 3 to 22 years. Thematic analysis was used to locate, analyze, and report patterns within the data related to barriers and facilitators for women in academic medicine. Three major themes were identified by researchers. Participants reported that (1) organizational culture and institutional policies affect opportunities for advancement; (2) relational interactions with leadership, mentors, colleagues, and staff affect promotion and attrition; and (3) individual characteristics mediate the perception of professional and personal success.

    Conclusions and Relevance  In this qualitative study of 26 female academic surgeons, a complex matrix of organizational and individual factors were found to contribute to sex inequities in academic surgery. This research may provide insight into the sex biases that inhibit advancement, may inform strategies that facilitate progress, and may inspire interventions that could help eliminate institutional and individual barriers to the academic success of women.

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