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Original Investigation
March 21, 2019

Assessment of Gender Differences in Perceptions of Work-Life Integration Among Head and Neck Surgeons

Author Affiliations
  • 1Department of Otolaryngology, University of Arkansas for Medical Sciences, Little Rock
  • 2Department of Otolaryngology, Mt Sinai School of Medicine, New York City, New York
  • 3Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia
JAMA Otolaryngol Head Neck Surg. 2019;145(5):453-458. doi:10.1001/jamaoto.2019.0104
Key Points

Question  What are the factors that may contribute to gender discrepancies among attending surgeons?

Findings  In this web-based survey study including 261 head and neck surgeons, a statistically significant difference in rank distribution was noted, with fewer women in higher academic ranks ranks compared with men. Female head and neck surgeons were more likely to be single, to have fewer children than male colleagues, and to have been treated for mental health issues.

Meaning  Despite improvements in work hours and gender balance in residency programs, there continues to be a discrepancy in the number of female surgeons with senior academic rankings and equitable levels of family life and well-being; further improvements are needed.


Importance  The factors that contribute to gender discrepancies among attending head and neck surgeons have yet to be fully characterized.

Objective  To evaluate the association of gender difference with the perceived quality of life of head and neck oncological surgeons.

Design, Setting, and Participants  Following approval from the American Head and Neck Society (AHNS) review board, a web-based survey study of 37 questions, mainly assessing daily lifestyle and quality of life, was sent to the entire membership.

Main Outcomes and Measures  The main outcome assessed was perceived quality of life among female and male surgeons.

Results  A total of 261 members (13.0%) responded, 71 women (27.2%) and 190 men (72.8%). In all, 66 female (92.5%) and 152 male (80%) surgeons worked at an academic institution. A greater percentage of women were at the associate professor level than men (20/64 [31%] vs 37/152 [24%]; difference, 6.9%; 95% CI, −5.6% to 20.5%) and a greater percentage of men were at the professor level than women (72/152 [47%] vs 18/64 [28%]; difference, 19%; 95% CI, 4.9% to 31.6%). This discrepancy was evident in administrative roles as well, with 4 female (6.2%) vs 23 male (17.6%) department chairs (difference, 11.3%; 95% CI, 0.9%-19.6%). Of the 71 women, 18 (25%) were not in a long-term relationship or were divorced, as opposed to 6 (3.2%) men (difference, 22%; 95% CI, 12.8%-33.5%). Women had a mean (median) 1.18 (1) children, whereas men had 2.29 (2) children. Mean age that participating women had their first child was 35.1 years, whereas the man age for men was 31.9 years. Overall, 117 men (61.9%) and 45 women (67.2%) found their family time limited compared with other otolaryngological subspecialties. Despite these results, 101 men (53.4%) vs 37 women (55.2%) stated that they had a good work-life balance. Six women vs 8 men indicated they would choose a different subspecialty if they could.

Conclusions and Relevance  Despite improvements in work hours and gender balance in residency programs, discrepancy in the number of female surgeons with senior academic rankings continues. However, female and male head and neck surgeons appear equally content with their subspecialty choice.