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Comment & Response
February 12, 2020

Improving Gender Equality in the Surgical Workplace—Reply

Author Affiliations
  • 1Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
JAMA Surg. Published online February 12, 2020. doi:10.1001/jamasurg.2019.6027

In Reply Our study1 challenges the notion that women and men surgeons who spend equal time working within a fee-for-service system have equal earnings. Pay disparities appear driven by unequal opportunity. As Ma and Luc and Finn et al note, women surgeons experience unequal opportunities in other aspects of their careers.

Ma and Luc ask the important question of what we should tell women medical students interested in surgical careers. Women are commonly warned about aspects of surgical training and practice that affect all surgeons: surgical training requires long hours and can impact family life. Curiously, they are not warned about barriers uniquely faced by women in surgery, specifically, that gender bias will affect their training and careers. There is incontrovertible evidence that women in surgery experience bias in evaluations, promotion, remuneration, and daily interactions with colleagues and patients; this can lead to poor career satisfaction and burnout.2,3 Sexual harassment and mistreatment occur at alarming levels: in the ABSITE survey,4 66% of women surgical residents reported discrimination on the basis of gender, race/ethnicity, or pregnancy/childcare status, and 20% reported sexual harassment.

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