The WTS report on the current status of women in cardiothoracic surgery

The purpose of this work was to assess career demographics, professional activities, and career satisfaction of board-certified female cardiothoracic surgeons in the United States, 50 years after certification of the first women diplomats by the American Board of Thoracic Surgery (ABTS).

All ABTS-certified women were surveyed anonymously in December 2010, using surveymonkey.com. Questions were in five categories: demographics, training, practice activities, activities of nonpracticing cardiothoracic surgeons, and career satisfaction. Respondents were grouped by year of certification: group 1 (1961 to 1999) and group 2 (2000 to 2010). Broad comparisons to the entire thoracic surgery workforce were based on The Society of Thoracic Surgeons and American Association for Thoracic Surgery 2009 practice survey.

Of the 204 living female diplomats, 190 were surveyed, as 14 (7%) were unavailable owing to lack of contact information. Survey response rate was 64% (121 of 190). Mean respondent's age was 48 years (range, 35 to 74), with the majority being Caucasian (94 of 121). Women spent a mean of 9.1 years in training, and 56% (68 of 121) reported non-Accreditation Council for Graduate Medical Education training time. Duration of training and resultant debt has increased over time, as respondents in group 1 (n=52) reported training for 8.5 years versus 9.5 years in group 2 (n=68; p=0.01), and a doubling of graduates with educational debt more than $100,000 from 19% to 41%, respectively (p=0.003). The average number of years in practice was 8 (range, 1 to 30), with the majority working in urban setting (65 of 106), in group practices of 2 to 10 surgeons (82 of 106), and as the sole female surgeon in their group (84 of 106). Of the 54 women with academic appointments, more than 60% (33 of 54) are at the instructor or assistant professor level, but 18% (10 of 54) are full professors. Nearly a third (16 of 54) have secured research funding, and 20% (11 of 54) have protected research time. Job satisfaction is high, with 64% (76 of 118) reporting being always or almost always satisfied with their career, and fewer than 9% (11 of 118) would choose a different career. Although demand on time is the greatest source of dissatisfaction, workplace politics for group 1 and lack of support for group 2 are significant issues. Only 12 respondents are no longer practicing, with the majority leaving because of retirement, health issues, or career advancement.

Women represent a minority of cardiothoracic surgeons in the United States. The numbers in academic versus private practice are roughly equal, with high levels of job satisfaction in both. Importantly, 90% of surveyed women remain in practice and are academically productive; 50% entered the profession in the past 10 years. The exponential increase in the number of women in the field over the past 10 years provides optimism for continued recruitment.