Promoting Female Leadership in Academic Surgery: Disrupting Systemic Gender Bias

Gender bias is a pervasive issue in academic surgery and is characterized by familiar patterns previously described in the business world. In this article, the authors illuminate gender bias patterns in academic surgery identified in prior in-depth interviews with female surgical department chairs across the United States. The 4 main gender bias patterns drawn from the business world and illuminated with data from the interviews are (1) prove-it-again, (2) tightrope or double-blind dilemma, (3) maternity wall or benevolent bias, and (4) tug-of-war. The authors propose steps to disrupt systemic gender bias issues recognized in the academic surgery community. The proposed steps are informed by guidance from surgical diversity task forces, by existing literature, and by the authors' own experiences in the field. The steps are divided into 3 main categories: education, structured mentorship, and transparency. The proposed changes include improving training and recognition of unconscious bias, establishing level-appropriate and deliberate mentorship across all stages of training and practice, standardizing promotional requirements, and eliminating outdated standards that contribute to the gender pay gap. Although this article addresses gender bias in academic surgery, the proposed steps toward change can promote equity across the surgical community as a whole and extend to other underrepresented groups in the field.