Beyond the scalpel: Barriers to advancement for Asian women in academic surgery

Asian women remain underrepresented in surgical leadership despite increasing numbers in the workforce. Their intersectional experiences in academic surgery are poorly understood. This study explores barriers to career advancement faced by Asian women in academic surgery.

Semi-structured interviews were conducted with Asian women surgeons recruited via a national surgical society. Transcripts were analyzed using grounded theory.

Twenty Asian women surgeons participated; 70% faculty, 35% international medical graduates. Six barrier domains were identified: (1) career advancement-opaque promotion criteria, exclusion from informal networks, disproportionate invisible labor, leadership stereotypes, and mid-career stagnation; (2) mentorship and sponsorship-limited mentorship beyond training, cultural and gender barriers to mentorship, and scarcity of sponsors; (3) bias and discrimination-racism, sexism, undermining of authority, heightened scrutiny, inequitable referrals, and double standards; (4) institutional barriers-favoritism, unsupportive leadership, tokenistic diversity efforts, and productivity-based compensation; (5) personal impact-social exclusion, burnout, disillusionment, and attrition; and (6) barriers related to IMG status, reflecting challenges uniquely reported by international medical graduates.

Structural reforms to improve promotion transparency, ensure leadership accountability, and formalize mentorship and sponsorship are essential to foster equity and retain Asian women in academic surgery.