Advances Towards Gender Equity in Surgery: An Australian Cross-Sectional Analysis

This study evaluates the effectiveness of gender equity initiatives toward increasing female surgical consultant representation in the Australian workforce. To assess the impact of the Royal Australasian College of Surgeons' (RACS) diversity and inclusion initiatives on female participation and acceptance rates in Surgical Education and Training (SET) programs in Australia.

A retrospective cross-sectional analysis of publicly available data from RACS activities reports spanning 2013 to 2021. Male and female applicants to SET programs across nine surgical subspecialties were studied before and after the release of RACS' Diversity and Inclusion Plan (DAIP) in November 2016. Analysis was conducted using STATA 18, employing a two-proportions z-test to determine the significance of changes in acceptance rates.

While overall applicant numbers declined in most subspecialties, minor increases were seen in cardiothoracic surgery and neurosurgery. A significant rise in female applicants occurred in orthopaedic surgery (14% to 18%, p = 0.047). Post-DAIP, female acceptance rates significantly increased in general surgery (39.07%), plastic surgery (25.55%), and orthopaedic surgery (60.64%). Male acceptance rates also rose in general and orthopaedic surgery, but in plastic surgery, the increase was specific to female applicants. Female acceptance improved relative to male acceptance in general, orthopaedic, plastic, neurosurgical and paediatric surgery.

This study highlights modest progress toward gender equity in surgical training following the RACS' DAIP release. Despite a general decline in applicant numbers, targeted efforts have improved female acceptance rates in a few subspecialties. Persistent female workforce underrepresentation requires ongoing initiatives that remove barriers to recruitment and training.