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Strategies to Reduce Gender Discrimination in Surgery: A Qualitative Study of Women Neurosurgeons and Cardiothoracic
Leeat Granek1, Deborah L Benzil2, Jessica Forcillo3
1School of Health Policy and Management & Department of Psychology, Faculty of Health, York University, Toronto, Ontario, Canada.
Objective:
Despite growing numbers of women entering medicine, female neurosurgeons and cardiothoracic surgeons continue to report persistent gender discrimination in their workplaces. While previous efforts to address these disparities have focused on individual-level interventions, less attention has been directed toward the cultural and structural dynamics that sustain inequity within these high-intensity surgical environments. This study explores female surgeons' perspectives on how neurosurgery and cardiothoracic surgery might become more equitable and inclusive.
Design And Setting:
This qualitative study involved semi-structured interviews with 18 female neurosurgeons and 4 cardiothoracic surgeons in North America. The grounded theory method of data collection and analysis was used. Analysis involved line-by-line coding and was inductive, with codes and categories emerging from participants' narratives.
Results:
Participants emphasized the need for a fundamental cultural shift within surgical practice. Six interrelated strategies were identified: (1) changing surgical training culture; (2) increasing female representation; (3) valuing surgeon differences; (4) supporting women through mentorship, advocacy, and sponsorship; (5) speaking up about bias and discrimination and pursuing legal action where necessary; and (6) implementing strategic policy changes and accountability mechanisms. Participants emphasized that policy reforms must be accompanied by cultural change and enforcement from leadership to produce meaningful impact.
Conclusions:
Female surgeons in neurosurgery and cardiothoracic surgery view gender inequity as embedded within the cultural and structural organization of surgical practice. Addressing these disparities requires coordinated reforms in training culture, representation, institutional policy, and accountability. Sustainable progress will depend on broader cultural transformation rather than isolated or symbolic interventions.
