Gender Distribution in the Vascular Surgery Workforce: A National Analysis of Temporal Trends and Geographic...

Gender disparities in the vascular surgery workforce remain incompletely characterized, particularly with respect to geographic distribution and career-stage variation. This study evaluated national patterns in female representation across career cohorts and regions in the United States.

The April 2026 Centers for Medicare & Medicaid Services Physician Compare National Downloadable File was queried to identify all active vascular surgeons. Surgeons were stratified by 5-year graduation cohorts. Female representation was assessed across career stage and US Census regions. Temporal trends were evaluated using the Cochran-Armitage test and linear regression. Geographic variation was assessed using descriptive statistics and multivariable logistic regression adjusting for graduation year.

Among 4,091 active vascular surgeons, 819 (20.0%) were women. Female representation was highest among surgeons with 6-10 years of experience (35.1%) and declined progressively to 4.9% among those with ≥36 years of experience (P < 0.001). Female surgeon density varied 22-fold across states (0.07-1.48 per 100,000 population), with higher representation in the west (OR 1.51, 95% confidence interval [CI] 1.21-1.87; P < 0.001) and northeast (OR 1.46, 95% CI 1.18-1.82; P = 0.001) compared with the South. Linear regression demonstrated increasing female representation among more recent cohorts (R² = 0.90).

Female representation in the vascular surgery workforce is higher among recent graduates but remains limited overall, with substantial geographic variation. These findings suggest that contemporary workforce composition is largely driven by cohort effects, while substantial regional variation persists. Further study is needed to better understand factors influencing long-term workforce trends.