By Vishwadha Chander

(Reuters Health) – Punishing hours and concerns about having little time to marry and have children deter both male and female medical students from choosing careers in surgery, but more women say they’ve been warned away from the field because of their gender, a survey found.

Researchers sent surveys to roughly 720 students at Harvard Medical School. Among the 261 who responded, similar proportions of both genders intended to become surgeons- roughly one in four men and one in five women.

Roughly similar proportions of men and women – about 61% and 65%, respectively – said someone had spoken to them to try to dissuade them from a career in surgery, especially if they planned to raise a family.

But 72.7% of women believed the verbal discouragement was related to their gender and their desire for a family, compared to 1.5% of the men, researchers report in Annals of Surgery. And 29% of women reported age-based discouragement, compared to 1.5% of the men.

“Despite an equal number of men and women in medical school, fewer than 25% of surgeons are women,” study coauthor Dr. Faith Robertson, a neurosurgery resident at Massachusetts General Hospital, told Reuters Health by email. “Our study was important to understand why gender ratios change between medical school and practice.”

Students generally decide which field to enter during the latter half of medical school, as they complete medical and surgical rotations and speak to peers, mentors and family members, the study authors note.

“Discouragement from faculty at the pre-med and student-level definitely has an impact,” study coauthor Dr. Susan Pories of Harvard Medical School in Boston told Reuters Health by email. Pories chairs the American College of Surgeons Women in Surgery Committee and is past president of the Association of Women Surgeons.

Dr. Carmen Fong, a colorectal surgeon at the Mount Sinai Health System in New York City, told Reuters Health that during her surgery rotation in medical school, “we had zero female surgeons, and this was at a relatively large hospital in a state capital. There were plenty of women in primary care, but I wanted a female surgeon who had made it, who could tell me that I could balance a life and an academic surgical career.”

Dr. Rachel Levine, Associate Vice Chair for Women’s Academic Careers in the Department of Medicine at Johns Hopkins University School of Medicine, points out that stereotypes also contribute to gender-based discouragement directed at women.

“We think of men as strong, decisive, risk-taking — traits more often associated with surgeons. We often think of women as nurturing and helpful,” Levine, who was not a part of the study, told Reuters Health. “It’s sometimes challenging to see a woman as a surgeon because she doesn’t fit these typical traits.”

The authors say their study at a private, urban institution may not reflect the situation at other universities, but they believe it calls for systemic change, including policies about maternity and paternity leave.

“We have to work towards equal pay, leadership roles for women and parental leave policies for men and women,” said Pories.

Robertson said the field of surgery has unique demands but also an “abundance” of unique rewards.

“We owe it to medical students to empower them to pursue fields based on their passions, and to patients to have a body of surgeons that reflects population diversity,” she said. “By discouraging individuals, particularly minorities, from entering the field, we do both a disservice.”

“The reality is women are successful in all surgical specialties (while still) achieving work-life balance,” Pories said.

SOURCE: http://bit.ly/2QBgBMn Annals of Surgery, online October 9, 2019.

(Reporting by Vishwadha Chander)

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