Under-Employment of Female Surgeons?

OBJECTIVE: To compare the complexity of operations performed by female versus male surgeons.

BACKGROUND: Prior literature has suggested that female surgeons are relatively under-employed when compared to male surgeons, with regards to operative case volume and specialization.

METHODS: Operative case records from a large academic medical center from 1997 to 2018 were evaluated. The primary end point was wRVU for each case with a secondary end point of total wRVU per month for each surgeon. Multivariate linear analysis was performed, adjusting for surgeon race, calendar year, seniority, and clinical subspecialty.

RESULTS: A total of 551,047 records were analyzed, from 131 surgeons and 13,666 surgeon-months. Among them, 104,424 (19.0%) of cases were performed by female surgeons, who make up 20.6% (n = 27) of the surgeon population, and 2,879 (21.1%) of the surgeon months. On adjusted analysis, male surgeons earned an additional 1.65 wRVU per case, compared to female surgeons (95% CI + 1.57 to + 1.74). Subset analyses found that gender disparity increased with surgeon seniority, and did not improve over the 20-year study period.

CONCLUSION: Female surgeons perform less complex cases than their male peers, even after accounting for subspecialty and seniority. These gender differences are not due to availability from competing professional or familial obligations. Future work should focus on determining the cause and mitigating this under-employment of female surgeons.