Career Satisfaction, Gender Bias, and Work-Life Balance: A Contemporary Assessment of General Surgeons

OBJECTIVE: To identify factors and patterns of career and life satisfaction among general surgery residency graduates who completed all of their general surgery training after the implementation of duty hour restrictions.DESIGN: A 91-point electronic survey was distributed to assess experiences during medical school, residency, current surgical practice and work-life balance. Descriptive statistics and chi-square tests were completed.SETTING: Twenty-nine ACGME-accredited surgery residencies.PARTICIPANTS: Graduates of surgery residencies between 2008 and 2018.RESULTS: Three hundred thirty-six surgeons completed the survey (21% response rate); 42% (n = 141) were female. Seventy-nine percent (n = 81) of female and 92% (n = 138) of male surgeons reported overall career satisfaction (p = 0.004). Overall, 97% and 94% reported feeling competent to practice clinically and operate independently at the conclusion of their training. Thirtyfour percent (n = 48) of women experienced gender bias/discrimination while on their medical school surgery rotation, compared to 6% (n = 12) of men (p < 0.001). Sixty-two percent (n = 63) of female surgeons reported gender bias in their practice, compared to 4% (n = 6) of men (p < 0.001). Of respondents with children, female surgeons were more likely to think having a child negatively affected their career advancement (p = 0.004), and 24% of female surgeons and 11% of male surgeons do not think having a family is supported by their practice (p = 0.02). If given the opportunity to choose a career again, 21% of female surgeons and 13% of male surgeons would choose a different profession (p = 0.13).CONCLUSIONS: General surgeons who completed their training after implementation of duty hour regulations are confident in their preparation for clinical practice. Female surgeons were less likely to be satisfied with their career and they report significantly more bias during their professional development and career. Work-life balance challenges were similar among men and women. Efforts are necessary to reduce gender bias across the spectrum of general surgeon training/career and to promote well-being among surgeons in practice. ((C) 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)