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      A woman’s place is in theatre: women’s perceptions and experiences of working in surgery from the Association of Surgeons of Great Britain and Ireland women in surgery working group

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          Abstract

          Objective

          Surgery remains an inherently male-dominated profession. The aim of this study was to survey women working within the discipline, to understand their current perceptions, providing insight into their practical day-to-day lives, supporting an action-oriented change.

          Design and setting

          The link to a confidential, online survey was distributed through the Association of Surgeons of Great Britain and Ireland (ASGBI) social media platforms on Facebook and Twitter over a 2-week period in October 2017.

          Participants

          Women working in surgical specialties and actively responding to the link shared through the ASGBI social media platforms. No patients were involved in the study.

          Primary and secondary outcome measures

          Data were analysed through a mixed-methods approach. The quantitative data were analysed through descriptive statistics and qualitative analysis was undertaken using a constant comparative analysis of the participants’ comments, to identify salient patterns (themes).

          Results

          A total of 81 female participants replied (42% response rate based on the Facebook group members), with 88% (n=71) perceiving surgery as a male-dominated field. Over half had experienced discrimination (59%, n=47), while 22% (n=18) perceived a ‘glass ceiling’ in surgical training. Orthopaedics was reported as the most sexist surgical specialty by 53% (n=43). Accounts of gendered language in the workplace were reported by 59% (n=47), with 32% (n=25) of surveys participants having used it. Overall, a lack of formal mentorship, inflexibility towards part-time careers, gender stereotypes and poor work–life balance were the main perceived barriers for women in surgical careers.

          Conclusion

          These findings highlight the implicit nature of the perceived discrimination that women report in their surgical careers. The ASGBI acknowledges these perceptual issues and relative implications as the first of many steps to create an action-oriented change by allowing all staff, regardless of gender, to reflect on their own behaviour, perceptions and the culture in which they work.

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          Most cited references23

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          Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians.

          Studies have found differences in practice patterns between male and female physicians, with female physicians more likely to adhere to clinical guidelines and evidence-based practice. However, whether patient outcomes differ between male and female physicians is largely unknown.
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            Impostor syndrome and burnout among American medical students: a pilot study

            Objectives To describe levels of burnout and impostor syndrome (IS) in medical students, and to recognize demographic differences in those experiencing burnout and IS. Methods Research participants included 2,612 medical students who entered Jefferson Medical College between 2002 and 2012. This sample was divided into two groups: Matriculants between 2002 and 2007 (n=1,380) and between 2008 and 2012 (n=1,232). Data for 2002-2007 matriculants were subjected to EFA (principal component factor extraction), and data for matriculants of 2008-2012 were used for CFA (structural equation modeling, and root mean square error for approximation). Results One hundred and thirty-eight students completed the questionnaire. Female gender was significantly associated with IS (χ2 (3)=10.6, p=0.004) with more than double the percentage of females displaying IS than their male counterparts (49.4% of females versus 23.7% of males). IS was significantly associated with the burnout components of exhaustion (χ2 (2)=5.9, p=0.045), cynicism (χ2 (2)=9.4, p=0.004), emotional exhaustion (χ2 (2)=8.0, p=0.018), and depersonalization (χ2 (2)=10.3, p=0.006). The fourth year of medical school was significantly associated with IS (χ2 (3)=10.5, p=0.015). Conclusions Almost a quarter of male medical students and nearly half of female students experience IS and IS was found to be significantly associated with burnout indices. Given the high psychological morbidity of these conditions, this association cannot be ignored. It behooves us to reconsider facets of medical education (i.e. shame-based learning and overall teaching style) and optimize the medical learning environment.
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              INSTITUTIONAL AND RESOURCE DEPENDENCE DETERMINANTS OF RESPONSIVENESS TO WORK-FAMILY ISSUES.

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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2019
                7 January 2019
                : 9
                : 1
                : e024349
                Affiliations
                [1 ] departmentRenal Transplant Directorate , Imperial College Healthcare NHS Trust , London, UK
                [2 ] departmentScience Complex, Faculty of Health Sciences and Wellbeing , University of Sunderland , Sunderland, Sunderland, UK
                [3 ] departmentDirectorate of General Surgery, Bariatric Surgical Unit , Sunderland Royal Hospital , Sunderland, Sunderland, UK
                [4 ] departmentDepartment of General Surgery , University College London Hospital NHS Foundation Trust , London, UK
                [5 ] departmentDirectorate of General Surgery , Hepatobiliary-Pancreatic Surgical Services Royal Infirmary of Edinburgh , Edinburgh, UK
                [6 ] departmentDepartment of Clinical Surgery , University of Edinburgh , Edinburgh, UK
                [7 ] departmentDepartment of Surgery and Cancer , Imperial College London , London, UK
                Author notes
                [Correspondence to ] Dr Maria Irene Bellini; mariairene.bellini@ 123456nhs.net
                Author information
                http://orcid.org/0000-0003-0730-4923
                Article
                bmjopen-2018-024349
                10.1136/bmjopen-2018-024349
                6326292
                30617103
                a53a3dd9-f343-4585-8dbb-c5601d631141
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 07 June 2018
                : 17 October 2018
                : 26 October 2018
                Categories
                Surgery
                Research
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                1349
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                Medicine
                surgery,gender equity,surgical career,stem
                Medicine
                surgery, gender equity, surgical career, stem

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