Presentation at ACS SP 09 on 10/2/12. I'm looking forward to pushing this work ahead to a more granular level and to designing interventions.

1. 2012 Clinical Congress
Presenter Disclosure Slide
American College of Surgeons♦ Division of Education
Amalia Cochran, MD, FACS
Nothing To Disclose

2. DEPARTMENT OF SURGERY
Barriers to Advancement in Academic
Surgery:
Views of Senior Residents and Early
Career Faculty
Amalia Cochran, MD, FACS
William B. Elder, MA
Marie Crandall, MD, FACS
Karen Brasel, MD, FACS
Tricia Hauschild, MD
Leigh Neumayer, MD, FACS

3. DEPARTMENT OF SURGERY
Our Challenge
• Attrition between the Assistant and
Associate Professor levels in academic
surgery is significant
– Greater in women than in men

4. DEPARTMENT OF SURGERY
Our hypothesis
• Senior residents andearly careerfaculty
have different perceptions of career
barriers in academic surgery

5. DEPARTMENT OF SURGERY
Our methods
• Web-based administration of modified
Career Barriers Inventory
– IRB approved or exempted at 8 AMCs

6. DEPARTMENT OF SURGERY
Our sample selection
• Sites selected to maximize geographic
and institutional diversity
• Site PI established email contact with
local participants
• Cohort 1: 4th and 5th year GS residents
• Cohort 2: Early career tenure-track
faculty, invited in 2:1 male: female ratio

7. DEPARTMENT OF SURGERY
Our participating centers

8. DEPARTMENT OF SURGERY
Our participants
• 154 respondents (51% response rate)
– 85 residents (44 female, 41 male)
• 74% response rate
– 69 faculty (26 female, 43 male)
• 37% response rate
• Percentages indicate “Strongly Agree” or
“Agree” on Likert Scale

9. DEPARTMENT OF SURGERY
Our findings- Females
Residents Faculty
In an academic surgical
practice I expect to be/
have been treated 40.9% 76.9%
differently because of my
sex*
In an academic surgical
practice I expect to
experience/ have
experienced
18.2% 50%
discrimination based
upon my sex*
My gender will be/
currently is a barrier to 13.6% 38.5%
my career advancement*
* Fisher’s Exact, p<0.05, residents vs. faculty

10. DEPARTMENT OF SURGERY
Our findings-
Lack of role models as a barrier
Residents Faculty
Male 22% 41.9%
Female** 15.9% 53.8%
** Fisher’s Exact, p<0.005, residents vs. faculty

11. DEPARTMENT OF SURGERY
Our findings-
Ability to overcome barriers
Residents Faculty
Male* 88.6% 65%
Female 63.4% 62.5%
* Fisher’s Exact, p<0.05, residents vs. faculty

12. DEPARTMENT OF SURGERY
Our limitations
• Relatively low response rate by early
career faculty
• Subjectivity of bias perceptions on sex-
specific questions
• Only general surgeons or subspecialists
who completed GS training included in
sample

13. DEPARTMENT OF SURGERY
Our conclusions
• Female surgeon perceptions of sex bias
increase significantly between residency
and early career
• Lack of role models is a career barrier
experienced by all junior faculty
• Male early career faculty are discouraged
about their ability to overcome barriers

14. DEPARTMENT OF SURGERY
Summary
• Academic surgery is still not “gender-
neutral”
• Greater need than ever for
mentorship, targeted faculty development
programs for early career faculty of both
sexes

15. DEPARTMENT OF SURGERY
Our appreciation
• WAGES collaborators
– PJ Schenarts (ECU)
– Rachel Danczyk and Susan Orloff (OHSU)
– Hilary Sanfey (SIU)
– Wendy Grant (U Nebraska)
– Colleen Brophy and Kevin Sexton
(Vanderbilt)