Gender and Family Status Have Powerful Effect on Surgical Career Choices

Gender, marital status and children appear to play a powerful role in influencing the careers of surgical residents, according to a new study by researchers at Yale School of Medicine. The study appears in the May issue of Archives of Surgery, a publication of the American Medical Association.

Researchers surveyed thousands of general surgery residents across the country to gauge perceptions about whether general surgery is becoming obsolete, giving way to a bigger emphasis on specialty surgery. They sought to identify factors that motivate residents to either specialize or launch a career in general surgery, honing in on the influence of marriage, family obligations and gender.

More than 55 percent of those who responded to the survey believed that a surgeon must receive specialty training in order to be successful, but far fewer women than men felt that way. In addition, far fewer married residents than single ones felt that specialization was necessary, as did far fewer of those who already had children. The more children a resident had, in fact, the less likely he or she was to believe that specialty training is the key to success as a surgeon.

Lead author Julie Ann Sosa, M.D., F.A.C.S., associate professor of endocrine surgery and surgical oncology at Yale School of Medicine, says these survey responses reveal perceptions shaped by residents’ personal lives. “There are still lingering concerns about maternity leave, child care, the amount of time surgical education takes, and a lack of enough female faculty role models to show the way to having it all. These issues are shaping the career paths that surgical residents choose to take,” she said.

In addition, 78 percent of the residents in the Yale survey associated specialty training with a better income, and 62 percent associated it with a better lifestyle.

There is concern among surgical educators that because of these lifestyle and income concerns, general surgery may eventually become obsolete. This is already being reflected in surgical education, with a rapid rise in the number of specialty fellowships, particularly in minimally invasive surgery. “There is a generation gap between current residents and the experienced surgeons who are teaching them,” Sosa said. “We need to accelerate our efforts to properly train residents to be excellent surgeons, without sacrificing their needs for family and a decent lifestyle.”

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