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National Survey of Plastic Surgery Trainees: Current Status of Gender Bias and Sexual Misconduct

Wendy Chen, MD, MS; Benjamin K Schilling, MS; Debra S. Bourne, MD; Sara Myers, MD, MS, MA; Carolyn Delacruz, MD
University of Pittsburgh Medical Center Department of Plastic Surgery
2019-02-11

Presenter: Wendy Chen

Affidavit:
Vu T. Nguyen

Director Name: Vu T. Nguyen

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction

Background:
While interventions aimed at mitigating sexual misconduct are being emphasized within medicine (JAMA 1995, 2016), these issues continue to negatively affect physicians. Maintaining professionalism in plastic surgery training is important.

Methods:
We conducted a national survey of current plastic surgery trainees (2018-2019) using previously validated surveys (Veterans Affairs, 1998; Cook 1996). Analyses included Chi-squared, logistic regression, and ANOVA. Significance accepted at p<0.05.

Results:
There were 211 responses (115 female, 88 male; 15% response rate). Average age was 30.7 years. Majority race was Caucasian (n=114; Asian, n=34). All training levels were represented (interns, n=30; residents, n=123; chiefs, n=23; fellows, n=24)

The feeling of hindrance to career advancement was 10-fold greater for females (p<0.00), and increased with age (p=0.00). Women felt uncomfortable challenging attitudes regarding gender inequality (p<0.00), and gender bias has a diminishing effect on female trainees' career goals/ambition (p<0.00). Perpetrators of gender bias were diverse (attendings, 30%; other trainees, 37%; nurses/ancillary staff, 21%; patients/families, 11%; medical students, 3%).

Female trainees experience sexual harassment as jokes (p=0.00) and comments about their body/sexuality (p=0.01), vs. men. Most common reasons to not report incidents included "not worth it/no change will result" (29%) and "fear of retaliation/distrust in institution" (20%). Women experienced at least three symptoms of depression/anxiety, significantly higher than men (p=0.01).

Conclusions:
Gender bias and sexual misconduct negatively affects female trainees' attitudes towards their career. Females experienced gender bias most commonly from physicians. Trainees perceive a culture non-conducive to reporting incidents. These findings can guide changes and discussions surrounding workplace culture.

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