From poorly fitting instruments to ingrained assumptions about competence, the surgical culture continues to marginalise women.
This is according to Canada’s first study of its kind.
Although women now make up more than half of medical students in Canada, only a third of practising surgeons are women.
A new study suggests that the gender norms ingrained in workplace culture significantly contribute to this disparity.
Researchers at McGill University emphasise that subtle yet persistent biases may be pushing women out of surgery entirely.
Lead author Dr. Jillian Schneidman, who earned her MD from McGill’s Faculty of Medicine and Health Sciences, said: ‘A lot of research into the gender gap in surgery has focused on increasing the number of women, but there wasn’t much on what day-to-day life actually felt like for women.’
To address this gap, Schneidman conducted the first ethnographic study of women in surgery in Canada, drawing on 67 hours of operating room observation and in-depth interviews with female surgeons at a Canadian teaching hospital.
The findings reveal a surgical environment that still reflects masculine norms, influencing everything from case assignments to instrument design.
While work-life balance and family demands are often cited as barriers, Schneidman emphasises that the deeper issue is structural: ‘Women’s surgical status is continually questioned and undermined.’
Participants reported being passed over for complex surgical referrals, paid less for comparable procedures, and working with tools that are too large or ill-fitting for their hands. One surgeon even chose her specialty because the instruments in another field were too big for her grip.
Schneidman identified three levels where gender influences surgical life:
• Organisational level: Women are overlooked for referrals, receive less operative time, are paid less, and are often perceived as less legitimate.
• Individual level: They face pressure to be confident and assertive without risking the label of being ‘unfeminine’.
• Environmental level: Surgical spaces and tools are designed with men in mind. An operating room sign even listed a ‘men’s hat’ as a required head covering.
She underscored that surgical culture isn’t just an issue of equity but one of patient care. Recent studies link diverse surgical teams with better patient outcomes.
Now beginning her general surgery residency at McGill, Schneidman said her next study will explore how female surgeons navigate structural exclusion, particularly the ways they downplay or internalise bias to succeed.
