Gynecologic Oncology and Inclusion of Women Into the Surgical Workforce: The Canary in This Coal Mine

Linda J Hong; Lisa Rubinsak; Michelle F Benoit; Deanna Teoh; Uma Chandavarkar; Amy Brockmeyer; Erin Stevens; Yevgeniya Ioffe; Sarah M Temkin

doi:10.3389/fonc.2022.789910

Gynecologic Oncology and Inclusion of Women Into the Surgical Workforce: The Canary in This Coal Mine

Front Oncol. 2022 Apr 6:12:789910. doi: 10.3389/fonc.2022.789910. eCollection 2022.

Authors

Linda J Hong¹, Lisa Rubinsak², Michelle F Benoit³, Deanna Teoh⁴, Uma Chandavarkar⁵, Amy Brockmeyer⁶, Erin Stevens⁷, Yevgeniya Ioffe¹, Sarah M Temkin⁸

Affiliations

¹ Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Loma Linda University School of Medicine, Loma Linda, CA, United States.
² Division of Gynecologic Oncology, Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States.
³ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Kaiser Permanente Washington, Seattle, WA, United States.
⁴ Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, MN, United States.
⁵ Department of Oncology, Sutter Medical Group, Sacramento, CA, United States.
⁶ Division of Gynecologic Oncology and Gynecology, Department of Surgery, Virginia Mason Medical Center, Seattle, WA, United States.
⁷ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prevea Health, Green Bay, WI, United States.
⁸ Independent Researcher, Washington, DC, United States.

Abstract

Objective: Women make up a majority of the gynecologic oncology workforce. Increasing the numbers of women in leadership has been proposed as a path towards professional gender equity. This study examined whether leadership gender and departmental infrastructure impact the work environment for women gynecologic oncologists.

Methods: Members of a 472-member private Facebook group "Women of Gynecologic Oncology" (WGO) who self-identified as women gynecologic oncologists provided demographics, practice infrastructure, personal experience with workplace bullying, gender discrimination, microaggressions using a REDcap survey platform.

Results: Of 250 (53%) respondents to this survey, most were younger than age 50 years (93.6%); White (82.2%) and non-Hispanic (94.3%); married (84.7%); and parenting (75.2%). Practice environments included academic (n=152, 61.0%), hospital employed (n=57, 22.9%), and private practice (n=31, 12.4%), and 89.9% supervised trainees. A significant percent of respondents had experienced bullying (52.8%), gender discrimination (57%) and microaggressions (83%). Age, race, ethnicity, practice setting, or mentorship were not statistically significantly associated with these experiences. Reported perpetrators were varied and included colleagues (84%), patients (44%), staff (41%), administrators (18%), and trainees (16%). Prevalence of bullying (55.0 vs 47.7%, p=0.33), gender discrimination (59.1 vs 52.3%, p=0.33) and microaggressions (83.3 vs 83.0%, p=1.00) were similar irrespective of departmental leadership gender.

Conclusions: Women gynecologic oncologists report a high prevalence of workplace bullying, gender discrimination and microaggressions regardless of the gender of their immediate leadership. Proactive and deliberate structural interventions to improve the work environment for surgeons who are women are urgently needed.

Keywords: bullying; gender discrimination; gynecologic oncologists; inclusion; microaggressions; women in medicine (WIM); women in surgery.