Disparate rates of surgeon attrition from academia in the United States by gender and subspecialty

Retention of women academic surgeons is important to continuing efforts to increase the diversity of the academic physician workforce. The goal of this study was therefore to investigate differences in rates of leaving academia between women and men surgeons overall and by surgical subspecialty.

This retrospective cohort study included 40,596 surgeons who billed Medicare from an academic teaching institution over 2014–2019, identified in the Centers for Medicare & Medicaid Services Care Compare database. The primary outcome was leaving academia, defined as not billing Medicare from an academic institution for > 1 year. Differences in attrition rates were analyzed through chi-square analysis, and multivariable analyses controlling for physician characteristics were constructed to determine the likelihood of leaving academia for women relative to men overall and in different surgical subspecialties.

Of the surgeons included, 5817 (14.3%) were women. The overall rate of leaving academia was greater for women than men (19.9% vs. 15.4%, p < 0.001). Surgical oncologists were the least likely to leave academia (10.5%), and relative to surgical oncology, subspecialties in which surgeons were more likely to leave academia were cardiac surgery, general surgery, hand surgery, maxillofacial surgery, orthopaedic surgery, otolaryngology, and plastic surgery (all, p < 0.05). Specialties in which women were more likely to leave academia than men were cardiac surgery, neurosurgery, orthopaedic surgery, otolaryngology, plastic surgery, urology, and vascular surgery (all, p < 0.05).

Overall, women surgeons were more likely to leave academia than men surgeons, and the degree of increased likelihood was greater in certain surgical subspecialties. Given the demonstrated importance of gender diversity among surgical subspecialties, these results suggest that efforts should be focused not only on recruitment, but also on retention of women surgeons.

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