Barriers to careers identified by women in academic surgery: A grounded theory model

Background: Faculty attrition has been widely acknowledged and poorly understood throughout academic medicine. To date, barriers to career advancement in academic surgery have been identified and described in a limited fashion using only survey data. The authors sought to characterize career barriers for women academic surgeons using grounded theory methodology. Methods: Authors conducted semi-structured interviews with 15 mid-career and senior female academic surgeons in the United States. Data were drawn together using grounded theory analysis of interview transcripts to develop a conceptual model. Results: Interviewees identified barriers constituting two intersecting categories: (1) obstacles within the system of academic surgery and (2) impediments based in broader culture and its power structures. Interviewees' robust description of the challenges of integrating clinical and non-clinical professional responsibilities is novel. Conclusions: Career barriers identified by women in academic surgery are complex and include cultural factors from within and outside of the profession. Identifying and dismantling barriers, particularly those that negatively impact perceptions of belonging, is imperative to creating a culture of sustained excellence in academic surgery. Summary: The authors used grounded theory method to develop a conceptual model of barriers to careers in academic surgery as described by successful female academic surgeons. The authors identified intersecting cultural barriers specific to academic surgery and derived from cultural power differentials. (C)2019 Elsevier Inc. All rights reserved.