Is the culture of surgery still a gender issue?

We appreciate the thoughtful response from McGrath, Brew and Warren. We acknowledge that we interviewed those who overcame the challenges of postgraduate training and became academic surgeons. We question whether they would perceive themselves as the “new establishment,” though we will concede that to be successful these individuals have agreed to the expectations of their department and their academic institution. We recognize that many surgical trainees leave training programs and many academic surgeons leave university departments to go into community practice because they cannot, or will not, make the compromises required to deal with the demands of their roles. We agree that many capable women leave surgical training or drop out of academic surgery because of the difficulty of combining family and professional roles.

We also acknowledge the limitations of our study group. We were interested in the case study represented by a department of surgery that intentionally set out to change the gender mix and to change policies to be more “family friendly.” We would contend that departments of surgery can make choices about how to support women and men during their training and as faculty members, and these choices will make trainees more likely to be successful. This is an evolutionary rather than a revolutionary approach.

Our paper indicates the critical importance of mentorship. If mentors are not assigned or identified in one’s own department, individuals need to look elsewhere—to national surgery organizations or other national organizations such as the Canadian Medical Association, which has a mentorship program to faculty members outside of surgery.

Again, we thank the authors for their comments and observations, all directed at inclusiveness in surgical training and academic pursuits.