V. Padmanaban1, A. Tran1, A. Gore2, P. Johnston1, S. Pentakota1, Z. C. Sifri1 1New Jersey Medical School,Department Of Surgery,Newark, NJ, USA 2University Of Colorado Denver,Department Of Surgery,Aurora, CO, USA
Introduction:
Opportunities for the provision of surgical care in resource-poor settings are increasingly available to surgical residents and attending surgeons. While substantial gender inequity exists in the surgical workforce, these disparities are not described in the arena of surgical outreach. Therefore, we aim to study the contributions of female surgical attendings and residents to short term surgical missions (STSMs) in a single volunteer non-governmental organization over 10 years.
Methods:
We performed a comprehensive review of STSMs conducted by the International Surgical Health Initiative (ISHI) from 2009-2018. Volunteer surgeons, anesthesiologists, emergency and medical physicians, and nurses were recruited from academic and non-academic institutions throughout the country.
Volunteer data was organized by gender, trainee status, site of mission, number of missions completed and duration of service. Mission sites included Guatemala, Haiti, Peru, Philippines, Bangladesh, Sierra Leone, and Ghana. Data was analyzed based on gender distribution at an individual level and a volunteer-mission level. Chi-square tests for categorical variables and Wilcoxon two-sample t-tests were used to analyze mission participation.
Results:
We studied a total of 23 STSMs carried out by ISHI volunteers over a period of 10 years. All 227 volunteers were included, 139 (61%) of whom were female. Non-surgical volunteers including anesthetists, internists, emergency physicians, and nurses were more likely to be female compared to surgical volunteers as an aggregate of attendings and residents (67% vs. 41%, p < 0.01). Nurses comprised the largest subgroup of volunteers, with 96 (42%) in total, of whom 82% were female. Of 22 surgical attendings, 8 (36%) were female; of 37 surgical residents, 18 (49%) were female with no significance noted on statistical comparison.
There were no gender differences noted by predilection for mission location. No gender differences were observed by average of missions completed or propensity for repeat missions (defined as greater than one mission). On subset analysis of mission participation by surgical volunteers, female surgical volunteers completed an average of 1.6 missions, while their male counterparts completed 2.1 missions, with no significant difference.
Conclusion:
Overall, female volunteers contribute substantially to surgical missions, representing over half the volunteers. Non-surgical volunteers are more likely to be female compared to surgical volunteers, in part due to the number of female nurses. Female surgeons contribute in parity with male surgeons when examining number of missions and propensity for repeat missions. This study found no gender inequity among surgical volunteers in this humanitarian organization. Additional studies of other surgical non-governmental organizations are needed to confirm these findings.