Izumi Aliya, Lee Grace, Gomes Zoya, Ouzounian Maral, Adinku Penelope, Montes Lorena, Vervoort Dominique
Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, ON, Canada.
Division of Cardiac Surgery, University of Toronto, Toronto, ON, Canada.
Eur J Cardiothorac Surg. 2024 Dec 26;67(1). doi: 10.1093/ejcts/ezae463.
Cardiac surgery remains one of the most gender-imbalanced surgical specialties. Women constitute 6-11% of the North American workforce, while other regional data are scarce. Despite the acknowledged under-representation of women in cardiac surgery globally and evidence that surgeon-patient gender concordance enhances postoperative outcomes, precise figures remain poorly defined. Herein, we provide the 1st global quantification of women cardiac surgeons (WCS) and explore correlates of workforce diversity.
The Cardiothoracic Surgery Network database was queried for cardiac surgeons within each country and cross-validated with external sources. Profile pronouns and the genderize.io application determined surgeon sex. Data were stratified by country, geographical region and national income group, and correlation analyses with socioeconomic and gender parity metrics were performed.
Women constitute 8.0% (1178/14 651) of the international cardiac surgical workforce, with a median of 0.00 WCS per million women (interquartile range: 0.00-0.09). North America (11.4%) and Europe (10.3%) lead regional representation, while East Asia (2.9%) and the Middle East (1.7%) rank lowest. High-income countries (9.9%) have double the proportion of WCS as low- and middle-income countries (4.8%), with a notable absence among low-income countries. Female representation correlates with Gross National Income per capita (τ = 0.39), the Global Gender Gap Index (τ = 0.26) and health expenditure (τ = 0.26).
Improving female representation in cardiac surgery is essential to advancing social justice and overall patient care. Yet, WCS remain a minority worldwide, with the most pronounced disparities in low- and middle-income countries and regions with low Gross National Income, Global Gender Gap Index and health expenditure. Confronting these inequities will require targeted mentorship efforts and addressing country-specific entry barriers, necessitating further research into the unique factors influencing women in low- and middle-income countries.
心脏外科仍然是性别失衡最为严重的外科专业之一。女性占北美心脏外科从业人员的6%-11%，而其他地区的数据则很匮乏。尽管全球范围内心脏外科领域女性代表性不足已得到公认，且有证据表明外科医生与患者性别匹配可提高术后疗效，但确切数据仍不明确。在此，我们首次对全球女性心脏外科医生（WCS）进行量化，并探讨劳动力多样性的相关因素。
查询心胸外科手术网络数据库中每个国家的心脏外科医生信息，并与外部来源进行交叉验证。通过个人简介代词和genderize.io应用程序确定外科医生的性别。数据按国家、地理区域和国民收入组进行分层，并与社会经济和性别平等指标进行相关性分析。
女性占国际心脏外科从业人员的8.0%（1178/14651），每百万女性中WCS的中位数为0.00（四分位间距：0.00-0.09）。北美（11.4%）和欧洲（10.3%）在地区代表性方面领先，而东亚（2.9%）和中东（1.7%）排名最低。高收入国家（9.9%）的WCS比例是低收入和中等收入国家（4.8%）的两倍，低收入国家明显缺乏女性代表。女性代表性与人均国民总收入（τ = 0.39）、全球性别差距指数（τ = 0.26）和卫生支出（τ = 0.26）相关。
提高女性在心脏外科领域的代表性对于推进社会公正和整体患者护理至关重要。然而，全球范围内WCS仍然是少数群体，在低收入和中等收入国家以及人均国民总收入、全球性别差距指数和卫生支出较低的地区，差距最为明显。应对这些不平等现象需要有针对性的指导努力，并解决各国特有的准入障碍，这需要进一步研究影响低收入和中等收入国家女性的独特因素。
