• Megumi Hirayama and Senaka Fernando.
• 1 AstraZeneca Kabushiki Kaisha, Osaka 5300011, Japan.
• J R Soc Med. 2018 Sep 1; 111 (9): 324334324-334.

AbstractObjective To identify organizational barriers to and facilitators for female surgeons' career progression. Design Systematic review of qualitative and quantitative studies relating to organizational barriers to and facilitators for female Surgeons' career progression. After the quality assessment of the peer-reviewed journal articles, twelve articles were selected for full review. Thematic analysis was used to identify key themes in these selected articles. Setting The studies solely focused on organizational factors linked to female physicians' career progression in surgical specialties. Partcipants Female surgeons. Main outcome measures Organizational barriers and facilitators Results Twelve peer-reviewed journal articles were included in the study which focused on barriers to female surgeons' career progression, ways of facilitating female surgeons' career progression, and female surgeons' job satisfaction. Conclusion The major organisational factors contributing to the lack of career progression for female surgeons are (1) organizational culture which promotes rigid career structure that is inclined to support male surgeons than female surgeons and also male domination in which male surgeons feel superior to female surgeons (2) work family conflict whereby women feel that they have to make a family sacrifice by being women; they experience the difficulty in securing a work-life balance in the masculine career structure in surgical specialties. This implies that policy makers and healthcare organizations need to pay significant attention to organizational facilitators for female surgeons' career progression such as flexible career pathways and work patterns, a variety of different viable career progressions, more family-friendly working conditions, and the promotion of female mentors and role models in surgical specialties to support female surgeons in dealing with the organizational barriers in the male-dominated organizational culture and the lifestyle issues as well.

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