• Wendy Chen, Benjamin K Schilling, Debra A Bourne, Sara Myers, and Carolyn De La Cruz.
• From the Department of Plastic Surgery, University of Pittsburgh Medical Center; the Department of Bioengineering, School of Engineering, and the Department of Surgery, School of Medicine, University of Pittsburgh; and the Department of Plastic Surgery, University of Kentucky.
• Plast. Reconstr. Surg. 2021 Jun 1; 147 (6): 1454-1468.

BackgroundGender bias and sexual misconduct continue to pervade medicine. The authors hypothesize that gender bias and sexual misconduct disproportionately and negatively affect female plastic surgery trainees.MethodsA national survey of plastic surgery trainees (2018 to 2019) was conducted using previously validated sexual harassment surveys adapted for relevance to plastic surgery. Respondents were queried about experiences with workplace gender bias and harassment; personal and professional impact; and reporting practices. Analyses included chi-square, logistic regression, and analysis of variance. Significance was accepted for values of p < 0.05.ResultsThere were 236 responses (115 female respondents; 20.1 percent response rate). Most respondents were Caucasian (Asian/Pacific Islander, n = 34) residents (n = 123). The feeling of hindrance to career advancement was greater for women, by 10-fold (p < 0.001), and increased with age (p = 0.046). Women felt uncomfortable challenging attitudes regarding gender inequality (p < 0.001), regardless of training levels (p = 0.670) or race (p = 0.300). Gender bias diminished female trainees' career goals/ambition (p < 0.001). Women were more likely to experience sexual harassment, in the form of jokes (p = 0.003) and comments about their body or sexuality (p = 0.014). Respondents reported the majority of perpetrators of harassment to be attending physicians (30 percent) and other trainees (37 percent). Most common reasons to not report incidents included "futility" (29 percent) and "fear" (20 percent). Women experienced at least three symptoms of depression/anxiety, significantly higher than men (p = 0.001).ConclusionsGender bias and sexual misconduct negatively affect female trainees' attitudes toward their career. Two-thirds of cases of sexual harassment originate from other physicians. Minority trainees are less prepared to address transgressions and more likely to experience sexual coercion. Trainees perceive a culture nonconducive to reporting. These findings can guide changes and discussions surrounding workplace culture in plastic surgery training.Copyright © 2021 by the American Society of Plastic Surgeons.

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