EP407 - Women in Colorectal Surgery: A National Survey of Gender-Related Experiences Among ASCRS Members

Purpose/Background: Despite achieving parity in medical school enrollment, women remain underrepresented in surgical leadership, academic promotion, and positions of influence within national societies. Prior studies across surgical subspecialties have demonstrated disparities in mentorship, sponsorship, compensation, and family leave policies, yet data specific to colorectal surgery remain limited. Recognizing this gap, the American Society of Colon and Rectal Surgeons (ASCRS) Women in Colorectal Surgery (WCS) Taskforce was established to identify gender-related challenges and opportunities for advancement for women within the specialty. This study sought to characterize the current professional experiences of all ASCRS members and highlight barriers to equity in training, practice, and leadership.

Methods/Interventions: A survey was developed following taskforce-led focus groups and disseminated electronically to ASCRS members. The survey included items on demographics, work patterns, compensation, mentorship and sponsorship, family planning, leave policies, and perceptions of gender bias. Participation was voluntary and anonymous. The protocol was reviewed and approved by the Tulane University Institutional Review Board and vetted by the ASCRS Survey Committee prior to dissemination. Chi-square tests of independence were used to compare gender differences supplemented by Fisher's exact tests where appropriate.

Results/Outcomes: A total of 266 surgeons responded. Of those that responded, 58% identified as female and 42% as male. Most respondents completed training after 2011 (67%). Nearly 70% reported working 5 days per week, with 32% perceiving their call burden as excessive. 80% of respondents perceived an improvement in work-life integration with lower call burden but identified barriers to pursuing this in their career due to financial implications (59%), coordination with colleagues (48%), and institutional limitations (36%). Thirty-four percent perceived inequitable compensation, citing base salary, FTE misalignment, and systemic bias. Fifty-five percent reported having mentorship and 32% sponsorship. Subgroup analysis revealed gender differences in many domains. Compared with men, women were substantially more likely to report fewer career opportunities, higher call burden, inequitable compensation, and less supportive leave structures. Women were significantly more likely to report perceiving fewer leadership opportunities (40% vs. 8%, p< 0.001). Women also more frequently experienced unwarranted criticism (29.7% vs. 13.5%, p< 0.001), reputational harm (33% vs. 17%, p< 0.001), and witnessed preferential treatment (24.8% very frequently vs. 5.7%, p< 0.001). Career influenced family planning in 73.5% of women vs. 40.5% of men (p < 0.001). Patterns of mentorship and sponsorship also differed, with women more often having cross-gender mentors/sponsors, whereas men more often reported same-gender alignment.

Conclusion/Discussion: This national survey of ASCRS members by the WCS Taskforce highlights ongoing challenges in mentorship, sponsorship, compensation equity, workload, and family leave support. These findings underscore the need for structural interventions, such as transparent compensation models, equitable leave policies, and intentional mentorship and sponsorship programs, to foster gender equity and leadership advancement in colorectal surgery. (The authors would like to acknowledge the Women in Colorectal Surgery Taskforce of the ASCRS for the development of the survey.)

Gender Disparities in Leadership Opportunities and Mentorship Patterns