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Capelli et al. Art Int Surg 2023;3:80-9 https://dx.doi.org/10.20517/ais.2022.40 Page 84

[46]
requirements .

Burnout among surgeons and surgical trainees was also recently assessed by Sauder et al. and was found
[16]
to be most frequent in younger and female surgeons . Factors including being a woman, childcare
responsibilities, and perceived poor work-life balance were reported to be responsible for reduced quality of
life and burnout.

[38]
A recent survey distributed among members of the American College of Surgeons , the results of which
were published in 2020, also exposed alarmingly high burnout rates affecting US surgeons, particularly
female surgeons, identifying difficulties in work-life balance as a big part of the issue.

Several solutions have been proposed to address such issues; overall, minimizing the impact of work duties
on work-life balance has been pointed out as a pivotal goal in the management of burnout for both men and
[47]
women surgeons . Moreover, surgeons seem to be at greater risk of developing compassion fatigue, a state
of physical and emotional distress caused by repeatedly caring for those experiencing traumatic episodes .
[48]
All of this can ultimately lead to a higher risk of dropout, negatively affecting patient care; it is well
acknowledged that a diverse workplace environment can better meet the needs of a diverse patient
[49]
population and that women can provide unique professional traits, ultimately enhancing the team’s
productivity and empathetic capacity . The dropout of women surgeons represents a loss not only for
[50]
healthcare systems but also for patients and their quality of care [51,52] .

Strategies to break the glass ceiling and promote gender equity in work-life balance
Although insufficient to dismantle the main challenges women face in conciliating career, family, and
personal life, awareness of those hindrances is the first mandatory step to overthrow them and to change the
many misperceptions to which women surgeons are exposed.

To build a fair and equitable work culture, Rusch et al. identified three main goals: overcoming obstacles,
especially in poorly represented specialties; creating supportive work-life balance policies; and closing the
gap in economic compensation and professional advancement . Flexible work schedules , the introduction
[7]
[20]
and encouragement of paternity leave for male surgeons , and the enforcement of mentorship and
[9]
sponsorship for female surgeons are some of the proposed solutions for building a fair and equitable work
culture for all surgeons and overthrowing old, conventional ideas concerning gender roles.
In a national survey by Troppmann et al. distributed among American Board of Surgery-certified
surgeons, most male and female interviewees confirmed the importance of childcare facilities within the
[19]
work environment . Childcare facilities, especially when available for extended hours and sick children,
have been widely acknowledged to facilitate work and family balance for both male and female surgeons,
but they are still lacking in many work environments.

[38]
According to a survey conducted among 3,807 practicing surgeons in the US in 2018 , career satisfaction
was tightly linked with the support of work-life integration efforts by colleagues. Collegial support of work-
life integration efforts was significantly associated with major contentment for both male and female
surgeons (P < 0.001), highlighting the impact of a supportive work environment on lowering burnout and
conflicts, particularly for women. On-site, extended-hour childcare, formal leaves, career sharing, and
flexible vacation time have also been proposed to facilitate work-life integration and reduce burnout.