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The central concerns of Hutchison’s1 paper are the under-representation and unequal pay of women in surgery and the role that subtle gender biases play in explaining these phenomena. My comments will focus on how well executed and important this work is and also why we need more of it to fully understand the gravity of the situation for women in surgery and how it compares with similar situations for women in other fields.
Hutchison argues that women in surgery experience many subtle inequities that together help to explain their unequal representation and pay relative to men. She conducted a qualitative study that involved in-depth interviews of 46 women surgeons: fellows or trainees of the Royal Australasian College of Surgeons (RACS). Effort was taken to recruit participants who were diverse in various ways, including in their perspectives on sexual harassment in surgery. They were asked about barriers they had encountered in their careers but not specifically about whether they were targets of gender bias, implicit bias or the like. Despite not being prompted to do so, they gave responses that revealed consistent patterns of explicit sexism and of implicit gender bias, including bias that results in epistemic injustice (ie, injustice in how one is treated as a knower). For example, the …
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