Barriers and Motivators for Women in Surgical Training: A Qualitative Study From Malaysia.

Abstract

Women are significantly underrepresented in surgical specialties, particularly in Southeast Asia. The factors influencing this gender disparity remain poorly understood. This study aims to explore the motivations, challenges, and barriers faced by female medical doctors in pursuing surgical careers in Malaysia. An exploratory qualitative study was conducted between May 2016 and November 2017, using semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs) with male and female senior surgeons, medical officers, and surgical trainees. A coding tree was constructed and refined after initial rounds of data analysis. Thematic content analysis was performed using the NVivo 11 Pro (Windows) qualitative data analysis software. Ten IDIs and five FGDs (N = 34 participants) revealed three key themes: (A) influences on trainees' career choices, (B) challenges encountered during surgical training, and (C) trainee empowerment. Participants highlighted the demanding nature of surgical training, the lack of flexibility in work schedules, and the male-dominated work environment as significant barriers for women. Despite these challenges, supportive family structures and strong mentorship were found to be critical for the retention of women in surgery. Institutional support, mentorship opportunities, and culture change are essential for improving the representation and retention of female surgeons in Malaysia. Tailored policies that acknowledge the unique challenges faced by women in surgery could foster a more inclusive and supportive environment.