The Glass Ceiling in Plastic Surgery: A Propensity-Matched Analysis of the Gender Gap in Career Advancement

Background: Gender parity remains elusive in academic plastic surgery. It is unknown whether this disparity is attributable to differences in qualifications or to the glass ceiling of gender bias. To parse this, the authors compared academic titles and departmental leadership of female academic plastic surgeons to a matched group of their male counterparts. Methods: The authors conducted a cross-sectional analysis of academic plastic surgeons. The authors identified faculty, sex, academic rank, and leadership positions from plastic surgery residency program websites. The authors then collected details on training institution, advanced degrees, years in practice, and h-index for use as independent variables. The authors performed a propensity score analysis to 1:1 match male and female academic plastic surgeons. Results: A total of 818 academic plastic surgeons were included. The cohort was predominately male [n = 658 (81 percent)], with a median 12 years in practice and a median h-index of 9. Before matching, men had more years in practice (13 years versus 9 years; p < 0.0001), a greater h-index (11 versus 5; p < 0.0001), were more likely to be professors (34 percent versus 13 percent; p < 0.0001), and held more leadership positions than women (41 percent versus 30 percent; p = 0.0221). Following matching, gender parity was demonstrated in academic rank and departmental leadership. Conclusions: Differences in training, qualifications, career length, and academic productivity may account for the leadership gap in academic plastic surgery. Gendered difficulties in reaching qualification benchmarks must be addressed before gender parity in promotion can be achieved.