Healthcare professionals and surgeons showed a tendency to associate men with career and surgery and women with family and family medicine, according to a study published in the JAMA Network Open.

Investigators of the study used the Implicit Association Test (IAT), which is a trusted tool used to measure implicit biases. Two types of IATs were used in the study. The first, the Gender-Career IAT, was hosted by Project Implicit to measure bias among self-identified healthcare professionals. There were a total of 42,991 participants, of which only 18% were men. The second, a novel Gender-Specialty IAT, was tested at a national surgical meeting in October 2017, at which surgeons of any age, gender, race, and country of origin were eligible to participate, there were a total of 131 participants, of which 64.9% were men. 

Important outcomes of the current study are the initial estimate of the extent of implicit gender bias within healthcare. The data from the Gender-Career IAT show that both men and women in healthcare strongly implicitly associate men with career and women with family. But in regard to explicit bias, men in health care were more likely than women to associate men with career and women with family. Investigators noted that these results of the Gender-Career IAT were similar to the Gender-Specialty IAT that assessed bias among surgeons. However, explicit gender-specialty biases for surgeons who were women were smaller than explicit gender career biases for health care workers who were women. The researchers also reported that they found no difference between the genders in implicit bias on the Gender-Specialty IAT.

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There are some limitations to the study. In the Gender-Career IAT data, there was no differentiation of the health care providers. The health care providers could have been nurse practitioners, physician assistants, or even dentists. Another important limitation is that the novel Gender-Specialty IAT only recruited surgeons that were attending the surgical meeting. The data also show that there was a considerable difference in the composition of men and women population taking the Gender-Career IAT (18% men) vs novel Gender-Specialty IAT (64.9% men). Furthermore, the sample size for the novel Gender-Specialty IAT was very small when compared to the sample size of the Gender-Career IAT data.

The researchers concluded that both men and women associated men with career and surgery and women with family and family medicine, however, men were more likely than women to consciously express the bias. They also suggested that “[f]urther documentation of implicit associations and other potential psychological obstacles to women’s success will be important for determining the most effective interventions to reduce gender inequality.”

Disclosure: Arghavan Salles, MD, PhD, reported receiving honoraria from Medtronic plc for consulting and speaking.


Salles A, Awad M, Goldin L, et al. Estimating implicit and explicit gender bias among health care professionals and surgeons. JAMA Netw Open. 2019;2(7):e196545.