Factors Influencing the Choice of Surgical Specialties Among Female Medical Students: A Cross-Sectional Study in Universities in Rio Grande do Sul, Brazil

WESCHENFELDER, LAURA BEATRIZ WUENSCH; GEISLER, RAFAELA MANETTI; DREISSIG, JENNIFER PALOMA; REHBEIN, STÉFHANI; MAFFESSONI, REBECA GOLDSTEIN; WOLOSKI, BERNARDO SAMPAIO; PETERSON, YASMIN ALVES; TONEL, CAROLINA BRACHT; SEBASTIANY, LAURA CARLIN; FRIGHETTO, ISABELA; SOARES, MARIANA REIS; MILDNER, YASMIN LAMBERT; FRANTZ, CAROLINA; BURMANN, JÚLIA COPETTI; DORNELES, CRISTINA MANERA

doi:10.1590/0100-6991e-2026003825-en

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Sumário

Original Article • Rev. Col. Bras. Cir. 53 • 2026 • https://doi.org/10.1590/0100-6991e-2026003825-en linkcopy

Factors Influencing the Choice of Surgical Specialties Among Female Medical Students: A Cross-Sectional Study in Universities in Rio Grande do Sul, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction: Although several barriers that discourage women physicians from pursuing surgical careers have been described, the factors that dissuade female medical students from choosing surgery during their training remain insufficiently understood.

Methods: This was a descriptive, cross-sectional, exploratory study approach among female medical students in the state of Rio Grande do Sul (RS), Brazil. Data were collected through a non-probability convenience sample between November 2022 and March 2023 using an online questionnaire.

Results: A total of 584 valid responses were analyzed. Most respondents (75.5%) had considered pursuing a surgical career at some point, with initial interest most commonly arising before medical school admission. No statistically significant association was found between stage of training progression and interest in surgery (p = 0.564). The primary reason for abandoning interest in surgery was dissatisfaction with the perceived lifestyle associated with the specialty. Overall, 59.6% of participants reported perceiving gender as a limiting factor in surgical careers. A substantial majority (75.9%) indicated they would be more likely to pursue a surgical career if there were greater female representation among faculty. Additionally, 70.2% reported experiencing gender bias during medical school, with many incidents attributed to faculty members. Faculty engagement and institutional support emerged as key strategies to promote greater female participation in surgery.

Conclusion: Despite the limitations inherent to the sample and study design, the findings highlight multiple factors contributing to the underrepresentation of women in surgical specialties and underscore the critical role of the educational environment in shaping career trajectories. These results may contribute to broader national discussions, given the shared curricular framework among Brazilian medical schools.

University	Female students enrolled during the data collection period (n)	Participants (n)	Estimated participation rate (%)
UNISC	372	130	34.9
ATITUS	317	57	18
UFRGS	451	47	10.4
FEEVALE	345	43	12.5
PUCRS	421	37	8.8
UCS	474	34	7.2
UNIJUÍ	135	32	23.7
UCPEL	661	32	4.8
University	Female students enrolled during the data collection period (n)	Participants (n)	Estimated participation rate (%)
FURG	250	24	9.6
UPF	406	23	5.7
UFSM	352	22	6.3
UNIVATES	360	17	4.7
UNISINOS	337	16	4.7
UFCSPA	271	15	5.5
UFN	336	12	3.6
UFFS	203	12	5.9
ULBRA	589	10	1.7
UFPEL	299	9	3.0
UNIPAMPA	186	7	3.8
URI	199	5	2.5
Total	6964	584	8.4

University	Undergraduate year						Total n (%)
	Basic cycle	Clinical cycle			Clinical internship
	1^st year n (%)	2^nd year n (%)	3^rd year n (%)	4^th year n (%)	5^th year n (%)	6^th year n (%)
UNISC	18 (3.1)	14 (2.4)	27 (4.6)	39 (6.7)	22 (3.8)	10 (1.7)	130 (22.3)
ATITUS	5 (0.9)	12 (2.0)	13 (2.2)	13 (2.2)	10 (1.7)	4 (0.7)	57 (9.8)
UFRGS	6 (1.0)	7 (1.2)	6 (1.0)	13 (2.2)	9 (1.5)	6 (1.0)	47 (8.0)
FEEVALE	5 (0.8)	3 (0.5)	13 (2.2)	11 (1.9)	8 (1.4)	3 (0.5)	43 (7.3)
PUCRS	3 (0.5)	6 (1.0)	6 (1.0)	8 (1.4)	11 (1.9)	3 (0.5)	37 (6.3)
UCS	2 (0.3)	7 (1.2)	11 (1.9)	9 (1.5)	4 (0.7)	1 (0.2)	34 (5.8)
University	Undergraduate year						Total n (%)
	Basic cycle	Clinical cycle			Clinical internship
	1^st year n (%)	2^nd year n (%)	3^rd year n (%)	4^th year n (%)	5^th year n (%)	6^th year n (%)
UNIJUÍ	14 (2.4)	5 (0.8)	7 (1.2)	5 (0.8)	1 (0.2)	0 (0.0)	32 (5.5)
UCPEL	13 (2.2)	7 (1.2)	5 (0.8)	3 (0.5)	4 (0.7)	0 (0.0)	32 (5.5)
FURG	3 (0.5)	4 (0.7)	9 (1.5)	2 (0.3)	3 (0.5)	3 (0.5)	24 (4.1)
UPF	7 (1.2)	8 (1.4)	1 (0.2)	2 (0.3)	2 (0.3)	3 (0.5)	23 (4.0)
UFSM	6 (1.0)	5 (0.8)	5 (0.8)	4 (0.7)	1 (0.2)	1 (0.2)	22 (3.8)
UNIVATES	1 (0.2)	1 (0.2)	6 (1.0)	3 (0.5)	3 (0.5)	3 (0.5)	17 (3.0)
UNISINOS	4 (0.7)	2 (0.3)	1 (0.2)	7 (1.2)	0 (0.0)	2 (0.2)	16 (2.7)
UFCSPA	1 (0.2)	4 (0.7)	6 (1.0)	2 (0.3)	1 (0.2)	1 (0.2)	15 (2.6)
UFN	3 (0.5)	2 (0.2)	1 (0.2)	4 (0.7)	1 (0.2)	1 (0.2)	12 (2.0)
UFFS	1 (0.2)	5 (0.8)	4 (0.7)	1 (0.2)	1 (0.2)	0 (0.0)	12 (2.0)
ULBRA	2 (0.3)	1 (0.2)	2 (0.3)	3 (0.5)	2 (0.3)	0 (0.0)	10 (1.7)
UFPEL	2 (0.3)	1 (0.2)	4 (0.7)	2 (0.3)	0 (0.0)	0 (0.0)	9 (1.5)
UNIPAMPA	1 (0.2)	1 (0.2)	2 (0.3)	1 (0.2)	2 (0.3)	0 (0.0)	7 (1.2)
URI	3 (0.5)	2 (0.3)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	5 (0.9)
Total by undergraduate year	100 (17.1)	97 (16.6)	129 (22.1)	132 (22.6)	85 (14.6)	41 (7.0)	584 (100)
Total by undergraduate cycle	100 (17.1)	358 (61.3)			126 (21.6)

Question	Response	n	%	Total n (%)
Aspiration for some medical specialization	Yes	555	95.0	584 (100)
	No	16	2.7
	Undefined	13	2.2
Desired type of specialization	Surgical	113	19.3	584 (100)
	Clinical-surgical	246	42.1
	Clinic	177	30.3
	Don't know/ Not applicable	48	8.2
Female students who at some point considered becoming surgeons	Yes	441	75.5	584 (100)
	Perhaps	84	14.4
	No	58	9.9
	Don't know	1	0.2
Question	Response	n	%	Total n (%)
The moment when pursuing a surgical career was considered	Before entering college	220	37.7	584 (100)
	Basic cycle	102	17.5
	Clinical cycle	170	29.1
	Clinical internship	14	2.4
	Don't know/ Don't remember	15	2.6
	Not applicable	63	10.8
Female students who chose surgery as their first specialty	Yes	167	28.6	584 (100)
	No	331	56.7
	Don't know	19	3.2
	Not applicable	67	11.5
For those whose surgery was their first choice of specialization, if there has been a change of mind	Yes (subcategory)	61	36.5	167 (28,6)
	No (subcategory)	91	54.5
	Don't know/ Don't remember/ Not applicable (subcategory)	15	9.0

Analytical categories	Discouraging factor	n	%
Lack of quality of life	Lifestyle doesn't match expectations	195	33.4
	Difficulty balancing work and personal life	170	29.1
	High workload	143	24.5
	High workload for medical residency	142	24.3
	Level of rigor of surgical training	91	15.6
	Concern about balancing a surgical career with motherhood and family planning	*	*
Lack of female role models and mentors	Lack of female surgeons in academia	93	15.9
Sexism in the surgical environment	Prejudice on the part of teachers with medical training	61	10.4
	Prejudice on the part of patients	46	7.9
	Prejudice on the part of other healthcare professionals	44	7.5
	Prejudice on the part of fellow graduates	29	5
	Prejudice on the part of family members	6	1
Analytical categories	Discouraging factor	n	%
Others	Lack of self-confidence	126	21.6
	Lack of incentive to seek a surgical medical specialty	91	15.6
	Dissatisfaction with the subject of surgery after studying it	69	11.8
	Lack of knowledge about surgical medical specialties	66	11.3
	Limitation of physical strength and ergonomics for women in the surgical setting	3	0.5
	Lack of teaching skills among the teachers	*	*
	Structural limitations of the intended hospital for operation	*	*

Group	n (%)
Teachers with medical training	235 (40.2)
Other healthcare professionals	206 (35.3)
Patients	201 (34.4)
Fellow graduates	178 (30.5)
Family members	60 (10.3)
Never experienced or witnessed prejudice	127 (21.7)
Don't know/ Don't remember	53 (9.1)

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[TFN1] Notes: 1. Number of female students enrolled obtained from the Higher Education Census (INEP, 2022), considering exclusively women from Medicine courses located in the state of Rio Grande do Sul. Residual differences may occur due to rounding. 2. The full name of each institution included is listed below:

[TFN2] UNISC - Universidade de Santa Cruz do Sul

[TFN3] ATITUS - Atitus Educação

[TFN4] UFRGS - Universidade Federal do Rio Grande do Sul

[TFN5] FEEVALE - Universidade Feevale

[TFN6] PUCRS - Pontifícia Universidade Católica do Rio Grande do Sul

[TFN7] UCS - Universidade de Caxias do Sul

[TFN8] UNIJUÍ - Universidade Regional do Noroeste do Estado do Rio Grande do Sul

[TFN9] UCPEL - Universidade Católica de Pelotas

[TFN10] FURG - Universidade Federal do Rio Grande

[TFN11] UPF - Universidade de Passo Fundo

[TFN12] UFSM - Universidade Federal de Santa Maria

[TFN13] UNIVATES - Universidade do Vale do Taquari

[TFN14] UNISINOS - Universidade do Vale do Rio dos Sinos

[TFN15] UFCSPA - Universidade Federal de Ciências da Saúde de Porto Alegre

[TFN16] UFN - Universidade Franciscana

[TFN17] UFFS - Universidade Federal da Fronteira Sul, sede Passo Fundo

[TFN18] ULBRA - Universidade Luterana do Brasil

[TFN19] UFPEL - Universidade Federal de Pelotas

[TFN20] UNIPAMPA - Universidade Federal do Pampa

[TFN21] URI - Universidade Regional Integrada do Alto Uruguai e das Missões