Gender differences among board-certified general surgeons in Israel: demographics, professional advancement, and leadership

BACKGROUND: Women remain underrepresented in general surgery leadership and academic roles globally, yet specialty-specific data from Israel are limited. This study examines gender differences among board-certified general surgeons in Israel across demographic, professional, and leadership domains. METHODS: A cross-sectional, confidential questionnaire was distributed electronically to all board-certified general surgeons registered with the Israeli Surgical Association in 2026. A total of 105 surgeons responded (15.2%). Participants were stratified by gender and compared across demographic characteristics, employment patterns, operative scope, fellowship training, academic activity, and management roles. RESULTS: Of 105 respondents, 78 (74.3%) were men and 27 (25.7%) were women. Women had a longer residency duration (median 7 vs. 6 years, p = 0.024). Women were less likely to hold full-time public hospital positions (63.0% vs. 84.6%, p = 0.029), participate in on-call (44.4% vs. 80.8%, p = 0.0009) or senior on-call duties (7.4% vs. 38.5%, p = 0.003), and had a substantially narrower operative scope (median 3 vs. 5 surgery types, p = 0.0002). Women were significantly more likely to practice breast surgery (48.1% vs. 16.7%, p = 0.002) and less likely to have completed a fellowship (59.3% vs. 84.6%, p = 0.013) or trained abroad (25.9% vs. 62.8%, p = 0.0015). Academic productivity was also lower among women: fewer taught students (74.1% vs. 91.0%, p = 0.044), published articles (29.6% vs. 65.4%, p = 0.002), or held academic appointments (25.9% vs. 50.0%, p = 0.042). Women were less likely to hold any management role (25.9% vs. 51.3%, p = 0.026). CONCLUSIONS: Significant gender disparities exist among board-certified general surgeons in Israel across all domains examined. Women bear a systematically different professional burden, with less call coverage, narrower operative scope, fewer fellowships, lower academic output, and reduced leadership representation. These findings highlight structural barriers that persist beyond training completion. Of particular concern is the leadership gap: in the Israeli hospital system, senior positions are long-tenured and turn over infrequently, meaning that generational change in the trainee demographic alone will not close this gap within any reasonable timeframe. Mandatory, policy-level structural intervention is required alongside broader institutional efforts to promote gender equity in Israeli general surgery.