Surgery (also interdisciplinary)

Background:Despite increasing numbers of women entering surgical training, gender gaps in advancement and leadership persist.Family responsibilities are frequently cited as career barriers but are rarely quantified across specialties and career stages.This study examines gender differences in family planning, caregiving, work patterns, and perceived institutional support among surgeons in Germany. Material and methods:We conducted a nationwide cross-sectional online survey (June-September 2024) of 432 surgeons and residents across multiple surgical disciplines.A validated 68-item instrument captured demographics, employment patterns, family planning, childcare arrangements, and perceived career barriers.Analyses included descriptive statistics, chi-square and t-tests, and regression models adjusted for age and institution; women were coded as 1 (men=0).Ethical approval was obtained from the ethics committee Hamburg.Participation was anonymous and consented. Results:Female surgeons comprised 73% of respondents and were less frequently employed at university hospitals than men (53.5% vs. 88.8%;OR 0.11, 95% CI 0.05-0.21).Women were far more likely to work part-time (25.5% vs. 5.4%; OR 12.03, 95% CI 4.19-50.87)and to experience prolonged specialization (47.1% vs. 31.2%;OR 1.74, 95% CI 1.03-2.96),with extensions linked to parental leave (OR 3.04, 95% CI 1.32-8.26).Nearly half of women postponed childbearing for career reasons (46.2% vs. 14.7%;OR 4.72, 95% CI 2.34-10.23),were more often childless (53.7% vs. 25.6%), and had fewer children ( = -0.55).During pregnancy, 46.4% of women reported reassignment to non-surgical duties.Parenthood was perceived to hinder careers by 82.5% of women versus 11.1% of men (OR 11.22,.Domestic and caregiving loads were uneven: women reported more weekly hours of unpaid work ( = 5.49), undertook most family logistics (OR 37.61,, and were more likely to stay home when a child was ill (OR 6.80,.Public childcare was used more often by female surgeons (OR 5.83,, and one-third of women would increase working hours with reliable childcare (OR 5.76,.Emotional (OR 2.61, 95% CI 1.39-5.20)and physical exhaustion (OR 2.32, 95% CI 1.32-4.17)were reported more frequently by women.Female surgeons expressed stronger preferences for flexible work arrangements (OR 2.29,