The rise of women in pediatric surgery training: Have we reached equity?

Background: Women have long been underrepresented in surgical fields, including pediatric general surgery (PGS), one of the most competitive subspecialties. This study examined trends in gender representation in PGS. Methods: We identified all PGS graduates from U.S. and Canadian programs between 1919 and 2025 using validated sources. Gender was determined, and male-to-female ratios were analyzed by year. National leadership roles were reviewed for their representation of females. Chi-square tests were used to assess statistical significance (p ​< ​0.05). Results: Seventy-nine programs produced 2235 graduates: 1675 (75 ​%) men and 560 (25 ​%) women. Female representation increased steadily, with gender parity emerging around 2020. Although women entered leadership roles in PGS earlier than in General Surgery, they still lag behind men in overall leadership representation. Conclusions: PGS has made significant progress toward gender equity in training, with recent parity among graduates. However, leadership remains an area for continued improvement to ensure equitable representation at all levels.