Challenges and Opportunities for Women in Vascular Surgery: Summary from an International Roundtable Discussion

Background: Despite advances in diversity, gender disparities in vascular surgery persist globally, particularly in academic leadership and career progression. This narrative review presents the results of a multinational roundtable held during the 11th Aortic Surgery, Peripheral and Venous: How To Do It Symposium in Milan (December 2024), which convened female vascular surgeons from Latin America, North America, and Europe to discuss challenges and propose strategies for career advancement. Methods: A structured roundtable included vascular surgeons with active roles in education and academic practice. Presentations addressed barriers to leadership, mentorship, academic promotion, work-life balance, and systemic bias. A designated participant collected notes, and a consensual summary of challenges and recommendations was reviewed by the group. Literature from the past two decades was also reviewed to contextualize the discussion. Results: Key challenges identified include underrepresentation in academic and societal leadership, slower promotion rates, pay inequities, disproportionate caregiving responsibilities, lack of structured mentorship, and cultural bias in professional environments. The group proposed eight areas for action: (1) transparent leadership pathways, (2) mentor- ship and sponsorship networks, (3) institutional reforms for equity and inclusion, (4) academic support for research and publication, (5) improved work-life integration policies, (6) early exposure to vascular surgery during training, (7) building supportive peer and ally networks, and (8) long-term cultural strategies. One immediate outcome was the proposal to include a gender equity-focused plenary session at the 2026 How To Do It Symposium. Conclusions: Although access to vascular surgery training has improved, persistent disparities in leadership and aca- demic progression remain. Addressing these gaps requires sustained, evidence-based strategies. This review summarizes key challenges and proposes actionable, inclusive solutions to support the advancement of women in vascular surgery.