Evolution of gender representation among Canadian OTL-HNS residents: a 27-year analysis

Abstract

Background: The proportion of females enrolling into medical schools has been growing steadily. However, the representation of female residents among individual specialties has shown considerable variation. The purpose of this study was to compare the trends of gender representation in Otolaryngology - Head and Neck Surgery (OTL-HNS) residency programs with other specialty training programs in Canada. In order to contextualize these findings, a second phase of analysis examined the success rate of applicants of different genders to OTL-HNS residency programs.

Method: Anonymized data were obtained from the Canadian Residency Matching Service (CaRMS) and from the Canadian Post-M.D. Education Registry (CAPER) from 1988 to 2014. The differences in gender growth rates were compared to other subspecialty programs of varying size. Descriptive analysis was used to examine gender representation among OTL-HNS residents across years, and to compare these trends with other specialties. Bayesian hierarchical models were fit to analyze the growth in program rates in OTL-HNS based on gender.

Results: CaRMS and CAPER data over a 27 year period demonstrated that OTL-HNS has doubled its female representation from 20% to 40% between 1990 and 1994 and 2010-2014. The difference in annual growth rate of female representation versus male representation in OTL-HNS over this time period was 2.7%, which was similar to other large specialty programs and surgical subspecialties. There was parity in success rates of female and male candidates ranking OTL-HNS as their first choice specialty for most years.

Conclusions: Female representation in Canadian OTL-HNS residency programs is steadily increasing over the last 27 years. Large variation in female applicant acceptance rates was observed across Canadian universities, possibly attributable to differences in student body or applicant demographics. Factors influencing female medical student career selection to OTL-HNS require further study to mitigate disparities in gender representation and identify barriers to prospective female OTL-HNS applicants.

Keywords: Diversity; Female; Gender; Minority; Otolaryngology; Residents.

Fig. 1

Female representation in OTL-HNS vs larger residency programs. Between 1990 and 2014, the proportion of female residents was averaged over four-year intervals for OTL-HNS and larger residency programs. The averaged data was plotted as a function of time from 1990 to 2014

Fig. 2

Female representation in OTL-HNS vs surgical subpecialty programs. Between 1990 and 2014, the proportion of female residents was averaged over 4 year intervals. This process was applied to OTL-HNS and surgical subspecialty programs of similar size. The averaged data was plotted as a function of time from 1990 to 2014

Fig. 3

Acceptance rates among first choice applicants to Canadian OTL-HNS programs. Between 2006 and 2014, the proportion of either males or females who ranked OTL-HNS as their first-choice and were accepted into postgraduate residency programs was tabulated. These results were computed according to gender and gender-specific acceptance rates were plotted over this period of time

Fig. 4

Trends of female representation and acceptance rates in OTL-HNS. Between 2006 and 2014, the proportion of females among all applicants that ranked OTL-HNS as their first choice was calculated and plotted. The proportion of female applicants to OTL-HNS that successfully matched to OTL-HNS postgraduate residency programs was also plotted between 2006 and 2014. The average of all acceptance rates between 2006 and 2014 was also plotted

Fig. 5

Female acceptance rates into OTL-HNS Canadian universities. Between 2006 and 2014, the proportion of females among all applicants to OTL-HNS that were accepted into postgraduate residency programs was collected for 13 individual Canadian universities. Data from universities were anonymized and plotted in increasing order