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. 2020 Sep 2;156(1):60-66.
doi: 10.1001/jamasurg.2020.3518. Online ahead of print.

Gender Disparity in Awards in General Surgery Residency Programs

Lindsay E Kuo  1 , Heather G Lyu  2 , Molly P Jarman  3 , Nelya Melnitchouk  2 , Gerard M Doherty  2   3 , Douglas S Smink  2   4 , Nancy L Cho  2
Affiliations

Gender Disparity in Awards in General Surgery Residency Programs

Lindsay E Kuo et al. JAMA Surg. .

Abstract

Importance: Women are disproportionately underrecognized as award winners within medical societies. The presence of this disparity has not been investigated in training programs.

Objective: To determine the presence of a gender disparity in award winners in general surgery residency programs.

Design, setting, and participants: In this retrospective survey study, 32 geographically diverse academic and independent general surgery residency programs were solicited for participation. The 24 participating programs (75.0%) submitted deidentified data regarding the gender distribution of residents and trainee award recipients for the period from July 1, 1996, to June 30, 2017. Data were analyzed from September 11, 2017, to December 21, 2018.

Exposures: Time and the proportion of female trainees.

Main outcomes and measures: The primary outcome was the percentage of female award winners. A multilevel logistic regression model accounting for the percentage of female residents in each program compared the odds of a female resident winning an award relative to a male resident. This analysis was repeated for the first and second decades of the study. Award winners were further analyzed by type of award (clinical excellence, nonclinical excellence, teaching, or research) and selection group (medical students, residents, or faculty members).

Results: A total of 5030 of 13 760 resident person-years (36.6%) and 455 of 1447 award winners (31.4%) were female. Overall, female residents were significantly less likely to receive an award compared with male residents (odds ratio [OR], 0.44; 95% CI, 0.37-0.54; P < .001). During the first decade of the study, female residents were 70.8% less likely to receive an award compared with male residents (OR, 0.29; 95% CI, 0.19-0.45; P < .001); this improved to 49.9% less likely in the second decade (OR, 0.50; 95% CI, 0.42-0.61; P < .001). Female residents were less likely to receive an award for teaching (OR, 0.33; 95% CI, 0.26-0.42; P < .001), clinical excellence (OR, 0.44; 95% CI, 0.31-0.61; P < .001), or nonclinical excellence (OR, 0.69; 95% CI, 0.48-0.98; P = .04). No statistical difference was observed for research award winners (OR, 0.76; 95% CI, 0.42-1.12; P = .17). The largest discrepancies were observed when award recipients were chosen by residents (OR, 0.23; 95% CI, 0.14-0.39; P < .001) and students (OR, 0.32; 95% CI, 0.25-0.42; P < .001) compared with faculty members (OR, 0.52; 95% CI, 0.42-0.66; P < .001).

Conclusions and relevance: This study found that female residents were significantly underrepresented as award recipients. These findings suggest the presence of ongoing implicit bias in surgery departments and training programs.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Jarman reported receiving grants from National Institute on Aging and the US Department of Defense outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Percentage of Female Residents and Female Resident Award Recipients by Residency Program, 1997-2017
Figure 2.
Figure 2.. Percentage of Female Residents and Female Resident Award Recipients During the Study Period
Figure 3.
Figure 3.. Percentage of Female Resident Award Recipients by Award Type During the Study Period
Figure 4.
Figure 4.. Percentage of Female Resident Award Recipients by Who Chose the Award Recipient During the Study Period
See this image and copyright information in PMC

Comment in

  • doi: 10.1001/jamasurg.2020.3532

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