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Comparative Study
. 2020 Nov 2;3(11):e2027938.
doi: 10.1001/jamanetworkopen.2020.27938.

Trends in Representation of Female Applicants and Matriculants in Canadian Residency Programs Across Specialties, 1995 to 2019

Gianni R Lorello  1   2   3   4 , Julie K Silver  5   6   7   8 , Genviève Moineau  9   10   11 , Kristian McCarthy  12 , Alana M Flexman  13
Affiliations
Comparative Study

Trends in Representation of Female Applicants and Matriculants in Canadian Residency Programs Across Specialties, 1995 to 2019

Gianni R Lorello et al. JAMA Netw Open. .

Abstract

Importance: Disparities in representation between sexes have been shown at multiple career stages in medicine despite increasing representation in the overall physician workforce.

Objective: To assess sex representation of applicants to the Canadian R-1 entry match for postgraduate training programs from 1995 to 2019, comparing distribution between different specialties as well as applied vs matched applicants.

Design, setting, and participants: This cross-sectional analysis of aggregate data provided by the Canadian Resident Matching Service between 1995 and 2019 analyzed aggregate data for the Canadian R-1 residency match from 1995 through 2019.

Exposures: Applicant sex as reported in the Canadian Resident Matching Service database.

Main outcomes and measures: The sex representation of applicants was compared and the longitudinal trends in sex representation were analyzed by specialty between 1995 and 2019. The sex representation of overall applicants to the Canadian R-1 entry match were compared with matched applicants, and both were stratified by specialty.

Results: A total of 48 424 applicants were identified (26 407 [54.5%] female applicants), of which 41 037 were matched applicants. Using specialty groupings, female applicants were most highly represented in obstetrics and gynecology (1776 of 2090 [85.0%]) and least represented in radiology (658 of 2055 [32.0%]). Within individual subspecialties, female applicants had the lowest representation in neurosurgery (90 of 394 [22.8%]). While female applicants represented an increasing proportion of the overall applicant population between 1995 and 2019 (z = 2.71; P = .007), significant increases were seen in some, but not all, individual specialties. Differences by sex were found among Canadian medical graduate match rates to their top-ranked specialty: female applicants had a lower likelihood of being rejected for family medicine (rejection of male applicants: OR, 0.46; 95% CI, 0.39-0.54; P < .001) and psychiatry (OR, 0.59; 95% CI, 0.46-0.76; P < .001) and were more likely to be rejected for all-encompassing surgery (acceptance of male applicants: OR, 1.19; 95% CI, 1.10-1.28; P < .001).

Conclusions and relevance: Increasing representation of female residency applicants over time was seen in some, but not all, medical specialties in Canada, and sex-based differences in successful match rates were observed in some specialties. The reasons for these disparities require further investigation for corrective strategies to be identified.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Silver reported receiving research funding from the Binational Scientific Foundation and Arnold P. Gold Foundation outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Percentage of Female Canadian Medical Graduate R-1 Entry Match Applicants to Each Specialty Group
The blue reference line indicates the overall percentage of female applicants in the data set (54.5%).
Figure 2.
Figure 2.. Percentage of Female Canadian Medical Graduate R-1 Entry Match Applicants Matched to Each Surgical Subspecialty
The blue reference line indicates the overall percentage of female applicants matched to surgery (36.8%).
Figure 3.
Figure 3.. Trend in Percentage of Female Applicants to Specialties in Canada From 1995 to 2019
Figure 4.
Figure 4.. Odds Ratio of Female:Male Canadian Medical Graduate Applicants Not Matched to Their Top-Ranked Specialty From 1995 to 2019
See this image and copyright information in PMC

Comment in

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