National Trends in Gender Diversity Among Trainees and Practicing Physicians in Otolaryngology-Head and Neck Surgery in Canada

Abstract

Importance: Monitoring the evolution of gender diversity within medicine is essential to understanding the medical workforce and anticipating its future.

Objective: To evaluate gender distribution and trends among trainees and practicing physicians in the field of otolaryngology-head and neck surgery (OHNS) across Canada.

Design, setting, and participants: This cross-sectional study collected demographic data on the Canadian population, medical students, resident physicians, fellows, practicing physicians, and full-time professors from the following publicly available databases: the Canadian Post-MD Education Registry, the Canadian Medical Education Statistics from the Association of Faculties of Medicine of Canada, the Canadian Medical Association Masterfile, the Canadian Resident Matching Service archives, and the Canadian Institute for Health Information from 2000 to 2019. Information about the gender distribution in leadership positions and fellowships was obtained through publicly available websites where gender was either listed or assigned by authors.

Main outcomes and measures: The primary outcomes were the proportion of women in OHNS and the evolution of gender diversity over time.

Results: In 2019, 65 of 155 of OHNS trainees were female (41.9%), whereas female representation among all surgical trainees combined was 1225 of 2496 (49.1%). Female OHNS trainees and practicing physicians are underrepresented despite a 13.3% increase in female trainees and a 14.3% increase in female staff physicians from 2000 to 2019. Proportionally fewer female graduates pursued a fellowship during a 10-year period compared with their male counterparts, with otology and neurotology having the lowest female representation (6 of 27 [22.2%]). A minimal increase occurred in the number of women holding academic leadership positions (eg, 4 of 13 residency training programs had a previous or current female director).

Conclusions and relevance: Despite the overall increase in the representation of women in the field of OHNS in Canada, these findings suggest that persistent gender gaps remain with respect to academic leadership positions and fellowship training. Continuous monitoring of the surgical workforce is important to highlight and address gender disparities within OHNS.

Figure 1.. Gender Composition of Otolaryngology–Head and Neck Surgery (OHNS) Trainees Compared With Other Specialties in 2019

Data were obtained from the Canadian Post-MD Education Registry.

Figure 2.. Female Representation in Medicine and Otolaryngology–Head and Neck Surgery (OHNS) Across Canada in 2019

Data were obtained from the 2019 Canadian Census–Statistics Canada, Canadian Institute of Health Information–Physicians in Canada 2019, Canadian Medical Education Statistics 2019 from the Association of Faculties of Medicine of Canada, the Canadian Medical Association Masterfile 2019, and the Canadian Resident Matching Service. ^aTrainees includes both resident and fellow physicians. ^bIncludes only applicants who ranked OHNS as their first choice.

Figure 3.. Gender Representation in Physicians and Trainees in Otolaryngology–Head and Neck Surgery (OHNS) From 2000 to 2019

Data were obtained from the Canadian Post-MD Education Registry. ^aTrainees includes both resident and fellow physicians.

Figure 4.. Proportion of Male and Female Otolaryngology–Head and Neck Surgery Residency Graduates by Fellowship Type (2011-2020)

Data are from publicly available institution websites and/or personal email communications. ^aOther includes graduates who pursued fellowships in Mohs surgery, sialoendoscopy, and 4 graduates for whom we were unable to obtain information.