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Original Investigation
November 18, 2021

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

Author Affiliations
  • 1Department of Otolaryngology–Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
  • 2Department of Otolaryngology–Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
  • 3Department of Otolaryngology–Head & Neck Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
  • 4Department of Otolaryngology–Head & Neck Surgery, St Michael’s Hospital, Toronto, Ontario, Canada
JAMA Otolaryngol Head Neck Surg. Published online November 18, 2021. doi:10.1001/jamaoto.2021.1431
Key Points

Question  What are the trends in gender diversity among trainees and practicing physicians in otolaryngology–head and neck surgery (OHNS) in Canada?

Findings  This cross-sectional study of OHNS trainees and physicians demonstrated that female representation in OHNS has increased at the trainee level and practicing physician level by 13.3% and 14.3%, respectively, during the last 20 years; however, there was only a 4.2% increase in the number of women holding full-time academic positions in OHNS. Rhinology, otology and neurotology, and head and neck surgery had fewer than 30% of female graduates pursuing these subspecialties.

Meaning  These findings suggest that gender diversity in OHNS is improving; however, disparities exist with respect to academia and fellowship training.


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.

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