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March 4, 2020

Should We Train Female and Male Residents Slightly Differently?

Author Affiliations
  • 1Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin–Madison, Madison
JAMA Surg. 2020;155(5):373-374. doi:10.1001/jamasurg.2019.5887

In coaching women, there is more of a need for “ego-boosting.“ With men, it is more “ego-busting.”

Anson Dorrance

Studies have shown gender differences in self-evaluation, confidence, and perceptions of competence.1-4 To our knowledge, how these gender disparities may affect surgical training is rarely discussed in academic surgery. On average, female surgical residents underrate themselves compared with male residents.1 Female self-underrating is also present in society—culturally and in professional domains.2 Differences in gender self-evaluation have been hypothesized to arise from differences in socialization, implicit gender bias, and even hormonal influences.2 It is important to consider how these differences are associated with surgical training, especially as recent studies have demonstrated a gender autonomy gap in residency.5,6 Furthermore, some programs are beginning to implement competency-based training in which unrecognized gender training gaps could systematically affect female trainees.

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    1 Comment for this article
    Steven Zeitzew, M.D. | Veterans Administration & Geffen UCLA Medical School
    There is far more difference between individual surgeons than there is between male surgeons and female surgeons as a group. There is also far more difference between surgeons and non-surgeon physicians than between male and female surgeons. We must endeavor to combat gender bias, but will do better by individualizing training than by replacing one gender stereotype with another gender stereotype. During my residency training in the very early 1980's there was open discrimination. There was widespread discrimination limiting the opportunity for women surgeons, for minority surgeons, and for Jewish surgeons. These biases have diminished, but have not been completely vanquished. Brave and brilliant surgeon leaders, such as Dr. Henry Mankin, winner of the American Academy of Orthopaedic Surgeons Diversity Award, made opportunities available without unfair discrimination, leaving a legacy of diverse and talented surgeon leaders who benefitted from his leadership. There are many talented surgeons in training, irrespective of their gender, their color, or their faith.

    I look to a day when people will not be judged by their gender, the color of their skin, or their religion, but by the content of their character, the quality of their work, and the extent of their ambition.