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Original Investigation
September 2, 2020

Gender Disparity in Awards in General Surgery Residency Programs

Author Affiliations
  • 1Department of Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
  • 2Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
  • 3Review Editor, JAMA Surgery
  • 4Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
JAMA Surg. Published online September 2, 2020. doi:10.1001/jamasurg.2020.3518
Key Points

Question  Are female general surgery residents underrepresented as award winners?

Findings  In this survey of 24 general surgery residency programs from 1997 to 2017, female residents were significantly less likely to win an award compared with male residents. This outcome factors into account the proportion of female residents in each program each year.

Meaning  These findings suggest that female general surgery residents are underrepresented as award winners.

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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