S. P. Beierle1, J. Lewis1, R. E. Heidel1, E. Stewart1, J. McLoughlin1 1University Of Tennessee,Graduate School Of Medicine,Knoxville, TN, USA
Introduction: Women are increasingly choosing general surgery as a career now comprising 37% of surgical residents. However, nearly 88% of members of the Association of Women Surgeons perceived gender based discrimination in residency. We observed a trend of junior female residents being assigned to more breast cases than their male counterparts. We hypothesized that a gender bias begins in the early years of surgical training with the assumption that females are more interested in a career in breast surgery.
Methods: We reviewed all partial mastectomies performed at our institution from July of 2010 through June of 2015 and recorded the PGY level and gender of the resident participating. A total of 850 cases were identified. Cases with no resident participating were excluded as well as cases with a male and a female resident scrubbed in together. The data was compared by PGY level as well as categorical vs. non-categorical status. Data was analyzed with SPSS to calculate significant differences using the Chi-square test.
Results: Female residents at our institution comprised 30% to 55% of the resident compliment depending on the academic year. When divided into PGY-level, female residents were responsible for a larger than expected proportion of the hookwire cases than their male counterparts for all but one year. The disproportionate representation reached statistical significance with a P of <.05 in 6 categories (2011-2012 all residents, PGY1-3, and categorical PGY1-3; 2012-2013 Categorical PGY1-3; 2013-2014 Categorical PGY-1, and 2014-2015 categorical PGY-2) When we looked at the attrition rate of the program there were 4 residents, all female, who left the program during the time period examined. Three left after the second year of residency and of the 3 residents who left after second year each had the highest percentage of hookwire cases of their class in the PGY-1 year.
Conclusion: There appears to be a trend in resident case assignment towards a higher proportion of female residents being assigned to breast cases compared to their male resident counterpart. This bias is likely multi-factorial but may have a significant influence on a female resident’s career choice. This bias may not only assume that a female resident only wants to perform breast surgery but also assumes conversely that they are not interested in a broad based surgical career. Further multi-institutional studies are needed to better assess this trend.