导言鉴于大多数专业中女医生的代表性不足,以及在住院医师申请中进行全面审查的目的,以改善美国(US)研究生医学培训计划中入读住院医师的多样性,我们研究了美国研究生培训项目中整体评价与女性居民代表之间的关联.方法我们对美国研究生培训计划进行了横断面调查,以询问其在居民申请中使用整体审查的情况(独立变量)。主要结果是每个计划中女性居民的百分比,这是在2023年4月从奖学金和居留电子交互式数据库访问(FREIDA)目录中获得的其他程序级特征。我们将分析限于2022年培训地点最多的10个专业,包括麻醉学,急诊医学,家庭医学,内科,神经学,妇产科,骨科手术,儿科,精神病学,和手术(一般)。我们还使用模型比较和简单的斜率分析研究了整体评论与专业之间的相互作用以及女性教师的百分比。结果在10个专业调查的3364个项目中,222(6.6%)作出回应。响应者和非响应者具有相似的程序级别特征,包括程序类型(例如,大学,社区),专业,并报告了最低的董事会考试成绩。在222名响应者中,179(80.6%)报告进行了整体审查。无整体审查组女性居民比例为49.0%(四分位距37.5~66.7),整体审查组女性居民比例为47.8%(35.4~65.0)(中位数差异0.9%,95%置信区间-6.7至8.3)。此外,没有证据表明整体审查与专业或女性教师百分比之间存在相互作用,这取决于女性居民百分比的结果。结论在美国研究生培训计划的有限样本中,对居住申请的整体审查与女性居民的百分比无关。整体审查在解决医疗保健队伍中男女医生不平衡方面的作用,特别是在专业之间,仍然未知。
Introduction Given the underrepresentation of female physicians in most specialties and the aim of holistic
review in residency applications to improve the diversity of matriculating resident physicians in the United States (US) postgraduate medical training programs, we examined the association between holistic review and female resident representation among US postgraduate training programs. Methods We conducted a cross-sectional survey of US postgraduate training programs to inquire about their use of holistic
review for resident applications (independent variable). The primary outcome was the percentage of female residents in each program, which was obtained along with other program-level characteristics from the Fellowship and Residency Electronic Interactive Database Access (FREIDA) catalog in April 2023. We limited the analysis to the 10 specialties with the most training spots in 2022, including anesthesiology, emergency medicine, family medicine, internal medicine, neurology, obstetrics and gynecology, orthopedic surgery, pediatrics, psychiatry, and surgery (general). We also examined the interactions between holistic
review and specialty and the percentage of female faculty using model comparison and simple slopes analyses. Results Of the 3,364 total programs surveyed from the 10 specialties, 222 (6.6%) responded. Responders and nonresponders had similar program-level characteristics, including program type (e.g., university, community), specialty, and reported minimum board examination scores. Of the 222 responders, 179 (80.6%) reported performing holistic
review. The percentage of female residents was 49.0% (interquartile range 37.5 to 66.7) in the no holistic review group and 47.8% (35.4 to 65.0) in the holistic
review group (median difference 0.9%, 95% confidence interval -6.7 to 8.3). Furthermore, there was no evidence of interaction between holistic review and either the specialty or the percentage of female faculty on the outcome of the percentage of female residents. Conclusions Holistic review of residency applications in this limited sample of US postgraduate training programs was not associated with the percentage of female residents. The role of holistic review in addressing the imbalance of male and female physicians in the healthcare workforce, particularly between specialties, remains unknown.