背景:妇女在领导角色中的代表性仍然不足,教师角色,以及骨科手术的居民。有人建议,让女性担任骨科手术的领导职务可能有助于增加居住计划的性别多样性。然而,根据我们的知识,没有研究探索这种关系,如果有的话,居住计划主任的性别与居住计划中妇女的百分比之间的关系。
目标:(1)计划主任的性别与女性骨科手术住院医师百分比的差异有关吗?(2)女性和男性在任命计划主任的时间上是否有所不同?
方法:从2021至2022学年的研究生医学教育认证委员会(ACGME)网站获得了207名骨科手术住院医师的列表。该研究排除了6%(13)的程序;4%(8)是那些没有ACGME认证和那些初步认证,2%(5)没有更新2021年至2022年的居民名单。从2021年7月至2022年7月,从可公开访问的资源中获得了有关194个程序的描述性信息。该机构的网站和美国医学协会(AMA)的奖学金和居留电子互动数据库(FREIDA)用于收集居留计划特征和居民人口统计数据[2]。Doximity,Healthgrades,和LinkedIn被用来进一步收集目前的整形外科住院医师项目主任的人口统计数据,包括性别,年龄,和教育/培训历史。为了确定性别,在他们的传记中使用的照片和代词(她/她/她或他/他/她)首先被使用。为了证实这一点,使用了次要来源,包括他们的NPI概况,其中列出了性别、Doximity和他们的LinkedIn个人资料。Scopus用于分析项目主管的研究成果-使用Hirsch指数(h指数)作为主要的文献计量指标。共确定了194名项目负责人,其中12%(23)是女性,88%(171)是男性。在这些项目的4421名居民中,20%(887)为女性,80%(3534)为男性。进行了单变量分析,比较了项目负责人,连续变量分析采用独立样本t检验,分类变量分析采用皮尔逊卡方检验。有了可用的数字,事后统计能力计算表明,我们可以检测到一个项目中女性百分比的32%差异是显著的,80%的能力在p<0.05水平,而我们可能没有能力辨别比这更小的差异。
结果:有了可用的数字,我们发现,女性项目主管管理的住院医师项目中的女性比例与男性项目中的女性比例没有差异(22%[558中的125]对20%[3863中的762],平均差2%[95%CI-1.24%至7.58%];p=0.08)。比较女性和男性项目主管,女性从完成居住权到被任命为项目主管(8±2年对12±7年,平均差4年[95%CI2.01至7.93年];p=0.02),平均h指数较低(7±4对11±11,平均差4[95%CI1.70至6.56];p=0.03)和出版物数量(24±23对41±62,平均差17[95%CI3.98至31.05];p=0.01),尽管他们的高级学位没有区别,培训时间,或者可能获得了奖学金。
结论:由女性管理的骨科住院医师计划没有包含更高比例的女性住院医师,这表明,在这个角色中,个人的性别可能不像其他人推测的那么重要。未来的研究应该调查性别的交叉性,种族,和居民的种族,项目主管,和现任教师。
结论:女性在职业生涯早期被安排担任项目主管的事实也可能对她们带来特殊危险。这些角色是困难的,会损害教师进行个人研究的能力,这通常是进一步学术晋升的关键。鉴于这一事实,以及项目主任的性别与居住项目的性别组成差异无关,我们相信,增加指导和获得管道计划将有助于促进居留计划的多样性。
BACKGROUND: Women remain underrepresented in leadership roles, faculty roles, and among residents in orthopaedic surgery. It has been suggested that having women in leadership positions in orthopaedic surgery may help to increase the gender diversity of residency programs. However, to our knowledge, no study has explored the relationship, if any, between the gender of the residency program director and the percentage of women in the residency program.
OBJECTIVE: (1) Is the program director\'s gender associated with differences in the percentage of women orthopaedic surgery residents? (2) Do women and men differ in the time to appointment of program director?
METHODS: A list of 207 orthopaedic surgery residencies was obtained from the Accreditation Council for Graduate Medical Education (ACGME) website for the academic year 2021 to 2022. The study excluded 6% (13) of programs; 4% (8) were those without ACGME accreditation and those with initial accreditation, and 2% (5) did not have updated 2021 to 2022 resident lists. Descriptive information on 194 programs was obtained from publicly accessible resources from July 2021 through July 2022. The institution\'s website and the American Medical Association\'s (AMA) Fellowship and Residency Electronic Interactive Database (FREIDA) was used to collect residency program characteristics and resident demographics [ 2 ]. Doximity, Healthgrades, and LinkedIn were used to further collect current orthopaedic surgery residency program director demographics, including gender, age, and education/training history. To determine gender, photographs and pronouns (she/her/hers or he/him/hers) used in their biographies were used first. To confirm this, secondary sources were used including their NPI profile, which lists gender; Doximity; and their LinkedIn profile. Scopus was used to analyze research output by the program directors-using the Hirsch index (h-index) as the primary bibliometric metric. A total of 194 program directors were identified, of whom of 12% (23) were women and 88% (171) were men. Of the 4421 total residents among these programs, 20% (887) were women and 80% (3534) were men. A univariate analysis comparing program directors was conducted, with continuous variables analyzed using an independent-sample t-test and categorical variables analyzed using a Pearson chi-square test. With the numbers available, a post hoc statistical power calculation indicated that we could detect an 32% difference in the percentage of women in a program as significant with 80% power at the p < 0.05 level, whereas we might have been underpowered to discern smaller differences than that.
RESULTS: With the numbers available, we found no difference in the percentage of women in residency programs run by women program directors than in programs in which the program director was a man (22% [125 of 558] versus 20% [762 of 3863], mean difference 2% [95% CI -1.24% to 7.58%]; p = 0.08). Comparing women to men program directors, women had fewer years between residency completion and appointment to the position of program director (8 ± 2 years versus 12 ± 7 years, mean difference 4 years [95% CI 2.01 to 7.93 years]; p = 0.02) and had a lower mean h-index (7 ± 4 versus 11 ± 11, mean difference 4 [95% CI 1.70 to 6.56]; p = 0.03) and number of publications (24 ± 23 versus 41 ± 62, mean difference 17 [95% CI 3.98 to 31.05]; p = 0.01), although they did not differ in terms of their advanced degrees, duration of training, or likelihood of having taken a fellowship.
CONCLUSIONS: Orthopaedic residency programs that were run by women did not contain a higher percentage of women residents, suggesting that the gender of the individual in that role may not be as important as has been speculated by others. Future studies should investigate the intersectionality of gender, race, and ethnicity of residents, program directors, and current faculty.
CONCLUSIONS: The fact that women were placed in program director roles earlier in career may also carry special jeopardy for them. Those roles are difficult and can impair a faculty member\'s ability to conduct individual research, which often is key to further academic promotions. Given that and the fact that the gender of the program director was not associated with differences in gender composition of residency programs, we believe that increasing mentorship and access to pipeline programs will help promote diversity in residency programs.