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Gender Trends in Applicants to General Surgery Residency Programs in Canada

  • Alveena Ahmed
    Affiliations
    Schulich School of Medicine & Dentistry, Western University, Windsor Campus, London, Ontario, Canada
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  • Jacob Davidson
    Affiliations
    Division of Pediatric Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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  • Julie Ann Van Koughnett
    Affiliations
    Division of General Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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  • Andreana Bütter
    Correspondence
    Corresponding author. Andreana Bütter, MD, MSc, FACS, FRCSC. Professor of Surgery and Pediatrics, Schulich School of Medicine and Dentistry, Western University. Chair/Chief, Division of Pediatric Surgery, Children’s Hospital, LHSC. 800 Commissioners Rd East, Rm B1-190. London ON N6A 4G5. 519.685.8401. tel) 519 685.8241 (fax.
    Affiliations
    Division of Pediatric Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada

    Division of General Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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      Highlights

      • Female representation in surgical disciplines, including General Surgery, lags behind that in non-surgical disciplines despite females constituting the majority of Canadian medical students. Trends in applicants to General Surgery residency programs in Canada have not been recently evaluated.
      • Over the last two decades, the gender gap in applicants has normalized with females representing the majority of successfully matched candidates to General Surgery. However, a significant gap exists in practicing General Surgeons, indicating the need for further intervention to ensure equitable representation.

      Summary

      Background

      Surgical disciplines lag behind non-surgical disciplines in attracting female trainees. Female representation of Canadian General Surgeons has not been evaluated in recent years in the literature. The objectives of this study were to assess gender trends in applicants to Canadian General Surgery residency programs and practicing general surgeons and subspecialists.

      Methods

      This retrospective cross-sectional study analyzed gender data for residency applicants ranking General Surgery as their first-choice discipline from publicly-available annual Canadian Residency Matching Service (CaRMS) R-1 match reports from 1998-2021. Aggregate gender data for practicing female physicians in General Surgery and related subspecialties, including Pediatric Surgery, obtained from annual Canadian Medical Association (CMA) census from 2000-2019 was also analysed.

      Results

      There was a significant increase in the proportion of female applicants from 34% in 1998 to 67% in 2021 (p<0.001) and of successfully matched candidates from 39% to 68% (p= 0.002) from 1998 to 2021. Success rates between male and female candidates were significantly different in 1998 (p<0.001), but not in 2021 (p=0.29). The proportion of practicing female General Surgeons also significantly increased from 10.1% in 2000 to 27.9% in 2019 (p=0.0013), with variable trends in subspecialties.

      Conclusion

      Gender inequality in General Surgery residency matches has normalized since 1998. Despite females representing more than 40% of applicants and successfully matched candidates to General Surgery since 2008, a gender gap still exists amongst practicing General Surgeons and subspecialists. This suggests the need for further cultural and systemic change to mitigate gender disparities.

      LEVEL OF EVIDENCE

      Level III (Retrospective cross-sectional study);

      Keywords

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