Discrepancies in Gender Representation Between Integrated and Independent Plastic Surgery Programs

Abstract

Purpose Despite increasing female representation in integrated plastic surgery training programs, independent programs have lower representation and slow improvement in female enrollment. Self-reported resident data were used to investigate trends of female representation in integrated and independent programs. Methods Data were collected from Accreditation Council of Graduate Medical Education resources of active residents' characteristics. Self-reported gender data were collected for integrated, independent, and general surgery programs from annual reports since 2009. χ2 analysis was conducted to compare female enrollment of integrated programs, independent programs, general surgery programs, and general surgery programs with matriculation-year adjustment. Results In 2008, 89 independent programs had nearly identical percentage of female enrollment with 30 integrated programs at 23.8% and 23.1%, respectively. Differences in representation between independent and integrated programs became significant in 2012, with independent programs demonstrating 25.1% female enrollment compared with 30.5% in integrated programs. This trend of higher female representation in integrated programs has persisted since 2012. To correct for preexisting disparity in general surgery programs, we compared female enrollment of independent programs with female enrollment of that class' general surgery matriculation-year 5 years earlier. In all examined years, general surgery still had proportionally higher female enrollment compared with independent programs, even with conservative 5-year matriculation adjustment. Conclusions Dramatic differences in female enrollment were found between integrated and independent programs, with representation in integrated programs rising more quickly. Adjustments for previous rates of female enrollment in general surgery did not yield explanation for low independent program enrollment. Increasing female representation in independent training models will continue to create a more diverse workforce.

Diversity, Equity, and Inclusion in Plastic Surgery

“…A total of 138 publications were identified 3–140 Figure 1. demonstrates the number of publications appearing annually in the 6 journals from January 2018 to September 2023.…”

“…In 2023, Woodyard et al 121 evaluated data provided by the Accreditation Council for Graduate Medical Education. Between 2009 and 2021, female enrollment in integrated residency programs increased from 23% to 43%.…”

“…The percentage of female medical students has equaled or surpassed males for over 2 decades 39 . In 2021 and 2022, the percentage of first-year female plastic surgery residents exceeded males for the first time 100,121 . Although female representation among full professors still lags, this discrepancy may be corrected soon as women progress in academic positions 12 .…”

“…This specialty choice fits with the general perception that, overall (and by no means for all women), women tend to think of families because they usually assume more family responsibilities than men. 13,17,32,59,60,121,137 Many specialties in which women physicians make up the majority focus on children, women, and families, including pediatrics, obstetrics and gynecology, pediatric hematology/oncology, child and adolescent psychiatry, and neonatal-perinatal medicine. 143 Women may select these careers as a matter of personal choice, 60 and not because of perceived obstacles to their advancement in plastic surgery.…”

“…39 In 2021 and 2022, the percentage of first-year female plastic surgery residents exceeded males for the first time. 100,121 Although female representation among full professors still lags, this discrepancy may be corrected soon as women progress in academic positions. 12 There are signs that women are welcome in these roles, including the observation that women program directors are significantly younger than men.…”