Influence of Factors Relating to Sex and Gender on Rank List Decisions and Perceptions of Residency Training: Survey Study

Abstract

Background Females make up more than half of medical school matriculants but only one-third of emergency medicine (EM) residents. Various factors may contribute to why fewer females choose the field of EM, such as the existing presence of females in the specialty. Objective This study is a follow-up to previous work, and a survey is used to assess current residents’ attitudes and perceptions on various factors, including those relating to sex and gender on creating rank lists as medical students and in perceived effects on residency education. Methods A web-based survey consisting of Likert scale questions regarding a variety of factors influencing a student’s decision to create a rank list and in perceived effects on residency education was sent to current EM residents in 2020. Results Residents from 17 programs participated in the survey with an 18.2% (138/758) response rate. The most important factors in creating a rank list were the personality of residents in the program, location, and facility type. For factors specifically related to gender, respondents who answered affirmatively to whether the gender composition of residents affected the selection of a program in making a rank list were more likely to also answer affirmatively to subsequent questions related to the gender of program leadership (P<.001) and gender composition of attending physicians (P<.001). The personality of residents was also the most important factor perceived to affect residency education. For factors influencing rank list and residency education, female respondents placed higher importance on subcategories related to gender (ie, gender composition of the residents, of the program leadership, and of the attending physicians) to a significant degree compared with their male counterparts. Conclusions Although factors such as location and resident personality show the most importance in influencing residency selection, when stratifying based on respondent sex, females tend to indicate that factors relating to gender have more influence on rank list and residency education compared with males.

Matching Against Men: 5 Years of Residency Match Data Show Disparities Still Exist

“…This is likely due to an interplay of multiple sociological and economic factors. For example, in previous research, female applicants have been shown to place increased importance on the gender diversity of a program in comparison to their male peers 38 . The social pressures that female matriculants face may encourage highly competitive applicants to apply to less competitive specialties, making them more eligible candidates for more competitive locations as a result.…”

“…For example, in previous research, female applicants have been shown to place increased importance on the gender diversity of a program in comparison to their male peers. 38 The social pressures that female matriculants face may encourage highly competitive applicants to apply to less competitive specialties, making them more eligible candidates for more competitive locations as a result. Further study, however, is necessary to elucidate the specific factors that allow female students to match into more prestigious residency locations.…”

Strategies for recruiting underrepresented in medicine and sexual and gender minority students to emergency medicine

“…Being intentional in improving diversity in emergency medicine is critical, as underrepresented in medicine and sexual and gender minority applicants are more likely to consider diversity when choosing a specialty and residency program, and they are more likely to consider programs perceived as diverse 50 . For female applicants, selection of a program may be influenced by the gender composition of the residents, gender of program directors and assistant program directors, gender of attending physicians, ethnic diversity of coresidents, and patient demographics 51 . Diversifying the physician workforce is a challenge that will not be easily overcome.…”

“…50 For female applicants, selection of a program may be influenced by the gender composition of the residents, gender of program directors and assistant program directors, gender of attending physicians, ethnic diversity of coresidents, and patient demographics. 51 Diversifying the physician workforce is a challenge that will not be easily overcome. However, programs can navigate obstacles in the preinterview, interview day, and postinterview stages with greater intentionality to efforts, which can increase recruitment of underrepresented in medicine and sexual and gender minority students.…”