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Resident autonomy in the operating room: Does gender matter?

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Female surgical residents require more guidance during laparoscopic procedures than males, indicating gender-based disparities in surgical autonomy. This finding persists even when controlling for technical skill and experience.

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Area of Science:

  • Surgical Education
  • Medical Training
  • Gender Studies in Medicine

Background:

  • Limited data exists on gender's impact on surgical trainee autonomy.
  • Autonomy is crucial for skill development in surgical residents.

Purpose of the Study:

  • To investigate gender-based differences in intraoperative autonomy for general surgery residents.
  • To determine if female residents require more guidance during laparoscopic procedures compared to males.

Main Methods:

  • Retrospective review of intraoperative procedure feedback forms and Fundamentals of Laparoscopic Surgery (FLS) tasks.
  • Analysis of data from 2013-2016, including resident/attending gender, guidance level, PGY level, and performance metrics.
  • Mixed-effects regression modeling for univariate and multivariate analyses.

Main Results:

  • Female residents received more intraoperative guidance than male residents (univariate p=0.019, multivariate p=0.034).
  • Technical performance and Fundamentals of Laparoscopic Surgery (FLS) skills were similar between genders.
  • No significant difference in guidance needed was observed based on PGY level or case complexity.

Conclusions:

  • Gender-based inequality in intraoperative autonomy exists for general surgery residents.
  • This disparity is evident even after accounting for technical proficiency, postgraduate year, and case factors.
  • Further research is needed to explore and address the root causes of this gender gap in surgical autonomy.