Exploring Gender Diversity in Canadian Surgical Residency Leadership

Studies in the United States demonstrate a low proportion of cisgender women in medical leadership. No research exists about the prevalence of transgender people in medical leadership. The objective of this study was to evaluate gender representation within Canadian surgical training leadership.

This study represents a survey based exploratory analysis and literature review. Associations between gender and leadership position, surgical subspecialty, years in practice and leadership role, province of work, and age were calculated using Chi squared goodness of fit and independence tests.

The study was based out of the University of British Columbia in Vancouver and included all Canadian surgical training programs.

Participants were identified using the Canadian Resident Matching Service and program websites. All prospective respondents (359) were emailed an encrypted survey link.

The survey response rate was 65/359 responses (18%). The overall gender distribution was cis men (n = 36, 56.5%), cis women (n = 26, 40%), nonbinary (n = 1, 1.5%), agender (n = 1, 1.5%) and nonresponse (n = 1, 1.5%). Sixty-three percent of program directors were cis men, 33% were cis women and 4% were agender. Sixty-seven percent of associate program directors were cis women and 33% were cis men. Sixty-five percent of division leads were cis men, 29% were cis women, and 6% were nonbinary. There were more cis women in general surgery leadership than expected (df = 1, N = 20, x² = 11.05, p ≤ 0.001). No statistically significant associations between gender identity/modality, leadership role, province, or age were found using chi squared tests.

Cis men continue to outnumber all others in surgical training leadership. More cis women than expected work in general surgery training leadership. However, these findings must be interpreted with caution considering the low survey response rate and the greater proportion of cis women respondents compared to cis women surgeons. There is a marked absence of binary-identified trans people in surgical training leadership in Canada, however a small number of nonbinary and agender people are present.