Gender Differences in Patient Safety Incident Risk Among Early Career Resident Physicians: A Cross-Sectional Analysis

Previous literature suggest that female physicians have better patient outcomes, following guidelines and evidence-based practices. This study explored the potential roles of workload and psychological burden in shaping the association between gender and patient safety incidents among early career resident physicians. This study aims to improve training environments during early medical careers.

We analyzed cross-sectional data from the 2022 General Medicine In-Training Examination (GM-ITE) in Japan, including 6063 resident physicians in their first or second postgraduation year. Serious patient safety incidents were collected via anonymous questionnaire, defined as deaths or serious adverse events resulting from medical errors made by the resident physicians themselves occurring during the past 12 months. Multilevel mixed-effects logistic regression accounted for hospital differences and additionally examined working conditions, including working hours, night shifts, burnout, and co-worker disruption.

Female resident physicians had a lower risk of serious patient safety incidents (odds ratio (OR) 0.71, 95% CI: 0.59-0.85) after considering co-worker disruption as a mediator. Males had a U-shaped association between weekly working hours and patient safety incidents (<45 h: OR 2.07, 95% CI: 1.39-3.09, ≥80 h: OR 1.35, 95% CI: 1.05-1.74), while females showed a dose-response association, especially with ≥80 hours (OR 2.10, 95% CI: 1.43-3.09). There was no significant interaction of physician gender with burnout or night shift frequency.

Female resident physicians experienced fewer serious patient safety incidents. Reducing working hours may benefit female resident physicians in preventing serious patient safety incidents.