"Closing the Gap" Longitudinal Analysis of Gender Differences in Cardiothoracic Surgery Training Operative...

Gender-based disparities in operative experience are reported in many surgical subspecialties; however, data in cardiothoracic surgery (CT) are limited. This study examined gender differences in operative experience among CT surgery trainees.

A retrospective analysis of Accreditation Council for Graduate Medical Education (ACGME) case log data was performed for cardiothoracic surgery trainees graduating in 2016-2024 (excluding 2022), including integrated (I-6) and traditional pathways. Cumulative operative volumes were compared by gender across pathways, subspecialty tracks, and regions. Temporal trends were assessed, and multivariable linear regression evaluated the association between gender and operative volume after adjustment for training and program factors.

Case logs from 724 CT surgery trainees (76.5% men, 23.5% women) were analyzed. Mean operative volume was 851 ± 207 cases, with no difference by gender. Women were more likely to pursue the thoracic track (48.8% vs 38.1%, p=0.041), and women's representation increased over time (p=0.040). Operative volume increased across training years for all trainees (p<0.001), with similar trends by gender. No gender differences were observed in total, major, thoracic, or cardiac case volumes in subgroup or adjusted analyses; minor case volume showed a non-significant trend toward higher volume among women.

Gender representation in cardiothoracic training is improving, with more women pursuing the thoracic track. Operative volumes are comparable by gender, with no differences in total case numbers. Future studies should assess operative autonomy and case complexity across genders.