Résumés
Abstract
Background: Ophthalmology has historically been a male-dominated specialty. Despite there being a higher proportion of females in Canadian medical schools since the early 2000s, it is unknown if trends in female applicants and those accepted to ophthalmology have followed suit. This study aims to evaluate trends in gender representation of ophthalmology applicants to Canadian residency programs from 1998 to 2020 and to compare those trends to other surgical specialties.
Methods: We obtained aggregate data of the annual number of male and female applicants ranking and successfully matching to ophthalmology as their first-choice specialty from the Canadian Residency Matching Service (CaRMS) database. We then carried out a retrospective cross-sectional analysis on the publicly available data. Subsequently, we compared trends in female applicants to ophthalmology, as well as female practicing ophthalmologists, to other surgical disciplines.
Results: The proportion of female applicants increased from 24.3% in 1998 to 33.3% in 2020 (p = 0.001), and matched female applicants increased from 28.6% in 1998 to 40.5% in 2020 (p = 0.023). However, the incremental change in proportion did not statistically significantly increase in 2008-2012, 2013-2016, and 2017-2020. Comparison of male and female matching success rates did not reveal a significant difference (p = 0.45). Trends in female applicants to ophthalmology and female practicing ophthalmologists were similar to other surgical specialties.
Conclusions: Although the proportion of female applicants is increasing, there is a recent plateau and an inability to equalize the female-to-male ratio in ophthalmology. Further studies are needed to identify potential barriers and mitigate possible residual gender biases.
Résumé
Contexte : L'ophtalmologie a toujours été une spécialité dominée par les hommes. Malgré une proportion plus élevée de femmes dans les facultés de médecine canadiennes depuis le début des années 2000, on ignore si les tendances en matière de candidatures féminines et d’admission en ophtalmologie ont suivi la même évolution. Cette étude vise à évaluer les tendances en matière de représentation des sexes parmi les postulants aux programmes de résidence en ophtalmologie au Canada de 1998 à 2020 et à comparer ces tendances à celles observées dans d'autres spécialités chirurgicales.
Méthodes : Nous avons obtenu des données agrégées sur le nombre annuel de postulants masculins et féminins ayant classé l'ophtalmologie comme spécialité de premier choix et y ayant été jumelés avec succès à partir de la base de données du Service canadien de jumelage des résidents (CaRMS). Nous avons ensuite effectué une analyse transversale rétrospective des données publiques disponibles. Par la suite, nous avons comparé les tendances des postulantes en ophtalmologie, ainsi parmi les femmes ophtalmologues en exercice, à celles observées dans d'autres disciplines chirurgicales.
Résultats : La proportion de candidatures féminines a augmenté de 24,3 % en 1998 à 33,3 % en 2020 (p = 0,001), et celle des candidates jumelées a augmenté de 28,6 % en 1998 à 40,5 % en 2020 (p = 0,023). Cependant, la variation incrémentale de cette proportion n'a pas augmenté de manière statistiquement significative en 2008-2012, 2013-2016 et 2017-2020. Une comparaison des taux de jumelage des hommes et des femmes n'a pas révélé de différence significative (p = 0,45). Les tendances parmi les femmes postulantes en ophtalmologie et les femmes ophtalmologues en exercice étaient similaires à celles des autres spécialités chirurgicales.
Conclusions : Bien que la proportion de femmes qui postulent en ophtalmologie augmente, il y a un plateau récent en-deçà d’une parité hommes-femmes. D'autres études sont nécessaires pour identifier les obstacles potentiels et atténuer d’éventuels préjugés sexistes résiduels.
Parties annexes
Bibliography
- Williams AP, Pierre KD, Vayda E. Women in medicine: toward a conceptual understanding of the potential for change. J Am Med Womens Assoc (1972). 1993;48(4):115-21.
- The Association of Faculties of Medicine of Canada. Canadian Medical Education Statistics 2021. Available from: https://www.afmc.ca/wp-content/uploads/2023/02/CMES-2021-Complete-EN.pdf. [Accessed May 2023].
- Tricco AC, Bourgeault I, Moore A, Grunfeld E, Peer N, Straus SE. Advancing gender equity in medicine. Can Med Assoc J. 2021;193(7):E244-E250. https://doi.org/10.1503/cmaj.200951
- Lorello GR, Silver JK, Moineau G, McCarthy K, Flexman AM. Trends in representation of female applicants and matriculants in Canadian residency programs across specialties, 1995 to 2019. JAMA Netw Open. 2020;3(11):e2027938. https://doi.org/10.1001/jamanetworkopen.2020.27938
- Canadian Residency Matching Services. R-1 Data and reports. Available from https://www.carms.ca/data-reports/r1-data-reports/ [Accessed Nov 2020].
- Servito M, Ouzounian M, Chung J, Yanagawa B. Trends in female cardiac surgery trainees and staff in Canada: 1998 to 2020. J Thorac Cardiovasc. 2022;163(2):e203-e206. https://doi.org/10.1016/j.jtcvs.2021.06.025
- Grose E, Chen T, Siu J, Campisi P, Witterick IJ, Chan Y. National trends in gender diversity among trainees and practicing physicians in otolaryngology–head and neck surgery in Canada. JAMA Otolaryngol Head Neck Surg. 2022;148(1):13–19. https://doi.org/10.1001/jamaoto.2021.1431
- Baerlocher MO, Noble J. Does sex affect the success rate of Canadian ophthalmology residency applicants? Can J Ophthalmol. 2006;41(2):163-8. https://doi.org/10.1139/I06-003
- Canadian Medical Association. Canadian Physician Data. Available from https://www.cma.ca/canadian-physician-data [Accessed Nov 2020].
- Papke L, Wooldridge J. Econometric methods for fractional response variables with an application to 401(K) plan participation rates. J Appl Econ. 1996;11:619–632. https://doi.org/10.1002/(SICI)1099-1255(199611)11:6<619::AID-JAE418>3.0.CO;2-1
- Anderson K, Tennankore K, Cox A. Trends in the training of female urology residents in Canada. Can Urol Assoc J. 2018;12(3):E105-11. https://doi.org/10.5489/cuaj.4697
- Chorfi S, Schwartz JS, Verma N, Young M, Joseph L, Nguyen LHP. Evolution of gender representation among Canadian OTL-HNS residents: a 27-year analysis. J Otolaryngol Head Neck Surg. 2017;46(1):55. https://doi.org/10.1186/s40463-017-0232-0
- Ruzycki SM, Earp M, Ma IWY. Applicant gender and matching to first-choice discipline: a cross-sectional analysis of data from the Canadian Resident Matching Service (2013-2019). CMAJ Open. 2020;8(2):E346-E351. https://doi.org/10.9778/cmajo.20190029
- Park J, Minor S, Taylor RA, Vikis E, Poenaru D. Why are women deterred from general surgery training? Am J Surg. 2005;1:141-6. https://doi.org/10.1016/j.amjsurg.2005.04.008
- Jolly S, Griffith KA, DeCastro R, Stewart A, Ubel P, Jagsi R. Gender differences in time spent on parenting and domestic responsibilities by high-achieving young physician-researchers. Ann Intern Med. 2014;160(5):344-353. https://doi.org/10.7326/M13-0974
- Parke II, DW. Gender and Leadership. EyeNet Magazine. 2017. Available from https://www.aao.org/eyenet/article/gender-and-leadership. [Accessed Mar 6, 2021].
- Kletke SN, Zhang A, Kohly RP. A national survey of Canadian women in ophthalmology: on role models, mentorship, and communities of practice. Can J Ophthalmol. 2021;56(3):203-205. https://doi.org/10.1016/j.jcjo.2020.10.004
- Trinh LN, O’Rorke E, Mulcahey MK. Factors influencing female medical students’ decision to pursue surgical specialties: a systematic review. J Surg Educ. 2021;78(3):836-849. https://doi.org/10.1016/j.jsurg.2020.08.050
- Levaillant M, Levaillant L, Lerolle N, Vallet B, Hamel-Broza JF. Factors influencing medical students’ choice of specialization: A gender based systematic review. EClinicalMedicine. 2020:28:100589. https://doi.org/10.1016/j.eclinm.2020.100589