THE IMPACT OF GENDER DYADS ON SELF-REPORTED OPERATIVE ROLE IN GENERAL SURGERY singlete@umich.edu

PW07-18

THE IMPACT OF GENDER DYADS ON SELF-REPORTED OPERATIVE ROLE IN GENERAL SURGERY

5

United States

Oral or Poster

Gender-based differences persist in the number of cases logged by senior female residents and their self-identified operative role within those cases. We sought to evaluate the impact of the gender of the trainee and the faculty surgeon on the learner’s self-identified operative role.

We analyzed the ACGME case logs of categorical residents from July 2016 to June 2023 using six university-based general surgery residency programs. Data were analyzed using a generalized linear mixed effects model with first assist cases coded as 1 and non-first assist cases coded as 0 for the dependent variable. Fixed effects included main effects for resident and attending gender as well as clinical year of training.

394,113 ACGME case logs for 473 residents (239 male, 234 female) involving 415 attending surgeons (274 male, 141 female) were analyzed. Cases involving female faculty were less likely to be assessed as “first assistant”. The likelihood of “first assistant” designation was higher when PGY4 or above residents operated with female faculty. There were no significant differences in the “first assistant” designation for residents operating with concordant vs discordant gender dyads.

ACGME case-logging patterns vary by attending gender and resident PGY level. Senior residents regardless of gender were more likely to log a case as “first assistant” with a female faculty. However, overall cases involving female faculty were less likely to be logged as “first assistant”. Limited insight into case logging decision making obscures whether disparities reflect perception, opportunity, or true operative autonomy. Figure 1. Effect of Gender Dyad on First Assistant Case Logging Trends by PGY Level