Commentary: deconstructing gender difference.

In Japan, as in the United States, a growing proportion of physicians are women. Hence, the different social roles that men and women occupy and the gendered norms for behavior are increasingly relevant in ensuring that male and female physicians have equal opportunity to participate and advance in all aspects of medicine. Elsewhere in this issue, Nomura and colleagues report on a large survey of primary care residents in Japan. They found that on average women's self-rated confidence on many clinical tasks was lower than men's. This is not surprising given similar gender differences in self-assessed competence in other research and the socialization of women in virtually all cultures to be modest. The actual differences in average scores were small suggesting considerable overlap in the distributions of responses from male and female residents. In addition, research from other countries finds no association between physicians' self-reported confidence in clinical tasks and objective measures of competence on which female physicians rate at or above the level of their male counterparts. Congruent with different social roles for men and women, Nomura and colleagues also found gender differences in the average responses about work-family priorities and aspirations toward leadership, but some women indicated a desire for research careers and some men were "life-oriented." The author of this commentary argues that to draw conclusions about all male or all female physicians from average differences of a large group of residents may reinforce gender stereotypes that continue to impede each individual female physician's career advancement and each individual male physician's struggle for work-life balance.