Dan Gong1, Bryan J Winn1, Casey J Beal2, Preston H Blomquist3, Royce W Chen1, Susan M Culican4, Lora R Dagi Glass1, Gary F Domeracki5, Jeffrey M Goshe6, Jeremy K Jones7, Albert S Khouri8, Gary L Legault9, Timothy J Martin10, Kelly T Mitchell11, Ayman Naseri12, Thomas A Oetting13, Joshua H Olson14, Jeff H Pettey15, Maria A Reinoso16, Andrew L Reynolds17, R Michael Siatkowski18, Jeffrey R SooHoo19, Grace Sun20, Misha F Syed21, Jeremiah P Tao22, Parisa Taravati23, Darrell WuDunn24, Lama A Al-Aswad1,25. 1. Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York. 2. Department of Ophthalmology, University of Florida, Gainesville. 3. Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas. 4. Department of Ophthalmology and Visual Sciences, Washington University School of Medicine in St Louis, St Louis, Missouri. 5. Department of Ophthalmology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania. 6. Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio. 7. Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia. 8. Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark. 9. Brooke Army Medical Center, Fort Sam Houston, Texas. 10. Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, North Carolina. 11. Department of Ophthalmology & Visual Sciences, Texas Tech University Health Sciences Center, Lubbock. 12. Department of Ophthalmology, University of California, San Francisco. 13. Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City. 14. Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis. 15. Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City. 16. Department of Ophthalmology, Louisiana State University Health Sciences Center, Louisiana State University Eye Center, New Orleans. 17. Ross Eye Institute, University at Buffalo Jacobs School of Medicine, Buffalo, New York. 18. Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma College of Medicine, Oklahoma City. 19. Department of Ophthalmology, University of Colorado School of Medicine, Aurora. 20. Department of Ophthalmology, Weill Cornell Medicine, New York, New York. 21. Ophthalmology and Visual Science, University of Texas Medical Branch, Galveston. 22. Gavin Herbert Eye Institute, University of California, Irvine. 23. Department of Ophthalmology, University of Washington, Seattle. 24. Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis. 25. Department of Ophthalmology, New York University School of Medicine, NYU Langone Health, New York, New York.
Abstract
IMPORTANCE: Although almost equal numbers of male and female medical students enter into ophthalmology residency programs, whether they have similar surgical experiences during training is unclear. OBJECTIVE: To determine differences for cataract surgery and total procedural volume between male and female residents during ophthalmology residency. DESIGN, SETTING, PARTICIPANTS: This retrospective, longitudinal analysis of resident case logs from 24 US ophthalmology residency programs spanned July 2005 to June 2017. A total of 1271 residents were included. Data were analyzed from August 12, 2017, through April 4, 2018. MAIN OUTCOMES AND MEASURES: Variables analyzed included mean volumes of cataract surgery and total procedures, resident gender, and maternity or paternity leave status. RESULTS: Among the 1271 residents included in the analysis (815 men [64.1%]), being female was associated with performing fewer cataract operations and total procedures. Male residents performed a mean (SD) of 176.7 (66.2) cataract operations, and female residents performed a mean (SD) of 161.7 (56.2) (mean difference, -15.0 [95% CI, -22.2 to -7.8]; P < .001); men performed a mean (SD) of 509.4 (208.6) total procedures and women performed a mean (SD) of 451.3 (158.8) (mean difference, -58.1 [95% CI, -80.2 to -36.0]; P < .001). Eighty-five of 815 male residents (10.4%) and 71 of 456 female residents (15.6%) took parental leave. Male residents who took paternity leave performed a mean of 27.5 (95% CI, 13.3 to 41.6; P < .001) more cataract operations compared with men who did not take leave, but female residents who took maternity leave performed similar numbers of operations as women who did not take leave (mean difference, -2.0 [95% CI, -18.0 to 14.0]; P = .81). From 2005 to 2017, each additional year was associated with a 5.5 (95% CI, 4.4 to 6.7; P < .001) increase in cataract volume and 24.4 (95% CI, 20.9 to 27.8; P < .001) increase in total procedural volume. This increase was not different between genders for cataract procedure volume (β = -1.6 [95% CI, -3.7 to 0.4]; P = .11) but was different for total procedural volume such that the increase in total procedural volume over time for men was greater than that for women (β = -8.0 [95% CI, -14.0 to -2.1]; P = .008). CONCLUSIONS AND RELEVANCE: Female residents performed 7.8 to 22.2 fewer cataract operations and 36.0 to 80.2 fewer total procedures compared with their male counterparts from 2005 to 2017, a finding that warrants further exploration to ensure that residents have equivalent surgical training experiences during residency regardless of gender. However, this study included a limited number of programs (24 of 119 [20.2%]). Future research including all ophthalmology residency programs may minimize the selection bias issues present in this study.
IMPORTANCE: Although almost equal numbers of male and female medical students enter into ophthalmology residency programs, whether they have similar surgical experiences during training is unclear. OBJECTIVE: To determine differences for cataract surgery and total procedural volume between male and female residents during ophthalmology residency. DESIGN, SETTING, PARTICIPANTS: This retrospective, longitudinal analysis of resident case logs from 24 US ophthalmology residency programs spanned July 2005 to June 2017. A total of 1271 residents were included. Data were analyzed from August 12, 2017, through April 4, 2018. MAIN OUTCOMES AND MEASURES: Variables analyzed included mean volumes of cataract surgery and total procedures, resident gender, and maternity or paternity leave status. RESULTS: Among the 1271 residents included in the analysis (815 men [64.1%]), being female was associated with performing fewer cataract operations and total procedures. Male residents performed a mean (SD) of 176.7 (66.2) cataract operations, and female residents performed a mean (SD) of 161.7 (56.2) (mean difference, -15.0 [95% CI, -22.2 to -7.8]; P < .001); men performed a mean (SD) of 509.4 (208.6) total procedures and women performed a mean (SD) of 451.3 (158.8) (mean difference, -58.1 [95% CI, -80.2 to -36.0]; P < .001). Eighty-five of 815 male residents (10.4%) and 71 of 456 female residents (15.6%) took parental leave. Male residents who took paternity leave performed a mean of 27.5 (95% CI, 13.3 to 41.6; P < .001) more cataract operations compared with men who did not take leave, but female residents who took maternity leave performed similar numbers of operations as women who did not take leave (mean difference, -2.0 [95% CI, -18.0 to 14.0]; P = .81). From 2005 to 2017, each additional year was associated with a 5.5 (95% CI, 4.4 to 6.7; P < .001) increase in cataract volume and 24.4 (95% CI, 20.9 to 27.8; P < .001) increase in total procedural volume. This increase was not different between genders for cataract procedure volume (β = -1.6 [95% CI, -3.7 to 0.4]; P = .11) but was different for total procedural volume such that the increase in total procedural volume over time for men was greater than that for women (β = -8.0 [95% CI, -14.0 to -2.1]; P = .008). CONCLUSIONS AND RELEVANCE: Female residents performed 7.8 to 22.2 fewer cataract operations and 36.0 to 80.2 fewer total procedures compared with their male counterparts from 2005 to 2017, a finding that warrants further exploration to ensure that residents have equivalent surgical training experiences during residency regardless of gender. However, this study included a limited number of programs (24 of 119 [20.2%]). Future research including all ophthalmology residency programs may minimize the selection bias issues present in this study.
Authors: Dana D Huh; Jiangxia Wang; Michael J Fliotsos; Casey J Beal; Charline S Boente; C Ellis Wisely; Lindsay M De Andrade; Alice C Lorch; Saras Ramanathan; Maria A Reinoso; Ramya N Swamy; Evan L Waxman; Fasika A Woreta; Divya Srikumaran Journal: JAMA Ophthalmol Date: 2022-09-29 Impact factor: 8.253
Authors: Katherine Gavinski; Erin Cleveland; Aashish K Didwania; Joseph M Feinglass; Melanie S Sulistio Journal: J Gen Intern Med Date: 2020-09-28 Impact factor: 5.128