Study reports gender and ethnic discrepancies in surgical specialization

Robin Wulffson MD's picture
racial discrimination, gender discriimination, general surgeon, medical training
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A new study has reported that gender and ethnic discrepancies exist for certification in general surgery. The findings were published in the May 1 issue of the Journal of the American college of Surgeons (JCS) by researchers at the Washington University School of Medicine in St. Louis. The researchers set out to determine the number of medical school graduates who planned a career in general surgery who completed their specialty training and became certified in general surgery, became certified in another specialty, or did not become certified in any specialty.

The study group was comprised of 3,373 medical school graduates. The researchers found that 2,036 (60.4 %) became certified in the American Board of Surgery (ABS), 342 (10.1 %) became certified in other specialties, and 995 (29.5 %) did not attain board certification in any specialty. In addition, the study found that medical school graduates who were women, older than 26 years old at graduation, and initially failed US Medical Licensing Examination Step 2 Clinical Knowledge were more likely to become certified in another specialty. Conversely, graduates who rated the quality of their surgery clerkship in medical school more highly were less likely to subsequently become certified in another specialty. In addition, graduates who were women, under-represented minority race/ethnicity, Asian/Pacific Islander race/ethnicity, older than 28 years old at graduation, initially failed US Medical Licensing Examination Step l, initially failed or received low passing scores on US Medical Licensing Examination Step 2 Clinical Knowledge, and graduated in more recent years were more likely to be not certified in any specialty. Despite lack of board certification, female and minority residents who failed to attain board certification in any field were more likely to continue in the surgical workforce compared to other groups.

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In conclusion, the authors wrote: “Demographic and professional development variables were associated with ABMS-member BC status among US medical graduates who had intended at medical school graduation to become certified in surgery.”

Take home message:
Medical training from medical school through residency training is demanding. Women are more prone than men to have their training disrupted by family situations. Pregnancy, newborn care, and breast feeding can impact training. Some women take a leave of absence from their training during a pregnancy and never return. A number of these women may later return to the medical field in a capacity compatible to their family commitments.

Racial and gender discrimination has decreased in medical training in recent years; however, it still exists. Those overseeing training programs can use subtle methods to discourage trainees who they dislike for any reason. One specialty that encompasses surgery is currently dominated by women: obstetrics and gynecology. Several decades ago, most of the residents in the field were women; however, currently the majority are women.

Reference: Journal of the American college of Surgeons

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