Hofler Lisa G, Hacker Michele R, Dodge Laura E, Schutzberg Rose, Ricciotti Hope A
Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Harvard School of Public Health, Boston, Massachusetts; and the Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia.
Obstet Gynecol. 2016 Mar;127(3):442-447. doi: 10.1097/AOG.0000000000001290.
To compare the representation of women in obstetrics and gynecology department-based leadership to other clinical specialties while accounting for proportions of women in historical residency cohorts.
This was a cross-sectional observational study. The gender of department-based leaders (chair, vice chair, division director) and residency program directors was determined from websites of 950 academic departments of anesthesiology, diagnostic radiology, general surgery, internal medicine, neurology, obstetrics and gynecology, pathology, pediatrics, and psychiatry. Each specialty's representation ratio-proportion of leadership roles held by women in 2013 divided by proportion of residents in 1990 who were women-and 95% confidence interval (CI) were calculated. A ratio of 1 indicates proportionate representation.
Women were significantly underrepresented among chairs for all specialties (ratios 0.60 or less, P≤.02) and division directors for all specialties except anesthesiology (ratio 1.13, 95% CI 0.87-1.46) and diagnostic radiology (ratio 0.97, 95% CI 0.81-1.16). The representation ratio for vice chair was below 1.0 for all specialties except anesthesiology; this finding reached statistical significance only for pathology, pediatrics, and psychiatry. Women were significantly overrepresented as residency program directors in general surgery, anesthesiology, obstetrics and gynecology, and pediatrics (ratios greater than 1.19, P≤.046). Obstetrics and gynecology and pediatrics had the highest proportions of residents in 1990 and department leaders in 2013 who were women.
Despite having the largest proportion of leaders who were women, representation ratios demonstrate obstetrics and gynecology is behind other specialties in progression of women to departmental leadership. Women's overrepresentation as residency program directors raises concern because education-based academic tracks may not lead to major leadership roles.
在考虑历史住院医师队列中女性比例的情况下，比较妇产科部门领导中女性的占比与其他临床专科的情况。
这是一项横断面观察性研究。通过950个麻醉学、诊断放射学、普通外科、内科、神经科、妇产科、病理学、儿科学和精神病学学术部门的网站确定部门领导（主任、副主任、科室主任）和住院医师培训项目主任的性别。计算每个专科的代表性比率——2013年女性担任领导职务的比例除以1990年女性住院医师的比例——以及95%置信区间（CI）。比率为1表示比例相称。
所有专科的主任中女性占比均显著不足（比率为0.60或更低，P≤0.02），除麻醉学（比率1.13，95%CI 0.87 - 1.46）和诊断放射学（比率0.97，95%CI 0.81 - 1.16）外，所有专科的科室主任中女性占比也不足。除麻醉学外，所有专科副主任的代表性比率均低于1.0；这一发现仅在病理学、儿科学和精神病学方面具有统计学意义。在普通外科、麻醉学、妇产科和儿科学中，女性作为住院医师培训项目主任的占比显著过高（比率大于1.19，P≤0.046）。妇产科和儿科学在1990年的住院医师以及2013年的部门领导中女性比例最高。
尽管女性领导的比例最高，但代表性比率表明，在女性晋升为部门领导方面，妇产科落后于其他专科。女性作为住院医师培训项目主任的占比过高令人担忧，因为基于教育的学术轨道可能无法通向主要领导职位。
