Division of General Internal Medicine, Department of Medicine (Ruzycki, Ma), Department of Community Health Sciences (Ruzycki) and Department of Oncology (Earp), Cumming School of Medicine, University of Calgary, Calgary, Alta.
CMAJ Open. 2020 May 7;8(2):E346-E351. doi: 10.9778/cmajo.20190029. Print 2020 Apr-Jun.
Previous studies examining potential sex and gender bias in the Canadian Resident Matching Service (CaRMS) match have had conflicting results. We examined the results of the CaRMS match over the period 2013-2019 to determine the potential association between applicants' gender and the outcome of matching to their first-choice discipline.
In this cross-sectional analysis, we determined the risk of matching to one's first-choice discipline in CaRMS by applicant gender and year, for all Canadian medical students who participated in the first iteration of the R-1 match for the years 2013 to 2019. We analyzed data in 3 categories of disciplines according to CaRMS classifications: family medicine, nonsurgical disciplines and surgical disciplines. We excluded disciplines with fewer than 10 applicants.
Match results were available for 20 033 participants, of whom 11 078 (55.3%) were female. Overall, female applicants were significantly more likely to match to their first-choice discipline (relative risk [RR] 1.03, 95% confidence interval [CI] 1.02-1.04). After adjustment for match year and stratification by discipline categories, we found that female applicants were more likely to match to family medicine as their first choice (RR 1.04, 95% CI 1.03-1.05) and less likely to match to a first-choice surgical discipline (RR 0.95, 95% CI 0.91-1.00) than their male peers. There was no significant difference between the genders in matching to one's first-choice nonsurgical discipline (RR 1.01, 95% CI 0.99-1.03).
These results suggest an association between an applicant's gender and the probability of matching to one's first-choice discipline. The possibility of gender bias in the application process for residency programs should be further evaluated and monitored.
之前研究加拿大住院医师匹配服务（CaRMS）匹配中潜在的性别和性别偏见的结果相互矛盾。我们检查了 2013 年至 2019 年期间 CaRMS 匹配的结果，以确定申请人的性别与他们匹配到首选学科的结果之间的潜在关联。
在这项横断面分析中，我们根据申请人的性别和年份，确定了所有参加 2013 年至 2019 年第一轮 R-1 匹配的加拿大医学生在 CaRMS 中匹配到首选学科的风险。我们根据 CaRMS 分类分析了 3 类学科的数据：家庭医学、非手术学科和手术学科。我们排除了申请人数少于 10 人的学科。
共有 20033 名参与者的匹配结果可用，其中 11078 名（55.3%）为女性。总体而言，女性申请人更有可能匹配到首选学科（相对风险 [RR] 1.03，95%置信区间 [CI] 1.02-1.04）。在调整匹配年份和按学科类别分层后，我们发现女性申请人更有可能选择家庭医学作为首选（RR 1.04，95%CI 1.03-1.05），而不太可能选择首选手术学科（RR 0.95，95%CI 0.91-1.00）比男性同龄人。在选择首选非手术学科方面，性别之间没有显著差异（RR 1.01，95%CI 0.99-1.03）。
这些结果表明申请人的性别与匹配到首选学科的概率之间存在关联。在住院医师计划的申请过程中存在性别偏见的可能性应进一步评估和监测。
