Kramer Maud, Heyligers Ide C, Könings Karen D
School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Centre, Heerlen, The Netherlands.
BMC Med Educ. 2021 May 2;21(1):253. doi: 10.1186/s12909-021-02694-9.
More and more female residents enter postgraduate medical training (PGMT). Meanwhile, women are still underrepresented in academic medicine, in leadership positions and in most surgical specialties. This suggests that female residents' career development may still be negatively impacted by subtle, often unconscious stereotype associations regarding gender and career-ambition, called implicit gender-career bias. This study explored the existence and strength of implicit gender-career bias in doctors who currently work in PGMT, i.e. in attending physicians who act as clinical trainers and in their residents.
We tested implicit gender-career bias in doctors working in PGMT by means of an online questionnaire and an online Implicit Association Test (IAT). We used standard IAT analysis to calculate participants' IAT D scores, which indicate the direction and strength of bias. Linear regression analyses were used to test whether the strength of bias was related to gender, position (resident or clinical trainer) or specialty (non-surgical or surgical specialty).
The mean IAT D score among 403 participants significantly differed from zero (D-score = 0.36 (SD = 0.39), indicating bias associating male with career and female with family. Stronger gender-career bias was found in women (β =0 .11; CI 0.02; 0.19; p = 0.01) and in residents (β 0.12; CI 0.01; 0.23; p = 0.03).
This study may provide a solid basis for explicitly addressing implicit gender-career bias in PGMT. The general understanding in the medical field is that gender bias is strongest among male doctors' in male-dominated surgical specialties. Contrary to this view, this study demonstrated that the strongest bias is held by females themselves and by residents, independently of their specialty. Apparently, the influx of female doctors in the medical field has not yet reduced implicit gender-career bias in the next generation of doctors, i.e. in today's residents, and in females.
越来越多的女性住院医师进入医学研究生培训(PGMT)阶段。与此同时,在学术医学领域、领导岗位以及大多数外科专业中,女性的代表性仍然不足。这表明女性住院医师的职业发展可能仍受到关于性别和职业抱负的微妙、往往无意识的刻板印象关联的负面影响,即隐性性别职业偏见。本研究探讨了目前从事PGMT工作的医生,即担任临床培训师的主治医师及其住院医师中隐性性别职业偏见的存在情况和程度。
我们通过在线问卷和在线内隐联想测验(IAT)对从事PGMT工作的医生的隐性性别职业偏见进行了测试。我们使用标准的IAT分析来计算参与者的IAT D分数,该分数表明偏见的方向和程度。线性回归分析用于测试偏见程度是否与性别、职位(住院医师或临床培训师)或专业(非外科或外科专业)相关。
403名参与者的平均IAT D分数显著不同于零(D分数 = 0.36(标准差 = 0.39)),表明存在将男性与职业、女性与家庭联系起来的偏见。在女性(β = 0.11;置信区间0.02;0.19;p = 0.01)和住院医师(β = 0.12;置信区间0.01;0.23;p = 0.03)中发现了更强的性别职业偏见。
本研究可能为明确解决PGMT中的隐性性别职业偏见提供坚实基础。医学领域的普遍认识是,在男性主导的外科专业中,男性医生的性别偏见最为严重。与这种观点相反,本研究表明,最强的偏见是由女性自身和住院医师持有,与他们的专业无关。显然,医学领域女性医生的涌入尚未减少下一代医生,即当今的住院医师和女性中的隐性性别职业偏见。