University of Washington School of Medicine, Seattle, Washington.
University of Washington School of Medicine, Seattle, Washington.
J Surg Educ. 2022 Sep-Oct;79(5):1132-1139. doi: 10.1016/j.jsurg.2022.05.008. Epub 2022 Jun 1.
General surgery remains a male-dominated specialty. Women constitute 54% of medical students at the University of Washington, but only 3.4% of full professors within the Department of Surgery. Many believe surgical attrition and "the leaky pipeline" starts during medical school clerkships, but the exact deterrents remain undefined. This study examined the impact of gender on grading during the third-year surgical clerkship.
Retrospective analysis of confidential final clerkship grades, examination scores and subjective clerkship grades was conducted. These were compared by gender, time period, and type of clerkship site. Chi-square analyses were performed.
Clerkship sites across multiple academic (n = 6) and nonacademic (n = 14) locations.
All third-year medical students undergoing a core surgical clerkship over 2 time periods-2007 to 2010 (period 1) and 2016 to 2019 (period 2)-were included.
There were 539 medical students in period 1 and 792 in period 2. The percentage of women was stable over time (52.0% vs 54.2%, p = 0.43). Final clerkship grades of Honors increased significantly from period 1 to 2 (22.3% vs 44.3%, p < 0.0001) and was similarly distributed by gender (women: 21.4% vs 48.0%, p < 0.0001; men 23.2% vs 39.9%, p < 0.0001). Honors on examinations remained stable over time and did not differ by gender. Women earned more final clerkship honors than men at academic sites in period 2 (48.4% vs 30.9%, p < 0.001). This finding was not identified in period 1, nor at nonacademic sites.
There was a significant increase in surgical clerkship honors over the past decade, independent of gender. Women attained more clinical and final clerkship honors than men and similar exam grades as time progressed, suggesting that gender bias in the subjective grading of women at this institution does not directly contribute to the loss of talented women as they progress from medical student to faculty within the department, with said gender imbalance not related to clerkship evaluations.
普通外科仍然是一个以男性为主导的专业。在华盛顿大学，女性占医学生的 54%，但在外科系的正教授中仅占 3.4%。许多人认为，外科医生的流失和“渗漏管道”始于医学生实习期间，但确切的阻碍因素仍未确定。本研究调查了性别对三年级外科实习期间评分的影响。
对机密的最终实习成绩、考试成绩和主观实习成绩进行回顾性分析。按性别、时间段和实习地点类型进行比较。进行卡方分析。
多个学术（n=6）和非学术（n=14）地点的实习地点。
所有在两个时间段（2007 年至 2010 年（第 1 期）和 2016 年至 2019 年（第 2 期））接受核心外科实习的三年级医学生均包括在内。
第 1 期有 539 名医学生，第 2 期有 792 名医学生。女性的比例在时间上保持稳定（52.0%对 54.2%，p=0.43）。从第 1 期到第 2 期，优秀的最终实习成绩显著增加（22.3%对 44.3%，p<0.0001），并且按性别分布相似（女性：21.4%对 48.0%，p<0.0001；男性：23.2%对 39.9%，p<0.0001）。考试中的优秀成绩在时间上保持稳定，性别之间没有差异。在第 2 期，女性在学术场所获得的最终实习荣誉比男性多（48.4%对 30.9%，p<0.001）。这一发现并未在第 1 期或非学术场所发现。
在过去的十年中，外科实习荣誉显著增加，与性别无关。随着时间的推移，女性获得的临床和最终实习荣誉比男性多，考试成绩也相似，这表明该机构对女性主观评分的性别偏见不会直接导致有才华的女性在从医学生向系里的教职员工过渡时流失，而这种性别失衡与实习评估无关。
