Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, U.S.A.
Seattle Children's Hospital and Research Institute, Seattle, Washington, U.S.A.
Laryngoscope. 2023 Oct;133(10):2558-2563. doi: 10.1002/lary.30592. Epub 2023 Feb 16.
Racial, ethnic, and gender disparities in the otolaryngology-head and neck surgery (OHNS) match have been described individually, but not intersectionally. Intersectionality recognizes how multiple forms of discrimination (e.g., sexism, racism) can have a combined effect. The objective of this study was to analyze racial, ethnic, and gender disparities in the OHNS match using an intersectional approach.
Cross-sectional evaluation of data from otolaryngology applicants from the Electronic Residency Application Service (ERAS) and of corresponding otolaryngology residents from the Accreditation Council for Graduate Medical Education (ACGME) from 2013 to 2019. Data were stratified by race, ethnicity, and gender. The Cochran-Armitage tests assessed trends over time in the proportions of applicants and corresponding residents. Chi-square tests with Yates' continuity correction were performed to evaluate differences between the aggregate proportions of applicants and corresponding residents.
The proportion of White men in the resident pool was increased compared to the applicant pool (ACGME 0.417, ERAS 0.375; Δ + 0.042; 95% CI 0.012 to 0.071; p = 0.03). This was also the case for White women (ACGME 0.206, ERAS 0.175; Δ + 0.031; 95% CI 0.007 to 0.055; p = 0.05). In contrast, there was a smaller proportion of residents compared to applicants among Multiracial men (ACGME 0.014, ERAS 0.047; Δ - 0.033; 95% CI -0.043 to -0.023; p < 0.001) and Multiracial women (ACGME 0.010, ERAS 0.026; Δ - 0.016; 95% CI -0.024 to -0.008; p < 0.001).
The findings of this study imply that White men have a persistent advantage, while several racial, ethnic, and gender minorities are disadvantaged in the OHNS match. Further research is necessary to examine why these differences exist in residency selection, including evaluation during the screening, reviewing, interviewing, and ranking stages. Laryngoscope, 133:2558-2563, 2023.
耳鼻喉科学-头颈外科学（otolaryngology-head and neck surgery，OHNS）领域的种族、民族和性别差异已分别得到描述，但尚未从交叉的角度进行分析。交叉性承认了多种形式的歧视（例如性别歧视、种族歧视）如何产生综合影响。本研究的目的是使用交叉方法分析 OHNS 匹配中的种族、民族和性别差异。
对 2013 年至 2019 年期间来自电子住院医师申请服务（Electronic Residency Application Service，ERAS）的耳鼻喉科申请者和来自研究生医学教育认证委员会（Accreditation Council for Graduate Medical Education，ACGME）的相应耳鼻喉科住院医师的数据进行横断面评估。数据按种族、民族和性别分层。Cochran-Armitage 检验评估了申请者和相应住院医师比例随时间的变化趋势。采用卡方检验（Yates 连续性校正）评估申请者和相应住院医师的总比例之间的差异。
与申请者相比，住院医师中白人男性的比例增加（ACGME 0.417，ERAS 0.375；Δ+0.042；95%CI 0.012 至 0.071；p=0.03）。白人女性也是如此（ACGME 0.206，ERAS 0.175；Δ+0.031；95%CI 0.007 至 0.055；p=0.05）。相比之下，与申请者相比，住院医师中多民族男性（ACGME 0.014，ERAS 0.047；Δ-0.033；95%CI -0.043 至 -0.023；p<0.001）和多民族女性（ACGME 0.010，ERAS 0.026；Δ-0.016；95%CI -0.024 至 -0.008；p<0.001）的比例较小。
本研究的结果表明，白人男性具有持续的优势，而 OHNS 匹配中的一些少数族裔、民族和性别群体处于劣势。需要进一步研究以检查为什么在住院医师选择中存在这些差异，包括筛选、审查、面试和排名阶段的评估。喉科学，133：2558-2563，2023。
