妇产科住院总医师遴选中的种族和性别差异。
Racial and sex disparities in the selection of chief residents in obstetrics and gynecology.
机构信息
Department of Women's Health, Dell Medical School, The University of Texas at Austin, Austin, TX (Dr Howard).
Intermountain Healthcare, McKay-Dee Behavioral Health, Ogden, UT (Dr Oyeniyi).
出版信息
Am J Obstet Gynecol MFM. 2023 May;5(5):100919. doi: 10.1016/j.ajogmf.2023.100919. Epub 2023 Mar 7.
BACKGROUND
Racial and ethnically minoritized individuals and women are underrepresented in leadership roles in academic medicine. Little is known about whether and to what extent these racial and sex disparities exist in graduate medical education.
OBJECTIVE
This study aimed to determine whether race-ethnicity or the intersection of race-ethnicity and sex impact the likelihood of being selected as chief resident in obstetrics and gynecology residency programs.
STUDY DESIGN
We performed cross-sectional analyses using data from Graduate Medical Education Track, a national resident database and tracking system. Those included in this analysis were final-year obstetrics and gynecology residents in US-based residency programs from 2015 to 2018. The exposure variables were self-reported race-ethnicity and sex. The outcome was being selected as chief resident. A logistic regression was used to estimate the odds of being selected as chief resident. We tested the following variables for potential confounding: survey year, United States citizenship, medical school type, geographic region of residency, and Alpha Omega Alpha status.
RESULTS
There were 5128 residents included. Black residents were 21% less likely to be selected as chief resident than White residents (odds ratio, 0.79; 95% confidence interval, 0.65-0.96). Females were 19% more likely to be chief resident than males (odds ratio, 1.19; 95% confidence interval, 1.02-1.38). When examining the intersection of race-ethnicity and sex, the results revealed some heterogeneity. Among males, Black individuals had the lowest odds of being selected as chief resident (odds ratio, 0.32; 95% confidence interval, 0.17-0.63; referent White males), whereas among females, Hispanic individuals were the least likely to be selected as chief resident (odds ratio, 0.69; 95% confidence interval, 0.52-0.92; referent White females). White females were almost 4 times more likely to be selected as chief resident than Black males (odds ratio, 3.79; 95% confidence interval, 1.97-7.29).
CONCLUSION
The odds of being selected as chief resident differ significantly by race-ethnicity, sex, and the intersection of these factors.
背景
在学术医学领域，少数族裔和女性在领导层中的代表性不足。对于这些种族和性别差异是否存在，以及存在的程度如何，在研究生医学教育中知之甚少。
目的
本研究旨在确定种族-民族或种族-民族与性别交叉是否会影响在妇产科住院医师培训计划中被选为住院总医师的可能性。
研究设计
我们使用来自研究生医学教育追踪（Graduate Medical Education Track）的数据进行了横断面分析，该数据库是一个全国性的住院医师数据库和跟踪系统。本分析包括 2015 年至 2018 年期间在美国住院医师培训计划中的最后一年妇产科住院医师。暴露变量是自我报告的种族-民族和性别。结果是被选为住院总医师。使用逻辑回归估计被选为住院总医师的可能性。我们测试了以下变量是否存在潜在混杂因素：调查年份、美国公民身份、医学院类型、住院医师的地理位置和阿尔法欧米茄阿尔法（Alpha Omega Alpha）状态。
结果
共纳入 5128 名住院医师。与白人住院医师相比，黑人住院医师被选为住院总医师的可能性低 21%（优势比，0.79；95%置信区间，0.65-0.96）。女性成为住院总医师的可能性比男性高 19%（优势比，1.19；95%置信区间，1.02-1.38）。当检查种族-民族和性别的交叉时，结果显示出一些异质性。在男性中，黑人被选为住院总医师的可能性最低（优势比，0.32；95%置信区间，0.17-0.63；参考白人男性），而在女性中，西班牙裔被选为住院总医师的可能性最低（优势比，0.69；95%置信区间，0.52-0.92；参考白人女性）。与黑人男性相比，白人女性被选为住院总医师的可能性几乎高出 4 倍（优势比，3.79；95%置信区间，1.97-7.29）。
结论
被选为住院总医师的可能性因种族-民族、性别以及这些因素的交叉而异。
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