Mannion Samantha, Halvorsen Andrew J, Andersen Carl, Leasure Emily, Bonnes Sara
Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Internal Medicine Residency Program, Mayo Clinic, Rochester, MN, USA.
J Gen Intern Med. 2025 Feb;40(2):318-324. doi: 10.1007/s11606-024-09075-0. Epub 2024 Oct 16.
Patients often prefer gender concordance when choosing a primary care practitioner. In a trainee setting, this may lead to unequal training opportunities for male and female resident physicians. Residency leadership may be interested in ways to promote balance in patient empanelment.
To assess the efficacy of an intervention to equalize imbalance in patient gender on resident primary care panels.
Observational cohort study.
Categorial internal medicine residents beginning residency in 2020.
The panels of internal medicine residents were manually rebalanced at the beginning of training for a new cohort of residents with the goal of having similar numbers of male and female patients on each resident's panel.
Panel data was observed for 2 years following intervention. Number of male patients, number of female patients, and overall panel size were compared between male and female residents at baseline, 6 months, and 24 months.
The analysis included 28 female residents and 20 male residents. After rebalancing, baseline panels had similar numbers of male patients (median of 50 on both male and female residents' panels; average panel 54.7% male) and female patients (median of 41.5 on female residents' panels and 41 on male residents' panels; average panel 45.3% female). At the end of the follow-up period, a significant difference was observed in the median number of male patients (59.5 and 43.5; p < 0.001) and female patients (33.5 and 48.5; p < 0.001) between male and female residents, but no difference was observed in overall panel size.
A steady drift towards gender concordance was observed over 2 years following a rebalancing intervention. Program leadership overseeing primary care empanelment for resident physicians may consider periodic rebalancing of panels in addition to other interventions to ensure equal training opportunities and best prepare residents for future practice.
患者在选择初级保健医生时通常更倾向于性别匹配。在实习环境中，这可能导致男性和女性住院医师的培训机会不平等。住院医师培训项目的领导可能有兴趣寻找促进患者分配平衡的方法。
评估一项干预措施在使住院医师初级保健患者性别失衡达到均衡方面的效果。
观察性队列研究。
2020年开始住院医师培训的内科分类住院医师。
在内科住院医师培训开始时，人工重新平衡新一批住院医师的患者分配，目标是每个住院医师的患者小组中男性和女性患者数量相似。
干预后观察2年的患者小组数据。比较男性和女性住院医师在基线、6个月和24个月时的男性患者数量、女性患者数量以及患者小组的总体规模。
分析纳入了28名女性住院医师和20名男性住院医师。重新平衡后，基线患者小组中的男性患者数量相似（男性和女性住院医师的患者小组中位数均为50；平均患者小组男性占54.7%），女性患者数量也相似（女性住院医师患者小组中位数为41.5，男性住院医师患者小组中位数为41；平均患者小组女性占45.3%）。在随访期结束时，男性和女性住院医师的男性患者中位数（分别为59.5和43.5；p<0.001）和女性患者中位数（分别为33.5和48.5；p<0.001）存在显著差异，但患者小组的总体规模没有差异。
在重新平衡干预后的2年中，观察到患者性别匹配有稳步的变化趋势。监督住院医师初级保健患者分配的项目领导除了采取其他干预措施外，可能还应考虑定期重新平衡患者小组，以确保平等的培训机会，并使住院医师为未来的实践做好最佳准备。
