The Effect of Gender on Case Log Volumes for Urology Residents: An 11 Year National Study.

OBJECTIVE

This study is the first examination of the relationship between gender and urology residency case log distribution on a national scale. We hypothesized that female urology residents log fewer overall cases and discrepancies exist within index case categories across genders.

DESIGN

`This study involved a retrospective review of a novel database integrating resident characteristics from multiple national data systems provided by the Accreditation Council for Graduate Medical Education (ACGME).

SETTING

This study included all graduating trainees from ACGME-accredited urology residencies over an 11-year period.

PARTICIPANTS

We analyzed 3,335 graduating residents from 145 urology programs over 11 years, between 2013 and 2023.

RESULTS

The percentage of female urology residents ranged from 21% to 28%, with no significant increase over time (p = 0.575). Total cases per resident increased from an average of 1259 (SD = 288) in 2013 to 1624 (SD = 378) in 2023 (p < 0.001). Female residents logged significantly fewer cases overall: 1,374 (SD = 330) vs. 1423 (SD = 365) for male residents (p < 0.001). Female residents logged significantly fewer cases in 4 of the 11 years, 3 of which were in the past 5 years. Males logged significantly more general urology, endoscopy, and oncology cases than females (p < 0.001 for all). Only pediatrics and reconstruction cases were logged more by females in any year.

CONCLUSIONS

The number of female urology graduates was statistically unchanged over 11 years. Although meeting required case minimums, females logged significantly fewer cases than males overall and in three of the last 5 years. Addressing this apparent gender gap is essential given the correlation between surgeons' case volumes and patient outcomes.