Maffei Jenna Bates, Johny Angeline, Park Yoon Soo, Holmboe Eric, Hogan Sean O, Badalato Gina M, Kraft Kate H, Mayer Wesley A
Scott Department of Urology, Baylor College of Medicine, Houston, TX.
Department of Medical Education, University of Illinois College of Medicine, Chicago, IL; Accreditation Council for Graduate Medical Education, Chicago, IL.
J Surg Educ. 2025 Jun;82(6):103515. doi: 10.1016/j.jsurg.2025.103515. Epub 2025 May 2.
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.
`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).
This study included all graduating trainees from ACGME-accredited urology residencies over an 11-year period.
We analyzed 3,335 graduating residents from 145 urology programs over 11 years, between 2013 and 2023.
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.
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.
本研究首次在全国范围内考察了性别与泌尿外科住院医师病例记录分布之间的关系。我们假设女性泌尿外科住院医师记录的总体病例数较少，并且在各性别间的索引病例类别中存在差异。
本研究对一个新型数据库进行了回顾性分析，该数据库整合了研究生医学教育认证委员会（ACGME）提供的多个国家数据系统中的住院医师特征。
本研究纳入了11年间所有从ACGME认证的泌尿外科住院医师项目毕业的学员。
我们分析了2013年至2023年11年间来自145个泌尿外科项目的3335名毕业住院医师。
女性泌尿外科住院医师的比例在21%至28%之间，且随时间无显著增加（p = 0.575）。每位住院医师记录的病例总数从2013年的平均1259例（标准差 = 288）增加到2023年的1624例（标准差 = 378）（p < 0.001）。女性住院医师记录的总体病例数显著较少：女性为1374例（标准差 = 330），男性为1423例（标准差 = 365）（p < 0.001）。在11年中的4年里，女性住院医师记录的病例数显著较少，其中3年是在过去5年。男性记录的普通泌尿外科、内镜检查和肿瘤病例显著多于女性（所有p值均 < 0.001）。仅在任何一年中，女性记录的儿科和重建病例更多。
11年间女性泌尿外科毕业生的数量在统计学上没有变化。尽管达到了所需的最低病例数，但女性记录的病例总数明显少于男性，且在过去5年中有3年如此。鉴于外科医生的病例数量与患者预后之间的相关性，解决这一明显的性别差距至关重要。
