K. A. Ban1,2,3, J. W. Chung1, R. S. Matulewicz1, R. R. Kelz4, A. R. Dahlke1, C. Quinn1, A. D. Yang1, K. Y. Bilimoria1,3 1Northwestern University,Surgical Outcomes And Quality Improvement Center (SOQIC), Department Of Surgery, Feinberg School Of Medicine,Chicago, IL, USA 2Loyola University Medical Center,Department Of Surgery,Maywood, IL, USA 3American College Of Surgeons,Chicago, IL, USA 4University Of Pennsylvania,Department Of Surgery, Perelman School Of Medicine,Philadelphia, PA, USA
Introduction: No studies have systematically investigated if gender differences exist in perceptions of residency training with respect to patient safety, resident education, wellbeing, and job satisfaction and if duty hour policies affect such gender differences. The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial collected novel survey data from all surgical residents on perceptions within these areas. Our objectives were to (1) compare male and female surgical resident perceptions of patient safety, resident education, wellbeing, and job satisfaction and (2) determine if duty hour policies affect gender differences in perception.
Methods: Using FIRST Trial resident survey data, we compared the proportion of male and female residents in categorical intern, junior (PGY 2-3), and senior (PGY 4-5) resident cohorts who expressed dissatisfaction (vs. neutrality or satisfaction) with dimensions of patient safety, resident education, and wellbeing or a perceived negative effect (vs. neutral or positive effect) of duty hours on patient safety, wellbeing, and job satisfaction. The association between dissatisfaction (or a perceived negative effect of duty hours), gender, duty hour policy, and the interaction between duty hour policy and gender was modeled using logistic regression with robust standard errors accounting for clustering of residents within programs.
Results:Comparing perception differences between males and females in each training level cohort, there were no significant differences among interns. Female junior residents were more likely to be dissatisfied with patient safety (OR 2.50, p=0.007) and overall wellbeing (OR 2.10, p<0.001) than males. Female senior residents were more likely to be dissatisfied with resident education (OR 1.56, p=0.035) than males. Comparing differences in gender perception differences between the standard and flexible duty hour arms in each training level cohort (i.e., significance of a gender by study arm interaction), female interns under standard duty hours were more likely to perceive a negative effect of duty hours on their satisfaction with the decision to become a surgeon than males, whereas female interns under flexible duty hours were less likely than males to perceive a negative effect (p=0.028). Among junior residents, females in both duty hour arms were more likely to perceive a negative effect of duty hours on patient safety and job satisfaction than males, and this gender difference was augmented under flexible duty hours (p<0.001 and p=0.007, respectively). For senior residents, there were no statistically significant differences in gender perception differences between the standard and flexible duty hour study arms.
Conclusion:Important gender differences may exist in perceptions of surgical residency regarding patient safety, resident education, wellbeing, and job satisfaction. These differences vary across cohorts and may be influenced by duty hour policies.