18. Resident Perception of Gender Disparities in Plastic Surgery Training

Background: Multi-institution prospective studies in cardiothoracic and general surgery have demonstrated that female residents are granted less operative autonomy than male residents. Female residents were scored lower than male residents by male attendings in a multi-institution study in plastic surgery. These findings are deeply concerning, especially as we move toward competency based training. Our study sought to better understand resident-perceived gender disparities in surgical training to inform educators and help close the gender autonomy gap. Methods: A survey was constructed based on data from a pilot study at our institution and was approved for distribution by ACAPS. The survey was distributed to U.S. Plastic Surgery Program Directors for distribution to their residents. Results: Seventy-three residents answered the survey. Of the approximately 1000 US plastic surgery residents, the total number of residents who received the survey is unknown. Respondents were 46% female and 53% male. The majority of female respondents reported that women were treated differently from men in training (73% vs 30%, p<0.002). Differences in treatment include differential treatment by scrub technicians, female residents working harder than male residents to earn the same respect, and faculty underestimating female residents’ abilities. Female residents also reported experiencing verbal abuse from attendings more often (52%) than male residents (21%), p<0.02. Female residents are more likely to ruminate on harsh criticism (77%) than male residents (36%), p<0.002. Female residents feel less comfortable asking questions in the OR, with 39% of female residents feeling comfortable asking questions with all faculty, versus 66% of male residents, p<0.05. Only 40% of female residents versus 94% of male residents believe that female and male residents are given the same operative autonomy, p<0.001. Conclusion: The majority of female plastic surgery residents report gender bias and less operative autonomy in training. As women compose nearly half of trainees, teaching faculty should be aware of implicit bias and consciously work to eliminate gender disparities.