How gender disparities affect otolaryngology specialty selection: an international cross-sectional survey

Abstract

Introduction: Most studies evaluating gender disparities in surgical specialties as a career choice are limited to high-income countries and have largely evaluated surgical subspecialties in aggregate. Objective: This study aimed to describe gender-based differences in otolaryngology specialty selection amongst medical students, trainees, and attendings/consultants across both low- and middle-income (LMICs) and high-income countries. Materials and methods: An online cross-sectional survey with 2 arms was administered. The first arm asked medical students about gender-related factors that impact interest in otolaryngology. The second arm asked otolaryngology residents and attendings about gender-related factors that impacted otolaryngology specialty selection and career satisfaction. Descriptive statistics were used to summarize patient demographics and survey responses. Responses were compared by gender using χ2 and Fisher Exact tests. Subgroup analyses between gender and country income status were also conducted. Results: There were 67 medical student respondents (45% male, 54% female, 1.5% nonbinary) and 38 attending/consultant or resident respondents (47% male, 53% female, 0% nonbinary). Thirty-six (36%) of medical students were from LMICs, while 45% of attending/residents were from LMICs. Overall, the results demonstrated gender discrimination and gender-based barriers against female medical students considering otolaryngology and otolaryngologists worldwide that may not be recognized by their male colleagues. Conclusion: The results of these surveys highlight the need for continued education and anti-discrimination policy and advocacy in otolaryngology globally. This information can be leveraged to inform regionally specific research on gender disparities in the otolaryngology workforce and provide a foundation for initiatives to address gender disparities in otolaryngology programs.

‘Seeing is believing’ – gender disparities in otolaryngology-head and neck surgery in Africa: a narrative review

“…In another study conducted by among medical students from both HICs and LMICs, >50% of respondents were interested in pursuing OHNS as a career, but females were twice as unlikely to be interested in OHNS compared to male students [1 ▪▪ ].…”

“…Nuss et al [1 ▪▪ ] reported that while a majority of male residents and attendings believed OHNS training is equally welcome to all genders, female attendings and residents did not believe this to be true. This further reinforces the unseen impact of gender disparities, especially when they are not discussed and actively dealt with.…”

“…In numerous LMICs, and particularly in Africa and Sub-Saharan Africa, culture influences perceptions and gender roles may significantly influence career progression. For example, Nuss et al [1 ▪▪ ] surveyed otolaryngologists from all over the world; among participants from LMICs, 75% of women vs. 6% of men were automatically assumed to be nurses, interns, or nonmedical practitioners by other medical personnel. This percentage was higher among patients and caretakers, who assumed 85% of the time that the female was a nurse, intern, or nonmedical practitioner [1 ▪▪ ].…”

“…Women assuming a medical career face continuous challenges. These obstacles include limited access to educational opportunities, difficulties entering medical schools, hardships in being accepted to residency programs, and discrimination experienced during residency training and in the early career years as a consultant or surgeon until the highest echelons of the academic medical career [1 ▪▪ ,2,3].…”

“…Gender-based disparities exist in all medical disciplines, including otolaryngology – head and neck surgery (OHNS) and are present worldwide in both high-income countries (HICs) and low- and middle-income countries (LMICs) [1 ▪▪ ,2,4]. However, these disparities are accentuated in LMICs as compared to HICs and more so in Africa [1 ▪▪ ].…”