I n Canada, the number of women admitted to medical schools has exceeded the number of men for 25 years. 1 Despite over 2 decades of numerical parity, evidence shows that female physicians continue to be underrepresented in academia, leadership and administration in Canada and worldwide. 2-9 Substantial evidence exists that female phys icians are held to a higher standard than their male peers in evaluations, assessments, grant applications, publishing and reference letters. 10-19 Although there is evidence for explicit bias against female physicians, 20-22 most bias is implicit, mani festing in subtle ways such as word choice when describing trainees and differential access to operating time. 11,23-28 Awards from residency associations allow residents to rec ognize physicians for their contributions. Unlike awards issued by other organizations, awards from residency associa tions reflect the values of residents, who may have different levels of bias than practising physicians. These awards may contribute to promotion, hiring, prestige and recognition. 29,30 Previous studies that have examined award recipients by sex have focused on awards given to staff physicians by national societies. 29,31-34 We sought to evaluate whether male staff and resident physicians are more likely to receive an award from Canadian residency associations than female physicians. Methods We conducted a retrospective observational study of award recipient sex for staff and resident physicians who received awards from Canadian residency associations for 2000-2018. Setting In Canada, there are 17 medical faculties distributed across 10 provinces: 6 in Ontario, 4 in Quebec, 2 in Alberta, and 1 each in Newfoundland and Labrador, the Maritime provinces, Manitoba, Saskatchewan and British Columbia. There are 8 provincial or regional residency associations that represent