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Evaluation of Emergency Medicine Residents Points to Gender Bias

Evaluation of Emergency Medicine Residents Points to Gender Bias
Author Information (click to view)

University of Chicago Medical Center


University of Chicago Medical Center (click to view)

University of Chicago Medical Center

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Faculty ratings of female ER docs fall behind males as training advances.

Although female doctors training to become emergency medicine specialists scored as well as their male colleagues during the first year of their three-year programs, by the end of the third year, male residents, on average, received higher evaluations on all 23 emergency medicine training categories – including medical knowledge, patient safety, team management and communication – than female residents.

The gap emerged early in the second year of training and steadily widened until graduation. By the end of the third and final year of residency, evaluations of female physicians placed them three to four months behind male colleagues in the same training programs.

“Women are already underrepresented in the highly competitive environment of academic medicine, and the period of greatest loss is during and shortly after residency,” said the study’s senior author, Vineet Arora, MD, associate professor of medicine at the University of Chicago.


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The study, published March 6, 2017, in JAMA Internal Medicine, included 359 emergency medicine residents – medical school graduates beginning advanced training in the specialty. One third (122) of the residents were female; two-thirds (237) were male. About a third of the faculty physicians who evaluated the trainees were female (91) and two-thirds were male (194). Male and female faculty members evaluated residents similarly, consistently giving female residents lower scores throughout residency years two and three.

From July 1, 2013, to July 1, 2015, the researchers collected 33,456 “milestone” evaluations, about 90 for each of the physicians in training. Milestone evaluations are detailed, direct observations by emergency medical faculty of residents performing 23 sets of tasks – known as subcompetencies. These include basic skills such as diagnosis and medical knowledge, as well as specific procedures, such as emergency stabilization, airway management or vascular access.

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