Background
Gender inequity is a major focus of efforts to improve the quality of surgical training for all trainees. Significant strides have been made in recent years to improve the gender balance of surgical trainees in Aotearoa New Zealand and Australia. Forerunning some of the other specialties, the New Zealand cohort of Plastic and Reconstructive Surgery (NZ-PRS) Trainees achieved gender balance in 2013. Prior studies have demonstrated that several facets of surgical training include implicit bias against female trainees – including the concept of surgical autonomy. We sought to determine if the previously described bias against female trainees’ surgical autonomy persistent in the gender balanced cohort of NZ-PRS trainees.
Methods
We conducted a retrospective audit of NZ-PRS trainees’ logbooks covering 6.5 training years, from December 2014 to July 2020. We analysed the self-reported logbook data for level of supervision, case complexity and case volumes. Multivariate analysis was used to compare outcomes between male and female trainees.
Results
38 Trainees were included in the study (58% female), with a total of 81,178 cases recorded over the study period. Between male and female trainees, no statistically significant difference in overall surgical autonomy was identified, and case complexity was similar throughout training. Male trainees reported more cases than female trainees, particularly simple cases.
Discussion
Male and female trainees in this cohort reported similar case complexity and levels of supervision throughout the study period. The negative impact of female gender on surgical autonomy identified in literature from other specialties was not identified in this cohort.
Conclusions
The findings suggest that where women make up an equal proportion of trainees, the implicit gender bias within surgical training may be ameliorated.