Gender-based Disparity Exists in the Surgical Experience of Female and Male Urology Residents

OBJECTIVE

To determine if a discrepancy exists in the number and type of cases logged between female and male urology residents.

MATERIALS AND METHODS

ACGME case log data from 13 urology residency programs was collected from 2007 to 2020. The number and type of cases for each resident were recorded and correlated with resident gender and year of graduation. The median, 25th and 75th percentiles number of cases were calculated by gender, and then compared between female and male residents using Wilcoxon rank sum test.

RESULTS

A total of 473 residents were included in the study, 100 (21%) were female. Female residents completed significantly fewer cases, 2174, compared to male residents, 2273 (P = .038). Analysis by case type revealed male residents completed significantly more general urology (526 vs 571, P = .011) and oncology cases (261 vs 280, P = .026). Additionally, female residents had a 1.3-fold increased odds of logging a case in the assistant role than male residents (95% confidence interval: 1.27-1.34, P < .001).

CONCLUSION

Gender-based disparity exists within the urology training of female and male residents. Male residents logged nearly 100 more cases than female residents over 4years, with significant differences in certain case subtypes and resident roles. The ACGME works to provide an equal training environment for all residents. Addressing this finding within individual training programs is critical.

Linguistic Differences Based on Gender and Race in Urology Application Personal Statements: A Comparison of 2017 and 2023 Applications

While diversity and inclusion efforts have increased in urology, comparative analysis of personal statements from 2016-2017 and 2022-2023 residency applications showed few linguistic changes over time by gender or race/ethnicity. These results suggest the need for directed efforts to engage, mentor, and coach females and underrepresented minorities during medical school and the urology application process.

The LEGO™ Exercise: An Assessment of Core Competencies in Urology Residency Interviews

BACKGROUND

In competitive residency specialties such as Urology, it has become increasingly challenging to differentiate similarly qualified applicants. Residency interviews are utilized to rank applicants, yet they are often biased and do not explicitly address ACGME core competencies.

OBJECTIVE

We hypothesized a team-based exercise in the urology residency interview centered on building LEGOs assesses core competences.

DESIGN

From 2014-2017, students interviewing for urology residency at two institutions participated in a LEGO™ building activity. Applicants were assigned to "architect"- describing how to construct a structure - or "builder" - constructing the same structure with pieces-using only verbal cues to assemble the structure. Participants were graded using a rubric assessing competencies of interpersonal communication, problem-based learning, professionalism, and manual dexterity (indicator of procedural skill). The total minimum score was 16 and maximum was 80.

SETTING

The study took place at two tertiary referral centers: University of Michigan Medical School in Ann Arbor, MI, and University of Utah School of Medicine in Salt Lake City, UT.

PARTICIPANTS

A total of 176 applicants participated, comprised of applicants interviewing for urology residency at two institutions during the study timeframe.

RESULTS

For architects and builders, there was a maximum score of 80, and minimum of 34 and 32, respectively. Both distributions show a right shift with mean scores of 64.3 and 65.9, and median scores of 69 and 65.5. Successful pairs excelled with consistent nomenclature and clear directionality. Ineffective pairs miscommunicated with false affirmations, inconsistent nomenclature, and lack of patience.

CONCLUSIONS

The LEGO™ exercise allowed for standardized assessment of applicants based on ACGME core competencies. The rubric identified poor performers who do not rise to the challenge of a team-based task.