Differences in Emergency Medicine Resident Procedural Reporting by Gender in the United States

Abstract

Background Studies across specialties have demonstrated gender disparities in feedback, learner assessments, and operative cases. However, data are limited on differences in numbers of procedures among residents. Objective To quantify the association between gender and the number of procedures reported among emergency medicine (EM) residents. Methods We conducted a retrospective review of procedural differences by self-identified gender among graduating EM residents at 8 separate programs over a 10-year period (2013 to 2022). Sites were selected to ensure diversity of program length, program type, and geography. Residents from combined training programs, those who did not complete their full training at that institution, and those who did not have data available were excluded. We calculated the mean, SD, median, and IQR for each procedure by gender. We compared reported procedures by gender using linear regression, controlling for institution, and performed a sensitivity analysis excluding outlier residents with procedure totals >3 SD from the mean. Results We collected data from 914 residents, with 880 (96.3%) meeting inclusion criteria. There were 358 (40.7%) women and 522 (59.3%) men. The most common procedures were point-of-care ultrasound, adult medical resuscitation, adult trauma resuscitation, and intubations. After adjusting for institutions, the number of dislocation reductions, chest tube insertions, and sedations were higher for men. The sensitivity analysis findings were stable except for central lines, which were also more common in men. Conclusions In a national sample of EM programs, there were increased numbers of dislocation reductions, chest tube insertions, and sedations reported by men compared with women.