Gender Differences in Case Volume among Ophthalmology Residents

Dan Gong, Bryan J. Winn, Casey J. Beal, Preston H. Blomquist, Royce W. Chen, Susan M. Culican, Lora R. Dagi Glass, Gary F. Domeracki, Jeffrey M. Goshe, Jeremy K. Jones, Albert S. Khouri, Gary L. Legault, Timothy J. Martin, Kelly T. Mitchell, Ayman Naseri, Thomas A. Oetting, Joshua H. Olson, Jeff H. Pettey, Maria A. Reinoso, Andrew L. Reynolds & 8 others R. Michael Siatkowski, Jeffrey R. Soohoo, Grace Sun, Misha Syed, Jeremiah P. Tao, Parisa Taravati, Darrell Wudunn, Lama A. Al-Aswad

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Importance: Although almost equal numbers of male and female medical students enter into ophthalmology residency programs, whether they have similar surgical experiences during training is unclear. Objective: To determine differences for cataract surgery and total procedural volume between male and female residents during ophthalmology residency. Design, Setting, Participants: This retrospective, longitudinal analysis of resident case logs from 24 US ophthalmology residency programs spanned July 2005 to June 2017. A total of 1271 residents were included. Data were analyzed from August 12, 2017, through April 4, 2018. Main Outcomes and Measures: Variables analyzed included mean volumes of cataract surgery and total procedures, resident gender, and maternity or paternity leave status. Results: Among the 1271 residents included in the analysis (815 men [64.1%]), being female was associated with performing fewer cataract operations and total procedures. Male residents performed a mean (SD) of 176.7 (66.2) cataract operations, and female residents performed a mean (SD) of 161.7 (56.2) (mean difference, -15.0 [95% CI, -22.2 to -7.8]; P <.001); men performed a mean (SD) of 509.4 (208.6) total procedures and women performed a mean (SD) of 451.3 (158.8) (mean difference, -58.1 [95% CI, -80.2 to -36.0]; P <.001). Eighty-five of 815 male residents (10.4%) and 71 of 456 female residents (15.6%) took parental leave. Male residents who took paternity leave performed a mean of 27.5 (95% CI, 13.3 to 41.6; P <.001) more cataract operations compared with men who did not take leave, but female residents who took maternity leave performed similar numbers of operations as women who did not take leave (mean difference, -2.0 [95% CI, -18.0 to 14.0]; P =.81). From 2005 to 2017, each additional year was associated with a 5.5 (95% CI, 4.4 to 6.7; P <.001) increase in cataract volume and 24.4 (95% CI, 20.9 to 27.8; P <.001) increase in total procedural volume. This increase was not different between genders for cataract procedure volume (β = -1.6 [95% CI, -3.7 to 0.4]; P =.11) but was different for total procedural volume such that the increase in total procedural volume over time for men was greater than that for women (β = -8.0 [95% CI, -14.0 to -2.1]; P =.008). Conclusions and Relevance: Female residents performed 7.8 to 22.2 fewer cataract operations and 36.0 to 80.2 fewer total procedures compared with their male counterparts from 2005 to 2017, a finding that warrants further exploration to ensure that residents have equivalent surgical training experiences during residency regardless of gender. However, this study included a limited number of programs (24 of 119 [20.2%]). Future research including all ophthalmology residency programs may minimize the selection bias issues present in this study.

Original languageEnglish (US)
JournalJAMA Ophthalmology
DOIs
StateAccepted/In press - Jan 1 2019

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Ophthalmology
Parental Leave
Cataract
Internship and Residency
Selection Bias
Medical Students
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Gong, D., Winn, B. J., Beal, C. J., Blomquist, P. H., Chen, R. W., Culican, S. M., ... Al-Aswad, L. A. (Accepted/In press). Gender Differences in Case Volume among Ophthalmology Residents. JAMA Ophthalmology. https://doi.org/10.1001/jamaophthalmol.2019.2427

Gender Differences in Case Volume among Ophthalmology Residents. / Gong, Dan; Winn, Bryan J.; Beal, Casey J.; Blomquist, Preston H.; Chen, Royce W.; Culican, Susan M.; Dagi Glass, Lora R.; Domeracki, Gary F.; Goshe, Jeffrey M.; Jones, Jeremy K.; Khouri, Albert S.; Legault, Gary L.; Martin, Timothy J.; Mitchell, Kelly T.; Naseri, Ayman; Oetting, Thomas A.; Olson, Joshua H.; Pettey, Jeff H.; Reinoso, Maria A.; Reynolds, Andrew L.; Siatkowski, R. Michael; Soohoo, Jeffrey R.; Sun, Grace; Syed, Misha; Tao, Jeremiah P.; Taravati, Parisa; Wudunn, Darrell; Al-Aswad, Lama A.

In: JAMA Ophthalmology, 01.01.2019.

Research output: Contribution to journalArticle

Gong, D, Winn, BJ, Beal, CJ, Blomquist, PH, Chen, RW, Culican, SM, Dagi Glass, LR, Domeracki, GF, Goshe, JM, Jones, JK, Khouri, AS, Legault, GL, Martin, TJ, Mitchell, KT, Naseri, A, Oetting, TA, Olson, JH, Pettey, JH, Reinoso, MA, Reynolds, AL, Siatkowski, RM, Soohoo, JR, Sun, G, Syed, M, Tao, JP, Taravati, P, Wudunn, D & Al-Aswad, LA 2019, 'Gender Differences in Case Volume among Ophthalmology Residents', JAMA Ophthalmology. https://doi.org/10.1001/jamaophthalmol.2019.2427
Gong, Dan ; Winn, Bryan J. ; Beal, Casey J. ; Blomquist, Preston H. ; Chen, Royce W. ; Culican, Susan M. ; Dagi Glass, Lora R. ; Domeracki, Gary F. ; Goshe, Jeffrey M. ; Jones, Jeremy K. ; Khouri, Albert S. ; Legault, Gary L. ; Martin, Timothy J. ; Mitchell, Kelly T. ; Naseri, Ayman ; Oetting, Thomas A. ; Olson, Joshua H. ; Pettey, Jeff H. ; Reinoso, Maria A. ; Reynolds, Andrew L. ; Siatkowski, R. Michael ; Soohoo, Jeffrey R. ; Sun, Grace ; Syed, Misha ; Tao, Jeremiah P. ; Taravati, Parisa ; Wudunn, Darrell ; Al-Aswad, Lama A. / Gender Differences in Case Volume among Ophthalmology Residents. In: JAMA Ophthalmology. 2019.
@article{d3bc30d0c1a1425d890d7ac05328f3df,
title = "Gender Differences in Case Volume among Ophthalmology Residents",
abstract = "Importance: Although almost equal numbers of male and female medical students enter into ophthalmology residency programs, whether they have similar surgical experiences during training is unclear. Objective: To determine differences for cataract surgery and total procedural volume between male and female residents during ophthalmology residency. Design, Setting, Participants: This retrospective, longitudinal analysis of resident case logs from 24 US ophthalmology residency programs spanned July 2005 to June 2017. A total of 1271 residents were included. Data were analyzed from August 12, 2017, through April 4, 2018. Main Outcomes and Measures: Variables analyzed included mean volumes of cataract surgery and total procedures, resident gender, and maternity or paternity leave status. Results: Among the 1271 residents included in the analysis (815 men [64.1{\%}]), being female was associated with performing fewer cataract operations and total procedures. Male residents performed a mean (SD) of 176.7 (66.2) cataract operations, and female residents performed a mean (SD) of 161.7 (56.2) (mean difference, -15.0 [95{\%} CI, -22.2 to -7.8]; P <.001); men performed a mean (SD) of 509.4 (208.6) total procedures and women performed a mean (SD) of 451.3 (158.8) (mean difference, -58.1 [95{\%} CI, -80.2 to -36.0]; P <.001). Eighty-five of 815 male residents (10.4{\%}) and 71 of 456 female residents (15.6{\%}) took parental leave. Male residents who took paternity leave performed a mean of 27.5 (95{\%} CI, 13.3 to 41.6; P <.001) more cataract operations compared with men who did not take leave, but female residents who took maternity leave performed similar numbers of operations as women who did not take leave (mean difference, -2.0 [95{\%} CI, -18.0 to 14.0]; P =.81). From 2005 to 2017, each additional year was associated with a 5.5 (95{\%} CI, 4.4 to 6.7; P <.001) increase in cataract volume and 24.4 (95{\%} CI, 20.9 to 27.8; P <.001) increase in total procedural volume. This increase was not different between genders for cataract procedure volume (β = -1.6 [95{\%} CI, -3.7 to 0.4]; P =.11) but was different for total procedural volume such that the increase in total procedural volume over time for men was greater than that for women (β = -8.0 [95{\%} CI, -14.0 to -2.1]; P =.008). Conclusions and Relevance: Female residents performed 7.8 to 22.2 fewer cataract operations and 36.0 to 80.2 fewer total procedures compared with their male counterparts from 2005 to 2017, a finding that warrants further exploration to ensure that residents have equivalent surgical training experiences during residency regardless of gender. However, this study included a limited number of programs (24 of 119 [20.2{\%}]). Future research including all ophthalmology residency programs may minimize the selection bias issues present in this study.",
author = "Dan Gong and Winn, {Bryan J.} and Beal, {Casey J.} and Blomquist, {Preston H.} and Chen, {Royce W.} and Culican, {Susan M.} and {Dagi Glass}, {Lora R.} and Domeracki, {Gary F.} and Goshe, {Jeffrey M.} and Jones, {Jeremy K.} and Khouri, {Albert S.} and Legault, {Gary L.} and Martin, {Timothy J.} and Mitchell, {Kelly T.} and Ayman Naseri and Oetting, {Thomas A.} and Olson, {Joshua H.} and Pettey, {Jeff H.} and Reinoso, {Maria A.} and Reynolds, {Andrew L.} and Siatkowski, {R. Michael} and Soohoo, {Jeffrey R.} and Grace Sun and Misha Syed and Tao, {Jeremiah P.} and Parisa Taravati and Darrell Wudunn and Al-Aswad, {Lama A.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1001/jamaophthalmol.2019.2427",
language = "English (US)",
journal = "JAMA Ophthalmology",
issn = "2168-6165",
publisher = "American Medical Association",

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TY - JOUR

T1 - Gender Differences in Case Volume among Ophthalmology Residents

AU - Gong, Dan

AU - Winn, Bryan J.

AU - Beal, Casey J.

AU - Blomquist, Preston H.

AU - Chen, Royce W.

AU - Culican, Susan M.

AU - Dagi Glass, Lora R.

AU - Domeracki, Gary F.

AU - Goshe, Jeffrey M.

AU - Jones, Jeremy K.

AU - Khouri, Albert S.

AU - Legault, Gary L.

AU - Martin, Timothy J.

AU - Mitchell, Kelly T.

AU - Naseri, Ayman

AU - Oetting, Thomas A.

AU - Olson, Joshua H.

AU - Pettey, Jeff H.

AU - Reinoso, Maria A.

AU - Reynolds, Andrew L.

AU - Siatkowski, R. Michael

AU - Soohoo, Jeffrey R.

AU - Sun, Grace

AU - Syed, Misha

AU - Tao, Jeremiah P.

AU - Taravati, Parisa

AU - Wudunn, Darrell

AU - Al-Aswad, Lama A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Importance: Although almost equal numbers of male and female medical students enter into ophthalmology residency programs, whether they have similar surgical experiences during training is unclear. Objective: To determine differences for cataract surgery and total procedural volume between male and female residents during ophthalmology residency. Design, Setting, Participants: This retrospective, longitudinal analysis of resident case logs from 24 US ophthalmology residency programs spanned July 2005 to June 2017. A total of 1271 residents were included. Data were analyzed from August 12, 2017, through April 4, 2018. Main Outcomes and Measures: Variables analyzed included mean volumes of cataract surgery and total procedures, resident gender, and maternity or paternity leave status. Results: Among the 1271 residents included in the analysis (815 men [64.1%]), being female was associated with performing fewer cataract operations and total procedures. Male residents performed a mean (SD) of 176.7 (66.2) cataract operations, and female residents performed a mean (SD) of 161.7 (56.2) (mean difference, -15.0 [95% CI, -22.2 to -7.8]; P <.001); men performed a mean (SD) of 509.4 (208.6) total procedures and women performed a mean (SD) of 451.3 (158.8) (mean difference, -58.1 [95% CI, -80.2 to -36.0]; P <.001). Eighty-five of 815 male residents (10.4%) and 71 of 456 female residents (15.6%) took parental leave. Male residents who took paternity leave performed a mean of 27.5 (95% CI, 13.3 to 41.6; P <.001) more cataract operations compared with men who did not take leave, but female residents who took maternity leave performed similar numbers of operations as women who did not take leave (mean difference, -2.0 [95% CI, -18.0 to 14.0]; P =.81). From 2005 to 2017, each additional year was associated with a 5.5 (95% CI, 4.4 to 6.7; P <.001) increase in cataract volume and 24.4 (95% CI, 20.9 to 27.8; P <.001) increase in total procedural volume. This increase was not different between genders for cataract procedure volume (β = -1.6 [95% CI, -3.7 to 0.4]; P =.11) but was different for total procedural volume such that the increase in total procedural volume over time for men was greater than that for women (β = -8.0 [95% CI, -14.0 to -2.1]; P =.008). Conclusions and Relevance: Female residents performed 7.8 to 22.2 fewer cataract operations and 36.0 to 80.2 fewer total procedures compared with their male counterparts from 2005 to 2017, a finding that warrants further exploration to ensure that residents have equivalent surgical training experiences during residency regardless of gender. However, this study included a limited number of programs (24 of 119 [20.2%]). Future research including all ophthalmology residency programs may minimize the selection bias issues present in this study.

AB - Importance: Although almost equal numbers of male and female medical students enter into ophthalmology residency programs, whether they have similar surgical experiences during training is unclear. Objective: To determine differences for cataract surgery and total procedural volume between male and female residents during ophthalmology residency. Design, Setting, Participants: This retrospective, longitudinal analysis of resident case logs from 24 US ophthalmology residency programs spanned July 2005 to June 2017. A total of 1271 residents were included. Data were analyzed from August 12, 2017, through April 4, 2018. Main Outcomes and Measures: Variables analyzed included mean volumes of cataract surgery and total procedures, resident gender, and maternity or paternity leave status. Results: Among the 1271 residents included in the analysis (815 men [64.1%]), being female was associated with performing fewer cataract operations and total procedures. Male residents performed a mean (SD) of 176.7 (66.2) cataract operations, and female residents performed a mean (SD) of 161.7 (56.2) (mean difference, -15.0 [95% CI, -22.2 to -7.8]; P <.001); men performed a mean (SD) of 509.4 (208.6) total procedures and women performed a mean (SD) of 451.3 (158.8) (mean difference, -58.1 [95% CI, -80.2 to -36.0]; P <.001). Eighty-five of 815 male residents (10.4%) and 71 of 456 female residents (15.6%) took parental leave. Male residents who took paternity leave performed a mean of 27.5 (95% CI, 13.3 to 41.6; P <.001) more cataract operations compared with men who did not take leave, but female residents who took maternity leave performed similar numbers of operations as women who did not take leave (mean difference, -2.0 [95% CI, -18.0 to 14.0]; P =.81). From 2005 to 2017, each additional year was associated with a 5.5 (95% CI, 4.4 to 6.7; P <.001) increase in cataract volume and 24.4 (95% CI, 20.9 to 27.8; P <.001) increase in total procedural volume. This increase was not different between genders for cataract procedure volume (β = -1.6 [95% CI, -3.7 to 0.4]; P =.11) but was different for total procedural volume such that the increase in total procedural volume over time for men was greater than that for women (β = -8.0 [95% CI, -14.0 to -2.1]; P =.008). Conclusions and Relevance: Female residents performed 7.8 to 22.2 fewer cataract operations and 36.0 to 80.2 fewer total procedures compared with their male counterparts from 2005 to 2017, a finding that warrants further exploration to ensure that residents have equivalent surgical training experiences during residency regardless of gender. However, this study included a limited number of programs (24 of 119 [20.2%]). Future research including all ophthalmology residency programs may minimize the selection bias issues present in this study.

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