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J Am Coll Surg. 2017 Feb;224(2):126-136.e2. doi: 10.1016/j.jamcollsurg.2016.10.043. Epub 2016 Nov 21.

Gender-Based Differences in Surgical Residents' Perceptions of Patient Safety, Continuity of Care, and Well-Being: An Analysis from the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial.

Author information

  • 1Surgical Outcomes and Quality Improvement Center, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL; American College of Surgeons, Chicago, IL; Department of Surgery, Loyola University Medical Center, Maywood, IL.
  • 2Surgical Outcomes and Quality Improvement Center, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
  • 3Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • 4Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • 5Surgical Outcomes and Quality Improvement Center, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL; American College of Surgeons, Chicago, IL. Electronic address: k-bilimoria@northwestern.edu.

Abstract

BACKGROUND:

Little is known about gender differences in residency training experiences and whether duty hour policies affect these differences. Using data from the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial, we examined gender differences in surgical resident perceptions of patient safety, education, health and well-being, and job satisfaction, and assessed whether duty hour policies affected gender differences.

STUDY DESIGN:

We compared proportions of male and female residents expressing dissatisfaction or perceiving a negative effect of duty hours on aspects of residency training (ie patient safety, resident education, well-being, job satisfaction) overall and by PGY. Logistic regression models with robust clustered SEs were used to test for significant gender differences and interaction effects of duty hour policies on gender differences.

RESULTS:

Female PGY2 to 3 residents were more likely than males to be dissatisfied with patient safety (odds ratio [OR] = 2.50; 95% CI, 1.29-4.84) and to perceive a negative effect of duty hours on most health and well-being outcomes (OR = 1.51-2.10; all p < 0.05). Female PGY4 to 5 residents were more likely to be dissatisfied with resident education (OR = 1.56; 95% CI, 1.03-2.35) and time for rest (OR = 1.55; 95% CI, 1.05-2.28) than males. Flexible duty hours reduced gender differences in career dissatisfaction among interns (p = 0.028), but widened gender differences in negative perceptions of duty hours on patient safety (p < 0.001), most health and well-being outcomes (p < 0.05), and outcomes related to job satisfaction (p < 0.05) among PGY2 to 3 residents.

CONCLUSIONS:

Gender differences exist in perceptions of surgical residency. These differences vary across cohorts and can be influenced by duty hour policies.

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