227 Gender Coding in Physician Job Advertisements and Sex Disparities in Medical and Surgical Fields

Abstract

Research in engineering fields has shown that using masculine or feminine coded language in job advertisements affects the proportion of men vs. women applying for those jobs, and that changing such wording alters the applicant pool in a way that improves diversity. In medicine, there are fields that are traditionally heavily male-dominated, such as surgery, and fields that attract more women, such as family practice, obstetrics, and pediatrics. We sought to determine if sex coded language in physician job advertisements reflects the sex disparities in medical and surgical fields. This was a cross sectional study of all physician job advertisements on 16 academic and non-academic medical job databases from September 2020-February 2021. Job advertisements were cut and pasted verbatim for the purposes of the study. Using a sex decoder program based on prior research by Gaucher et al on sexed wording in job advertisements, we analyzed each job to determine if the job advertisement contained any sex coded words and if the advertisement was overall highly masculine, masculine, highly feminine, feminine, or neutral. Region of the country, requirement for subspecialty training, and field (emergency medicine (EM), internal medicine (IM), surgery, pediatrics, obstetrics (OB), family practice (FP), and multiple fields) were also recorded. Data was reviewed and duplicate listings were deleted. Data were analyzed using descriptive statistics and logistic regression. The study was reviewed by the IRB and found to be exempt. 509 jobs were posted to the study websites during the study period. The jobs included 193 IM jobs (37.9%), 89 surgery jobs (17.5%), 74 EM jobs (14.5%), 63 FP jobs (12.4%), 41 pediatric jobs (8.1%), 29 OB jobs (5.7%). 43.6% of job advertisements coded as masculine or strongly masculine (M), 35.4% coded as feminine or strongly feminine (F), 20.8% coded as neutral (N). Of those neutral coded jobs, only 19 advertisements (3.7%) had no sex coded language at all. Region of the country and requirement for subspecialty training were not associated with sex coding. Field of practice was predictive of sex coding, with pediatrics (29.3%M, 54.8%F) and OB (24.1%M, 41.4%F) more commonly having feminine coded language and IM (48.7%M, 31.6%F) and EM (54.8%M, 25%F) having disproportionately more masculine coded job advertisements (p=0.001). Surgery (36%M, 39.3%F) and FP (39.7%M, 39.7%F) were more balanced. This is consistent with the sex proportion of some fields, such as OB and pediatrics, which have 59% and 64% women in practice respectively, and EM and IM, which have 72% and 61% men in practice, respectively. Surgical job advertisements are less commonly masculine coded, although the specialty is 78% male. Job advertisements for medical positions often contain sex coded language that may reduce the diversity of the applicant pool. For most medical fields, this sexed language is in keeping with the sex make-up of the specialty. Further studies should focus on whether modification of recruitment materials impacts applicant pool diversity.