What explains the "gendered reputation" of residency subjects? : Reasons for gendered specialty selection and careers in spine-surgery residency programs-compared to a"female" specialty

Abstract

Currently, the proportion of women in academic education and residency is predominant, but specialty-specific distribution of leading positions is partly reciprocal (orthopedics/surgery). Are there any differences that indicate agender-dependent redistribution in leadership positions already in the selection of postgraduate training? Online survey with orthopedics/trauma surgery (OUC) and neurosurgery (NCH) residents. Comparison with gynecology (GYN). Statistical analysis, mean in percent, statistical differences using t‑ or chi2-test (significance level α = 0,05). Returned questionnaire = 277, complete participation = 250. Female residents: OUC:52%, NCH:57%, GYN:85%. Atotal of 49% were told in medical school that asubject was inappropriate for gender reasons (f57-76%, m10-33%). The most frequent reason for asubject: all = "operating activity". The second most frequent reason: OUC-f = "good working atmosphere", OUC-m = "establishment", NCH-f = "career" and "good working atmosphere", NCH-m = "good working atmosphere", GYN-f = "establishment", GYN-m = "career". The most frequent reason against: OUC/GYN = "hardly any possibility to become established", NCH = "negative leadership style by superiors". For female residents in OUC/NCH, work/family balance had the smallest influence on the choice of specialty. Their subjective evaluation of compatibility was significantly the worst, and overall OUC/NCH was significantly worse than GYN. Although female residents in NCH were more likely to justify the specialty choice based on career goals, male residents in OUC/NCH were more likely to aim for ahigher hierarchical position. The results of this study emphasize that disciplines receive agender-specific conditioning already at the undergraduate level, which has aclear impact on the choice of specialty. The image in this regard needs to be reconsidered, as even surgical subjects will predictably have to rely on more female specialists.