The Role of Gender in Perceived Vascular Surgical and Cardiovascular Residency Training Experience: A Canadian Experience

In medicine, there is an underrepresentation of women and individuals from visible minority (VM) groups. Importantly, several studies have highlighted higher prevalence of gender and race-based discrimination towards these groups in residency training programs. This study attempted to understand the impact of gender and VM status on training experiences among residents and fellows of vascular surgery, cardiac surgery, and cardiology (CV) programs in Canada. This prospective survey-based study utilized a previously validated 95-item questionnaire. It was emailed to residents and fellows enrolled in Canadian CV training programs from November 2021 to January 2023 using SurveyMonkey. Of the estimated 198 CV residents invited, a total of 80 (40.4%) completed the survey. The majority of respondents were CMGs (77.5%). From the respondents, 42.5% identified as a VM, 32.5% as an immigrant, and 51.2% were female. A Kruskal-Wallis analysis demonstrated that compared with males, females in CV programs reported a statistically significant lack of gender diversity in clinical staff (H(2) = 8.348; P = .015), with a mean rank score of 41.42 for females and 27.67 for males. Similarly, a statistically significant proportion of females reported receiving less training opportunities in clinical and operating room environments (H(2) = 9.867; P = .007), with a mean rank score of 36.27 for females, 24.10 for males. Vascular surgery residents who identified as VM reported that more patients were often surprised that they were a surgeon-in-training (P = .05), whereas female vascular surgery residents who identified as VM reported that they had been approached more often with unsolicited personal life advice by colleagues (attendings, peers, nurses) (P = .05). This study for the first time provides a Canadian perspective on the role of gender, and VM status on cardiovascular specialty training. For vascular surgical residents, these findings would suggest that special consideration should be given to creating new strategies focused on gender to improve the training experience of at-risk residents.