Gender differences in surgical case volume among ophthalmology trainees.

Gill, Hannah K; Niederer, Rachael L; Danesh-Meyer, Helen V

BACKGROUND The number of females in ophthalmology has steadily increased over recent decades. The aim of this study was to evaluate whether there is a difference in procedural volume and cataract surgery between male and female trainees in the Royal Australian and New Zealand College of Ophthalmologists (RANZCO). METHODS A longitudinal retrospective review of de-identified surgical RANZCO trainee logbook data from 2008 to 2020 was undertaken. Data from 241 trainee logbooks were analysed for: location of training, gender, date of commencement of training, maternity/paternity leave status, number of surgeries observed, assisted, supervised and unsupervised. Surgical cases were grouped as: 1) all surgical cases; 2) complete cataract cases; 3) partial cataract cases. RESULTS Among 241 trainees (40.7% females), 197 263 procedures were performed. Total surgical volume was 21.1% lower at 4 years for females (median 665.5 vs 843.5;p = 0.036). Completed cataract surgery was 21.5% lower at 18 months (median 87.5 vs 111.5; p = 0.022) and 41.7% lower at 4 years (median 216 vs 369;p < 0.001). Interrupted training was significantly more common in females (30.6% vs 0.7%;p < 0.001). However, linear regression analysis did not identify parental leave or duration as a significant predictor for number of completed cataracts (p = 0.206). Complication rate was not different between males and females(p = 0.35). CONCLUSIONS Female trainees completed 41.7% fewer cataract operations at the end of their training compared to male counterparts with the gap widening between years 1 to 4 of training. The current data demonstrates that female and male RANZCO trainees are not receiving equivalent operating experiences. This article is protected by copyright. All rights reserved.