Gender differences in pediatric urology fellowship and job selection
Lily C. Wang, MD, PhD1, Angela G. Mittal, MD1, Kathleen Puttmann, MD1, Nicolette Janzen, MD1, Lane S. Palmer, MD2, Elizabeth B. Yerkes, MD3, Sheila L. Ryan, JD1, Edmond T. Gonzales, MD1, David R. Roth, MD1, Chester J. Koh, MD1.
1Texas Children's Hospital, Houston, TX, USA, 2Cohen Children's Medical Center of New York, New Hyde Park, NY, USA, 3Lurie's Children's Hospital, Chicago, IL, USA.
BACKGROUND: Women are entering the subspecialty of pediatric urology at an accelerated rate. Gender differences may account for the different rates of selecting a fellowship in pediatric urology and may also affect practice patterns. We hypothesize that understanding gender differences in pediatric urology fellowship decision and job selection will help the pediatric urology specialty anticipate the changing needs in the workforce and in fellowship training.
METHODS: A 47-question electronic survey consisting of questions regarding demographics, residency training, factors influencing fellowship and job selection was distributed to current fellows and recent graduates in pediatric urology in May 2017 and survey responses were analyzed using Chi-square testing and Wilcox Rank Sum tests.
RESULTS: 111 recent and current fellows were contacted and 80 (72%) completed the survey (comprised of 55% female (F), 45% male (M) and 61% current fellows and 39% recent fellows). Respondents rated factors important in choosing pediatric urology on a scale of 1-5 (1-Not important, 5-Extremely important) and the top three for both genders were 1-working with children, 2-influential mentors, and 3-bread and butter cases such as inguinal orchiopexy. During residency, 92.5% respondents reported having influential mentors in pediatric urology. However, mentorship was more important in fellowship choice for males than females (3.64 F, 4.11 M, p-value=0.048). While 54% of respondents reported having both male and female mentors, 44.6% reported having only male mentors.Rating factors important in job choice on a scale of 1-5, respondents reported the top factors as 1-rapport with partners/mentorship (4.47), 2-geography/family preferences (4.32), and 3-participation in mentoring/teaching (3.75). While the majority of job selection criteria was rated similarly between genders, females rated call schedule higher than males (3.45 F, 2.94 M, p-value=0.009). Although a similar percentage of females and males (75% F, 78% M, p-value=0.868) sought primarily academic positions, a smaller proportion of females accepted academic positions (52% F, 72% M, p-value 0.26) and females reported lower satisfaction regarding the availability of jobs (3.09 F, 3.72 M, p-value=0.034), particularly in academic positions (3.08 F, 3.69 M, p-value = 0.06).
CONCLUSIONS: While significant gender differences in fellowship and job selection may exist in other fields, we found that women and men choose pediatric urology fellowships and jobs using similar criteria, which include work-life balance. Gender differences exist in the influence of mentors, indicating a need for more female mentors which should met by the increasing number of females entering the field. In addition, women were less satisfied with the availability of jobs, particularly academic jobs than men, which warrants further investigation.
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