xRead - Mentorship in Otolaryngology Trainees (March 2026)

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Ear, Nose & Throat Journal 00(0)

fellowship directorships, and less than 5% of department chair positions. 4 The only specialty with a lower represen tation of women in department chair positions in Orthopedic Surgery, with only 1 female department chair (0.8%) as of 2019. 2 Although improvements have been made in the number of women medical students and OHNS residents, the lower numbers of women OHNS faculty in leadership positions may indicate that the promotion of women in OHNS is lagging. Factors such as higher burnout rates, mistreat ment of women surgeons, and lack of women mentors are frequently cited as reasons for suboptimal retainment and promotion in most surgical specialties. 6-8 The importance of women mentors has been well dem onstrated in academic medicine. 8,9 Women medical stu dents are more likely to specialize in OHNS when their medical school has full-time OHNS women faculty. These students are also more likely to choose a residency pro gram with a higher proportion of women residents across all specialties. 9 Another recent study demonstrated a sig nificant correlation between plastic surgery faculty gender and plastic surgery resident gender. 10 Early career women faculty frequently cite a lack of female role models as a barrier to promotion and voice the importance of same-sex mentorship more frequently than their male counterparts. 7,8 Despite this, to our knowledge, no study has comprehen sively investigated trends in gender diversity and the cor relation between leadership gender diversity and resident and faculty representation in OHNS. This study aims to examine the gender composition of residents and faculty in academic OHNS residency programs in the United States over the past decade and to investigate any associa tion between female representation in leadership positions and gender diversity among faculty and residents. Exemption status was obtained from the Institutional Review Board at Vanderbilt University Medical Center. A comprehensive literature review of the PubMed, SCOPUS, and EMBASE online databases was performed in May of 2023 using variations of the terms “Otolaryngology-Head and Neck Surgery,” “Female Surgeon,” and “Internship and Residency” (Supplemental Appendix 1). There was no limitation on the initial years queried. Each search was run separately, and all references were uploaded to Endnote reference software, where duplicates were removed. Title and abstract screening were completed by a single reviewer (N.D.). All articles investigating the gender diversity of residents and faculty in OHNS residency programs within the past 10 years were included for final review. Full-text review and data extraction were performed by the same Methods Study Design and Data Collection

reviewer. Article inclusion was finalized by the senior author (S.Y.). Data on total numbers and percent represen tation of women OHNS department chairs and residency program directors, OHNS faculty, and OHNS residents was collected from each of the selected articles. These numbers were analyzed to determine trends among the number of women within different ranks in OHNS resi dency programs. A cross-sectional study of the gender composition of residents and faculty in OHNS residency programs in the United States was performed in August 2022. Residency programs were identified using the Electronic Residency Application Service (ERAS) 2023 Participating Specialties and Programs website. The following data was collected for each residency program: gender of associated medical school dean, gender of OHNS department chair and resi dency program director, and total number and gender of fellowship directors, OHNS faculty, and OHNS residents. Data was collected from program websites, as the Accreditation Council for Graduate Medical Education (ACGME) and the Association of American Medical Colleges (AAMC) do not publicly release individual pro gram data. The gender of each resident and faculty mem ber was recorded based on pronouns used and provided photographs on each departmental website. The gender of the department chair and program director for each pro gram were recorded in the same manner. If program web sites were incomplete, social media accounts and other public listings for each program were explored. Program coordinators were also contacted to complete the data set if needed. Data on total number and gender of OHNS fellows was not collected, as fellowship programs are typically limited to 1 to 2 years, not all fellows are part of programs accred ited by the ACGME, and fellows are not consistently listed on department websites. In addition, fellowship director’s gender was only collected for OHNS fellowships associ ated with a residency program. When OHNS was not a department but a division of Surgery, the gender of the chair of the department of Surgery was included. The following relationships were investigated: correla tion between chair gender and program director gender, fellowship director gender, faculty gender, and resident gender; correlation between program director gender and resident gender; correlation between faculty gender and resident gender; correlation between medical school dean gender and department chair gender, faculty gender, and resident gender. Statistical Analysis Trends in gender diversity at the department chair, resi dency program director, faculty, and resident level were analyzed using the quick analysis and chart functions in