xRead - Mentorship in Otolaryngology Trainees (March 2026)

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Ear, Nose & Throat Journal 00(0)

Table 2. OHNS Fellowship Directors Associated with Residency Program by Gender (2022-2023 Academic Year). Fellowship Women Men

% Women

Head and Neck Surgery (n = 38)

8 3 2 8 3 4 0 1

30 23 24 19 24 15

21.1 11.5

Facial Plastic and Reconstructive Surgery (n = 26)

Rhinology (n = 26) Pediatrics (n = 27)

7.7

29.6 11.1 21.1

Otology/Neurotology (n = 27)

Laryngology (n = 19)

Sleep (n = 2)

2 3

0.0

Endocrine (n = 4)

25.0

Abbreviation: OHNS, Otolaryngology-Head and Neck Surgery.

women in all levels of OHNS training and academic medicine. Despite fewer women in the highest OHNS leadership positions, there has been increasing gender representation documented in the literature. In the 1980s, less than 1% of practicing Otolaryngologists were women with only 6 being represented in full-time academic positions. 17 In 2008, 29.8% of OHNS residents were women, a number that has steadily increased to 35% in 2019 and 42% in 2022. 12,21 In fact, a recent analysis concluded that OHNS has the highest rate of women residents of any of the surgi cal specialties other than obstetrics and gynecology. 22 Despite these advances and the consistent rise in the num ber of woman residents, the proportion of women is smaller as academic rank increases. 3 Pereira et al found that women made up 37% of assistant and associate pro fessors but only 10% of full professors in 2022 and male gender was a statistically significant predictor of full pro fessorship ( P < .001). 3 In 2013, 16% of program directors were women with a rise to 27% in 2019 and 30% in 2022. 11,12,14,16 However, there remains a significant decline in gender representation at the highest academic rank with less than 5% of department chairs being women prior to 2021. 12,14 Although our study demonstrates a rise in this number to 8.1%, there is still significant room for improvement. Despite a discrepancy in gender diversity at the highest leadership levels, our study demonstrates an association between women in any academic leadership position and an increased percentage of women OHNS faculty at that institution. This highlights the need for improvement in gender diversity across leadership positions. However, it is important to consider factors that may impact the gender representation disparity seen at higher leadership levels. The number of women medical school matriculants has rapidly increased over the past several decades from 11% in 1970 to 56% in 2021. 1,23 Similarly, the number of women OHNS residents has steadily increased. This increase has resulted in a greater total number of women OHNS faculty members, but discrepancy at the mid to

a leadership position (medical school dean, program direc tor, fellowship director, and department chair) was corre lated with a statistically significant increase in the percentage of women faculty. Programs with no women in leadership positions had a lower median percent of women faculty (23%) than programs with a woman in a leadership position (30%; P = .006). Gender of OHNS department chair was not associated with the gender of OHNS residents or the gender of the fellowship director. There was also no association between the gender of the program director and the proportion of women residents or the percentage of women faculty and percent of women residents. Discussion The importance of women mentorship and role models in the recruitment, retention, and promotion of women in medicine has been well demonstrated in academic gastro enterology, urology, and plastic surgery. 10,19,20 The find ings in our study corroborate those of prior studies. There was a strong association between women in any academic leadership position, including OHNS department chair, and the number of women OHNS faculty. In contrast to other studies completed in surgical specialties, there was no association between OHNS chair gender and program director or fellowship director gender. 10,19 There was also no association between the chair, program director, or fac ulty gender and the gender composition of current resi dents. These findings are consistent across recent publications that have investigated gender disparity across Otolaryngology leadership positions. 12,14,16 This may be explained by the relatively low number of total woman chairs (8.1%) compared to a relatively higher number of woman residency program directors (37, 30.1%), fellow ship directors (36, 18.8%), and residents (42%). The num ber of woman OHNS chairs has increased from less than 5% in 2019 to 8.1% in August 2022. 4,12 It is possible that the growing number of women in leadership positions may contribute to the observed increase in the number of