In 2017, women accounted for 50.7% of medical school matriculants. That same year, 42.4% of internal medicine residents were women. A recent JAMA Internal Medicine study analyzed enrollment data to determine how the gender breakdown of 9 internal medicine subspecialties changed from 1991 to 2016. Study results showed that although the percentage of women in internal medicine residency programs increased, the number of those pursuing in subspecialty fellowships decreased.
Overall, percentages of women residents in internal medicine rose from 30.2% in 1991 to 43.2% in 2016. Of those in subspecialty fellowships, 33.3% were women and 66.7% were men in 1991, and 23.6% were women and 76.4% were men in 2016. Three fields were identified as experiencing the highest rates of increase in the percentage of women fellows: endocrinology, rheumatology, and geriatrics. The lowest rates of increase were seen in critical care, pulmonary disease, and cardiology. The researchers identified a variety of factors that affect medical students’ choice of internal medicine residency and that may explain this disparity, such as lifestyle perceptions, views of patient care, and educational experience. For both genders, time with family was the most highly rated factor when choosing a subspecialty. Women have been found to assign more importance to factors such as family time and long-term patient relationships than financial considerations when choosing a residency. Perceptions of cardiology, the field with the lowest percentage of women, showed stark differences between genders. More women reported that they had never considered pursuing cardiology, perhaps because of factors such as women cardiologists reporting less satisfaction with family life, being less likely to have children, and experiencing more parenting discrimination than men. As a result, the study authors recommend that subspecialties such as cardiology continue to address the issue of gender disparity.
Stone AT, Carlson KM, Douglas PS, Morris KL, Walsh MN. Assessment of subspecialty choices of men and women in internal medicine from 1991 to 2016 [published online September 23, 2019]. JAMA Intern Med. doi:10.1001/jamainternmed.2019.3833