SheMD Journal Club: Differences in Emergency Medicine Resident Procedural Reporting by Gender in the United States
- Dr. Lexie Mannix
- Apr 16
- 2 min read
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Link to Article: https://jgme.kglmeridian.com/view/journals/jgme/16/1/article-p70.xml
Why is this article important?
We’ve spent years studying gender differences in evaluations, feedback, and operative experience. But in Emergency Medicine, where procedural competence is core to training, we’ve had surprisingly little data on something fundamental: Do men and women residents actually get the same procedural experience?
Because in EM, opportunity = experience = competence = confidence.
Article Summary
What they looked at: Whether there are gender differences in the number of procedures performed (and reported) by Emergency Medicine residents.
How they measured things:
Retrospective review of procedure logs from 8 EM residency programs
Timeframe: 2013–2022
880 residents included (358 women, 522 men)
Compared procedural counts by gender using regression analysis, controlling for institution
What were their outcomes:
Most procedures showed no significant gender difference
However, men performed more of several key procedures, including:
Dislocation reductions
Chest tube insertions
Sedations
On sensitivity analysis, central lines were also higher among men
Importantly, all residents exceeded ACGME minimums—but differences still existed within that range.
Why do we care about this article?
What does this mean?
At first glance, this feels reassuring: Most procedures? No difference.
But the details matter.
1. Not all procedures are equal
The differences showed up in:
Lower-frequency procedures
Higher-stakes procedures
Procedures that often require assertiveness + timing + access
These are exactly the moments where:
Confidence grows
Autonomy develops
Identity as a proceduralist forms
2. Opportunity is not evenly distributed
This study doesn’t tell us why the differences exist—but prior literature gives us clues:
Differences in assertiveness or self-advocacy
Differences in faculty entrustment/autonomy
Subtle differences in who gets offered the procedure
Environmental factors (resus vs procedural service, etc.)
This is rarely explicit. It’s often quiet, cumulative, and invisible in real time.
3. “Meeting minimums” doesn’t mean equity
All residents met ACGME requirements.
But:
Minimums ≠ mastery
Minimums ≠ confidence
Minimums ≠ equal experience
And small differences over time can compound into:
Procedural comfort
Fellowship decisions
Career trajectory
4. This is a systems issue, not an individual one
It would be easy—but incorrect—to frame this as: “Some residents just seek out procedures more.”
The better question is: Who gets encouraged, trusted, and offered opportunities—and when?
The takeaway:
In EM training, equity isn’t just about evaluation, it’s about access in the moment.
Because the difference between watching and doing… is where physicians are made.
Similar Articles
Dayal et al. Gender differences in EM milestone evaluations
Mueller et al. Gender differences in feedback to residents
Chen et al. Gender disparities in surgical autonomy
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This study highlights how quiet, systemic gender gaps shape high-stakes procedural experience for emergency medicine residents far beyond basic training minimums. Even subtle opportunity imbalances add up over time, and AI Vision Technology could help objectively track procedure access to spot these hidden disparities early on. It’s a vital reminder that meeting baseline requirements never equals fair, equitable professional growth.