Sex-Based Disparities in Cataract Teaching Volumes and Operating Room Resources at the University of Toronto

Theme: Cataract surgery*
What: Cataract surgery
Part of: Cataract II: Anterior segment surgery for the cataract surgeon / Cataracte II - Chirurgie du segment antérieur pour le chirurgien spécialiste de la cataracte
When: 6/1/2024, 04:15 PM - 05:45 PM
Where: Room | Salle 801

Abstract

Purpose: Female ophthalmologists work fewer hours, spend more time with patients and have lower clinic and surgical volumes compared to males. It is unclear if this discrepancy also extends to cataract teaching volumes. The purose of this study is to assess the distribution of operating room (OR) time and cataract volumes designated for teaching between staff sex, and the relationship between supervised cataract teaching by staff and resident sex and resident stage of training.

Study Design: Retrospective cohort study 

Methods: Resident surgical logbooks were analyzed from July 1, 2015 to June 30, 2020 at the main teaching site (Kensington Eye Institute) at Canada’s largest residency program, the University of Toronto (UoT). Data collected included staff sex, cataract complexity, stage of resident training and the degree of resident participation for each case. Participants included residents who completed cataract surgical training and teaching staff from 2015-2020 at UoT. Cataract surgical training during postgraduate (PGY)-4 and PGY-5 years were analyzed. The main outcome measure was median number of OR days and case volumes designated for teaching by staff sex and supervised teaching volumes by staff and resident sex.

Results: Forty-nine staff surgeons (30.6% female) and 35 residents (54.3% female) operated during the study period. Median number of OR days by staff was similar between the sexes (difference 1.5-4 days/year). At the earliest training level, female staff oversaw a greater proportion of complete cataract cases compared to male staff for all residents (9.0% vs 5.3%), female residents (4.8% vs 4.3%), and male residents (10.2% vs 5.9%). Early in training, female staff allowed male residents to complete more cases compared to female residents (10.2% vs 9.0%, respectively). At the most senior level of surgical training, male staff allowed male residents to complete more cataract cases compared to female residents (64.1% vs 58.3%, respectively). However, at the most senior level of training, female staff allowed a similar proportion of complete cases to be performed by both sexes (49.8% male vs 48.9% female).

Conclusions: Overall, female staff allowed a greater proportion of cataract cases to be completed early in training by all residents compared to male staff. This suggests female staff are more burdened with teaching the earliest, and arguably, the most difficult stage of cataract surgery.

Presenter(s)

Presenting Author: Sumana Naidu

Additional Author(s):

Yvonne Buys, University of Toronto Department of Ophthalmology and Vision Sciences

Tanya Trinh, Sydney Eye Hospital, Sydney, Australia

David Yan, University of Toronto Department of Ophthalmology and Vision Sciences

Radha Kohly, University of Toronto Department of Ophthalmology and Vision Sciences

---