Purpose: Despite increasing numbers of women entering surgical fields, orthopaedic surgery residency continues to have the lowest percentage of women (11%) of all primary surgical specialties. In an effort to examine prevailing attitudes, we compared the performance of male and female orthopaedic residents using a variety of measures. We hypothesized that the performance of men and women would not differ significantly.

Method: We prospectively gathered data on 81 residents (67 male, 14 female) with graduation years of 1999–2010. Six males and one female dropped out of the program during their training, leaving a group of 74 residents (61 male, 13 female) with data available for analysis. Residents were compared on the basis of their Orthopaedic In-Training Exam (OITE) scores, American Board of Orthopaedic Surgery (ABOS) results, and a comprehensive eight category electronic faculty evaluation measure (E*ValueTM) that rates resident performance in every category on each rotation on a 1–5 scale. Practice profile data was gathered through a survey which looked at fellowship training and current practice patterns.

Results: Males and females had no statistically significant differences in their E*ValueTM scores in any of the eight categories measured (medical knowledge, patient care, behaviors, technical, communication, practice-based, systems-based, overall competence). Males and females had no significant difference in their mean OITE scores for year 2 and year 3 of residency; however, men had higher mean scores at year 4 (66.9 vs. 47.0), year 5 (66.8 vs. 45.8) and overall (61.7 vs. 46.5, p < 0.001). All resident graduates that had taken ABOS Parts 1 had passed; however, the percentage of men that took more than one attempt to pass Part 1 was significantly lower statistically than women (7% vs. 43%). No difference was seen in Part 2 pass attempts. For residents that had matched in our program, 9% of males and 7% of females have dropped out due to lifestyle issues (NSD).

Conclusion: In our program, male and female residents were seen as equally competent physicians as graded by comprehensive faculty evaluations. However, men outperformed women on both OITE measures and ABOS Part 1 measures. Further study is needed to explain these differences.