How Medical School Experiences Bias Specialty Selection: Perspectives From Current U.S. Otolaryngology Residents.

OBJECTIVES: This study examined the medical school experiences of current U.S. otolaryngology residents to better understand gender biases that may persist within the specialty and to inform strategies that could improve workforce excellence. METHODS: A voluntary, IRB-approved survey was distributed to U.S. otolaryngology residency program directors and coordinators for distribution to their residents. Gender-stratified analyses were performed using Chi-squared tests, Mann-Whitney tests, and thematic analysis. A P-value < .05 was considered statistically significant. RESULTS: Of 137 complete surveys, 58% of respondents identified as female (mean age 29.7 ± 2.8 years). Factors that deterred female respondents from pursuing otolaryngology included a perceived requirement of high USMLE board scores (P < .05), concerns about racial, ethnic, gender, and sexual diversity (P < .05), and concerns about time limitations for raising a family (P < .0005). Female respondents were significantly more likely to have witnessed or experienced gender discrimination (P < .05) and received negative comments about their clinical abilities (P < .0005) compared to their male counterparts. Having a gender-concordant mentor significantly influenced career choice among female respondents (P < .0005). CONCLUSIONS: Persistent gender disparities continue to shape otolaryngology residents' experiences and perceptions, from mentorship access to perceptions of bias. Key targets for intervention include gender-concordant mentorship, early medical school exposure, and addressing inherent bias through educational and department-wide initiatives. Meaningful progress requires collective institutional commitment to structural and cultural change to ensure a more supportive environment for all trainees. LEVEL OF EVIDENCE: 4.