title: Gender differences in the acquisition of surgical skills: a systematic review.
abstract: BACKGROUND
  Females are less attracted than males to surgical specialties, which may be due to differences in the acquisition of skills. The aim of this study was to systematically review studies that investigate gender differences in the acquisition of surgical skills.
  
  
  METHODS
  We performed a comprehensive database search using relevant search phrases and MeSH terms. We included studies that investigated the role of gender in the acquisition of surgical skills.
  
  
  RESULTS
  Our search yielded 247 studies, 18 of which were found to be eligible and were therefore included. These studies included a total of 2,106 study participants. The studies were qualitatively synthesized in five categories (studies on medical students, studies on both medical students and residents, studies on residents, studies on gender differences in needed physical strength, and studies on other gender-related training conditions). Male medical students tended to outperform females, while no gender differences were found among residents. Gaming experience and interest in surgery correlated with better acquisition of surgical skills, regardless of gender. Although initial levels of surgical abilities seemed lower among females, one-on-one training and instructor feedback worked better on females and were able to help the acquisition of surgical skills at a level that negated measurable gender differences. Female physicians possess the required physical strength for surgical procedures, but may face gender-related challenges in daily clinical practice.
  
  
  CONCLUSIONS
  Medical students are a heterogeneous group with a range of interests and experiences, while surgical residents are more homogeneous perhaps due to selection bias. Gender-related differences are more pronounced among medical students. Future surgical curricula should consider tailoring personalized programs that accommodate more mentoring and one-on-one training for female physicians while giving male physicians more practice opportunities in order to increase the output of surgical training and acquisition of surgical skills.
authors: Centre for Clinical Education, University of Copenhagen and the Capital Region of Denmark, Copenhagen, Denmark. amirmukhtarali@gmail.com.
authors: Amir
authors: A
authors: Ali
authors: Centre for Clinical Education, University of Copenhagen and the Capital Region of Denmark, Copenhagen, Denmark.|Clinical Eye Research Unit, Department of Ophthalmology, Copenhagen University Hospital Roskilde, Roskilde, Denmark.
authors: Yousif
authors: Y
authors: Subhi
authors: Department of Anesthesia, University of Toronto, Toronto, Canada.|Faculty of Health, Aarhus University, Aarhus, Denmark.
authors: Charlotte
authors: C
authors: Ringsted
authors: Centre for Clinical Education, University of Copenhagen and the Capital Region of Denmark, Copenhagen, Denmark.
authors: Lars
authors: L
authors: Konge
mesh_terms: D002170:Canada; D002321:Career Choice; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate; D005060:Europe; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D012737:Sex Factors; D013043:Specialties, Surgical / Q000193:education*; D013337:Students, Medical / Q000523:psychology*; D013514:Surgical Procedures, Operative / Q000193:education* / Q000523:psychology; D014481:United States
keywords: Gender differences; Medical education; Surgery; Surgical career; Surgical simulation; Surgical skills
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