Sex Diversity in the Cardiothoracic Anesthesiology Fellowship: The Influence of Geographic Region.

OBJECTIVES: To investigate if the lack of sex diversity in adult cardiothoracic anesthesiology fellowships is a result of few female applicants or low acceptance rate. DESIGN: Retrospective review of adult cardiothoracic anesthesiology applicants and fellows by sex and geographic regions across the United States. SETTING: Accreditation Council for Graduate Medical Education's adult cardiothoracic anesthesiology fellowship programs across the United States. PARTICIPANTS: Applicants to adult cardiothoracic anesthesiology fellowship programs and fellows. INTERVENTIONS: No intervention. MEASUREMENTS AND MAIN RESULTS: Numerical comparison of male and female applicants by percentage and acceptance rates into adult cardiothoracic anesthesiology fellowship programs in each geographic region. Women comprised between 27% and 35% of applicants from 2013 to 2018. Acceptance rates for men completing residency in the Midwest region ranged between 67% and 84%, and 67% and 87% for women from the Midwest (p = 0.1-0.9). Men from Northeast residencies had acceptance rate of 71% to 86% and women had rate of 69% to 83% (p = 0.2-0.8). Male and female residents from the Southeast had acceptance rates of 65% to 94% and 71% to 93%, respectively (p = 0.3-0.8). The male residents from the Southwest had acceptance rates of 73% to 85%, and female residents had rates between 44% and 100% (p = 0.02-0.8). The male residents from the West had rates of 59% to 88%, female residents had rates between 64% and 100% (p = 0.1-0.7). CONCLUSIONS: There is an absence of clear identification of the barriers preventing women from entering cardiac anesthesiology. The reasons leading to a male-dominated field of cardiac anesthesiologists stem from fewer female anesthesiology residents applying to cardiothoracic anesthesiology fellowships. No bias against acceptance of women into cardiothoracic anesthesiology fellowships was found.