Effects of a Gender-Balancing Strategy on Resident Panels in a Primary Care Setting

Background

Patients often prefer gender concordance when choosing a primary care practitioner. In a trainee setting, this may lead to unequal training opportunities for male and female resident physicians. Residency leadership may be interested in ways to promote balance in patient empanelment.

Objective

To assess the efficacy of an intervention to equalize imbalance in patient gender on resident primary care panels.

Design

Observational cohort study.

Participants

Categorial internal medicine residents beginning residency in 2020.

Interventions

The panels of internal medicine residents were manually rebalanced at the beginning of training for a new cohort of residents with the goal of having similar numbers of male and female patients on each resident’s panel.

Main Measures

Panel data was observed for 2 years following intervention. Number of male patients, number of female patients, and overall panel size were compared between male and female residents at baseline, 6 months, and 24 months.

Key Results

The analysis included 28 female residents and 20 male residents. After rebalancing, baseline panels had similar numbers of male patients (median of 50 on both male and female residents’ panels; average panel 54.7% male) and female patients (median of 41.5 on female residents’ panels and 41 on male residents’ panels; average panel 45.3% female). At the end of the follow-up period, a significant difference was observed in the median number of male patients (59.5 and 43.5; p < 0.001) and female patients (33.5 and 48.5; p < 0.001) between male and female residents, but no difference was observed in overall panel size.

Conclusions

A steady drift towards gender concordance was observed over 2 years following a rebalancing intervention. Program leadership overseeing primary care empanelment for resident physicians may consider periodic rebalancing of panels in addition to other interventions to ensure equal training opportunities and best prepare residents for future practice.