Impact of faculty and resident gender on milestone evaluations in anesthesiology residency: a retrospective analysis

Background Anesthesia-specific milestone evaluations are intended to objectively assess performance in ACGME core competencies for anesthesiology residents. Recent reports in several medical specialties have documented differences in resident evaluations based on gender.Objective We studied the impact of faculty and resident gender on milestone evaluations during Anesthesiology residency.Design This was a retrospective analysis of 20,570 anesthesiology resident milestone evaluations from a single institution over a 7-year period during the ACGME milestones 1.0 time frame. Standardized scores were analyzed using a linear mixed model.Results 170 anesthesiology residents were evaluated by 194 faculty. For CA1 evaluations, mean standardized milestone scores for the core competencies of professionalism (p = 0.002) and interpersonal/communication (p < 0.001) and for overall assessment (p = 0.009) were dependent on faculty gender. For CA2 evaluations, regardless of the evaluator gender, the mean standardized milestone scores for many individual core competencies were significantly higher for female residents compared to male residents. For CA3 evaluations, mean standardized milestone scores did not differ significantly between male residents and female residents for any core competency, however overall assessment scores were dependent on faculty gender with male faculty scoring male residents more highly and female faculty scoring female residents more highly (p < 0.001).Conclusions We observed an association between faculty gender and milestone evaluation scores of residents that was most evident for CA1 residents. We also observed the overall assessment scores for male and female residents were significantly influenced by the gender of the faculty evaluator. Further work is required to better understand and mitigate gender bias to promote equity in resident assessment.