Males in Obstetrics and Gynecology: Then, Now and Tomorrow
Authors: Romero Iris , Rayburn William , Tucker J Martin , Phelan Sharon , Xierali Imam 
Published: July 2024

Objective: Efforts aimed at equity are not focused on as male gender equity. In this study, we used national datasets to analyze trends of male faculty and residents in obstetrics and gynecology (ob-gyn) over 50 years to predict the future of men in the specialty.

Methods: This retrospective observational study examined the gender of ob-gyns from 1972 to 2021 using data from the Association of American Medical Colleges (Faculty Roster and Graduate Medical Education Track) and American Medical Association (Physician Characteristics and Distribution). Gender was self-reported as being either female or male. Only faculty identified as “full-time” were included. Regression slopes defined rates of changes in the percentage of male ob-gyn faculty and residents. Statistical analyses were conducted with SAS version 9.4 (SAS Institute, Cary, North Carolina). The University of Mississippi Medical Center Institutional Review Board deemed the study exempt.

Results: Continuous declines in male ob-gyn faculty and residents are observed. Over a 50-year period, male faculty decreased from 88.1% of faculty to 37.8%. There were similar declines among male residents (84.6% to 11%). By 1992, women comprised half of all ob-gyn residents and by 2005 half of all faculty. Males in ob-gyn have decreased every five years by 5.6% (95% CI: 5.5 – 6.0%) for faculty and 6.0% (95% CI: 5.3– 6.5%) for residents. Graphing the data over 45 years shows a nearly linear decline that is parallel for faculty and residents. If the current rate of decline continues, it is predicted that by 2040 less than 10% of ob-gyn faculty will be male (95% CI: 3.5 – 22.8%) and nearly all residents will be female.

Conclusions: Medical education organizations support the concept that truly diverse medical teams improve medical outcomes. Gender and racial diversity in health care brings perspectives that improve group problem solving and creativity. Gender diversity is considered critical for excellence in medicine. The focus has been on women in medicine, while a long-term retrospective analysis of men in ob-gyn has not been published. Findings from this study show that over a 50-year period, there has been a steady decline in male ob-gyn faculty and residents. The annual rate of decline in male faculty reported here is comparable to the 1.4% reported by D.J. Wooding et al. (2020) between 2007 and 2018. At the current rate of decline, our results predict that in 17 years, less than 10% of all ob-gyn faculty will be men and nearly all residents will be women.

The literature provides insight into activities that appear to contribute to this ongoing trend. With the expansion of medical schools, the number of female medical students has increased. Furthermore, the percentage of female medical students has reached 50%. Males represented only 20% of applicants to first-year ob-gyn residency positions and were less likely to be selected in the match (Bowe et al 2021). Experiences during the ob-gyn clerkship show reports of occasional exclusion of male students from clinical activities. Males are told that patient preference for gender concordance will negatively impact their clinical practice opportunities. In fact, gender concordance is fourth on the list of characteristics valued by women after a provider’s technical skills, interpersonal style and communication skills (Johnson et al. 2005). At institutional level, medical students have few male ob-gyn role models or, in the case of racial minorities, none. The dwindling number of male faculty, especially at the junior level, and residents may be indicative to students that there is no longer a role for men in ob-gyn.

Strengths of this analysis include use of large national datasets spanning five decades. Study limitations include that the projections may be underestimates due to a lack of age data for analysis of attrition. Retirement is expected to be proportionally greater for men than women over the next 20 years. Information about gender expansive individuals was not available as gender was collected as a dichotomous variable. Finally, an analysis of gender in academic ob-gyn leadership and rank was beyond the scope of this report.

The present study clearly demonstrated the steady decline of males in the academic ob-gyn settings. Academic leadership, and especially ob-gyn department chairs and medical education organizations, need to acknowledge this decrease of gender diversity and determine if this is acceptable. In an expert review in 2018, L.B. Craig et. al. stated that, in a field that is seemingly less attractive to male medical students, identifying the root of gender differences in ob-gyn training may help elucidate and, perhaps, even reverse this trend. This is a strategy being employed in other specialties to increase the representation of women. This data could provide a metric for determining whether efforts to improve gender diversity in ob-gyn are warranted. Moving forward, the specialty of ob-gyn will either accept becoming nearly exclusively female or institute strategies to encourage those male medical students considering pursuing ob-gyn residencies.