[What explains the "gendered reputation" of residency subjects? : Reasons for gendered specialty selection and careers in spine-surgery residency programs-compared to a "female" specialty].

Background: Currently, the proportion of women in academic education and residency is predominant, but specialty-specific distribution of leading positions is partly reciprocal (orthopedics/surgery). Are there any differences that indicate a gender-dependent redistribution in leadership positions already in the selection of postgraduate training?

Methods: Online survey with orthopedics/trauma surgery (OUC) and neurosurgery (NCH) residents. Comparison with gynecology (GYN). Statistical analysis, mean in percent, statistical differences using t‑ or chi-test (significance level α = 0,05).

Results: Returned questionnaire = 277, complete participation = 250. Female residents: OUC:52%, NCH:57%, GYN:85%. A total of 49% were told in medical school that a subject was inappropriate for gender reasons (f57-76%, m10-33%). The most frequent reason for a subject: all = "operating activity". The second most frequent reason: OUC-f = "good working atmosphere", OUC-m = "establishment", NCH-f = "career" and "good working atmosphere", NCH-m = "good working atmosphere", GYN-f = "establishment", GYN-m = "career". The most frequent reason against: OUC/GYN = "hardly any possibility to become established", NCH = "negative leadership style by superiors". For female residents in OUC/NCH, work/family balance had the smallest influence on the choice of specialty. Their subjective evaluation of compatibility was significantly the worst, and overall OUC/NCH was significantly worse than GYN. Although female residents in NCH were more likely to justify the specialty choice based on career goals, male residents in OUC/NCH were more likely to aim for a higher hierarchical position.

Discussion: The results of this study emphasize that disciplines receive a gender-specific conditioning already at the undergraduate level, which has a clear impact on the choice of specialty. The image in this regard needs to be reconsidered, as even surgical subjects will predictably have to rely on more female specialists.