Differences in operative self-assessment between male and female plastic surgery residents: A survey of 8,149 cases

Am J Surg. 2021 Apr;221(4):799-803. doi: 10.1016/j.amjsurg.2020.04.009. Epub 2020 Apr 24.


Background: Previous studies show female residents tend to underrate and male residents to overrate their own performance. We sought to determine if plastic surgery resident trainee self-evaluations differ by resident sex.

Methods: We extracted Operative Entrustability Assessment (OEA) data for plastic surgery programs from MileMarker™, a program capable of storing assessment data for CPT-coded procedures. Complete OEAs contain a trainee self-assessment and attending surgeon assessment. We used simple statistics and linear regression to assess differences, stratifying by trainee sex and post-graduate year (PGY).

Results: We analyzed 8149 OEAs from 3 training programs representing 64 residents (25% female) and 51 attendings. Compared to attending assessments, both male and female residents significantly underrated their performance during PGY1. However, during PGY2-6 male residents' self-evaluations were significantly higher and female residents' self-evaluations significantly lower than their attending evaluations.

Conclusions: Results demonstrated female plastic surgery residents underestimated and male residents overestimated their performance. Further studies are needed to determine reasons for these differences.

Keywords: Gender differences; Graduate medical education; Operative skill; Resident assessment; Self-assessment; Surgical education.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Clinical Competence*
  • Education, Medical, Graduate
  • Female
  • Humans
  • Internship and Residency
  • Male
  • Self-Assessment*
  • Sex Factors
  • Surgery, Plastic / education*