(1113) Trends in Female Leadership and Trainee Representation in Head and Neck Oncologic Surgery Fellowships, 2015-2024

Introduction: Although women constitute the majority of U.S. medical school matriculants, otolaryngology–head and neck surgery (OHNS) remains predominantly male, particularly within leadership. Female representation in Head and Neck Oncologic Surgery fellowships has increased over time, but the influence of fellowship director (FD) gender on trainee composition is not well defined. This study evaluates trends in female participation and examines whether female FDs are associated with higher proportions of female fellows.

Methods: We conducted a retrospective cross-sectional analysis of U.S. Head and Neck Oncologic Surgery fellowship programs from academic years 2015–2024 using American Head and Neck Society data. The primary outcome was the proportion of female fellows per program-year; the primary predictor was FD gender. A linear mixed-effects regression model assessed the association between FD gender and female fellow representation, adjusting for secular trends and including a program-level random intercept. National trends were evaluated using a Mann–Kendall test.

Results: Female FDs increased from 11.5% (n=3) in 2015 to 21.6% (n=8) in 2024. Programs led by female FDs had significantly higher proportions of female fellows, with an adjusted absolute increase of 16.75 percentage points (95% CI, 2.04–31.46; p=0.03). National data demonstrated a significant upward trend in female fellow representation (τ=0.60, p< 0.01).

Conclusions: Female leadership in head and neck oncology fellowships is associated with substantially greater female trainee representation, supporting the importance of leadership diversity in fostering inclusive training environments.