Academic medical careers remain marked by persistent gender inequalities, despite the growing feminisation of the medical workforce. The objective of this study was to examine whether gender differences exist in key individual and institutional determinants of academic medical career aspirations among medical residents, including research motivation, mentoring, work centrality, self-efficacy, perceived discrimination and stress.

This was a national cross-sectional online survey.

Multicentre study conducted across 36 medical schools in France.

A total of 1570 medical residents (997 women and 573 men) voluntarily participated between November 2022 and February 2023. All participants completed validated self-report questionnaires. There were no exclusion criteria beyond being enrolled in a French residency programme.

Attitudes towards research (interest, motivation, significance) were measured using the Scale of Attitudes towards Research. Mentoring was assessed with the Mentor–Mentee Perception Questionnaire, work centrality with Hirschfeld and Feild’s scale, self-efficacy with the General Self-Efficacy Scale, perceived discrimination with the Sexual Harassment and Discrimination Experiences of Academic Medical Faculty instrument and stress with the Perceived Stress Scale. Gender differences were analysed using t-tests or ² tests with Holm-Bonferroni corrections for multiple comparisons.

Compared with men, women reported lower research motivation (mean (SD) 21.0 (5.5) vs 22.8 (5.5); p_adj=0.011), lower research interest (27.1 (5.5) vs 28.1 (5.7); p_adj=0.011), lower work centrality (26.7 (7.0) vs 28.2 (8.1); p_adj=0.011) and lower self-efficacy (28.3 (5.2) vs 29.9 (5.0); p_adj=0.011). Women were less likely to report having a mentor (38.5% vs 44.5%; p_adj=0.02). They also reported substantially higher levels of experienced gender discrimination (22.8% vs 3.8%; p_adj=0.005), sexual harassment (57.7% vs 18.2%; p_adj=0.005) and perceived stress (8.48 (3.29) vs 7.27 (3.43); p_adj=0.011)

Gender differences were observed across several individual and institutional factors associated with academic medical career aspirations. Reduced access to mentoring and greater exposure to discrimination and stress among women may contribute to lower research motivation and self-efficacy. These findings highlight the need for institutional strategies addressing mentoring, workplace culture and equity to support gender parity in academic medicine.

OSF preregistration for this study is available at https://osf.io/9yseq/?view_only=1c72743f542b402ba67beed6908e597d