51
|
Mueller L, Morenas R, Loe M, Toraih E, Turner J. Gender and Race Demographics of Fellowships After General Surgery Training in the United States: A Five-Year Analysis in Applicant and Resident Trends. Am Surg 2022:31348221146945. [PMID: 36565153 DOI: 10.1177/00031348221146945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The gender and minority gap in general surgery residency is narrowing; however, literature lacks comprehensive data regarding the demographics of fellowship programs following general surgery training. METHODS Data from 2017 to 2021 for gender, ethnicity, and surgical subspecialty are publicly available from the ERAS database and ACGME yearly data reports. Cochran-Armitage trend tests were used to determine statistical significance in trends for female and minority applicants and trainees. RESULTS The overall trend of female applicants to surgical specialties remained stagnant. However, female applicants to vascular surgery increased significantly from 25% to 35% (P = .045). There was no significant increase in female trainees in any surgical specialties evaluated. Furthermore, the overall trend of minority applicants to surgical specialties also remained stagnant, except for pediatric surgery, which showed significantly fewer minority applicants. Despite pediatric surgery having fewer applicants, minority trainees in this specialty increased significantly from 8% to 19% (P = .008). CONCLUSION Several current initiatives, such as intentional mentorship, are being reported to promote diverse and equal representation among female and minority applicants and trainees. However, the current overall margin of increase in diversity among surgical specialty applicants and trainees is minimal, indicating that continued efforts are needed to diversify surgical specialty training programs.
Collapse
Affiliation(s)
- Lauren Mueller
- School of Medicine, 12255Tulane University, New Orleans, LA, USA
| | - Rohan Morenas
- School of Medicine, 12255Tulane University, New Orleans, LA, USA
| | - Mallory Loe
- School of Medicine, 12255Tulane University, New Orleans, LA, USA
| | - Eman Toraih
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, 12255Tulane University, New Orleans, LA, USA.,Genetics Unit, Department of Histology and Cell Biology, 12255Suez Canal University, Ismailia, Egypt
| | - Jacquelyn Turner
- Department of Surgery, Division of Colon and Rectal Surgery, 12255Tulane University School of Medicine, New Orleans, LA, USA
| |
Collapse
|
52
|
Thompson BN, Colbert K, Nussbaum MS, Paget CJ. Practical Strategies for Underrepresented Minority Recruitment in General Surgery Residency. JOURNAL OF SURGICAL EDUCATION 2022; 79:e130-e136. [PMID: 36266229 DOI: 10.1016/j.jsurg.2022.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/19/2022] [Accepted: 09/10/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To analyze the effects of diversification efforts on underrepresented minority in medicine (URiM) resident recruitment in general surgery residency at a single large southeastern United States academic institution with five categorical positions. METHODS A retrospective review of applications from the 2016 to 2022 ACGME match cycles was conducted. In an effort to diversify resident recruitment, multiple new strategies were enacted in 2021. URiM candidates were identified via a more laborious review of individual applications to the program. In addition, a holistic review process was conducted, URiM faculty and residents were prominently featured, previous underperformance in diversity was openly addressed, and URiM applicants were contacted with follow up emails. Cohorts pre- and post-implementation of these strategies were analyzed. The proportion of URiM applicants invited, interviewed, ranked, and matched were compared. RESULTS Pre-intervention during the 2016to 20 match cycles, URiM candidates represented 4% of total applicants invited. Post-intervention during the 2021to 22 match cycles, URiM candidates represented 27% of total applicants invited. Over the past 5 years under the present program director, 1 URiM resident of 24 (4%) matched into the categorical program. Over the past 15 years under the direction of 3 program directors, a total of 6 out of 69 matched residents (9%) identified as URiM. Post intervention, the program matched on average 30% of its incoming categorical class from URiM candidates. CONCLUSION Recruitment and selection of diverse medical school applicants is an ongoing concern of general surgery residency program directors. Historically, URiM candidates are underrepresented in applicants selected for interview. Interventions aimed at increasing the matriculation of URiM include concentrated efforts to identify more URiM candidates for interview. However, importantly, transparency of ongoing diversity efforts and diversifying both faculty and trainees involved in the selection process may also improve general surgery URiM recruitment.
Collapse
Affiliation(s)
- Britany N Thompson
- Virginia Tech Carilion School of Medicine, Carilion Clinic, Department of Surgery, Roanoke, Virginia
| | - Kendra Colbert
- Virginia Tech Carilion School of Medicine, Carilion Clinic, Department of Surgery, Roanoke, Virginia
| | - Michael S Nussbaum
- Virginia Tech Carilion School of Medicine, Carilion Clinic, Department of Surgery, Roanoke, Virginia
| | - Charles J Paget
- Virginia Tech Carilion School of Medicine, Carilion Clinic, Department of Surgery, Roanoke, Virginia.
| |
Collapse
|
53
|
Bredbeck BC, Delaney LD, Kwakye G. Demographic Factors Associated With Research and Career Interests in Aspiring Academic Surgeons: What are the Implications for Tomorrow's Workforce? JOURNAL OF SURGICAL EDUCATION 2022; 79:1447-1453. [PMID: 35732577 PMCID: PMC10473172 DOI: 10.1016/j.jsurg.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/11/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To evaluate the research and career interests of aspiring academic surgeons and determine the influence of demographic factors. DESIGN Cross-sectional survey SETTING: Single institution, academic general surgery residency program PARTICIPANTS: Medical students invited to interview during 2019-2020 and 2020-2021 residency cycle RESULTS: One hundred fifty-four of 160 (96%) potential respondents representing 63 medical schools completed the survey, American Association for Public Opinion Research Response Rate 6. Fifty-three percent of the study population was female. Seventeen percent identified as Black, 14% Asian, 13% Latinx, 50% white, and 6% other. Respondents were most interested in education, professional development, and surgical culture (32%) followed by basic and translational science (23%), global and community health (20%), and health services (18%). On multiple logistic regression, interest in global/community health was associated with identifying as Black (OR 5.9 [2.0, 17.8] p = 0.001) and female (OR 2.7 [1.0, 7.0] p = 0.044). A plurality of participants were undecided on future specialty (n = 63, 41%). The most common specialty interests were surgical oncology (n = 28, 18%); trauma, acute care, or surgical critical care (n = 21, 14%); pediatric and cardiothoracic surgery (n = 20 for each, 13%); and abdominal transplant (n = 15, 10%). CONCLUSIONS In this cross-sectional survey of highly competitive academic general surgery applicants, respondents who were underrepresented in medicine (URiM) and women were more interested in research fields with a history of lower relative NIH funding. In light of these findings, academic programs seeking a more diverse residency workforce should consider strategies beyond recruitment to promote the scholarly achievement of women and URiM residents.
Collapse
Affiliation(s)
- Brooke C Bredbeck
- Department of Surgery, University of Michigan, Ann Arbor, Michigan; Center for Healthcare Outcomes and Policy, Ann Arbor, Michigan.
| | - Lia D Delaney
- Department of Surgery, University of Michigan, Ann Arbor, Michigan; University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan
| | - Gifty Kwakye
- Department of Surgery, University of Michigan, Ann Arbor, Michigan; Center for Healthcare Outcomes and Policy, Ann Arbor, Michigan
| |
Collapse
|
54
|
Nguemeni Tiako MJ, Johnson S, Muhammad M, Osman NY, Solomon SR. Association Between Racial and Ethnic Diversity in Medical Specialties and Residency Application Rates. JAMA Netw Open 2022; 5:e2240817. [PMID: 36367730 PMCID: PMC9652751 DOI: 10.1001/jamanetworkopen.2022.40817] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
IMPORTANCE The lack of racial and ethnic diversity in the US medical profession is a well-recognized problem, and racial and ethnic representation is highly variable across the medical specialties. Residency selection is a crucial juncture at which diversity and representation in specialties can be increased. OBJECTIVE To identify factors associated with residency application rates for medical specialties by race and ethnicity. DESIGN, SETTING, AND PARTICIPANTS This national cross-sectional study of medical student residency applications used American Association of Medical Colleges data on 2019-2020 applicants and information about the racial and ethnic characteristics of practicing physicians (including medical school faculty) and department chairs. A total of 26 320 applicants to medical residency programs, 592 296 practicing physicians, and 2121 department chairs across the US were included. Residency application rates for 18 medical specialties were evaluated. MAIN OUTCOMES AND MEASURES The main outcome was the specialty representation quotient (SRQ), which estimated the extent to which students from a racial or ethnic group were overrepresented (an SRQ >1) or underrepresented (an SRQ <1) in a given specialty compared with the racial and ethnic demographic characteristics of the corresponding graduating class. Covariates included the racial and ethnic demographic characteristics of practicing physicians and department chairs by specialty based on American Association of Medical Colleges data and student academic factors (mean United States Medical Licensing Examination step 1 score, number of research experiences, and AΩA honor society membership among matched students from the previous application cycle). Multivariable logistic regression analysis was used to examine associations between these covariates and application rates by race and ethnicity. RESULTS Among 26 320 specialty-specific applications to medical residency programs in 18 specialties, 90 (0.3%) were from American Indian or Alaska Native students, 6718 (25.5%) were from Asian students, 2575 (9.8%) were from Black students, 1896 (7.2%) were from Hispanic students, and 15 041 (57.1%) were from White students. Among 592 296 practicing physicians, 2777 (0.5%) were American Indian or Alaska Native, 117 358 (19.8%) were Asian, 36 639 (6.2%) were Black, 41 071 (6.9%) were Hispanic, and 394 451 (66.6%) were White. Among 2121 department chairs, 5 (0.2%) were American Indian or Alaska Native, 212 (10.0%) were Asian, 86 (4.1%) were Black, 88 (4.1%) were Hispanic, and 1730 (81.6%) were White. The specialties with the greatest representation among applicants from racial and ethnic groups underrepresented in medicine (URM) were family medicine (SRQ, 1.70), physical medicine and rehabilitation (SRQ, 1.60), and obstetrics and gynecology (SRQ, 1.47). The specialties with the lowest URM representation among applicants were plastic surgery (SRQ, 0.47), otolaryngology (SRQ, 0.53), and orthopedic surgery (SRQ, 0.86). Membership in AΩA was negatively associated with SRQ among American Indian or Alaska Native students only (β = -0.11; 95% CI, -0.17 to -0.05; P = .002). Racial and ethnic representation among practicing physicians was positively associated with SRQ for American Indian or Alaska Native students (β = 6.05; 95% CI, 4.26-7.85; P < .001), Asian students (β = 0.07; 95% CI, 0.06-0.09; P < .001), Black students (β = 0.10; 95% CI, 0.06-0.15; P < .001), and URM students overall (β = 0.05; 95% CI, 0.01-0.08; P = .02). CONCLUSIONS AND RELEVANCE This study's findings suggest that the propensity of medical students, particularly those from racial and ethnic minority groups, to apply to a given specialty for residency was associated with the representation of their racial or ethnic group among the specialty's practicing physicians. Future work to characterize the mechanisms of occupational sorting may guide interventions to improve equity within the physician workforce.
Collapse
Affiliation(s)
- Max Jordan Nguemeni Tiako
- Department of Internal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Shawn Johnson
- Department of Internal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | | | - Nora Y. Osman
- Department of Internal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Sonja R. Solomon
- Department of Internal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
55
|
Bernstein SL, Wei C, Gu A, Campbell JC, Fufa D. An Analysis of Underrepresented in Medicine Away Rotation Scholarships in Surgical Specialties. J Grad Med Educ 2022; 14:533-541. [PMID: 36274775 PMCID: PMC9580313 DOI: 10.4300/jgme-d-21-00952.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/14/2022] [Accepted: 07/26/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Underrepresented in medicine (UIM) visiting student clerkship scholarships provide an opportunity for supporting diversity. Although these scholarships have become a popular initiative to recruit diverse surgical applicants, they have not been thoroughly analyzed regarding which programs offer scholarships and the characteristics of the scholarships. UIM scholarship opportunity disparities may exist depending on location, funding, reputation, and program size among different specialties. OBJECTIVE To describe the characteristics and prevalence of UIM visiting student scholarships by examining institutional and program websites for the surgical specialties. METHODS Using the Accreditation Council for Graduate Medical Education (ACGME) Accreditation Data System for 2021, residency training and diversity websites were identified and evaluated for the availability of UIM visiting student scholarships in July 2021. Eight surgical specialties were examined. Scholarships were categorized by how UIM was defined, the funding amount provided, and scholarship application requirements. We analyzed the association of the program's National Institutes of Health funding, size, type, region, reputation, and population density of the program's area via Doximity on scholarship availability using chi-square and multivariate analysis. RESULTS Of the 1058 analyzed programs, 314 (29.7%) had a UIM visiting student scholarship. There were 4 different definitions of UIM used among the analyzed programs. The average scholarship amount offered was $1,852.25 ($500-$4,000). Depending on the specialty, different variables were associated with whether a program had a UIM scholarship. CONCLUSIONS Currently, UIM scholarship offerings were variable between programs and surgical specialties.
Collapse
Affiliation(s)
- Sophie L Bernstein
- is a Medical Student, University of Missouri-Kansas City School of Medicine
| | - Chapman Wei
- is PGY-1 Resident, Department of Medicine, Staten Island University Northwell Health
| | - Alex Gu
- is a PGY-2 Resident, Department of Orthopaedic Surgery, The George Washington School of Medicine and Health Sciences
| | - Joshua C Campbell
- is Assistant Professor of Orthopedic Surgery, The George Washington School of Medicine and Health Sciences
| | - Duretti Fufa
- is Associate Professor and Program Director of Orthopedic Surgery, Hospital for Special Surgery
| |
Collapse
|
56
|
Asfaw ZK, Soto E, Yaeger K, Feng R, Carrasquilla A, Barthélemy EJ, Tabani H, Berkalieva A, Mazumdar M, McNeill IT, Germano IM. Racial and Ethnical Diversity Within the Neurosurgery Resident and Faculty Workforce in the United States. Neurosurgery 2022; 91:72-79. [PMID: 35384926 DOI: 10.1227/neu.0000000000001920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/24/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Promoting workplace diversity leads to a variety of benefits related to a broader range of perspectives and insights. Underrepresented in medicine (URiM), including African Americans, Latinx, and Natives (Americans/Alaskan/Hawaiians/Pacific Islanders), are currently accounting for approximately 40% of the US population. OBJECTIVE To establish a snapshot of current URiM representation within academic neurosurgery (NS) programs and trends within NS residency. METHODS All 115 NS residencies and academic programs accredited by the Accreditation Council for Graduate Medical Education in 2020 were included in this study. The National Residency Matching Program database was reviewed from 2011 to 2020 to analyze URiM representation trends over time within the NS resident workforce. The academic rank, academic and clinical title(s), subspecialty, sex, and race of URiM NS faculty (NSF) were obtained from publicly available data. RESULTS The Black and Latinx NS resident workforce currently accounts for 4.8% and 5.8% of the total workforce, respectively. URiM NSF are present in 71% of the Accreditation Council for Graduate Medical Education-accredited NS programs and account for 8% (148 of 1776) of the workforce. Black and Latinx women comprise 10% of URiM NSF. Latinx NSFs are the majority within the URiM cohort for both men and women. URiM comprise 5% of all department chairs. All are men. Spine (26%), tumor (26%), and trauma (17%) were the top 3 subspecialties among URiM NSF. CONCLUSION NS has evolved, expanded, and diversified in numerous directions, including race and gender representation. Our data show that ample opportunities remain to improve URiM representation within NS.
Collapse
Affiliation(s)
- Zerubabbel K Asfaw
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Elizabeth Soto
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kurt Yaeger
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rui Feng
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alejandro Carrasquilla
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ernest J Barthélemy
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Halima Tabani
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Asem Berkalieva
- Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Madhu Mazumdar
- Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ian T McNeill
- Division of Neurosurgery, Department of Surgery, University of Connecticut, Farmington, Connecticut, USA
| | - Isabelle M Germano
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| |
Collapse
|
57
|
Bowe SN, Bly RA, Wang X, Whipple ME. Racial and Ethnic Differences in Resident Selection in 11 Specialties, 2013-2018. JAMA 2022; 327:2450-2452. [PMID: 35763005 PMCID: PMC9240901 DOI: 10.1001/jama.2022.6424] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This study compares the racial and ethnic representation of applicants and matched residents from competitive US medical and surgical specialty programs between 2013 and 2018.
Collapse
Affiliation(s)
- Sarah N. Bowe
- Department of Otolaryngology–Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, Joint Base San Antonio–Fort Sam Houston, Texas
| | - Randall A. Bly
- Department of Otolaryngology–Head and Neck Surgery, University of Washington School of Medicine, Seattle
| | - Xing Wang
- Seattle Children’s Hospital and Research Institute, Seattle, Washington
| | - Mark E. Whipple
- Department of Otolaryngology–Head and Neck Surgery, University of Washington School of Medicine, Seattle
| |
Collapse
|
58
|
Eruchalu CN, He K, Etheridge JC, Wu C, Ashley SW, Nitzschke SL, Smink DS, Cho NL. Gender and Racial/Ethnic Disparities in Operative Volumes of Graduating General Surgery Residents. J Surg Res 2022; 279:104-112. [PMID: 35759927 DOI: 10.1016/j.jss.2022.05.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/25/2022] [Accepted: 05/22/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Gender disparities in resident operative experience have been described; however, their etiology is poorly understood, and racial/ethnic disparities have not been explored. This study investigated the relationship between gender, race/ethnicity, and surgery resident case volumes. MATERIALS AND METHODS A retrospective analysis of graduating general surgery resident case logs (2010-2020) at an academic medical center was performed. Self-reported gender and race/ethnicity data were collected from program records. Residents were categorized as underrepresented in medicine (URM) (Black, Hispanic, Native American) or non-URM (White, Asian). Associations between gender and URM status and major, chief, and teaching assistant (TA) mean case volumes were analyzed using t-tests. RESULTS The cohort included 80 residents: 39 female (48.8%) and 17 URM (21.3%). Compared to male residents, female residents performed fewer TA cases (33 versus 47, P < 0.001). Compared to non-URM residents, URM residents graduated with fewer major (948 versus 1043, P = 0.008) and TA cases (32 versus 42, P = 0.038). Male URM residents performed fewer TA cases than male non-URM residents (32 versus 50, P = 0.031). Subanalysis stratified by graduation year demonstrated that from 2010 to 2015, female residents performed fewer chief (218 versus 248, P = 0.039) and TA cases (29 versus 50, P = 0.001) than male residents. However, from 2016 to 2020, when gender parity was achieved, no significant associations were observed between gender and case volumes. CONCLUSIONS Female and URM residents perform fewer TA and major cases than male non-URM residents, which may contribute to reduced operative autonomy, confidence, and entrustment. Prioritizing gender and URM parity may help decrease case volume gaps among underrepresented residents.
Collapse
Affiliation(s)
- Chukwuma N Eruchalu
- Harvard Medical School, Boston, Massachusetts; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Katherine He
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - James C Etheridge
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Ariadne Labs, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, Boston, Massachusetts
| | - Christine Wu
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Stanley W Ashley
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Stephanie L Nitzschke
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Douglas S Smink
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nancy L Cho
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
59
|
Hucko L, Al-Khersan H, Lopez Dominguez J, Cavuoto KM, Scott NL, Williams BK, Fountain T, Sridhar J. Racial and Ethnic Diversity of U.S. Residency Programs, 2011-2019. N Engl J Med 2022; 386:2152-2153. [PMID: 35648712 DOI: 10.1056/nejmc2200107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
60
|
Bamdad MC, Vitous CA, Rivard SJ, Anderson M, Lussiez A, De Roo AC, Englesbe MJ, Suwanabol PA. The Best Gift You Could Give a Resident: A Qualitative Study of Well-Being Resources and Use Following Unwanted Outcomes. ANNALS OF SURGERY OPEN 2022; 3:e139. [PMID: 36936721 PMCID: PMC10013169 DOI: 10.1097/as9.0000000000000139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/31/2022] [Indexed: 11/26/2022] Open
Abstract
In recent years, there has been increasing focus on the well-being of resident physicians. Considering the persistent problem of burnout and attrition particularly among surgical trainees, this is a well-warranted and laudable area of focus. However, despite the widespread adoption of resources available to residents through individual institutions, there is little understanding of how and why these resources are engaged or not during particularly vulnerable moments, such as following an unwanted patient event including postoperative complications and deaths. Methods This qualitative study explored access to and usage of resources to promote well-being following an unwanted patient outcome through semi-structured interviews of 28 general surgery residents from 14 residency programs across the United States, including community, academic, and hybrid programs. A qualitative descriptive approach was used to analyze transcripts. Results Residents described 3 main types of institutional resources available to them to promote well-being, including counseling services, support from program leadership, and wellness committees. Residents also described important barriers to use for each of these resources, which limited their access and value of these resources. Finally, residents shared their recommendations for future initiatives, including additional protected time off during weekdays and regular usage of structured debrief sessions following adverse patient outcomes. Conclusions While institutional resources are commonly available to surgery residents, there remain important limitations and barriers to use, which may limit their effectiveness in supporting resident well-being in times of need. These barriers should be addressed at the program level to improve services and accessibility for residents.
Collapse
Affiliation(s)
- Michaela C. Bamdad
- From the Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - C. Ann Vitous
- From the Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Samantha J. Rivard
- From the Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Maia Anderson
- From the Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Alisha Lussiez
- From the Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Ana C. De Roo
- From the Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Michael J. Englesbe
- From the Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Pasithorn A. Suwanabol
- From the Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI
- Department of Surgery, University of Michigan, Ann Arbor, MI
| |
Collapse
|
61
|
Dill-Macky A, Hsu CH, Neumayer LA, Nfonsam VN, Turner AP. The Role of Implicit Bias in Surgical Resident Evaluations. JOURNAL OF SURGICAL EDUCATION 2022; 79:761-768. [PMID: 34973900 DOI: 10.1016/j.jsurg.2021.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/31/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Implicit bias is a key factor preventing the advancement and retention of women and underrepresented minorities in academic surgery. PURPOSE We examined the role of implicit bias in the technical component of the residency performance evaluation. The Fundamentals of Laparoscopic Surgery (FLS) score, an objective measure of technical performance, was compared to the subjective technical skills (TS) score given by attending surgeons. PROCEDURES FLS scores and the average TS scores from chief resident evaluations at a university program were analyzed from 2015 to 2019 (n = 29 residents; female 22%, underrepresented minorities 27%). The average TS score for each resident was calculated, scores dichotomized above and below the mean for the program and analyzed across gender and racial identity. MAIN FINDINGS There were no significant differences in FLS or TS scores between male and female trainees or racial identity. The Kappa correlation coefficient between the 2 dichotomized scores was significantly lower for female (-0.50) versus male (0.23) trainees (p < 0.01); it was not significantly different between racial groups (p = 0.34). PRINCIPAL CONCLUSIONS There was statistically significant difference in agreement between the FLS and TS scores of individual female and male trainees, suggesting the presence of implicit bias in our pilot study. Further research with a larger sample size is warranted. OBJECTIVE To investigate the presence of implicit bias against women and underrepresented minorities in the technical component of the residency performance evaluation. We hypothesized that women and underrepresented racial minorities would have lower subjective technical skills (TS) scores as compared to their objective FLS scores, relative to the mean for the training program. DESIGN FLS scores and the average TS scores from chief resident performance evaluations were analyzed from 2015-2019. Both FLS and the average TS scores were dichotomized above and below the mean for the program and analyzed across gender and racial identity. Research was approved by institutional IRB. SETTING This study was conducted at the University of Arizona General Surgery Residency Program at Banner University Medical Center in Tucson, Arizona. This is a tertiary care university training program. PARTICIPANTS Educational records of graduated general surgery chief residents from 2015 to 2019 were accessed for the study. We analyzed 37 TS scores from attending performance evaluations and 29 FLS scores reported to the program during the study period (22% female, 27% underrepresented racial minorities). RESULTS There were no significant differences in FLS or TS scores between male and female trainees or racial identity. The Kappa correlation coefficient between the 2 dichotomized scores was significantly lower for female (-0.50) versus male (0.23) trainees (p < 0.01); it was not significantly different between racial groups (p = 0.34). CONCLUSIONS There was a statistically significant difference in agreement between the FLS and TS score of individual female and male trainees, suggesting the presence of implicit bias in this pilot study. Further research with a larger sample size is warranted.
Collapse
Affiliation(s)
- Arabella Dill-Macky
- Department of Surgery, College of Medicine, The University of Arizona, Tucson, Arizona
| | - Chiu-Hsieh Hsu
- Department of Surgery, College of Medicine, The University of Arizona, Tucson, Arizona
| | - Leigh A Neumayer
- Department of Surgery, College of Medicine, The University of Florida, Jacksonville, Florida
| | - Valentine N Nfonsam
- Department of Surgery, College of Medicine, The University of Arizona, Tucson, Arizona
| | - Alexandra P Turner
- Department of Surgery, College of Medicine, The University of Arizona, Tucson, Arizona.
| |
Collapse
|
62
|
Aguwa UT, Aguwa CJ, Onor GI, Srikumaran D, Canner J, Knight OJ, Green LK, Woreta F. Racial and Ethnic Diversity Within U.S. Residencies: Trends from 2011 to 2019. JOURNAL OF SURGICAL EDUCATION 2022; 79:587-594. [PMID: 35153146 DOI: 10.1016/j.jsurg.2022.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 12/15/2021] [Accepted: 01/08/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Examine trends in the proportion of underrepresented minority (URM) residents from 2011 to 2019 across all specialties and investigate differences between surgical and non-surgical specialties. DESIGN Cross-sectional study. SETTING N/A. PARTICIPANTS The authors extracted data on the proportion of URM residents in all specialties from the Accreditation Council for Graduate Medical Education yearly reports. RESULTS There was a statistically significant decline in the proportion of URM residents in surgical specialties (p < 0.01) from 2011 (9.9%) to 2019 (9.1%) and a significant increase in the proportion of URM residents in non-surgical specialties (p < 0.01) from 2011 (9.6%) to 2019 (10.2%). CONCLUSIONS This study emphasizes the need to increase recruitment of URMs in medicine, especially in surgical specialties. Findings from this study can inform much-needed initiatives to address barriers to entry for diverse applicants within specialties that lack diversity and have shown minimal improvement over time.
Collapse
Affiliation(s)
- Ugochi T Aguwa
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Chibuzo J Aguwa
- Meharry Medical College School of Medicine, Nashville, Tennessee
| | - Gabriel I Onor
- Department of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Divya Srikumaran
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - Joseph Canner
- Johns Hopkins Surgery Center for Outcomes Research, Johns Hopkins University, Baltimore, Maryland
| | - O'Rese J Knight
- Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Laura K Green
- Department of Ophthalmology, Krieger Eye Institute, Sinai Hospital, Baltimore, Maryland
| | - Fasika Woreta
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
| |
Collapse
|
63
|
Edwards GC, Wong SL, Russell MC, Winslow ER, Shaffer VO, Pawlik TM. Society for Surgery of the Alimentary Tract Health Care Quality and Outcomes Committee Webinar: Addressing Disparities. J Gastrointest Surg 2022; 26:997-1005. [PMID: 35318595 DOI: 10.1007/s11605-022-05300-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/09/2022] [Indexed: 01/31/2023]
Affiliation(s)
- Gretchen C Edwards
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sandra L Wong
- Department of Surgery, Dartmouth-Hitchcock and Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Maria C Russell
- Department of Surgery, Winship Cancer Institute at Emory University, Atlanta, GA, USA
| | - Emily R Winslow
- Department of Surgery, Medstar Georgetown Medical Center, Washington, DC, USA
| | - Virginia O Shaffer
- Department of Surgery, Winship Cancer Institute at Emory University, Atlanta, GA, USA
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, 395 W. 12th Ave., Suite 670, Columbus, OH, USA.
| |
Collapse
|
64
|
Aguwa UT, Wang J, Woreta F, Pettey J, Sun G, Pineles S, Srikumaran D. Residency Program Diversity Recruitment and Education: Survey of Efforts and Barriers to Implementation. JOURNAL OF SURGICAL EDUCATION 2022; 79:595-605. [PMID: 34952819 PMCID: PMC9064934 DOI: 10.1016/j.jsurg.2021.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 11/01/2021] [Accepted: 11/27/2021] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Examine underrepresented minority (URM) recruitment and diversity education initiatives provided by residency programs in ophthalmology and other specialties, and identify means to support programs as they work to enhance diversity efforts. DESIGN Cross-sectional study. SETTING Multi-center survey of residency program leadership of the Association of University Professors of Ophthalmology, Johns Hopkins Medicine, University of Utah, and the University of California, Los Angeles. PARTICIPANTS Residency program leadership (i.e., residency program directors and associate residency program directors) RESULTS: Our survey response rate was 34% (63/188); 56% percent of responses were from ophthalmology and 44% were from other specialties. Across all specialties, programs with a large number of clinical faculty and trainees were associated with having ≥1 URM resident in their program (p = 0.026 and p = 0.028, respectively). There was no significant difference between ophthalmology and other specialties with regard to the number of URM residents. Ninety-two percent of programs utilized strategies to recruit URM applicants. While certain strategies were more common for ophthalmology than other specialties, information sessions for URM students (62%) and a unique review of all URM residency applicants by a separate committee/person (46%) were most commonly used overall. Although 92% of residency program leadership believed it was highly important for health professionals to receive formal diversity training, only 54% of programs had a diversity education curriculum for both trainees and faculty, 11% had a curriculum for faculty only, and 3% had a curriculum for trainees only. Barriers to implementation of curricula included lack of faculty expertise (30%) and curricular time (30%). CONCLUSIONS An overwhelming majority of programs in our study utilized strategies to recruit URM applicants, but 22% had 0 URM residents in their program. To address the reported barriers to diversity education implementation, shared central resources/diversity education toolkits should be created to provide programs with needed support.
Collapse
Affiliation(s)
- Ugochi T Aguwa
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jiangxia Wang
- Department of Biostatistics, Johns Hopkins University School of Public Health, Baltimore, Maryland
| | - Fasika Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jeff Pettey
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Grace Sun
- Department of Ophthalmology, Weill Cornell Medicine, New York, New York
| | - Stacy Pineles
- Jules Stein Eye Institute, University of California, Los Angeles, California
| | - Divya Srikumaran
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
| |
Collapse
|
65
|
Zhu C, McCloskey D, Sandilos G, Zilberman B, Crudeli C, Hunter K, Mitchell T, Burg JM, Shersher DD. The State of Racial and Gender Diversity In Cardiothoracic Surgery Training. Ann Thorac Surg 2022; 114:1492-1499. [PMID: 35398039 DOI: 10.1016/j.athoracsur.2022.02.083] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 01/31/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The field of cardiothoracic surgery has been striving to increase its gender and racial diversity. We sought to examine changes in gender and racial diversity in cardiothoracic fellowships and integrated residencies in the past decade. METHODS Accreditation Council for Graduate Medical Education data was obtained from 2011 to 2019. Presence of linear trends was assessed for year-by-year data. Average percentages of women and under-represented minorities were then calculated in three-year intervals. Intervals were compared with t-test and chi-square tests. RESULTS There was no statistically significant increase in percent female trainees in cardiothoracic fellowships (18.5% to 22.1% [p=0.10]) or integrated residencies (22.8% to 27.8% [p=0.17]), despite a significant increase in percent female applicants to fellowship (18.2% to 35.3% [p<0.01]) and integrated residency (8.9% to 33.0% [p<0.01]). Cardiothoracic fellowships had no increase in under-represented minority trainees (8.3% to 9.4% [p=0.48]). Under-represented minority trainees in integrated residencies increased from 2.7% to 6.9% [p=0.03]. Although there was no significant increase in under-represented minority applicants to fellowships (10.2% to 11.3% [p=0.66]), the percent of under-represented minority applicants to integrated residencies increased from 13.1% to 19.3% [p<0.01]. CONCLUSION Cardiothoracic surgery training programs are attracting more female applicants, but this has not resulted in more female trainees. While percentages of under-represented minorities increased among integrated residency applicants and trainees, they remain low compared to other specialties. This data reflects positive changes but highlights that much remains to be done to increase diversity in cardiothoracic surgery training.
Collapse
Affiliation(s)
- Clara Zhu
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Dana McCloskey
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | | | - Brian Zilberman
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Connor Crudeli
- Cooper Medical School of Rowan University, Camden, New Jersey
| | - Krystal Hunter
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Tovah Mitchell
- Department of Anthropology, Rowan University, Glassboro, New Jersey
| | - Jennifer M Burg
- Department of Surgery, Cooper University Hospital, Camden, New Jersey.
| | - David D Shersher
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| |
Collapse
|
66
|
Jain A, Nichols G, Tarabishy S, Scomacao I, Herrera FA. A Comparison of Applicant and Resident Physician Demographics Among Surgical Subspecialties From 2009 to 2019: Trends in Gender and Underrepresented Minorities in Medicine. Ann Plast Surg 2022; 88:451-459. [PMID: 34711732 DOI: 10.1097/sap.0000000000003041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The purposes of this study were to compare applicant statistics to resident physician demographics among several surgical subspecialties (SSSs), to identify trends of gender and underrepresented minorities in medicine (UIM), and to evaluate current diversity among these specialties. METHODS Graduate medical education reports from 2009 to 2019 were queried to determine trends among programs. Further identification of gender and UIM statistics was obtained in 4 several SSSs: integrated plastic surgery, orthopedic surgery (OS), otolaryngology surgery (ENT), and neurosurgery (NS). These were compared with Association of American Medical Colleges data of residency applicants for the respective years. RESULTS Significant differences were seen among gender and UIM(s) of the applicant pool when compared with resident data. All specialties had significantly fewer American Indian and African American residents compared with applicants. Significant differences between applicants and residents were also found among Hispanic, Native Hawaiian, and female demographics. All SSSs had a significant positive trend for the percentage of female residents. Significant differences between specialties were identified among African American, Hispanic, and female residents. Orthopedic surgery and NS had significantly higher percentage of African American residents compared with ENT and integrated plastic surgery. Neurosurgery had significantly higher percentage of Hispanic residents compared with OS and ENT. Integrated plastic surgery and ENT had significantly higher percentage of female residents compared with OS and NS. CONCLUSIONS There has been significant increase in number of residency programs and resident positions since 2009. However, increase in female residents and UIM(s) among SSSs has not matched the pace of growth.
Collapse
Affiliation(s)
| | - Georgina Nichols
- Division of Plastic Surgery, Medical University of South Carolina
| | - Sami Tarabishy
- Division of Plastic Surgery, Medical University of South Carolina
| | | | | |
Collapse
|
67
|
Wang A, Shlobin NA, DiCesare JAT, Holly LT, Liau LM. Diversity in Neurosurgical Recruitment and Training in the United States: A Systematic Review. World Neurosurg 2022; 162:111-117.e1. [PMID: 35339710 DOI: 10.1016/j.wneu.2022.03.086] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The benefits of diversity are particularly salient in neurosurgical training because of treatment of varied patient populations and the importance of close collaboration between trainees and attending neurosurgeons of different backgrounds. However, there is a paucity of literature that comprehensively examines diversity in neurosurgical recruitment and training. The aim of this study is to systematically review the scope of diversity in neurosurgical recruitment and training. METHODS PudMed, Embase, and Scopus were searched since inception to October 31, 2021. Inclusion consisted of 1) on neurosurgery training; 2) sample was medical student, resident, fellows or attending; 3) discussed diversity variable(s). This study followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS Of 1578 articles, 15 studies were included. Studies largely reported gender (n = 14) underrepresentation in neurosurgery compared with racial/ethnic diversity (n = 2) and socioeconomic status (n = 1). From studies focusing on residency match (n = 4), women medical students placed greater emphasis on mentorship, earlier clinical exposure, and program camaraderie and reputation as most important. From studies (n = 4) reporting retention and attrition, although women residents and attendings representation has increased, black, indigenous and people of color groups continue to represent <15% of studies on neurosurgical training. Studies (n = 4) discussing research suggested that women residents were more likely to have lower h-indices with fewer research grants. Studies (n = 4) describing workforce employment further showed that women and racial/ethnic minority groups were less likely to hold high academic and leadership positions. In studies (n = 4) on work-life balance, 18.5% women attendings found less career fulfillment and 20.4% would not choose to pursue neurosurgery again because of lack of protected personal time. CONCLUSIONS This systematic review shows the scope of studies of diversity within neurosurgery and provides impetus for efforts to expand our understanding of diversity within the field.
Collapse
Affiliation(s)
- Andrew Wang
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA; College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, Los Angeles, California, USA.
| | - Nathan A Shlobin
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Jasmine A T DiCesare
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Langston T Holly
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Linda M Liau
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| |
Collapse
|
68
|
Siddiqui AA, Reese A, Debs S, Carr MM. Otolaryngology Residency Match During the COVID-19 Pandemic. Cureus 2022; 14:e23258. [PMID: 35449625 PMCID: PMC9012558 DOI: 10.7759/cureus.23258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To review changes made by otolaryngology residency program directors (PDs) during the 2020-2021 National Resident Matching Program (NRMP) match cycle and describe their attitudes toward the 2021-2022 match cycle. Methods Cross-sectional study using an anonymous 31-item online survey in Research Electronic Data Capture (REDCap) with questions regarding the 2020-2021 NRMP match. This survey was distributed to 125 PDs from Accreditation Council for Graduate Medical Education (ACGME)-accredited otolaryngology residency programs. Results Thirty-three PDs responded (26.4%). Of the PDs, 78.8% had an online info-session prior to the start of the cycle, and 30.3% reported that an increased number of applicants contacted them compared to the prior cycle. There were no changes made in Step 1 criteria (72.7%), and 81.8% reported no changes in interview selection. Of the PDs, 54.5% reported interviewing more candidates. Respondents reported a decreased cancellation rate (66.7%) and cost of recruiting (87.9%); 87.9% said that they did not change the way they developed their rank order list (ROL), and 84.8% reported matching at their usual level compared to prior years. Of the respondents, 42.4% reported making a change that was an overall improvement for their program. Of the PDs, 34.4% were unsure whether they would sustain virtual interviews in 2021-2022, 25% stated that they would not incorporate virtual interviews, and 40.7% stated that they would incorporate a virtual interview in some part of the cycle. Conclusion Otolaryngology PDs approached virtual interviewing in different ways. Despite the changes made, applicants can find comfort in knowing that match outcomes were perceived as typical by a majority of PDs.
Collapse
|
69
|
Bamdad MC, Vitous CA, Rivard SJ, Anderson M, Lussiez A, Jafri SM, Roo AD, Suwanabol PA. "You Remember Those Days"-A Qualitative Study of Resident Surgeon Responses to Complications and Deaths. JOURNAL OF SURGICAL EDUCATION 2022; 79:452-462. [PMID: 34756685 PMCID: PMC10249722 DOI: 10.1016/j.jsurg.2021.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/04/2021] [Accepted: 09/16/2021] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Postoperative complications and deaths are unavoidable aspects of a surgical career, but little is known about the impacts of these unwanted outcomes on resident surgeons. The goal of this study was to characterize the impact of complications and deaths on surgery residents in order to facilitate development of improved support systems. DESIGN This qualitative study was designed to explore resident surgeons' experiences with unwanted outcomes, including postoperative complications and death. Semi-structured interviews explored a range of topics related to personal experiences with unwanted outcomes. Analyses of interview transcripts were performed iteratively and informed by thematic analysis. SETTING An anthropologist at the University of Michigan conducted interviews with general surgery residents from academic, community, and hybrid training programs across the country. PARTICIPANTS Twenty-eight mid-level and senior residents (PGY3 and above) were recruited for participation from 14 different training programs across the United States. RESULTS Resident surgeons described an initial period of emotional response, characterized by feelings of sadness, frustration, or grief. Simultaneously or soon afterward, interviewees described a period of intellectual response aimed at understanding how and why an outcome occurred, with the expressed goal of learning from it. Many residents described impacts to their personal lives. Several factors that influenced the duration and intensity of these responses were identified, including a sense of ownership, which was a powerful driver for improvement. CONCLUSIONS This qualitative study provides a nuanced description of resident surgeons' responses to unwanted outcomes. While emotional responses were characterized by strong feelings, such as sadness and grief, intellectual responses were focused on learning from the events. These data may help inform the development of structured support systems by residency programs. STRUCTURED ABSTRACT Facing post-operative complications and deaths is an unavoidable aspect of surgical training, but the impacts on surgery residents has not been well characterized. Through semi-structured interviews with general surgery residents from programs across the United States, this qualitative study explored the ways that residents respond to unwanted outcomes. Residents described an initial period of emotional response, characterized by strong feelings, often of sadness or grief. There was a subsequent or concomitant period of intellectual response, in which residents examined how and why this outcome occurred, with the goal of learning from it. A feeling of ownership was strengthened by involvement in patient care and length of rotation. In light of this detailed description of resident experiences, residency programs can foster the development of improved support for trainees as they navigate these profoundly impactful events.
Collapse
Affiliation(s)
- Michaela C Bamdad
- Center for Health care Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan.
| | - C Ann Vitous
- Center for Health care Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Samantha J Rivard
- Center for Health care Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Maia Anderson
- Center for Health care Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Alisha Lussiez
- Center for Health care Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Sara M Jafri
- Center for Health care Outcomes and Policy, University of Michigan, Ann Arbor, Michigan
| | - Ana De Roo
- Center for Health care Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Pasithorn A Suwanabol
- Center for Health care Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan
| |
Collapse
|
70
|
Dorismond C, Farzal Z, Shah RN, Ebert CS, Buckmire RA. Effect of Application Screening Methods on Racial and Ethnic Diversity in Otolaryngology. Otolaryngol Head Neck Surg 2022; 166:1166-1168. [PMID: 35230910 DOI: 10.1177/01945998221083281] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Otolaryngology-head and neck surgery (OHNS) lags behind other surgical subspecialties in the representation of underrepresented minorities in medicine (URMs). Given the recently announced changes to Step 1 scoring, we aimed to assess the effect of alternative application screening methods-Step 2 Clinical Knowledge scores and Alpha Omega Alpha membership-on the racial/ethnic diversity of the OHNS applicant pool. After reviewing OHNS residency applications submitted to our institution for the 2015-2020 matches (N = 2177), we determined that a significantly greater proportion of URM vs non-URM applicants would be screened out from interview consideration if any the following were used as an initial screening method: Step 2 cutoff score of 240, Step 2 cutoff score of 253 or non-Alpha Omega Alpha membership (P < .01 for each). Given that using these metrics to screen applications disproportionately affects URMs, programs should consider implementing alternative application review methods, such as holistic evaluation, which may promote more equitable distribution of interviews.
Collapse
Affiliation(s)
- Christina Dorismond
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Zainab Farzal
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rupali N Shah
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Charles S Ebert
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Robert A Buckmire
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| |
Collapse
|
71
|
Kay HG, Makhoul AT, Ganesh Kumar N, Pontell ME, Drolet BC, Whigham AS. Otolaryngology Program Director, House-Staff, and Student Opinions: Step 1 Pass/Fail Score Reporting. Ann Otol Rhinol Laryngol 2022; 132:63-68. [PMID: 35152774 DOI: 10.1177/00034894221078364] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE(S) To compare otolaryngology program director, house-staff, and medical student perspectives on the score reporting change of USMLE Step 1 to pass/fail. METHODS Separate electronic surveys were sent to program directors of ACGME-accredited otolaryngology programs (Cronbach's alpha = .87), otolaryngology house-staff (Cronbach's alpha = .91), and medical students interested in otolaryngology (Cronbach's alpha = .76). RESULTS Among the 51 otolaryngology program directors that completed the survey (response rate of 46.8%), 17.6% favored reporting USMLE Step 1 as pass/fail. A majority believed the reporting change would make it more difficult to screen (74.5%) and objectively compare applicants (82.4%). Step 2 CK scores will be more important to most program directors due to the reporting change (83.7%). Of the 93 house-staff that completed surveys, most did not favor the reporting change (61.3%). Over half (54.0%) of the 87 medical students that completed surveys did not support the scoring change, and most (65.5%) did not feel that it would decrease anxiety around residency applications (65.5%). Most house-staff and medical students felt that the scoring change would put non-U.S. MD students at a disadvantage (65.6% of house-staff, 69.8% of medical students). CONCLUSION Most survey respondents do not agree with the decision to report Step 1 as pass/fail. Despite its intended goals, most do not believe pass/fail Step 1 reporting will improve medical student well-being and believe it will put certain student populations at a greater disadvantage.
Collapse
Affiliation(s)
- Hannah G Kay
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Alan T Makhoul
- Vanderbilt University School of Medicine, Nashville, TN, USA.,Department of Medical Bioinformatics, Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Nishant Ganesh Kumar
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Matthew E Pontell
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brian C Drolet
- Department of Medical Bioinformatics, Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amy S Whigham
- Vanderbilt University School of Medicine, Nashville, TN, USA.,Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.,Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
72
|
Johnson BC, Hayden J, Jackson J, Harley R, Harley EH. Hurdles in Diversifying Otolaryngology: A Survey of Medical Students. Otolaryngol Head Neck Surg 2022; 166:1161-1165. [PMID: 35133915 DOI: 10.1177/01945998221076835] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The field of otolaryngology has one of the lowest rates of racial and ethnic diversity. An anonymous survey was distributed to members of the Student National Medical Association at different medical schools to identify factors that may contribute to this disparity. Responses were received from 104 students at 36 allopathic medical schools. Most respondents identified as black (86.5%). One-third of students (34.6%) noted that they were discouraged from pursuing otolaryngology due to lack of mentorship, and among these students, most noted that they lack mentors of the same race (75%). One-fourth of respondents (25%) indicated that they lack a home otolaryngology program. The most common reasons for participants' disinterest in otolaryngology included competitiveness, inadequate exposure, research, and the high board scores needed to match. This hypothesis-generating, proof-of-concept study highlights potential barriers that may discourage underrepresented medical students from pursuing a career in otolaryngology.
Collapse
Affiliation(s)
- Bria C Johnson
- Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Jamil Hayden
- Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Jarrett Jackson
- Howard University College of Medicine, Washington, District of Columbia, USA
| | - Randall Harley
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Earl H Harley
- Department of Otolaryngology-HNS, Medstar Georgetown University Hospital, Washington, District of Columbia, USA
| |
Collapse
|
73
|
Sopeyin A, Knight OJ, Green LK, Woreta F. Improving Self-Reported Metrics on Racial/Ethnic Diversity in Ophthalmology Trainee Recruitment: Lessons Learned and Future Directions. Am J Ophthalmol 2022; 234:A1-A4. [PMID: 34280367 DOI: 10.1016/j.ajo.2021.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/11/2021] [Accepted: 07/01/2021] [Indexed: 11/01/2022]
|
74
|
Trends in Diversity in Integrated Cardiothoracic Surgery Residencies. Ann Thorac Surg 2022; 114:1044-1048. [DOI: 10.1016/j.athoracsur.2022.01.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/18/2021] [Accepted: 01/23/2022] [Indexed: 11/20/2022]
|
75
|
Saboor S, Naveed S, Safdar B, Chaudhary AM, Khan S, Khosa F. Working Towards Gender and Racial Diversity in Pediatric Residency Programs in the United States. Cureus 2022; 14:e21633. [PMID: 35233311 PMCID: PMC8881275 DOI: 10.7759/cureus.21633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction The gender and racial profile of the pediatric population in the United States (US) is more diverse than that of the pediatricians that cater to their healthcare needs. Gender and racial diversity remains limited among pediatric residents and fellows, faculty, and leadership. Our study objectives were to explore the gender and racial disparity among pediatric residents in the US. Methods This was a retrospective analysis of the Accreditation Council for Graduate Medical Education (ACGME) database. The database encompassed all residents in US pediatrics residency programs from 2007 to 2021, categorizing them into White (non-Hispanic), Asian/Pacific Islander, Hispanic, African American/Black (non-Hispanic), Native American/Alaskan, others (races not included in the mentioned categories), and unknown. Gender was grouped into male, female, and not reported. Results From 2011 to 2021, the greatest increase in relative change (%) was seen for Asian or Pacific Islander (+58.42%), followed by Black (non-Hispanic) (+45.24%), White (non-Hispanic) (+43.37%), and Hispanic (+42.18%) races. The Native American/Alaskan relatively decreased 50%. The representation of female residents relatively increased by 13.27% as compared to the relative increase of male residents (+14.77%) from 2007 to 2021. Conclusion It is imperative to have a healthcare workforce that is representative of the existing communities in the US in terms of race, ethnicity, and gender to provide culturally sensitive care to the diverse patient population of the US.
Collapse
|
76
|
Schmeusser B, Gauthier Z, Nagy K. Assessment of Resident Burnout After Formalization of Wellness Program. Mil Med 2022; 188:usac004. [PMID: 35043956 DOI: 10.1093/milmed/usac004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/01/2021] [Accepted: 01/10/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Burnout has reached epidemic levels among resident physicians. Characterized by emotional exhaustion (EE), depersonalization, and feelings of inefficacy, burnout negatively affects patient outcomes, increases costs, and decreases physician quality of life. These negative outcomes catalyze leaders in graduate medical education to address burnout and reverse its trends. The primary aim of this project is to design a residency Wellness Program utilizing the facets of physician wellness, assess levels of burnout among resident physicians, and determine the program's effects on burnout. MATERIALS AND METHODS A Wellness Program was formalized at a Midwestern, military-civilian Obstetrics and Gynecology residency program for the 2019-2020 academic year. Resident wellness and perceptions were assessed at three time points (0, 6, and 12 months) through surveys consisting of free response, yes-no questions, and the Maslach Burnout Inventory Scales. RESULTS On average, 17 of 24 residents completed all three survey assessments. Perception of the residency program prioritization of wellness increased significantly from 52.9% to 94.4% (P = .007). Residents consistently demonstrated burnout throughout the year with low levels of EE, high levels of depersonalization, and moderate levels of personal achievement. Residents were consistently satisfied with their personal wellness (80%-92.9%) during the program. Residents wanted to see physical activity incorporated into the program. CONCLUSIONS This study assessed burnout during a formalization of a Wellness Program and insight on resident perceptions and wellness requests. Military medicine, graduate medical education, and other residency programs can utilize this research to better develop and study the implementation of wellness initiatives aimed at reducing burn out.
Collapse
|
77
|
Oseni TO, Kelly BN, Pei K, Nielsen M, Pitt SC, Diego E, Mouawad NJ, Stein SL. Diversity efforts in surgery: Are we there yet? Am J Surg 2022; 224:259-263. [DOI: 10.1016/j.amjsurg.2022.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/24/2021] [Accepted: 01/19/2022] [Indexed: 12/12/2022]
|
78
|
Affi Koprowski M, Dickinson KJ, Johnson-Mann CN, Godfrey M, Diego EJ, Crandall M, Pei KY. Cross-mentorship: A Unique Lens Into the Realities and Challenges of Diversity in Surgery. Ann Surg 2022; 275:e6-e7. [PMID: 34520426 DOI: 10.1097/sla.0000000000005213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Karen J Dickinson
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Crystal N Johnson-Mann
- Division of Gastrointestinal Surgery, Department of Surgery, University of Florida College of Medicine, Gainesville, FL
| | - Martha Godfrey
- Department of Surgery, University of Florida College of Medicine, Gainesville, FL
| | - Emilia J Diego
- Division of Surgical Oncology, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Marie Crandall
- Division of Acute Care Surgery, Department of Surgery, University of Florida College of Medicine, Jacksonville, FL
| | - Kevin Y Pei
- Department of Surgery, Parkview Health Graduate Medical Education, Fort Wayne, IN
| |
Collapse
|
79
|
Usher I, Hellyer P, Lee KS, Leech R, Hampshire A, Alamri A, Chari A. "It's not rocket science" and "It's not brain surgery"-"It's a walk in the park": prospective comparative study. BMJ 2021; 375:e067883. [PMID: 34903556 PMCID: PMC8667323 DOI: 10.1136/bmj-2021-067883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare cognitive testing scores in neurosurgeons and aerospace engineers to help settle the age old argument of which phrase-"It's not brain surgery" or "It's not rocket science"-is most deserved. DESIGN International prospective comparative study. SETTING United Kingdom, Europe, the United States, and Canada. PARTICIPANTS 748 people (600 aerospace engineers and 148 neurosurgeons). After data cleaning, 401 complete datasets were included in the final analysis (329 aerospace engineers and 72 neurosurgeons). MAIN OUTCOME MEASURES Validated online test (Cognitron's Great British Intelligence Test) measuring distinct aspects of cognition, spanning planning and reasoning, working memory, attention, and emotion processing abilities. RESULTS The neurosurgeons showed significantly higher scores than the aerospace engineers in semantic problem solving (difference 0.33, 95% confidence interval 0.13 to 0.52). Aerospace engineers showed significantly higher scores in mental manipulation and attention (-0.29, -0.48 to -0.09). No difference was found between groups in domain scores for memory (-0.18, -0.40 to 0.03), spatial problem solving (-0.19, -0.39 to 0.01), problem solving speed (0.03, -0.20 to 0.25), and memory recall speed (0.12, -0.10 to 0.35). When each group's scores for the six domains were compared with those in the general population, only two differences were significant: the neurosurgeons' problem solving speed was quicker (mean z score 0.24, 95% confidence interval 0.07 to 0.41) and their memory recall speed was slower (-0.19, -0.34 to -0.04). CONCLUSIONS In situations that do not require rapid problem solving, it might be more correct to use the phrase "It's not brain surgery." It is possible that both neurosurgeons and aerospace engineers are unnecessarily placed on a pedestal and that "It's a walk in the park" or another phrase unrelated to careers might be more appropriate. Other specialties might deserve to be on that pedestal, and future work should aim to determine the most deserving profession.
Collapse
Affiliation(s)
- Inga Usher
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
- Cancer Institute, University College London, London, UK
- Brainbook, London, UK
| | - Peter Hellyer
- Department of Brain Sciences, Imperial College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Keng Siang Lee
- Brainbook, London, UK
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Robert Leech
- Department of Neuroimaging, Kings College London, London, UK
| | - Adam Hampshire
- Department of Brain Sciences, Imperial College London, London, UK
| | - Alexander Alamri
- Brainbook, London, UK
- Neurosciences Research Centre, Molecular and Clinical Sciences Institute, St George's University of London, London, UK
| | - Aswin Chari
- Brainbook, London, UK
- Great Ormond Street Institute of Child Health, University College London, London, WC1N 3JH, UK
- Department of Neurosurgery, Great Ormond Street Hospital, London, UK
| |
Collapse
|
80
|
Uppal PA, Kollu T, Thomas M, Mammen L, Mortensen M. Otolaryngology Department and Society Leadership: Evaluation of Diversity in a Nationwide Study. Laryngoscope 2021; 132:1729-1737. [PMID: 34854488 DOI: 10.1002/lary.29957] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 10/14/2021] [Accepted: 11/15/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS Diversity in medicine positively influences healthcare delivery. As we aim to make otolaryngology more diverse, it is essential to analyze our current leadership. STUDY DESIGN Observational study. METHODS A total of 262 department chairs and chiefs, residency program directors, and assistant and associate directors from 117 otolaryngology residency programs as well as 92 society leaders from nine otolaryngology national societies from 2010 to 2020 in the United States are included in this study. The position, academic rank, name, gender, inferred race (based on name and image), and h-index are collected and recorded from publicly available data. Fisher's exact test, unpaired t tests, and analysis of variance tests are used. RESULTS The ethno-racial breakdown of all otolaryngology residency leaders is as follows: 78.63% non-Hispanic (NH) White, 16.03% NH Asian, 2.29% Middle Eastern, 1.91% NH Black, and 1.15% Latinx. Male gender is found to be a predictor of full professorship title (P < .0001) with an odds ratio (OR) of 4.066. NH White male is also a predictor of full professorship (P < .0001) with an OR 3.05. When comparing h-index, males and females differ (P < .0001) across all residency leadership positions. There is a higher h-index among full professors compared to non-full professors (P < .0001). The ethno-racial breakdown of society leaders is 84% NH White, 11% NH Asian, 2% NH Black, 2% Latinx, and 1% Middle Eastern. CONCLUSIONS In conclusion, otolaryngology leadership has an under-representation of women and certain ethno-racial groups. Continued efforts should be made to diversify our specialty's leadership. LEVEL OF EVIDENCE NA Laryngoscope, 2021.
Collapse
Affiliation(s)
- Priya A Uppal
- Department of Otolaryngology, Albany Medical Center, Albany, New York, U.S.A
| | - Tejas Kollu
- Department of Otolaryngology, Albany Medical Center, Albany, New York, U.S.A
| | - Melissa Thomas
- Department of Otolaryngology, Albany Medical Center, Albany, New York, U.S.A
| | - Luke Mammen
- Department of Otolaryngology, Albany Medical Center, Albany, New York, U.S.A
| | - Melissa Mortensen
- Department of Otolaryngology, Albany Medical Center, Albany, New York, U.S.A
| |
Collapse
|
81
|
Cleland J, Razack S. When I say … privilege. MEDICAL EDUCATION 2021; 55:1347-1349. [PMID: 34291495 DOI: 10.1111/medu.14599] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/10/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Jennifer Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Saleem Razack
- Department of Pediatrics and Institute for Health Sciences Education, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
82
|
Mohan AT, Banuelos J, Cespedes-Gomez O, Kapoor T, Moran SL, Heller SF, Dozois EJ, Nelson H, Stulak JM, Martinez-Jorge J. Diversity Matters: A 21-Year Review of Trends in Resident Recruitment into Surgical Specialties. ANNALS OF SURGERY OPEN 2021; 2:e100. [PMID: 37637873 PMCID: PMC10455279 DOI: 10.1097/as9.0000000000000100] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022] Open
Abstract
Background Diversity within the healthcare workforce is essential to improve quality of care, although evaluation of diversity within surgical training remains limited. This study analyzed diversity in recruitment of residents into surgical subspecialties at a large academic medical institution and national trends. Methods A 21-year cross-sectional study of medical school graduates accepted into all surgical subspecialty training programs was performed. The institutional cohort was divided into two groups (1997-2006, 2007-2017). Subspecialty acceptance rates were determined between 2011 and 2018. Data on candidate demographics including gender, race, ethnicity, citizenship, and origin of medical education at a single institution and nationally were extracted. Results Two thousand found hundred seventy-two residents were included in this study. From 1997 to 2018, female acceptances increased from 21.1% to 29.7% (p < 0.01), non-White increased from 27.9% to 31.8% (p = 0.01), and international medical graduates decreased from 28.8% to 25.5% (p = 0.02). There was no significant change in accepted Hispanic and Non-US candidates. Female subspecialty rates for subspecialties increased nationally and was comparable to our cohort, except in general surgery. Hispanic subspecialty acceptance rates were less than 10% and Black/African American acceptance rates remained less than 5% across subspecialties nationally and at our institution. Conclusion Diversity in surgical training has modestly progressed over the last two decades, but the degree of positive change has not been universal and highlights the critical need for improvement and action. Continued institution driven and collaborative strategies are essential to promote diversity in recruitment across all surgical specialties that has implications on our future workforce and surgical leadership.
Collapse
Affiliation(s)
- Anita T. Mohan
- Department of Surgery, Division of Plastic Surgery, Mayo Clinic, Rochester, MN
| | - Joseph Banuelos
- Department of Surgery, Division of Plastic Surgery, Mayo Clinic, Rochester, MN
| | - Omar Cespedes-Gomez
- Department of Surgery, Division of Plastic Surgery, Mayo Clinic, Rochester, MN
| | - Trishul Kapoor
- Department of Surgery, Division of Plastic Surgery, Mayo Clinic, Rochester, MN
- Department of Surgery, Division of Trauma, Critical Care, and General Surgery, Mayo Clinic, Rochester, MN
| | - Steven L. Moran
- Department of Surgery, Division of Plastic Surgery, Mayo Clinic, Rochester, MN
| | - Stephanie F. Heller
- Department of Surgery, Division of Trauma, Critical Care, and General Surgery, Mayo Clinic, Rochester, MN
| | - Eric J. Dozois
- Department of Surgery, Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN
| | - Heidi Nelson
- Department of Surgery, Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN
| | - John M. Stulak
- Department of Surgery, Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN
| | | |
Collapse
|
83
|
Acuña AJ, Sato EH, Jella TK, Samuel LT, Jeong SH, Chen AF, Kamath AF. Reply to the Letter to the Editor: How Long Will It Take to Reach Gender Parity in Orthopaedic Surgery in the United States? An Analysis of the National Provider Identifier Registry. Clin Orthop Relat Res 2021; 479:2759-2760. [PMID: 34581698 PMCID: PMC8726535 DOI: 10.1097/corr.0000000000001999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Alexander J. Acuña
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Eleanor H. Sato
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
| | - Tarun K. Jella
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Linsen T. Samuel
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Stacy H. Jeong
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Antonia F. Chen
- Orthopaedic and Arthritis Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Atul F. Kamath
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| |
Collapse
|
84
|
Sharma D, Cotton M. Physician, heal thyself. Trop Doct 2021; 51:470-472. [PMID: 34775870 DOI: 10.1177/00494755211050529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
85
|
Kong AW, Schallhorn JM, Ou Y. Single Ophthalmology Program Trends in Resident Surgical and Research Productivity by Gender, Underrepresented Minority Status, and Welcoming a Child. JOURNAL OF ACADEMIC OPHTHALMOLOGY 2021. [DOI: 10.1055/s-0041-1735580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Abstract
Objective The aim of the study is to identify differences for cataract surgery, total procedural volume, and publication rates between residents by gender, underrepresented minority (URM) status, and welcoming a child during ophthalmology residency.
Design This is a retrospective, cross-sectional study.
Participants A total of 89 residents graduating from 2002 to 2020 at a single program were included.
Methods A multiple linear regression model was created to determine factors predictive of the number of cataract surgeries performed as the primary surgeon, total procedural volume, number of publications, or first author publications. Independent variables included resident gender, URM status, PhD degree, welcoming a child during residency, and graduation year.
Results Of the 89 graduating residents included in this study, identifying as female (45 women, 50.6%) and as URM (eight identifying as URM, 9.0%) was not associated with a difference in surgical or research volume. Female residents performed a mean (SD) of 240.1 (55.1) cataract surgeries while male residents performed 210.6 (46.1) cataract surgeries. Residents identifying as URM completed 228.1 (41.9), while non-URM residents completed 234.8 (51.9) cataract surgeries. Since 2008, eight female residents (22.2%) and two male residents (6.9%) added children to their families. Welcoming a child to the family was also not associated with decreased surgical or publication volume. Number of cataract surgeries, total procedures, and number of publications did increase over time (p <0.001), as each graduation year was associated with 5.4 (95% CI: 3.9, 7.1) more cataract surgeries and 30.5 (95% CI: 25.7, 36.9) more procedures. Each year was also associated with 0.24 (95% CI: 0.09, 0.38) more publications and 0.18 (95% CI: 0.08, 0.28) more first author publications.
Conclusion Surgical and research productivity has increased, and female residents and residents who identify as URM did not have fewer cataract surgeries or procedures. Welcoming a child also did not correlate with differences in surgical or procedural volume. Programs should continue to promote equitable surgery and procedural distributions as well as identify more targeted strategies to encourage and recruit underrepresented medical students into ophthalmology.
Collapse
Affiliation(s)
- Alan W. Kong
- Department of Ophthalmology, School of Medicine, University of California San Francisco, San Francisco, California
| | - Julie M. Schallhorn
- Department of Ophthalmology, School of Medicine, University of California San Francisco, San Francisco, California
| | - Yvonne Ou
- Department of Ophthalmology, School of Medicine, University of California San Francisco, San Francisco, California
| |
Collapse
|
86
|
Kollu T, Giutashvili T, Uppal P, Ruffner R, Mortensen M. Diversity in Academic Laryngology: An Evaluation of Academic Advancement and Research Productivity. Laryngoscope 2021; 132:1245-1250. [PMID: 34726277 DOI: 10.1002/lary.29918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Diversity within the medical profession with respect to sex and racial minorities has been shown to have a positive effect on health and healthcare. Characterization of a field is key to evaluating trends and the advancement of diversity in an otolaryngology subspecialty. STUDY DESIGN Observational study. METHODS A comprehensive list of all the academic laryngologists was compiled from the Accreditation Council for Graduate Medical Education accredited otolaryngology residency programs in 2020. The last 20 past presidents of the American Laryngological Association (ALA) and American Broncho-Esophogological Association (ABEA) were analyzed. Academic rank and years in practice were determined from departmental websites, with online search tools used as secondary resources. The h-index was utilized as a measure of research productivity. Regression analysis was performed to analyze these variables. RESULTS There are 184 academic laryngologists in the 124 programs. The majority of the population is Caucasian 76.6% (141/184), followed by Asian 16.3% (30/184), African American 4.34% (8/184), and then Hispanic 1% (2/184). There are 47 full professors with 83% Caucasian, 14.1% Asian, and 2.1% African American and 91.5% male and only 8.5% female. Past ALA presidents were 90% male and for the ABEA 75% male. H-index revealed a statistically significant difference between Caucasian and African American colleagues [P value (<.0005)]. CONCLUSIONS Minorities are disproportionately underrepresented in laryngology. Women are less likely to be in leadership roles in laryngology and become full professors. Laryngology lags behind other surgical specialties in the representation of minorities and women. Continued efforts should be made to increase diversity in the field of laryngology, especially in regard to underrepresented minorities. LEVEL OF EVIDENCE N/A Laryngoscope, 2021.
Collapse
Affiliation(s)
- Tejas Kollu
- Department of Otolaryngology, Albany Medical Center, Albany, New York, U.S.A
| | | | - Priya Uppal
- Department of Otolaryngology, Albany Medical Center, Albany, New York, U.S.A
| | - Randall Ruffner
- Department of Otolaryngology, Albany Medical Center, Albany, New York, U.S.A
| | - Melissa Mortensen
- Department of Otolaryngology, Albany Medical Center, Albany, New York, U.S.A
| |
Collapse
|
87
|
Feldman AG, Squires JE, Hsu EK, Lobritto S, Mohammad S. The current state of pediatric transplant hepatology fellowships: A survey of recent graduates. Pediatr Transplant 2021; 25:e14065. [PMID: 34120405 PMCID: PMC10155256 DOI: 10.1111/petr.14065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/03/2021] [Accepted: 05/17/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND The number of programs offering a PTH fellowship has grown rapidly over the last 10 years. This study aimed to describe the clinical, didactic, procedural, and research experiences of recent PTH fellowship graduates. In addition, we sought to understand graduates' post-fellowship professional responsibilities and their perception about the utility of the PTH fellowship. METHODS An anonymous survey was distributed from February to October 2020 through REDCap to all recent graduates (2015-2019) of an ACGME-approved PTH fellowship program. The survey consisted of 49 questions focused on the PTH fellowship experience. Results were summarized using descriptive statistics. RESULTS Thirty-eight of 43 graduates (88%) responded to the survey representing 12 PTH fellowship programs. The didactic experience varied; 97% received pathology lectures, 81% radiology lectures, 54% organ allocation lectures, 54% procedural lectures, 57% immunology lectures, and 43% live donation lectures. During the PTH fellowship, the majority of fellows performed >10 liver biopsies (82%) and >5 variceal bandings (58%); however, 63%, 32%, 8%, and 8% never performed paracentesis, variceal sclerotherapy, variceal banding, and liver biopsies, respectively. The majority of fellows (95%) completed a research project during PTH fellowship. Currently, 84% of graduates are employed at a transplant academic institution. All graduates recommended the fellowship. CONCLUSIONS There is variability in the didactic, clinical, and procedural training among PTH fellowship programs. Although uniformly viewed as a beneficial fellowship year, there is an opportunity to collaborate to create a more standardized training experience.
Collapse
Affiliation(s)
- Amy G Feldman
- Section of Gastroenterology, Hepatology and Nutrition, The Digestive Health Institute, Children's Hospital Colorado, University of Colorado Denver School of Medicine, Aurora, CO, USA
| | - James E Squires
- Division of Gastroenterology, Hepatology and Nutrition, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Evelyn K Hsu
- Division of Gastroenterology, Hepatology and Nutrition, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Steven Lobritto
- Center for Liver Disease and Transplantation, NY Presbyterian-Morgan Stanley Children's Hospital, New York, NY, USA
| | - Saeed Mohammad
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | |
Collapse
|
88
|
Whitley JA, Joyner BD, Asante PG, Waters WB, Kieran K. Exploring Barriers to the Inclusion of Underrepresented Minorities in Urology: The Temporal and Financial Costs of Residency Interviews. Urology 2021; 162:91-98. [PMID: 34728331 DOI: 10.1016/j.urology.2021.08.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/19/2021] [Accepted: 08/19/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate whether interview travel cost and time differed for urology residency applicants from medical schools with higher versus lower proportions of students from groups underrepresented in medicine (URiMs). METHODS We identified 22 medical schools, 11 with <15% and 11 with >20% URiM students, and 17 "highly ranked" urology residency programs. We contacted the residency programs and requested interview dates, preferred lodging options, and institution-based cost-savings. We constructed interview itineraries for 22 hypothetical students (one from each school), and compared the total cost and time for travel to all 17 interviews. Total travel time and interview costs for the students at schools with <15% and >20% URiM were compared, with findings considered statistically significant at p<0.05. RESULTS Each student was able to attend all 17 interviews. The median total cost was similar for applicants from schools >20% URiM ($8074.80; range: $7027.60-$13,702.59) and <15% URiM ($8764.60; range: $6698.48-$11966.83; p=0.89). The median aggregate travel time for applicants from schools >20% URiM was 176.4 (range: 93.7-246.2) hours and for applicants from schools <15% URiM was 160.5 (range: 128.2-203.9) hours (p=0.62). CONCLUSIONS Financial and temporal costs were similar for applicants from medical schools with <15% or >20% URiM students. Thus, absolute cost considerations are unlikely to account for differences in URiM representation in urology. However, the relative impact of interview costs may be different for URiM students. Effective and durable engagement of URiM students in urology requires an introspective assessment of objective versus anecdotal barriers to recruiting and retaining URiM medical students.
Collapse
Affiliation(s)
- Jorge A Whitley
- Seattle Children's Hospital, Division of Urology, Seattle, WA
| | - Byron D Joyner
- Seattle Children's Hospital, Division of Urology, Seattle, WA; University of Washington Department of Urology, Seattle, WA
| | | | | | - Kathleen Kieran
- Seattle Children's Hospital, Division of Urology, Seattle, WA; University of Washington Department of Urology, Seattle, WA.
| |
Collapse
|
89
|
Sola R, Roberts S, Thomas TJ, Dickerson TA, Soriano IS, Cook TFA, Barksdale EM. Impact of Mentoring on Diversity and Inclusion in Surgery. Am Surg 2021; 87:1739-1745. [PMID: 34645333 DOI: 10.1177/00031348211047486] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Richard Sola
- Department of Surgery, 1374Morehouse School of Medicine, Atlanta, GA, USA
| | - Sanford Roberts
- Department of Surgery, Perelman School of Medicine, 14640University of Pennsylvania, Philadelphia, PA, USA
| | - Tito J Thomas
- Department of Surgery, 24575Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Theresa A Dickerson
- Department of Surgery, 24575Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Ian S Soriano
- Department of Surgery, Perelman School of Medicine, 14640University of Pennsylvania, Philadelphia, PA, USA
| | | | - Edward M Barksdale
- Division of Pediatric Surgery, 159284Rainbow Babies & Children's Hospital/University Hospitals, Cleveland, OH, USA
| |
Collapse
|
90
|
Nguyen M, Cerasani M, Dinka LA, Rodriguez JA, Omoruan M, Acosta E, Alder KD, Brutus NN, Termuhlen PM, Dardik A, Mason HRC, Stain SC. Association of Demographic Factors and Medical School Experiences With Students' Intention to Pursue a Surgical Specialty and Practice in Underserved Areas. JAMA Surg 2021; 156:e214898. [PMID: 34613342 DOI: 10.1001/jamasurg.2021.4898] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance The surgical workforce shortage is a threat to promoting health equity in medically underserved areas. Although the Health Resources and Services Administration and the American College of Surgeons have called to increase the surgical pipeline for trainees to mitigate this shortage, the demographic factors associated with students' intention to practice in underserved areas is unknown. Objective To evaluate the association between students' demographics and medical school experiences with intention to pursue surgery and practice in underserved areas. Design, Setting, and Participants This cross-sectional study surveyed graduating US allopathic medical students who matriculated between 2007-2008 and 2011-2012. Analysis began June 2020 and ended December 2020. Main Outcomes and Measures Intention to pursue surgery and practice in underserved areas were retrieved from the Association of American Medical Colleges graduation questionnaire. Logistic regression models were constructed to evaluate (1) the association between demographic factors and medical students' intention to pursue surgical specialties vs medical specialties and (2) the association between demographic factors and medical school electives with intention to practice in underserved areas. Results Among 57 307 students who completed the graduation questionnaire, 48 096 (83.9%) had complete demographic data and were included in the study cohort. The mean (SD) age at matriculation was 23.4 (2.5) years. Compared with students who reported intent to pursue nonsurgical careers, a lower proportion of students who reported intent to pursue a surgical specialty identified as female (3264 [32.4%] vs 19 731 [51.9%]; χ2 P < .001). Multiracial Black and White students (adjusted odds ratio [aOR], 1.72; 95% CI, 1.11-2.65) were more likely to report an intent for surgery compared with White students. Among students who reported an intention to pursue surgery, Black/African American students (aOR, 3.24; 95% CI, 2.49-4.22), Hispanic students (aOR, 2.00; 95% CI, 1.61-2.47), multiracial Black and White students (aOR, 2.27; 95% CI, 1.03-5.01), and Indian/Pakistani students (aOR, 1.31; 95% CI, 1.02-1.69) were more likely than White students to report an intent to practice in underserved areas. Students who reported participating in community health (aOR, 1.61; 95% CI, 1.42-1.83) or global health (aOR, 1.83; 95% CI, 1.61-2.07) experiences were more likely to report an intention to practice in underserved areas. Conclusions and Relevance This study suggests that diversifying the surgical training pipeline and incorporating health disparity and community health in undergraduate or graduate medical education may promote students' motivation to practice in underserved areas.
Collapse
Affiliation(s)
| | | | | | | | - Moje Omoruan
- SUNY Upstate Medical University, Syracuse, New York
| | | | - Kareme D Alder
- Yale School of Medicine, New Haven, Connecticut.,Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | | | - Paula M Termuhlen
- Homer Stryker MD School of Medicine, Western Michigan University, Kalamazoo, Michigan
| | - Alan Dardik
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut.,Department of Surgery, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Hyacinth R C Mason
- Tufts University School of Medicine, Boston, Massachusetts.,Department of Family and Community Medicine, Albany Medical College, Albany, New York
| | - Steven C Stain
- Lahey Hospital and Medical Center, Boston, Massachusetts
| |
Collapse
|
91
|
Lang JJ, Issa R, Lombardi C, Garcia E, Oke OC, Ekwenna O. Trends in Race and Ethnicity Among Matriculants to US Oncology Training Programs, 2015-2020. JAMA Netw Open 2021; 4:e2128530. [PMID: 34618042 PMCID: PMC8498847 DOI: 10.1001/jamanetworkopen.2021.28530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This cross-sectional study assesses underrepresented minority trends across oncology specialties from 2015 to 2020.
Collapse
Affiliation(s)
- Jacob J. Lang
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Rochell Issa
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Conner Lombardi
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Emilie Garcia
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Oluchi C. Oke
- Department of General Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - Obi Ekwenna
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
- Office of Student Affairs & Department of Urology and Transplantation, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| |
Collapse
|
92
|
Goffredo P, Sun MY, Jensen CC, Trudel JL, Madoff RD, Lowry AC, Gaertner WB. Factors Associated With Colon and Rectal Surgery Fellowship Program Ranking Before and After the COVID-19 Pandemic. Dis Colon Rectum 2021; 64:1163-1166. [PMID: 34174038 PMCID: PMC8432288 DOI: 10.1097/dcr.0000000000002193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Supplemental Digital Content is available in the text.
Collapse
Affiliation(s)
- Paolo Goffredo
- Division of Colon & Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Mark Y. Sun
- Division of Colon & Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Christine C. Jensen
- Division of Colon & Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Judith L. Trudel
- Division of Colon & Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Robert D. Madoff
- Division of Colon & Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Ann C. Lowry
- Division of Colon & Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Wolfgang B. Gaertner
- Division of Colon & Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| |
Collapse
|
93
|
Valbuena VSM, Obayemi JE, Purnell TS, Scantlebury VP, Olthoff KM, Martins PN, Higgins RS, Blackstock DM, Dick AAS, Watkins AC, Englesbe MJ, Simpson DC. Gender and racial disparities in the transplant surgery workforce. Curr Opin Organ Transplant 2021; 26:560-566. [PMID: 34524181 PMCID: PMC8524746 DOI: 10.1097/mot.0000000000000915] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review explores trends in the United States (US) transplant surgery workforce with a focus on historical demographics, post-fellowship job market, and quality of life reported by transplant surgeons. Ongoing efforts to improve women and racial/ethnic minority representation in transplant surgery are highlighted. Future directions to create a transplant workforce that reflects the diversity of the US population are discussed. RECENT FINDINGS Representation of women and racial and ethnic minorities among transplant surgeons is minimal. Although recent data shows an improvement in the number of Black transplant surgeons from 2% to 5.5% and an increase in women to 12%, the White to Non-White transplant workforce ratio has increased 35% from 2000 to 2013. Transplant surgeons report an average of 4.3 call nights per week and less than five leisure days a month. Transplant ranks 1st among surgical sub-specialties in the prevalence of three well-studied facets of burnout. Concerns about lifestyle may contribute to the decreasing demand for advanced training in abdominal transplantation by US graduates. SUMMARY Minimal improvements have been made in transplant surgery workforce diversity. Sustained and intentional recruitment and promotion efforts are needed to improve the representation of women and minority physicians and advanced practice providers in the field.
Collapse
Affiliation(s)
- Valeria S. M. Valbuena
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
- National Clinician Scholars Program, University of Michigan, Ann Arbor, MI, USA
| | - Joy E. Obayemi
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Tanjala S. Purnell
- Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Velma P. Scantlebury
- Texas Christian University and University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Kim M. Olthoff
- Department of Surgery, Division of Transplant Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Paulo N. Martins
- Department of Surgery, Division of Organ Transplantation, UMass Memorial Medical Center, University of Massachusetts, Worcester, MA, USA
| | - Robert S. Higgins
- Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - André A. S. Dick
- Department of Surgery, Division of Transplantation, University of Washington, Seattle, WA, USA
| | - Anthony C. Watkins
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | | | - Dinee C. Simpson
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| |
Collapse
|
94
|
Wiggins AJ, Agha O, Diaz A, Jones KJ, Feeley BT, Pandya NK. Current Perceptions of Diversity Among Head Team Physicians and Head Athletic Trainers: Results Across US Professional Sports Leagues. Orthop J Sports Med 2021; 9:23259671211047271. [PMID: 34660831 PMCID: PMC8516385 DOI: 10.1177/23259671211047271] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/02/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Discrepancies in race, ethnicity, and sex among health care providers and their patients have been shown to affect the patient-provider relationship as well as the quality of care. Currently, minority and female representation among orthopaedic surgeons remains low. Given the large proportion of minority athletes and their degree of public visibility, professional sports serves as an important arena within which to analyze the diversity of health care providers. PURPOSE To describe and evaluate the current level of diversity of head team physicians (HTPs) and head athletic trainers (ATCs), primarily in terms of race and sex, within men's professional sports leagues in the United States. STUDY DESIGN Cross-sectional study. METHODS Five major US professional sports leagues were evaluated: National Basketball Association, National Football League, National Hockey League, Major League Soccer, and Major League Baseball. Publicly available data were collected to identify the HTPs and head ATCs for each team within these leagues. Two independent observers analyzed photographs and names of these individuals to determine his or her perceived race and sex, with disagreements being resolved by a third independent observer. Other physician data collected included graduate degree(s), specialty, and number of years in practice. Kappa coefficients (κ) were employed to evaluate interobserver reliability. Chi-square, Fisher exact, and t tests were used for statistical comparisons across leagues. RESULTS The κ values for perceived race were 0.85 for HTPs and 0.89 for head ATCs, representing near-perfect interobserver agreement. Minorities comprised 15.5% of HTPs and 20.7% of ATCs (P = .24). Women comprised 3.9% of HTPs and 1.3% of head ATCs (P = .017). The majority of HTPs were orthopaedic surgeons with medical doctorates. Female HTPs had significantly fewer years in practice compared with male HTPs (15.0 ± 4.9 vs 23.1 ± 9.6; P = .04). CONCLUSION The lead physicians and athletic training providers for men's professional sports teams demonstrated low rates of minority and female representation, denoting a highly visible area for discussing the role of increased diversity in health care.
Collapse
Affiliation(s)
- Anthony J. Wiggins
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Obiajulu Agha
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Agustin Diaz
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Kristofer J. Jones
- Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California, USA
| | - Brian T. Feeley
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Nirav K. Pandya
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| |
Collapse
|
95
|
Ferguson BL, Morgan M, Wilson SB. Trends in Diversity Related to Gender and Race in the Surgical Specialties and Subspecialties Inclusive of Oral and Maxillofacial Surgery. Oral Maxillofac Surg Clin North Am 2021; 33:491-503. [PMID: 34565512 DOI: 10.1016/j.coms.2021.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Medical training in the United States has undergone multiple evolutions and maturations. The Flexner Report and its effects, written in 1910, still has significant impact on modern professional education in the medical and dental arenas. The National Academy of Medicine (Institute of Medicine) in 2003 documented the need for diversity in the health care workforce, and the Association of American Medical Colleges additionally looked at Medical Education and health care through the lens of Academic Medicine. Both these reports reflected that health care institutions, providers, educators, students, and surgical residents are mandated to improve the health of the nation.
Collapse
Affiliation(s)
- Brett L Ferguson
- Department of Oral and Maxillofacial Surgery, Truman Medical Center, 2301 Holmes, Kansas City, MO 64108, USA.
| | - Maria Morgan
- Department of Diversity and Inclusion, Truman Medical Center, 2301 Holmes, Kansas City, MO 64108, USA
| | - Susan B Wilson
- Department of Diversity and Inclusion, UMKC School of Dentistry, 650 E. 25th Street, Kansas City, MO 64108, USA
| |
Collapse
|
96
|
Sumler ML, Capdeville M, Ngai J, Cormican D, Oakes D. A Call for Diversity: Underrepresented Minorities and Cardiothoracic Anesthesiology Fellowship Education. J Cardiothorac Vasc Anesth 2021; 36:58-65. [PMID: 34696968 DOI: 10.1053/j.jvca.2021.09.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/15/2021] [Accepted: 09/19/2021] [Indexed: 11/11/2022]
Abstract
This paper is the first of a four-part series that details the current barriers to diversity in the field of adult cardiothoracic anesthesiology and outlines actionable programs that can be implemented to create change. Part I and Part II address the training experience of women and underrepresented minorities (URMs) in adult cardiothoracic anesthesiology (ACTA), respectively, and explore concrete opportunities to promote positive change. Part III and Part IV examine the professional experience of URMs and women in ACTA, respectively, and discuss interventions that can facilitate a more equitable and inclusive environment for both groups. Although these problems are complex, the authors here offer a detailed analysis of the challenges faced by each group both in the training phase and the professional practice phase of their careers. The authors also present meaningful and concrete actions that can be implemented to create a more diverse, equitable, and inclusive professional environment in cardiovascular and thoracic anesthesiology.
Collapse
Affiliation(s)
| | | | - Jennie Ngai
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Health, New York, NY
| | | | - Daryl Oakes
- Stanford Department of Anesthesiology, Perioperative and Pain Medicine, Stanford, CA
| |
Collapse
|
97
|
Trends in the Racial and Ethnic Diversity in the US Urology Workforce. Urology 2021; 162:9-19. [PMID: 34469768 DOI: 10.1016/j.urology.2021.07.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/07/2021] [Accepted: 07/29/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine the historical trends and factors underlying the current state of racial/ethnic representation within the urology workforce at each stage of the educational pipeline. METHODS Using data from the US Census Bureau and the Association of American Medical Colleges, trends in racial/ethnic distribution for 2007-2008 to 2019-2020 were tracked in the educational pipeline for academic urologists. This pipeline was defined as progressively diminishing cohorts, starting with the US population, leading to medical school application, acceptance, and graduation, through to urology residency application, matching, and graduation, and ending with urology faculty appointment. A comparative cohort analysis was performed for academic year 2018-2019 for differences in racial/ethnic distribution across cohorts by binomial tests. RESULTS From 2007-2008 to 2019-2020, while the proportion of Latinx/Hispanic urology applicants increased by 0.38% per year (95% CI 0.24, 0.52), their proportion in the urology resident population remained unchanged (0.07% per year, 95% CI -0.20, 0.06) from 2011-2012 to 2019-2020. There was a decrease in the proportion of Black urology applicants (-0.13% per year, 95% CI -0.24, -0.02) and no change in the resident population (-0.03% per year, 95% CI -0.11, 0.05), despite an increase in total number of residents (n = 1043 to n = 1734) from 2009-2010 to 2019-2020. In 2018-2019, there were step-wise decreases in proportion of Black and Latinx/Hispanic members represented at critical stages of the educational pipeline (P <0.0001). CONCLUSION Attrition in URM urologists occur at key educational stages. This paper offers opportunities for the design of interventions to diversify the urology workforce.
Collapse
|
98
|
Sutton E, Montgomery Rice V. Impact of the Lack of Diversity Within Surgery Career Pathways and Mitigating Factors. Am Surg 2021; 87:1713-1717. [PMID: 34355988 DOI: 10.1177/00031348211034755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The lack of diversity in surgical career pathways impacts the cultural competence of the learning and working environment, the variety of leadership styles found within surgical leadership, and the ability of an organization to achieve equity in the workplace due to ongoing mistrust and untouched bias. Leading mitigating factors include developing pathways for greater numbers of diverse people at the high school and college level and implicit bias training. Though educators have had some success with these factors in the initial stages of diversifying early pathways, these factors are not yet correlated to entry into a surgical career. Future solutions to the lack of diversity in surgery will be predicated on surgeons collectively valuing justice, equity, diversity, and inclusion.
Collapse
Affiliation(s)
- Erica Sutton
- 1374Morehouse School of Medicine, Atlanta, GA, USA
| | | |
Collapse
|
99
|
Racial disparities in vascular surgery: An analysis of race and ethnicity among U.S. medical students, general surgery residents, vascular surgery trainees, and the vascular surgery workforce. J Vasc Surg 2021; 74:33S-46S. [PMID: 34303458 DOI: 10.1016/j.jvs.2021.03.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/13/2021] [Indexed: 11/21/2022]
Abstract
The ever-increasing diversity of the U.S. population has resulted in a challenge to a vascular surgery workforce that does not represent the national demographics. Educational institutions, medical organizations, and medical agencies, through initiatives and programs, have attempted to increase the number of underrepresented minorities, with, however, only modest changes during the past 30 years. Several obstacles have been identified, some of which include racism, issues of finances, lack of mentors and scholarly activities, and inequity in promotion. In the present study, we have reviewed the reported data addressing these concerns and provided guidance toward the amelioration of these issues with the hope of constructive change toward encouraging a diverse vascular surgery workforce.
Collapse
|
100
|
Moreira CC. Developing cultural competency and maximizing its effect in vascular surgery. J Vasc Surg 2021; 74:76S-85S. [PMID: 34303463 DOI: 10.1016/j.jvs.2021.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/13/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Carla C Moreira
- Department of Surgery, Warren Alpert Medical School of Brown University, Providence, RI.
| |
Collapse
|