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Hutchings H, Behinaein P, Okereke I. Well-being Through the Synergy of Community Engagement, Health Equity, and Advocacy. Thorac Surg Clin 2024; 34:281-290. [PMID: 38944455 DOI: 10.1016/j.thorsurg.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
Facets of well-being for cardiothoracic surgeons include interconnectivity, or a sense of belonging within a community, and social relatedness. Striving for health equity achieves a sense of belonging and meaning to one's work. In "Elevating Health Equity: The Synergy of Community Engagement and Advocacy," the imperative for mentorship and diversification within health care is expounded, establishing a multitiered blueprint for equity. Integral to this framework is the nurturing of a heterogeneous health care workforce, ameliorating racial and gender disparities in patient care. This article puts forth an intricate, empirically substantiated roadmap toward a more empathic and efficacious health care system.
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Affiliation(s)
- Hollis Hutchings
- Henry Ford Health, 2799 West Grand Boulevard, Detroit, MI 48202, USA
| | - Parnia Behinaein
- School of Medicine, Wayne State University, 540 Canfield Street, Detroit, MI 48201, USA
| | - Ikenna Okereke
- Department of Surgery, Thoracic Surgery, Henry Ford Health, 2799 West Grand Boulevard, Detroit, MI 48202, USA.
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Thompson K, Hammond N, Lynch D, Van Der Merwe M, Modra L, Yong SA, Grattan S, Stokes-Parish J. Perceptions of gender equity among critical care and other health professionals: A cross-sectional survey. Aust Crit Care 2024; 37:265-272. [PMID: 37574389 DOI: 10.1016/j.aucc.2023.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/29/2023] [Accepted: 07/09/2023] [Indexed: 08/15/2023] Open
Abstract
OBJECTIVE The objective of this study was to determine the association between gender and perceived gender equity in the critical care workforce and other health specialties. DESIGN AND SETTING We conducted an online cross-sectional survey between September and November 2020. Data on demographics and perceptions of equity including the representation of women across departments and in leadership roles, knowledge of and access to flexible work practices and carers leave, and opportunities for promotion were collected. PARTICIPANTS The study population included health professionals from critical care (defined as intensive care and emergency) and other specialties. We conducted a descriptive gender-disaggregated analysis. RESULTS A total of 478 respondents (70% women) completed the survey. The mean age of respondents was 43.9 ± 11.2 years. Approximately half of respondents were medical practitioners (n = 235, 54%), followed by nurses (n = 135, 36%)-the remainder were from other professions. The critical care workforce accounted for 280 (64%) of responder practice settings. Statistically significant differences were reported between genders on issues such as having confidence that their department would resolve equity issues (87 [70.7%] men vs. 146 [48.2%] women; p = 0.007), access to flexible work practices (5/124 [4.0%] men vs. 20/305 [6.6%] women p = 0.001), and taking unpaid leave for carer responsibilities (91 [30.3%] women vs 9 [7.4%] men, p < 0.001). CONCLUSIONS This work highlights differences in how men and women perceive gender equity, particularly in the critical care workforce. These findings are important to understand health care practitioners' perceptions of gender equity, as these perceptions inform behaviour.
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Affiliation(s)
- Kelly Thompson
- The George Institute for Global Health, UNSW, Sydney, Australia; Nepean and Blue Mountains Local Health District, Kingswood, Australia
| | - Naomi Hammond
- The George Institute for Global Health, UNSW, Sydney, Australia; Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Doug Lynch
- EMR & Informatics Directorate, Monash Health, Clayton, Victoria, Australia
| | | | - Lucy Modra
- Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia; ICU, Austin Hospital, Melbourne, Victoria, Australia
| | - Sarah A Yong
- Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, Victoria, Australia; ANZIC-RC, Department of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - Sarah Grattan
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Jessica Stokes-Parish
- Bond University, Gold Coast, Australia; Intensive Care, John Flynn Private Hospital, Tugun, Queensland, Australia.
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Frank AK, Lin JJ, Warren SB, Bullock JL, O'Sullivan P, Malishchak LE, Berman RA, Yialamas MA, Hauer KE. Stereotype Threat and Gender Bias in Internal Medicine Residency: It is Still Hard to be in Charge. J Gen Intern Med 2024; 39:636-642. [PMID: 37985610 DOI: 10.1007/s11606-023-08498-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Despite similar numbers of women and men in internal medicine (IM) residency, women face unique challenges. Stereotype threat is hypothesized to contribute to underrepresentation of women in academic leadership, and exploring how it manifests in residency may provide insight into forces that perpetuate gender disparities. OBJECTIVE To quantify the prevalence of stereotype threat in IM residency and explore experiences contributing to that stereotype threat. DESIGN We used a mixed methods study design. First, we surveyed IM residents using the Stereotype Vulnerability Scale (SVS) to screen for stereotype threat. Second, we conducted focus groups with women who scored high on the SVS to understand experiences that led to stereotype threat. PARTICIPANTS The survey was sent to all IM residents at University of California, San Francisco (UCSF), in September-November 2019. Focus groups were conducted at UCSF in Spring 2020. APPROACH The survey included an adapted version of the SVS. For focus groups, we developed a focus group guide informed by literature on stereotype threat. We used a thematic approach to data analysis. The mixed methods design enabled us to draw metainferences by integrating the two data sources. KEY RESULTS Survey response rate was 61% (110/181). Women were significantly more likely than men to have a score indicating stereotype threat vulnerability (77% vs 0%, p < 0.001). Four themes from focus groups characterized women's experiences of gender bias and stereotype threat: gender norm tension, microaggressions and sexual harassment, authority questioned, and support and allyship. CONCLUSIONS Gender-based stereotype threat is highly prevalent among women IM residents. This phenomenon poses a threat to confidence and ability to execute patient care responsibilities, detracting from well-being and professional development. These findings indicate that, despite robust representation of women in IM training, further attention is needed to address gendered experiences and contributors to women's vulnerability to stereotype threat.
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Affiliation(s)
- Annabel K Frank
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
| | - Jackie J Lin
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | - Justin L Bullock
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Patricia O'Sullivan
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | - Rebecca A Berman
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Maria A Yialamas
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Karen E Hauer
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Gottlieb AS, Roy B, Herrin J, Holaday LW, Weiss J, Salazar MC, Okoli N, Nagarkatti N, Otridge J, Pomeroy C. Why Are There So Few Women Medical School Deans? Debunking the Myth That Shorter Tenures Drive Disparities. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:63-69. [PMID: 37418698 DOI: 10.1097/acm.0000000000005315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
PURPOSE Gender disparities among the senior echelons of academic medicine are striking and persistent. The role of medical school dean has been particularly immune to gender diversity, and limited prior research identified women's shorter decanal tenures as a potential driver. The authors assessed gender differences in tenure length of deanships in the current era to elucidate this finding. METHOD From October 2020 to June 2021, the authors collected information about medical school deanships that were held from January 1, 2006, to June 30, 2020. All schools were members of the Association of American Medical Colleges (AAMC). The authors collected data from online public records and augmented their findings via direct outreach to medical schools. They used time-to-event analyses before and after adjustment for interim vs permanent status of the initial appointment, school ownership (public/private), and school size to assess for gender differences in length of deanship tenure during the study period. The unit of analysis was deanships, and the primary outcome was length of deanships measured in years. RESULTS Authors included data on 528 deanships. Women held 91 (17%) of these terms. Men held the majority of permanent deanships (n = 352 [85%]). A greater percentage of the deanships held by women were interim only (n = 27 [30%]) compared with men (n = 85 [20%]). In unadjusted and adjusted analyses, there were no significant gender differences in length of deanship tenures. CONCLUSIONS Analysis of appointments of AAMC-member medical school deans from 2006 to 2020 revealed that women have remained in their deanships as long as their male counterparts. The myth about women deans' shorter longevity should no longer be promulgated. Academic medicine should consider novel solutions to addressing women's persistent underrepresentation in the dean role, including employing the gender proportionality principle used in the business and legal communities.
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Hausteiner-Wiehle C, Michaelis R, Senf-Beckenbach AP, Bauer PR, Kleinstäuber M, van Tilburg MAL. Learning from functional disorders - From a feminist perspective and beyond. J Psychosom Res 2023; 174:111428. [PMID: 37684118 DOI: 10.1016/j.jpsychores.2023.111428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 09/10/2023]
Affiliation(s)
- Constanze Hausteiner-Wiehle
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; Department of Neurology, BG Trauma Center Murnau, Murnau, Germany.
| | - Rosa Michaelis
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
| | | | - Prisca R Bauer
- Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Freiburg, Germany
| | | | - Miranda A L van Tilburg
- University of North Carolina, School of Medicine, Chapel Hill, NC, USA; University of Washington, School of Social Work, Seattle, WA, USA; Marshall University, Joan C Edwards School of Medicine, Huntington, WV, USA; Cape Fear Valley Medical Center, Fayetteville, NC, USA
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Ronchese F, Ricci F, Peccolo G, Persechino B, Rondinone BM, Buresti G, Negro C, Bovenzi M, Miani A. Relation of the work ability index to fitness for work in healthcare and public employees in a region of Northeastern Italy. Int Arch Occup Environ Health 2023; 96:1203-1210. [PMID: 37584735 PMCID: PMC10504097 DOI: 10.1007/s00420-023-02001-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/12/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE Work ability indicates an individual's capacity to match job demands according to his/her physical and mental conditions and work circumstances. Occupational physicians should take into consideration the global health status of a worker in order to correctly assess if he/she is fit for the job. The aim of this study was to verify the association between fitness for work evaluation and Work Ability Index scores, as well as individual factors (age, gender, and anthropometric characteristics) and work-related variables (job type, years of working duration). METHODS A cross-sectional study was conducted within the occupational health surveillance of health and public employers in the Friuli-Venezia Giulia region (2018-2022). The participants voluntarily agreed to answer the standard Work Ability Index questionnaire. Data were investigated by univariable as well as multivariable regression analysis. RESULTS The Work Ability Index of the workers included in the study (N = 6893) resulted negatively associated with age, female sex, and body mass index. It was averagely lower in nurses and assistive personnel, and the highest in medical doctors and public employers. The fitness for work assessments was also statistically related to WAI scores. The results obtained from the univariable and the multivariable analysis were consistent. CONCLUSIONS The Work Ability Index is an efficient tool to measure an individual's capability to sustain job demands, and can be taken into account to produce a correct fitness for work evaluation and consequently preserve workers' health status.
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Affiliation(s)
- Federico Ronchese
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34148, Trieste, Italy
| | - Francesca Ricci
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34148, Trieste, Italy
| | - Giulia Peccolo
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34148, Trieste, Italy.
| | - Benedetta Persechino
- Department of Occupational and Environmental Medicine Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Via Fontana Candida 1, 00078, Rome, Italy
| | - Bruna Maria Rondinone
- Department of Occupational and Environmental Medicine Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Via Fontana Candida 1, 00078, Rome, Italy
| | - Giuliana Buresti
- Department of Occupational and Environmental Medicine Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Via Fontana Candida 1, 00078, Rome, Italy
| | - Corrado Negro
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34148, Trieste, Italy
| | - Massimo Bovenzi
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34148, Trieste, Italy
| | - Andrea Miani
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34148, Trieste, Italy
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McMains KC, Konopasky A, Durning SJ, Meyer HS. Do All Roads Lead to Full Participation? Examining Trajectories of Clinical Educators in Graduate Medical Education through Situated Learning Theory. TEACHING AND LEARNING IN MEDICINE 2023:1-11. [PMID: 37547996 DOI: 10.1080/10401334.2023.2230188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 05/23/2023] [Accepted: 06/22/2023] [Indexed: 08/08/2023]
Abstract
Phenomenon: As new faculty members begin their careers in Graduate Medical Education, each begins a journey of Professional Identity Formation from the periphery of their educational communities. The trajectories traveled vary widely, and full participation in a given educational community is not assured. While some medical school and post-graduate training programs may nurture Professional Identity Formation, there is scant support for faculty. To date, the trajectories that Graduate Medical Education faculty travel, what may derail inbound trajectories, and what tools Graduate Medical Education faculty use to navigate these trajectories have not been explicitly described. We explore these three questions here. Approach: Communities of Practice, a component of Situated Learning Theory, serves as a helpful framework to explore trajectories of educator identity development among Graduate Medical Educators. We used a inductive and deductive approach to Thematic Analysis, with Situated Learning Theory as our interpretive frame. Semi-structured interviews of faculty members of GME programs matriculating into a Health Professions Education Program were conducted, focusing on participants' lived experiences in medical education and how these experiences shaped their Professional Identity Formation. Findings: Participants noted peripheral, inbound, boundary, and outbound trajectories, but not an insider trajectory. Trajectory derailment was attributed to competing demands, imposter syndrome and gendered marginality. Modes of belonging were critical tools participants used to shape PIF, not only engagement with educator roles but disengagement with other roles; imagination of future roles with the support of mentors; and fluid alignment with multiple mutually reinforcing identities. Participants identified boundary objects like resumes and formal roles that helped them negotiate across Community of Practice boundaries. Insights: Despite a desire for full participation, some clinical educators remain marginal, struggling along a peripheral trajectory. Further research exploring this struggle and potential interventions to strengthen modes of belonging and boundary objects is critical to create equitable access to the inbound trajectory for all of our colleagues, leaving the choice of trajectories up to them.
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Affiliation(s)
- Kevin C McMains
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Abigail Konopasky
- Department of Medical Education, Dartmouth School of Medicine, Hannover, New Hampshire, USA
| | - Steven J Durning
- Department of Medical Education, Dartmouth School of Medicine, Hannover, New Hampshire, USA
| | - Holly S Meyer
- Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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McBee E, Dong T, Ramani D, Durning SJ, Konopasky A. Relationship Between Gender and Academic and Military Achievement Among USU Medical School Graduates. Mil Med 2023; 188:115-121. [PMID: 37201483 DOI: 10.1093/milmed/usac259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/01/2022] [Accepted: 08/19/2022] [Indexed: 05/20/2023] Open
Abstract
INTRODUCTION Despite increases in the number of female matriculants in medical school, civilian data demonstrate that women still struggle to reach parity in attainment of leadership positions. In military medicine, we have seen a major increase in the number of women graduating from the USU. Yet, we still know little about the representation of female military physicians in leadership positions. The aim of this study is to examine the relationship between gender and academic and military achievement among USU School of Medicine graduates. METHODS Utilizing the USU alumni survey sent to graduates from the classes of 1980 to 2017, items of interest, such as highest military rank, leadership positions held, academic rank, and time in service, were used to evaluate the relationship between gender and academic and military achievement. Contingency table statistical analysis was conducted to compare the gender distribution on the survey items of interest. RESULTS Pairwise comparison demonstrated significant differences between gender in the O-4 (P = .003) and O-6 (P = .0002) groups, with females having a higher-than-expected number of O-4 officers and males having a higher-than-expected number of O-6 officers. These differences persisted in a subsample analysis that excluded those who separated from active duty prior to 20 years of service. There was a significant association between gender and holding the position of commanding officer (χ2(1) = 6.61, P < .05) with fewer females than expected. In addition, there was a significant association between gender and the highest academic rank achieved (χ2(3) = 9.48, P < 0.05) with lower-than-expected number of females reaching the level of full professor, in contrast to males who exceed the expected number. CONCLUSIONS This study suggests that female graduates of USU School of Medicine have not achieved promotion to the highest levels of rank, military, or academic leadership at the projected rate. Efforts to explore what barriers may impact military medicine's desire to have more equal representation of women in higher ranks and positions should be undertaken with specific attention to what drives retention versus separation of medical officers and if systematic changes are needed to help promote equity for women in military medicine.
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Affiliation(s)
- Elexis McBee
- Department of Medicine, Uniformed Service University, Bethesda, MD 20814, USA
| | - Ting Dong
- Center for Health Professions Education, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Divya Ramani
- Center for Health Professions Education, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Steven J Durning
- Center for Health Professions Education, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Abigail Konopasky
- Center for Health Professions Education, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
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Gisselbaek M, Barreto Chang OL, Saxena S. Gender equity in anesthesia: is it time to rock the boat? BMC Anesthesiol 2023; 23:67. [PMID: 36882715 PMCID: PMC9991878 DOI: 10.1186/s12871-023-01987-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Affiliation(s)
- M Gisselbaek
- Department of Anesthesiology and Acute Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - O L Barreto Chang
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
| | - S Saxena
- Department of Anesthesia and Reanimation, AZ Sint-Jan Brugge Oostende AV, Brugge, Belgium.
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Corrie PG, Wadsley J. Safeguarding Clinical Research in the National Health Service. Clin Oncol (R Coll Radiol) 2023; 35:311-313. [PMID: 36841682 DOI: 10.1016/j.clon.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/19/2023]
Affiliation(s)
- P G Corrie
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
| | - J Wadsley
- Department of Oncology, Weston Park Cancer Centre, Sheffield, UK
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Kokas MS, Passalacqua KD, Mortimore A, Hoffert MM. Advice for women considering a career in medicine: A qualitative study of women physicians' perspectives. Work 2022; 75:169-180. [PMID: 36591668 DOI: 10.3233/wor-211217] [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: 12/28/2022] Open
Abstract
BACKGROUND Research has explored the problems that women encounter during a medical career; however, the advice that experienced women physicians would give to women who have not yet entered the field is needed to reveal how the medical work landscape is evolving and to provide real-world narratives to help career seekers make informed choices. OBJECTIVE By eliciting women's perspectives on their medical careers by asking them what advice they would give to aspiring women physicians. We aimed to reveal areas for improving career satisfaction of women physicians and to inform those who advise women considering a medical career. METHODS In this qualitative study, we used a phenomenological approach to conduct semi-structured one-on-one interviews with 24 women physicians to query the advice they would give to women contemplating a career in medicine. RESULTS Thematic analysis of interview transcriptions revealed 10 themes that women physicians communicated as being important to consider before deciding to become a physician. Although some advice had a cautionary tone, encouraging and practical advice was also conveyed. The most abundant themes concerned the centrality of patient care, a passion for practicing medicine, and the importance of planning. Other key topics included family and friends, self-reflection, life balance, finances, ethics, maintaining presence, and two overt cautionary statements. CONCLUSION Interviews revealed that meaning and purpose derived from a medical career and maintaining work-life balance are valued by some women physicians. Participants were encouraging in recommending medicine as a career choice for women, while highlighting some challenges.
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Affiliation(s)
- Maria S Kokas
- Department of Graduate Medical Education, Henry Ford Hospital, Detroit, MI, USA
| | - Karla D Passalacqua
- Department of Graduate Medical Education, Henry Ford Hospital, Detroit, MI, USA
| | - Anastasia Mortimore
- Department of Graduate Medical Education, Henry Ford Hospital, Detroit, MI, USA
| | - Mara M Hoffert
- Department of Graduate Medical Education, Henry Ford Hospital, Detroit, MI, USA
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12
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Jacobs JW, Jagsi R, Stanford FC, Sarno D, Spector ND, Silver JK, Booth GS. Gender Representation Among United States Medical Board Leadership. J Womens Health (Larchmt) 2022; 31:1710-1718. [PMID: 36318764 PMCID: PMC9805854 DOI: 10.1089/jwh.2022.0271] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To assess the gender composition of the American Board of Medical Specialties' (ABMS) member boards and evaluate the equitable inclusion of women and a subset of women physicians. Methods: The gender of individuals on 24 boards as of March 1, 2022, was assessed. Two benchmarks-parity (50:50 representation) and equity (compared to the proportion of practicing physicians in each medical specialty)-were utilized to determine if women are equitably represented on medical boards. Results: Four hundred forty individuals hold 449 total positions on the boards examined. Of board the members, 60.7% (267/440) are men, and 92.3% (406/440) are physicians. Physician board members comprised more men (64.0%, 260/406; p < 0.001), whereas more women comprise the 34 nonphysician board members (79.4%, 27/34; p < 0.001). Using specialty representation (equity) as the benchmark, of 22 specialties for which physician gender/sex data are available, women physicians are underrepresented on 36.4% (8/22) of boards. When parity (50%) is the comparator, 72.0% (18/25) of boards comprised less than 50% women. Compared to a 2016 analysis, the proportion of women overall (including non-physicians) increased on 68.0% (17/25), decreased on 24.0% (6/25), and remained unchanged on 8.0% (2/25) of boards in 2022. Conclusions: This study reveals mixed results in the equitable inclusion of women on ABMS boards. Our findings suggest that progress should not be assumed and that it may be subject to setbacks when it occurs. There is a need to continue to monitor the equitable inclusion of women on ABMS boards.
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Affiliation(s)
- Jeremy W. Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Reshma Jagsi
- Department of Radiation Oncology, Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Fatima Cody Stanford
- Neuroendocrine Unit, Department of Medicine, Nutrition Obesity Research Center at Harvard (NORCH), Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Endocrinology, Department of Pediatrics, Nutrition Obesity Research Center at Harvard (NORCH), Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Danielle Sarno
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy D. Spector
- Executive Leadership in Academic Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Julie K. Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - Garrett S. Booth
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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13
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Blalock AE, Leal DR. Redressing injustices: how women students enact agency in undergraduate medical education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022:1-18. [PMID: 36394683 PMCID: PMC9672615 DOI: 10.1007/s10459-022-10183-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
This study presents descriptions of epistemic injustice in the experiences of women medical students and provides accounts about how these students worked to redress these injustices. Epistemic injustice is both the immediate discrediting of an individual's knowledge based on their social identity and the act of persistently ignoring possibilities for other ways of knowing. Using critical narrative interviews and personal reflections over an eight-month period, 22 women students during their first year of medical school described instances when their knowledge and experience was discredited and ignored, then the ways they enacted agency to redress these injustices. Participants described three distinct ways they worked to redress injustices: reclaiming why they belong in medicine, speaking up and calling out the curriculum, and uplifting one another. This study has implications for recognizing medical students as whole individuals with lived histories and experiences and advocates for recognizing medical students' perspectives as valuable sources of knowledge.
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Affiliation(s)
- A Emiko Blalock
- Office of Medical Education Research and Development, Michigan State University College of Human Medicine, 964 Wilson Road, Fee Hall A214, East Lansing, MI, 48824, USA.
| | - Dianey R Leal
- Michigan State University College of Education, East Lansing, USA
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Akbani U, Vasant DH. Regional survey of foundation trainee doctors' views on a career in gastroenterology: implications for diversity and inclusion. Frontline Gastroenterol 2022; 14:179-180. [PMID: 37056325 PMCID: PMC10086705 DOI: 10.1136/flgastro-2022-102232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 09/10/2022] [Indexed: 04/15/2023] Open
Abstract
Objective We aimed to establish the perception of foundation doctors (FDs) towards gastroenterology, focusing on identifying determinants which make the career desirable or undesirable between genders, and to recognise factors to increase diversity in recruitment. Method An electronic survey was circulated to Northwest of England FDs, categorical variables and data were analysed using χ2 test including comparisons by gender and exposure to gastroenterology either as an undergraduate or FD. Results 133 responses were received (males 55.6%, 37 foundation year 1 (FY1) doctors, 85 FY2 doctors and 11 FY3 doctors). Four (3.0%) FDs were considering a career in gastroenterology. Gastroenterology was perceived positively by 72 (54.1%) of FDs. Significant differences were found between genders in the importance of the following factors influencing specialty selection; patient-centred care (female 52.5% vs male 25.7%, p=0.01), good mentorship (female 67.8% vs male 45.9, p=0.012), income (female 33.9% vs male 59.5%, p=0.003) and length of training (female 27.1% vs male 52.7%, p=0.003). The male predominant existing workforce (female 27.1% vs male 6.8%, p=0.001), and requirement to be a medical registrar (female 74.6% vs male 56.8%, p=0.033) were negatively perceived aspects of gastroenterology among female FDs. Most FDs (female 80.5%, male 70.7%) indicated increased acceptability of less than full time training and greater flexibility may attract more females to gastroenterology. Conclusion Increased flexibility in training and greater postfoundation exposure and mentorship may improve diversity within the specialty. The role of general medicine poses significant concern for FDs and may need further evaluation.
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Affiliation(s)
- Umair Akbani
- Gastroenterology department, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Dipesh Harshvadan Vasant
- Gastroenterology department, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Diabetes, Endocrinology and Gastroenterology, The University of Manchester, Manchester, UK
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Hiemstra LA, Kerslake S, Clark M, Temple-Oberle C, Boynton E. Experiences of Canadian Female Orthopaedic Surgeons in the Workplace: Defining the Barriers to Gender Equity. J Bone Joint Surg Am 2022; 104:1455-1461. [PMID: 35594484 DOI: 10.2106/jbjs.21.01462] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Only 13.6% of orthopaedic surgeons in Canada are women, even though there is nothing inherent to the practice of orthopaedic surgery that favors men over women. Clearly, there is a need to identify, define, and measure the barriers faced by women in orthopaedic surgery. METHODS An electronic survey was distributed to 330 female-identifying Canadian orthopaedic surgeons and trainees and included the validated Gender Bias Scale (GBS) and questions about career burnout. The barriers for women in Canadian orthopaedics were identified using the GBS. The relationships between the GBS and burnout were investigated. Open-text questions explored the barriers perceived by female orthopaedic surgeons. RESULTS The survey was completed by 220 female orthopaedic surgeons and trainees (66.7%). Five barriers to gender equity were identified from the GBS: Constrained Communication, Unequal Standards, Male Culture, Lack of Mentoring, and Workplace Harassment. Career burnout correlated with the GBS domains of Male Privilege (r = 0.215; p < 0.01), Disproportionate Constraints (r = 0.152; p < 0.05), and Devaluation (r = 0.166; p < 0.05). Five main themes emerged from the open-text responses, of which 4 linked closely to the barriers identified in the GBS. Work-life integration was also identified qualitatively as a theme, most notably the difficulty of balancing disproportionate parental and childcare responsibilities alongside career aspirations. CONCLUSIONS In this study, 5 barriers to workplace equity for Canadian female orthopaedic surgeons were identified using the validated GBS and substantiated with qualitative assessment using a mixed-methods approach. Awareness of these barriers is a necessary step toward dismantling them and changing the prevailing culture to be fair and equitable for all. CLINICAL RELEVANCE A just and equitable orthopaedic profession is imperative to have healthy and thriving surgeons who are able to provide optimal patient care.
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Affiliation(s)
- Laurie A Hiemstra
- Banff Sport Medicine Foundation, Banff, Alberta, Canada.,Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Marcia Clark
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Claire Temple-Oberle
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Arnie Charbonneau Cancer Institute, Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Erin Boynton
- Banff Sport Medicine Foundation, Banff, Alberta, Canada.,Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Arnie Charbonneau Cancer Institute, Department of Oncology, University of Calgary, Calgary, Alberta, Canada
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Affiliation(s)
- Sherine Salib
- Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, USA.
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