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Myrcha P, Siripurapu V, Gloviczki M, Dua A, Gloviczki P. Women Surgeons: Barriers and Solutions. Ann Vasc Surg 2024; 105:325-333. [PMID: 38599486 DOI: 10.1016/j.avsg.2024.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/18/2024] [Accepted: 02/18/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Underrepresentation and undertreatment of women in surgery continues to be highly prevalent, with major barriers to improvement. The aim of the study was to review the current state of women surgeons in Poland. METHODS Information from the various Polish databases on women surgeons in 9 medical universities in general, oncological, vascular, thoracic, and cardiac surgery was retrospectively evaluated. Demographics of residents and staff surgeons, academic ranks and leadership positions at universities, in surgical societies and on scientific journals editorial boards were analyzed. Descriptive statistics were used. RESULTS In 2020, 61% of 3,668 graduates of Polish medical universities were women. In 5 surgical specialties, 11.9% (1,243 of 10,411) of the surgeons were women, with the lowest numbers in cardiac (5.6%), and in vascular surgery (6.4%); 40.4% of general surgery residents were women, less in vascular (18.4%) and thoracic surgery (24%), more in oncological surgery (28.7%). In 35 surgical departments of 9 universities, all department chairs were men, all full professors were men; 7% of associate professors and 16% of assistant professors were women. Rectors of all universities were men; 27% of the vice-rectors were women. In the senates and university councils, 39% and 35%, respectively, were women. Presidents, vice presidents, and secretaries of surgical societies and Editor-in-Chief of 4 surgical journals were all men. CONCLUSIONS Polish women surgeons face major difficulties with representation in surgery, in departmental, institutional, and societal leadership, and on scientific journal editorial boards. A multifaceted approach to correct these serious inequalities is urgently needed.
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Affiliation(s)
- Piotr Myrcha
- Depatment of General and Vascular Surgery, Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Vaishnavi Siripurapu
- East Carolina Brody School of Medicine, East Carolina University, Greenville, NC
| | - Monika Gloviczki
- Emeritus, The Department of Internal Medicine and Gonda Vascular Center, Mayo Clinic, Rochester, MN
| | - Anahita Dua
- Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA.
| | - Peter Gloviczki
- Emeritus, Division of Vascular and Endovascular Surgery, Gonda Vascular Center, Mayo Clinic, Rochester, MN
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Truong M, Advincula A. Complex Benign Gynecology: Shaping the Future Beyond a Name Change Through Training and Leadership. J Minim Invasive Gynecol 2024; 31:545-546. [PMID: 38670335 DOI: 10.1016/j.jmig.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 04/28/2024]
Affiliation(s)
- Mireille Truong
- Cedars-Sinai Medical Center (Dr. Truong), Los Angeles, California.
| | - Arnold Advincula
- Columbia University College of Physicians and Surgeons (Dr. Advincula), New York, New York
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McNeill K, Vaillancourt S, Choe S, Yang I, Sonnadara R. "I don't know if I can keep doing this": a qualitative investigation of surgeon burnout and opportunities for organization-level improvement. Front Public Health 2024; 12:1379280. [PMID: 38799682 PMCID: PMC11116672 DOI: 10.3389/fpubh.2024.1379280] [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] [Received: 01/30/2024] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction Burnout is a pressing issue within surgical environments, bearing considerable consequences for both patients and surgeons alike. Given its prevalence and the unique contextual factors within academic surgical departments, it is critical that efforts are dedicated to understanding this issue. Moreover, active involvement of surgeons in these investigations is critical to ensure viability and uptake of potential strategies in their local setting. Thus, the purpose of this study was to explore surgeons' experiences with burnout and identify strategies to mitigate its drivers at the level of the organization. Methods A qualitative case study was conducted by recruiting surgeons for participation in a cross-sectional survey and semi-structured interviews. Data collected were analyzed using reflexive thematic analysis, which was informed by the Areas of Worklife Model. Results Overall, 28 unique surgeons participated in this study; 11 surgeons participated in interviews and 22 provided responses through the survey. Significant contributors to burnout identified included difficulties providing adequate care to patients due to limited resources and time available in academic medical centers and the moral injury associated with these challenges. The inequitable remuneration associated with education, administration, and leadership roles as a result of the Fee-For-Service model, as well as issues of gender inequity and the individualistic culture prevalent in surgical specialties were also described as contributing factors. Participants suggested increasing engagement between hospital leadership and staff to ensure surgeons are able to access resources to care for their patients, reforming payment plans and workplace polities to address issues of inequity, and improving workplace social dynamics as strategies for addressing burnout. Discussion The high prevalence and negative sequalae of burnout in surgery necessitates the formation of targeted interventions to address this issue. A collaborative approach to developing interventions to improve burnout among surgeons may lead to feasible and sustainable solutions.
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Affiliation(s)
- Kestrel McNeill
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Sierra Vaillancourt
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
- Department of Biology, McMaster University, Hamilton, ON, Canada
| | - Stella Choe
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Ilun Yang
- Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Ranil Sonnadara
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
- Department of Surgery, McMaster University, Hamilton, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
- Vector Institute for Artificial Intelligence, Toronto, ON, Canada
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Isak E, Hegde YD, Barrett M, Mazer LM, Dimick JB, Sandhu G. "I Came up Short on the Academic Ladder": A Grounded Theory Study of Careerism in Academic Surgery. Ann Surg 2023; 278:e1148-e1153. [PMID: 37051902 DOI: 10.1097/sla.0000000000005875] [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: 04/14/2023]
Abstract
OBJECTIVE This study aims to explore the definition of career success in academic surgery. BACKGROUND Career success in academic surgery is frequently defined as the achievement of a specific title, from full professor to department chair. This type of definition is convenient and established but potentially incomplete. The business literature has a more nuanced view of the relationship between titles and success, but this relationship has not been studied in medicine. METHODS Semi-structured interviews were conducted from May to November 2020. Data were analyzed in an iterative fashion using grounded theory methodology to develop a conceptual model. RESULTS We conducted 26 semi-structured interviews with practicing surgeons differing in years of experience; 12 (46%) participants were female, mean age of 48. Participants included 5 chairs of surgery, 6 division chiefs, and 7 past or current presidents of national societies. Four themes emerged on the importance of titles: Some study participants reported that (1) titles are a barometer of success; others argued that (2) titles are not a sufficient metric to define success; (3) titles are a means to an end; and (4) there is a desire to achieve the title of a respected mentor. CONCLUSIONS As the definition of career success in academic surgery changes to encompass a broader range of interests and ambitions, the traditional markers of success must come into review. Academic surgeons see the value of titles as a marker of success and as a means to achieving other goals, but overwhelmingly our interviewees felt that titles were a double-edged sword and that a more inclusive definition of academic success was needed.
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Affiliation(s)
- Ergest Isak
- Michigan State University College of Human Medicine, East Lansing, MI
| | - Yash D Hegde
- Michigan State University College of Human Medicine, East Lansing, MI
| | - Meredith Barrett
- Department of Surgery, University of Michigan Health, Ann Arbor, MI
| | | | - Justin B Dimick
- Department of Surgery, University of Michigan Health, Ann Arbor, MI
| | - Gurjit Sandhu
- Department of Surgery, University of Michigan Health, Ann Arbor, MI
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He ZW, Wang C, Li Y, Danzeng A, Liu FB, Zhu Y, Shi JY, Ciren P, Yuan XY, Wu CX, Lan RH, Zhang BH. The state of female hepato-pancreato-biliary (HPB) surgeons in China: see us in operation theater with great prospects. HPB (Oxford) 2023; 25:1402-1410. [PMID: 37543474 DOI: 10.1016/j.hpb.2023.07.884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/02/2023] [Accepted: 07/12/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVE This study aims to investigate the proportion and distribution of female HPB surgeons in China, describe their current status, and analyze the possible barriers and challenges in their careers. METHOD Tertiary hospitals with the division of HPB in mainland China in 2021 were enrolled and surgeon demographic information was collected through the review of official websites and/or telephone interviews. RESULTS The majority of female HPB surgeons (72.92%) were located in the first or second-tier cities in mainland China, with an increasing number of new female HPB surgeons entering the field annually, particularly after 2005 (from 27 to 52 per 5 years). Despite no significant difference in academic backgrounds, female HPB surgeons initiated their careers at an earlier age and took a longer time to obtain chief titles (P < 0.05). Interestingly, female HPB surgeons performed laparoscopic complex HPB cases at a similar rate (95.42%) to their male counterparts and were more likely to specialize in endoscopic surgery (P = 0.021), with a similar ratio of obtaining administrative positions. CONCLUSION Minimally invasive surgery may provide females with unprecedented opportunities in the HPB surgery field. However, despite the increasing numbers of female HPB surgeons, the proportion remains low in China.
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Affiliation(s)
- Zheng-Wei He
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Chao Wang
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yong Li
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Awang Danzeng
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Fu-Bin Liu
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Yuan Zhu
- School of Automation, China University of Geosciences, Wuhan, 430074, China
| | - Jia-Yu Shi
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Pingcuo Ciren
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao-Yin Yuan
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Cheng-Xian Wu
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Run-Hu Lan
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Bin-Hao Zhang
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China.
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Schaechter JD, Goldstein R, Zafonte RD, Silver JK. Workplace Belonging of Women Healthcare Professionals Relates to Likelihood of Leaving. J Healthc Leadersh 2023; 15:273-284. [PMID: 37908972 PMCID: PMC10615104 DOI: 10.2147/jhl.s431157] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Purpose There is a high rate of attrition of professionals from healthcare institutions, which threatens the economic viability of these institutions and the quality of care they provide to patients. Women professionals face particular challenges that may lower their sense of belonging in the healthcare workplace. We sought to test the hypothesis that workplace belonging of women healthcare professionals relates to the likelihood that they expect to leave their institution. Methods Participants of a continuing education course on women's leadership skills in health care completed a survey about their experiences of belonging in workplace and their likelihood of leaving that institution within the next 2 years. An association between workplace belonging (measured by the cumulative number of belonging factors experienced, scale 0-10) and likelihood of leaving (measured on a 5-point Likert scale) was evaluated using ordinal logistic regression. The relative importance of workplace belonging factors in predicting the likelihood of leaving was assessed using dominance analysis. Results Ninety-nine percent of survey participants were women, and 63% were clinicians. Sixty-one percent of participants reported at least a slight likelihood of leaving their healthcare institution within the next 2 years. Greater workplace belonging was found to be associated with a significant reduction in the reported likelihood of leaving their institution after accounting for the number of years having worked in their current institution, underrepresented minority status, and the interaction between the latter two covariates. The workplace belonging factor found to be most important in predicting the likelihood of leaving was the belief that there was an opportunity to thrive professionally in the institution. Belonging factors involving feeling able to freely share thoughts and opinions were also found to be of relatively high importance in predicting the likelihood of leaving. Conclusion Greater workplace belonging was found to relate significantly to a reduced likelihood of leaving their institution within the next 2 years. Our findings suggest that leaders of healthcare organizations might reduce attrition of women by fostering workplace belonging with particular attention to empowering professional thriving and creating a culture that values open communication.
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Affiliation(s)
- Judith D Schaechter
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
| | - Richard Goldstein
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Ross D Zafonte
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
- Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Brigham and Women’s Hospital, Boston, MA, USA
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
- Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Brigham and Women’s Hospital, Boston, MA, USA
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7
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Mesiti AM, Yeo HL. Social Media: The Good, The Bad, and The Ugly. Clin Colon Rectal Surg 2023; 36:347-352. [PMID: 37564339 PMCID: PMC10411074 DOI: 10.1055/s-0043-1763281] [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: 08/12/2023]
Abstract
The use of social media platforms in a professional capacity has grown and presents unique opportunities for women surgeons. Women surgeons face unique obstacles and challenges compared with their male counterparts. Social media has helped women surgeons create an online community and has provided opportunities for mentorship and professional advancement. In addition, it has helped break down traditional constructs of what it means to be a surgeon and allowed the medical community and public to view images of a modern surgeon. Social media has played an important role in continually increasing efforts to diversify the field of surgery and break down traditional stereotypes associated with surgeons. However, there are some downsides of social media that women surgeons need to be aware of, particularly, the risk of harassment, criticism, and potentially harmful online reviews.
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Affiliation(s)
- Andrea M. Mesiti
- Department of Surgery, Weill Cornell Medical College, New York, New York
| | - Heather L. Yeo
- Department of Surgery, Weill Cornell Medical College, New York, New York
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Russel SM, Carter TM, Wright ST, Hirshfield LE. How Do Academic Medicine Pathways Differ for Underrepresented Trainees and Physicians? A Critical Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:00001888-990000000-00537. [PMID: 37556817 PMCID: PMC10834859 DOI: 10.1097/acm.0000000000005364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
PURPOSE Academic medicine faces difficulty recruiting and retaining a diverse workforce. The proportion of medical students who are underrepresented in medicine (URiM) is smaller than the proportion of URiM's in the general population, and these numbers worsen with each step up the academic medicine ladder. Previously known as the "leaky pipeline," this phenomenon may be better understood as disparate "pathways with potholes," which acknowledges the different structural barriers that URiM trainees and faculty face in academic medicine. This critical scoping review analyzed current literature to determine what variables contribute to the inequitable "pathways and potholes" URiM physicians experience in academic medicine. METHOD The authors combined scoping review methodology with a critical lens. The comprehensive search strategy used terms about academic medicine, underrepresented groups, and leaving academic medical careers. One reviewer conducted screening, full text review, and data extraction while in consultation with members of the research team. Data extraction focused on themes related to pathways and potholes, such as attrition, recruitment, and retention in academic medicine. Themes were iteratively merged, and quality of contribution to the field and literature gaps were noted. RESULTS Included papers clustered into attrition, recruitment, and retention. Those pertaining to attrition noted that URiM faculty are less likely to get promoted even when controlling for scholarly output, and a hostile work environment may exacerbate attrition. Recruitment and retention strategies were most effective when multi-pronged approaches changed every step of the recruitment and promotion processes. CONCLUSIONS These studies provide examples of various "potholes" that can affect representation in academic medicine of URiM trainees and faculty. However, only a few studies examined the link between isolating and hostile work environments, the so-called "chilly climate," and attrition from academic medicine. Understanding these concepts is key to producing the most effective interventions to improve diversity in medicine.
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Affiliation(s)
- Sarah M Russel
- S.M. Russel is a third-year resident physician, Department of Otolaryngology/Head & Neck Surgery, University of North Carolina, Chapel Hill, North Carolina; ORCID: https://orcid.org/0000-0001-9299-8047
| | - Taylor M Carter
- T.M. Carter is a fourth-year resident physician, Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, and a surgical education fellow, University of Utah, Salt Lake City, Utah
| | - Sarah T Wright
- S.T. Wright is a librarian, Health Sciences Library, University of North Carolina, Chapel Hill, North Carolina
| | - Laura E Hirshfield
- L.E. Hirshfield is The Dr. Georges Bordage Medical Education Faculty Scholar and associate professor of medical education and sociology, Department of Medical Education, University of Illinois College of Medicine, Chicago, Illinois; ORCID: https://orcid.org/0000-0003-0894-2994
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9
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Abraham P, Corey B. Hired her? Great -- Now support her. Am J Surg 2023; 225:266-267. [PMID: 36244833 DOI: 10.1016/j.amjsurg.2022.09.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 09/22/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Peter Abraham
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Britney Corey
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Surgery, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA.
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10
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Cote Estrada L. Female surgeons and academic surgery. Cir Esp 2023; 101:123-126. [PMID: 35918048 DOI: 10.1016/j.cireng.2022.06.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/20/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Lilia Cote Estrada
- Expresidente de la Asociación Mexicana de Cirugía General, Asesor Académico de Seguridad del Paciente, Fundación Academia Aescualp México, Mexico.
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11
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Lee RM, Crandall M, Shaffer VO. One century to parity: The need for increased gender equality in academic surgery. Am J Surg 2022; 224:1337-1341. [PMID: 35871029 DOI: 10.1016/j.amjsurg.2022.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/15/2022] [Accepted: 07/17/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Rachel M Lee
- Department of Surgery, Emory University, Atlanta, GA, USA
| | - Marie Crandall
- Department of Surgery, University of Florida College of Medicine - Jacksonville, Jacksonville, FL, USA
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12
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Saif A, Demblowski LA, Blakely AM, Zeiger MA. NIH Funding Across Surgical Specialties; How Do Women Fare? Surgery 2022; 172:890-896. [PMID: 35835627 PMCID: PMC9467910 DOI: 10.1016/j.surg.2022.04.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/21/2022] [Accepted: 04/29/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Much has been written about the under-representation of women in academic medicine. However, no study has comprehensively described the gender-based trends of National Institutes of Health funding across surgical specialties; this study provides such an overview. METHODS We queried a previously created database to identify both male and female National Institutes of Health-funded surgeons. Surgical specialties and subspecialties were determined based upon formal training. Total grant costs and average costs per R01 and K grant were calculated and compared. Bivariate χ2 analyses were performed using population totals. RESULTS In 2020, the specialties with the highest proportion of National Institutes of Health-funded female surgeon-scientists were obstetrics and gynecology (57%) and vascular surgery (40%). The general surgery subspecialties with the highest proportion of women were breast (85%), endocrine (58%), and colorectal surgery (40%). An analysis of total grant costs in 2020 revealed that in most specialties, the proportion of funding held by women was substantially less than the proportion of women investigators. In obstetrics and gynecology, women comprised 57% of surgeons, but held only 46% of the funding. Similarly, in breast surgery, women comprised 85% of surgeons, but held only 45% of the funding. Women and men had similar changes in the average total cost per R01 and K grant awarded from 2010 to 2020. In 2020, women were awarded less than men per R01 grant in general, otolaryngology, plastic and reconstructive, urology, and vascular surgery. CONCLUSION Although female surgeon-scientists have made significant advances in some surgical specialties, they continue to lag in others. An in-depth analysis of the factors contributing to these trends is necessary to achieve gender parity across all academic surgical specialties.
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Affiliation(s)
- Areeba Saif
- Surgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Lindsay A Demblowski
- Office of Surgeon Scientists Programs, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Andrew M Blakely
- Surgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Martha A Zeiger
- Office of Surgeon Scientists Programs, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD.
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13
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Cote Estrada L. La mujer cirujana y la cirugía académica. Cir Esp 2022. [DOI: 10.1016/j.ciresp.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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14
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Adar R, Kahalon R, Ullrich J, Afek A, Eisenberg VH. Gender bias in the evaluation of interns in different medical specialties: An archival study. MEDICAL TEACHER 2022; 44:893-899. [PMID: 35316160 DOI: 10.1080/0142159x.2022.2046715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The field of medicine is characterized by within-field gender segregation: Gender ratios vary systematically by subdisciplines. This segregation might be, in part, due to gender bias in the assessment of women and men medical doctors. METHODS We examined whether the assessments, i.e. overall score, department scores and skills scores, interns receive by their superiors during their internship year, vary as a function of their gender and the representation of women in the field. We analyzed an archival data set from a large hospital in Israel which included 3326 assessments that were given to all interns who completed their internship year between 2015 and 2019. RESULTS Women received lower department scores and skills scores in fields with a low (versus high) representation of women. Men received higher scores in fields with a high (versus low) representation of men, yet there was no difference in their skills scores. CONCLUSIONS Women are evaluated more negatively in fields with a low representation of women doctors. Similarly, men are evaluated more negatively in fields with a low representation of men, yet this cannot be explained by their skills. This pattern of results might point to a gender bias in assessments. A better understanding of these differences is important as assessments affect interns' career choices and options.
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Affiliation(s)
- Roy Adar
- Department of Urology, Sheba Medical Center, Ramat Gan, Israel
| | - Rotem Kahalon
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychology, Simon Fraser University, Canada
| | - Johannes Ullrich
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Arnon Afek
- Management & research unit, Sheba Medical Center, Tel Hashomer, Israel
| | - Vered H Eisenberg
- Management & research unit, Sheba Medical Center, Tel Hashomer, Israel
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Pandrowala S, Patkar S, Nair D, Maheshwari A, Pramesh CS, Puri A. Gender discrimination in surgical oncology: An in-house appraisal. Front Surg 2022; 9:939010. [PMID: 35903261 PMCID: PMC9314771 DOI: 10.3389/fsurg.2022.939010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Gender discrimination (GD) though rarely blatant, may present indirectly within a surgical department in the form of subtle inequities, differing standards, and bias. GD encompasses a wide spectrum including academic development, surgical opportunities and sexual harassment. Methods We conducted an online survey to analyse the perceived incidence of GD in the surgical oncology department at a tertiary care cancer centre in India. The questionnaire consisted of 15 questions and was mailed to the entire department including trainees and faculty. Anonymity was maintained while collecting the data only of the participants' gender and whether they were faculty or trainee. Collated responses were analysed using proportions. Results The questionnaire was sent out to 200 recipients of whom 56% (112/200) responded via an online survey. Respondents included 84% of faculty (42/50) and 46.6% of trainees (70/150). GD was perceived by 28% of female trainees (7/25) as compared to 6.6% of male trainees (3/45), whereas amongst faculty, GD was perceived by 26.6% of female faculty (4/15) compared to 14.8% of male faculty (3/27). Approximately 13% of our trainees and 12% of our faculty mentioned that GD affected their professional performance or mental well-being. GD was experienced in terms of work experience and opportunities by a majority of trainees (13%) and faculty (9.5%). There was a significant lack of awareness about recourse to an institutional grievance committee by trainees (47%) compared to faculty (14%). About 7% of trainees and 12% of faculty acknowledged that they may have been responsible for intentional/unintentional GD. Conclusion Gender discrimination can present in subtle or overt fashion in surgical departments and requires active sustained efforts to allow both genders to feel equally empowered. Establishing a system to objectively evaluate gender equity while avoiding stereotyping for certain roles can help minimize GD.
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Affiliation(s)
- Saneya Pandrowala
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - Shraddha Patkar
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
- Correspondence: Shraddha Patkar
| | - Deepa Nair
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - Amita Maheshwari
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - C. S. Pramesh
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - Ajay Puri
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
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16
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Early Barriers to Career Progression of Women in Surgery and Solutions to Improve Them: A Systematic Scoping Review. Ann Surg 2022; 276:246-255. [PMID: 35797642 DOI: 10.1097/sla.0000000000005510] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aims to summarize the evidence concerning the barriers that exist to the career progression of women in surgery and to provide potential solutions to overcome these obstacles. BACKGROUND Visible and invisible impediments can hinder female doctors' pursuit of a surgical career, from choosing a surgical specialty to training opportunities and all the way through career progression. METHODS Database search of original studies about barriers for female surgeons during choice of surgical career, residency, and career progression. A query including possible solutions such as mentorship and network was included. RESULTS Of 4618 total articles; 4497 were excluded as duplicates, having incorrect study focus, or not being original studies; leaving 120 studies meeting the inclusion criteria. Of the articles included, 22 (18%) focused on factors affecting the pursuit of a surgical career, such as surgical work hours and limited time for outside interests, 55 (46%) analyzed the main barriers that exist during surgical residency and fellowship training, such as discrimination and sexual harassment, 27 (23%) focused on barriers to career advancement, heavy workloads, ineffective mentorship, unclear expectations for advancement, inequality in pay or work-home conflicts. Among studies reporting on possible solutions, 8 (6.5%) articles reported on the role of effective mentorship to support career advancement and to provide moral support and 8 (6.5%) on the emerging role of social media for networking. Our analysis showed how different impediments hinder surgical career progression for women, with notable consequences on burnout and attrition. CONCLUSIONS Identification and recognition of obstacles to career progression is the first step to addressing the gender gap in surgery. Active strategies should be improved to promote a culture of diversity and to create equal opportunity for women in surgery, while implementing structured mentoring programs and investing on an adequate communication on social media to engage the future generations.
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17
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Neumayer LA. Are We There Yet? J Am Coll Surg 2022; 235:1-7. [PMID: 35703956 DOI: 10.1097/xcs.0000000000000260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Leigh A Neumayer
- From the Department of Surgery, University of Florida College of Medicine, Jacksonville, FL
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18
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Burton E, Jebaraj A, Eddington D, Brintz BJ, Simpson RG, Pettey JH. Gender Representation Among Presenters in Ophthalmology Subspecialties in 2019: A Retrospective Review. Am J Ophthalmol 2022; 242:18-25. [PMID: 35618022 DOI: 10.1016/j.ajo.2022.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To describe gender representation at eight national ophthalmology conferences, stratified by role, session category, and sub-specialty. DESIGN Retrospective cross-sectional study. STUDY POPULATION 3,817 presenters at the 2019 American Academy of Ophthalmology subspecialty days, American Society of Cataract and Refractive Surgery, American Glaucoma Society, American Society of Retina Specialists, American Society of Ophthalmic Plastic and Reconstructive Surgery, American Association for Pediatric Ophthalmology and Strabismus, North American Neuro-Ophthalmology Society, and American Uveitis Society meetings. MAIN OUTCOME MEASURES Gender of presenters in seven sub-specialties stratified by category and role. RESULTS The proportion of female presenters was less than the ABO-estimated proportion of women in their respective fields in glaucoma (28.0% vs. 39.8%), neuro-ophthalmology (35.3% vs. 45.3%), and pediatrics (42.1% vs. 53.3%) and greater than expected in retina (24.6% vs. 19.8%). Overall, the proportion of female presenters exceeded the ABO-estimated proportion of females in ophthalmology (24.5%) for clinical (mean: 38.5%, 95% CI: [35.8%, 41.4%]) and scientific (39.4% [30.3%, 49.2%]) sessions. For clinical sub-specialty sessions, the proportion of female leaders exceeded the overall proportion of female leaders in the respective sub-specialty in cornea (35.1%, [30.4%, 40.1%] vs. 24.6% all sessions). Females represented fewer than the expected number of surgical session leaders in cornea (22.0% [19.9%, 24.3%]), glaucoma (18.0% [13.2%, 24.1%]), pediatrics (22.0% [14.4%, 32.1%]), and retina (18.6% [14.2%, 24.1%]). CONCLUSIONS Gender representation varied, with fewer than expected female presenters in glaucoma, neuro-ophthalmology, and pediatrics. Females led relatively more clinical sessions, but were underrepresented in surgical sessions, in most sub-specialties.
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Affiliation(s)
- Eleanor Burton
- From the Johns Hopkins University School of Medicine (E.B.), Baltimore, Maryland, USA
| | - Abigail Jebaraj
- University of Utah Health John A Moran Eye Center (A.J., R.G.S., J.H.P.), Salt Lake City, Utah, USA
| | - Devin Eddington
- Division of Epidemiology (D.E., B.J.B.), Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Ben J Brintz
- Division of Epidemiology (D.E., B.J.B.), Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Rachel G Simpson
- University of Utah Health John A Moran Eye Center (A.J., R.G.S., J.H.P.), Salt Lake City, Utah, USA
| | - Jeff H Pettey
- University of Utah Health John A Moran Eye Center (A.J., R.G.S., J.H.P.), Salt Lake City, Utah, USA.
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19
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Ammann AM, Delman AM, Bethi M, Turner KM, Sedaghat AR, Holm TM. Gender Disparities in Academic Productivity and Promotion Among Endocrine Surgery Faculty. J Surg Res 2022; 277:335-341. [PMID: 35561649 DOI: 10.1016/j.jss.2022.04.045] [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] [Received: 12/09/2021] [Revised: 03/25/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Academic rank and metrics such as total publications (pubs) and H-index are indicators to measure academic achievement. This study aims to determine whether there are gender differences in academic productivity or faculty appointments among endocrine surgeons in the United States. METHODS A database was generated from the American Association of Endocrine Surgeons (AAES) website. Community or academic practice was designated by institution affiliation and faculty appointment. Academic metrics, including pubs, H-index, and weighted-RCR (relative citation ratio), were obtained from public databases. RESULTS A total of 258 AAES members were affiliated with an academic institution. The majority were men (58%). Overall, men in endocrine surgery had higher academic metrics: pubs (56.0 [26-134], 23.0 [11-56], P < 0.0001), H-index (19.0 [11-35], 9.0 [5-21], P < 0.0001), weighted-RCR (63.5 [22-193], 24.1 [8-74], P < 0.005) and rank (associate professor or professor, P < 0.0001). Subgroup analysis accounting for time in practice found no difference in total publications, weighted RCR, or faculty appointments between genders in practice for 0-5 y. However, among surgeons in practice for 6-10 y, men had higher academic metrics (pubs: 31.0 [16-79], 18.5 [9-33]; RCR: 46.0 [14-102], 13.3 [9-34]) and faculty appointments (all P < 0.05). CONCLUSIONS There are gender disparities in academic productivity and faculty appointment among US endocrine surgeons. While junior faculty show no gender differences in most indicators of academic productivity or rank, men with 6-10 y in practice have higher average academic metrics and rank. Whether the absence of gender disparities among junior faculty is a sustainable reflection of recent efforts to encourage equal mentorship and professional opportunities or whether disparities will manifest as faculty progress remains to be determined.
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Affiliation(s)
- Allison M Ammann
- The University of Cincinnati, Department of Surgery, Cincinnati, Ohio
| | - Aaron M Delman
- The University of Cincinnati, Department of Surgery, Cincinnati, Ohio
| | - Mridula Bethi
- The University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Kevin M Turner
- The University of Cincinnati, Department of Surgery, Cincinnati, Ohio
| | - Ahmad R Sedaghat
- The University of Cincinnati, Department of Otolaryngology-Head and Neck Surgery, Cincinnati, Ohio
| | - Tammy M Holm
- The University of Cincinnati, Department of Surgery, Cincinnati, Ohio.
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20
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Equity, Inclusion and Diversity in Surgical Training. Indian J Surg 2022. [DOI: 10.1007/s12262-021-03068-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Mohammadifar Y, Naderi N, Khosravi E, Karamian F. Developing a Paradigm Model for Resilience of Rural Entrepreneurial Businesses in Dealing With the COVID-19 Crisis; Application of Grounded Theory in Western of Iran. Front Public Health 2022; 10:833909. [PMID: 35284375 PMCID: PMC8913521 DOI: 10.3389/fpubh.2022.833909] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/31/2022] [Indexed: 12/23/2022] Open
Abstract
Pandemic the COVID-19 is a global threat to rural entrepreneurial businesses with an uncertain ending. Therefore, it is necessary to provide a paradigm model to reduce the negative effects of this crisis, increase the resilience of rural entrepreneurial businesses or even turn this threat into an opportunity for the development of rural entrepreneurial businesses in the long run. This study, using a qualitative approach, investigated the resilience of rural entrepreneurial businesses in dealing with the COVID-19 crisis in Kermanshah province using a paradigm model. Using purposeful and theoretical sampling, 26 cases were selected. The tools used for data collection were open questionnaires (unstructured), individual depth interviews, and taking notes. The results provide a relatively comprehensive model that consists of six basic parts: causal conditions (included economic management, health factors, human resources management, and adaptation factors), the phenomenon (included low resilience of rural entrepreneurial businesses in the face of the COVID-19 crisis), contextual conditions (including social factors; cultural factors and psychological factors), interventing conditions (included business management and legal supports), action strategies (included Planned resilient actions and Unplanned resilient actions), finally, the consequences (included adapting to crisis conditions and increasing resilience in the long run, and also lack of adaptation to crisis conditions and lack of continuity of business survival in the long run). In general, rural entrepreneurial businesses in the face of crisis must, through planned resilience measures, both increase their business resilience in the short term, as well as develop the business and gain a competitive advantage in the long run. Finally, based on the findings and in order to developing resilience in rural entrepreneurial businesses during the COVID-19 crisis, some recommendations were presented.
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Affiliation(s)
- Yousef Mohammadifar
- Department of Management and Entrepreneurship, Faculty of Social Sciences, Razi University, Kermanshah, Iran
- *Correspondence: Yousef Mohammadifar
| | - Nader Naderi
- Department of Management and Entrepreneurship, Faculty of Social Sciences, Razi University, Kermanshah, Iran
| | - Ehsan Khosravi
- Department of Management and Entrepreneurship, Faculty of Social Sciences, Razi University, Kermanshah, Iran
| | - Faranak Karamian
- Department of Agriculture Extension and Education, Agricultural College, Razi University, Kermanshah, Iran
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22
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Litvack JR, Lindsay RW. Moving Toward Professional Equity in Otolaryngology. Otolaryngol Clin North Am 2021; 55:11-22. [PMID: 34823709 DOI: 10.1016/j.otc.2021.08.003] [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: 10/19/2022]
Abstract
Gender-based equity in compensation, access to opportunity and resources, and leadership roles are critical to the health and future of otolaryngology; however, significant gaps continue to persist. Professional equity in otolaryngology will be achieved by leadership prioritization of equity as mission critical, improving organizational culture and developing systems for advocacy, understanding what constitutes equal pay in otolaryngology, the development of transparent and reoccurring equity review processes and the promotion of women and underrepresented minorities into leadership positions.
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Affiliation(s)
- Jamie R Litvack
- Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, Everett, Spokane, Tri-Cities, Vancouver
| | - Robin W Lindsay
- Department of Otolaryngology - Head & Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114, USA.
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Abstract
BACKGROUND Women in surgery are often told that they are not "tough enough" to be surgeons. A Grit Score provides a validated measure of passion and perseverance, which are aspects of "toughness." METHODS Survey data were collected from residents and attendings in all surgical fields through multiple surgical societies. Grit and burnout were measured using validated measures. RESULTS Among surgeons, gender did not have an impact on Grit Score. Burnout had a statistically significant inverse relationship with Grit Score, and women were more likely to report burnout compared to men surgeons. CONCLUSIONS Women in surgery have just as much grit as their male counterparts. Grit should not be a factor in women pursuing a career in surgery.
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24
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Kennedy GE, Bergstresser SL, Rakestraw SL, Novak Z, Corey B, Chen H, Sutzko DC. Does Chair of Surgery Gender Influence Divisional or Residency Program Director Gender Diversity? J Surg Res 2021; 267:224-228. [PMID: 34157491 DOI: 10.1016/j.jss.2021.05.026] [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] [Received: 02/03/2021] [Revised: 04/26/2021] [Accepted: 05/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Workplace diversity is beneficial and results in new ideas and improved performance. Within surgery leadership, the gender gap is improving, but still present. Given the increasing number of women surgery department chairs, we aimed to examine the association of surgery chair gender with division and residency program director gender. We hypothesized that surgery departments with female leadership would have an increase in gender diversity compared to departments led by male chairs. MATERIALS AND METHODS A list of all surgery departments were compiled from the Society of Surgical Chairs website. Gender of department chair, division director and residency program director were examined and compared. Chair position term length was determined based on online public announcements, publicly available curriculum vitae, and institutional profile biographies. RESULTS Of 178 department chairs included, 10.7% were female, and 89.3% were male. There was no difference in female residency program director leadership between female versus male led programs (42.1 versus 26.1%, P= 0.147). Of the programs with female department chairs, only 29.4% had any female division directors compared to 54.6% led by male chairs (P= 0.055). When examining departments with ≥5 division directors, there was no difference in the average number of female division directors within departments led by female versus male chairs. There was a significant difference in length of surgery chairship, with female chairs holding the position for fewer years than male chairs (median time 5.3 (IQR = 3.4-5.8) versus 7.0 (IQR=4.3-12.3) years, P= 0.032). CONCLUSIONS Female department chair leadership was not associated with increased diversity in divisional leadership compared to departments of surgery led by males.
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Affiliation(s)
- Grace E Kennedy
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | | | | | - Zdenek Novak
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Britney Corey
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Herbert Chen
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Danielle C Sutzko
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.
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25
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Acuña AJ, Sato EH, Jella TK, Samuel LT, Jeong SH, Chen AF, Kamath AF. 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; 479:1179-1189. [PMID: 33871403 PMCID: PMC8133193 DOI: 10.1097/corr.0000000000001724] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/11/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although previous studies have evaluated how the proportion of women in orthopaedic surgery has changed over time, these analyses have been limited by small sample sizes, have primarily used data on residents, and have not included information on growth across subspecialties and geographic regions. QUESTION/PURPOSE We used the National Provider Identifier registry to ask: How have the (1) overall, (2) regional, and (3) subspecialty percentages of women among all currently practicing orthopaedic providers changed over time in the United States? METHODS The National Provider Identifier Registry of the Centers for Medicare and Medicaid Services (CMS) was queried for all active providers with taxonomy codes pertaining to orthopaedic subspecialties as of April 2020. Women orthopaedic surgeons were identified among all physicians with subspecialty taxonomy codes. As all providers are required to provide a gender when applying for an NPI, all providers with queried taxonomy codes additionally had gender classification. Our final cohort consisted of 31,296 practicing orthopaedic surgeons, of whom 8% (2363 of 31,296) were women. A total of 11,714 (37%) surgeons possessed taxonomy codes corresponding with a specific orthopaedic subspecialty. A univariate linear regression analysis was used to analyze trends in the annual proportions of women who are active orthopaedic surgeons based on NPI enumeration dates. Specifically, annual proportions were defined using cross-sections of the NPI registry on December 31 of each year. Linear regression was similarly used to evaluate changes in the annual proportion of women orthopaedic surgeons across United States Census regions and divisions, as well as orthopaedic subspecialties. The national growth rate was then projected forward to determine the year at which the representation of women orthopaedic surgeons would achieve parity with the proportion of all women physicians (36.3% or 340,018 of 936,254, as determined by the 2019 American Medical Association Physician Masterfile) and the proportion of all women in the United States (50.8% or 166,650,550 of 328,239,523 as determined by 2019 American Community Survey from the United States Census Bureau). Gender parity projections along with corresponding 95% confidence intervals were calculated using the Holt-Winters forecasting algorithm. The proportions of women physicians and women in the United States were assumed to remain fixed at 2019 values of 36.3% and 50.8%, respectively. RESULTS There was a national increase in the proportion of women orthopaedic surgeons between 2010 and 2019 (r2 = 0.98; p < 0.001) at a compound annual growth rate of 2%. Specifically, the national proportion of orthopaedic surgeons who were women increased from 6% (1670 of 26,186) to 8% (2350 of 30,647). Assuming constant growth at this rate following 2019, the time to achieve gender parity with the overall medical profession (that is, to achieve 36.3% women in orthopaedic surgery) is projected to be 217 years, or by the year 2236. Likewise, the time to achieve gender parity with the overall US population (which is 50.8% women) is projected to be 326 years, or by the year 2354. During our study period, there were increases in the proportion of women orthopaedic surgeons across US Census regions. The lowest growth was in the West (17%) and the South (19%). Similar growth was demonstrated across census divisions. In each orthopaedic subspecialty, we found increases in the proportion of women surgeons throughout the study period. Adult reconstruction (0%) and spine surgery (1%) had the lowest growth. CONCLUSION We calculate that at the current rate of change, it will take more than 200 years for orthopaedic surgery to achieve gender parity with the overall medical profession. Although some regions and subspecialties have grown at comparably higher rates, collectively, there has been minimal growth across all domains. CLINICAL RELEVANCE Given this meager growth, we believe that substantive changes must be made across all levels of orthopaedic education and leadership to steepen the current curve. These include mandating that all medical school curricula include dedicated exposure to orthopaedic surgery to increase the number of women coming through the orthopaedic pipeline. Additionally, we believe the Accreditation Council for Graduate Medical Education and individual programs should require specific benchmarks for the proportion of orthopaedic faculty and fellowship program directors, as well as for the proportion of incoming trainees, who are women. Furthermore, we believe there should be a national effort led by American Academy of Orthopaedic Surgeons and orthopaedic subspecialty societies to foster the academic development of women in orthopaedic surgery while recruiting more women into leadership positions. Future analyses should evaluate the efficacy of diversity efforts among other surgical specialties that have achieved or made greater strides toward gender parity, as well as how these programs can be implemented into orthopaedic surgery.
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Affiliation(s)
- Alexander J. Acuña
- A. J. Acuña, T. K. Jella, L. T. Samuel, S. H. Jeong, A. F. Kamath, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
- E. H. Sato, Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
- A. F. Chen, Orthopaedic and Arthritis Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Eleanor H. Sato
- A. J. Acuña, T. K. Jella, L. T. Samuel, S. H. Jeong, A. F. Kamath, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
- E. H. Sato, Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
- A. F. Chen, Orthopaedic and Arthritis Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Tarun K. Jella
- A. J. Acuña, T. K. Jella, L. T. Samuel, S. H. Jeong, A. F. Kamath, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
- E. H. Sato, Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
- A. F. Chen, Orthopaedic and Arthritis Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Linsen T. Samuel
- A. J. Acuña, T. K. Jella, L. T. Samuel, S. H. Jeong, A. F. Kamath, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
- E. H. Sato, Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
- A. F. Chen, Orthopaedic and Arthritis Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Stacy H. Jeong
- A. J. Acuña, T. K. Jella, L. T. Samuel, S. H. Jeong, A. F. Kamath, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
- E. H. Sato, Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
- A. F. Chen, Orthopaedic and Arthritis Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Antonia F. Chen
- A. J. Acuña, T. K. Jella, L. T. Samuel, S. H. Jeong, A. F. Kamath, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
- E. H. Sato, Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
- A. F. Chen, Orthopaedic and Arthritis Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Atul F. Kamath
- A. J. Acuña, T. K. Jella, L. T. Samuel, S. H. Jeong, A. F. Kamath, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
- E. H. Sato, Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
- A. F. Chen, Orthopaedic and Arthritis Center, Brigham and Women’s Hospital, Boston, MA, USA
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Sadler SJ, Yuki Ip HK, Kim E, Karekezi C, Robertson FC. Investing in the future: a call for strategies to empower and expand representation of women in neurosurgery worldwide. Neurosurg Focus 2021; 50:E8. [PMID: 33789242 DOI: 10.3171/2020.12.focus20963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 12/21/2020] [Indexed: 11/06/2022]
Abstract
As progress is gradually being made toward increased representation and retention of women in neurosurgery, the neurosurgical community should elevate effective efforts that may be driving positive change. Here, the authors describe explicit efforts by the neurosurgery community to empower and expand representation of women in neurosurgery, among which they identified four themes: 1) formal mentorship channels; 2) scholarships and awards; 3) training and exposure opportunities; and 4) infrastructural approaches. Ultimately, a data-driven approach is needed to improve representation and empowerment of women in neurosurgery and to best direct the neurosurgical community's efforts across the globe.
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Affiliation(s)
| | - Ho Kei Yuki Ip
- 2Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Eliana Kim
- 3University of California, San Francisco School of Medicine, San Francisco, California
| | - Claire Karekezi
- 4Department of Neurosurgery, Rwanda Military Hospital, Kigali, Rwanda; and
| | - Faith C Robertson
- 5Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
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Xepoleas MD, Munabi NCO, Auslander A, Magee WP, Yao CA. The experiences of female surgeons around the world: a scoping review. HUMAN RESOURCES FOR HEALTH 2020; 18:80. [PMID: 33115509 PMCID: PMC7594298 DOI: 10.1186/s12960-020-00526-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/15/2020] [Indexed: 05/25/2023]
Abstract
INTRODUCTION The Lancet Commission for Global Surgery identified an adequate surgical workforce as one indicator of surgical care accessibility. Many countries where women in surgery are underrepresented struggle to meet the recommended 20 surgeons per 100,000 population. We evaluated female surgeons' experiences globally to identify strategies to increase surgical capacity through women. METHODS Three database searches identified original studies examining female surgeon experiences. Countries were grouped using the World Bank income level and Global Gender Gap Index (GGGI). RESULTS Of 12,914 studies meeting search criteria, 139 studies were included and examined populations from 26 countries. Of the accepted studies, 132 (95%) included populations from high-income countries (HICs) and 125 (90%) exclusively examined populations from the upper 50% of GGGI ranked countries. Country income and GGGI ranking did not independently predict gender equity in surgery. Female surgeons in low GGGI HIC (Japan) were limited by familial support, while those in low income, but high GGGI countries (Rwanda) were constrained by cultural attitudes about female education. Across all populations, lack of mentorship was seen as a career barrier. HIC studies demonstrate that establishing a critical mass of women in surgery encourages female students to enter surgery. In HICs, trainee abilities are reported as equal between genders. Yet, HIC women experience discrimination from male co-workers, strain from pregnancy and childcare commitments, and may suffer more negative health consequences. Female surgeon abilities were seen as inferior in lower income countries, but more child rearing support led to fewer women delaying childbearing during training compared to North Americans and Europeans. CONCLUSION The relationship between country income and GGGI is complex and neither independently predict gender equity. Cultural norms between geographic regions influence the variability of female surgeons' experiences. More research is needed in lower income and low GGGI ranked countries to understand female surgeons' experiences and promote gender equity in increasing the number of surgical providers.
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Affiliation(s)
- Meredith D. Xepoleas
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA USA
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
| | - Naikhoba C. O. Munabi
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, 1510 San Pablo St, Suite 415, Los Angeles, CA USA
| | - Allyn Auslander
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA USA
| | - William P. Magee
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA USA
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, 1510 San Pablo St, Suite 415, Los Angeles, CA USA
- Division of Plastic Surgery, Shriners Hospital for Children, Los Angeles, CA USA
| | - Caroline A. Yao
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, 1510 San Pablo St, Suite 415, Los Angeles, CA USA
- Division of Plastic Surgery, Shriners Hospital for Children, Los Angeles, CA USA
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Odell DD, Edwards M, Fuller S, Loor G, Antonoff MB. The Art and Science of Mentorship in Cardiothoracic Surgery: A Systematic Review of the Literature. Ann Thorac Surg 2020; 113:1093-1100. [PMID: 32857995 DOI: 10.1016/j.athoracsur.2020.06.051] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/07/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND As academic cardiothoracic surgeons focus on producing a new generation of successful surgeon leaders, mentorship has emerged as one of the most important variables influencing professional and personal success and satisfaction. We explore the literature to determine the benefits, qualities and features of the mentor relationship. METHODS A comprehensive review was performed in February for 2020 of Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and the SCOPUS Database using 'mentor' as a primary search term. The titles and abstracts of these publications were then reviewed by 2 of the authors to identify relevant sources addressing topics related to mentorship in cardiothoracic surgery and identify 4 specific areas of focus (1) the value of mentorship, (2) the skills needed to be an effective mentor, (3) effective approaches for identifying and receiving mentorship, and (4) the unique considerations associated with mentorship for traditionally underrepresented populations in surgery. RESULTS Of 16,469 articles reviewed, 167 relevant manuscripts were identified and 62 were included. CONCLUSIONS There is undeniable value in mentorship when navigating a career in cardiothoracic surgery. By sharing the most significant features and skills of both ideal mentors and mentees, we hope to provide a framework to improve the quality of mentorship from both sides.
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Affiliation(s)
- David D Odell
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - Melanie Edwards
- Department of Surgery, St. Joseph's Medical Center, Ann Arbor, Michigan
| | - Stephanie Fuller
- Division of Cardiothoracic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Gabriel Loor
- Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
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Sangji NF, Telem D. Time to end the secrecy: Publish salaries to narrow the gender-based wage gap in surgery. Am J Surg 2020; 220:254-255. [DOI: 10.1016/j.amjsurg.2020.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 11/25/2022]
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Crandall M. Invited commentary for: Gender differences in urology society award recipients. Am J Surg 2020; 220:1151. [PMID: 32682500 DOI: 10.1016/j.amjsurg.2020.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/10/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Marie Crandall
- Department of Surgery Program Director, General Surgery Residency University of Florida College of Medicine Jacksonville 655 W. 8th Street, Jacksonville, FL, 32209, United States.
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Anderson KT, Hyman S, Henry MCW. Demographics in general surgery programs: Relationship between female faculty and proportion of female residents. Am J Surg 2020; 220:1189-1193. [PMID: 32646583 DOI: 10.1016/j.amjsurg.2020.06.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/01/2020] [Accepted: 06/25/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We hypothesized that general surgery programs with more female faculty and leadership may be associated with more female residents. METHODS The Fellowship and Residency Electronic Interactive Database Access system (FREIDA) was assessed for chair gender, program director gender, percentage of female faculty, and percentage of female residents at general surgery residency programs. Programs were stratified by type: university-based (UB), community-based/university-affiliated (UA) and community-based (CB). RESULTS 304 general surgery programs reported a mean of 38.4% female residents which did not differ by program type. Chairs were more likely female in UB programs (12.8%) versus 5.5% in UA and CB programs (p = 0.05). There were more female faculty at UB programs (23.3%) versus UA (21.7%) and CB (17.4%) (p = 0.04). Chair (p = 0.21), program director (p = 0.98) and faculty gender proportion (p = 0.40) was not associated with female resident complement. CONCLUSIONS In general surgery programs, faculty and leadership gender composition was not associated with proportion of female residents.
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Affiliation(s)
- K Tinsley Anderson
- University of Arizona School of Medicine, Tucson, Department of Surgery1501 N. Campbell Ave, Tucson, AZ, 85724, United States.
| | - Simone Hyman
- University of Arizona School of Medicine, Tucson, Department of Surgery1501 N. Campbell Ave, Tucson, AZ, 85724, United States
| | - Marion C W Henry
- University of Arizona School of Medicine, Tucson, Department of Surgery1501 N. Campbell Ave, Tucson, AZ, 85724, United States
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Endocrine surgery is at the forefront of gender diversity. Am J Surg 2020; 221:86-89. [PMID: 32622505 DOI: 10.1016/j.amjsurg.2020.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND The purpose of this study is to assess gender diversity across surgical subspecialties, with a focus on endocrine surgery. METHODS We collected publicly-reported data from Association of American Medical Colleges (AAMC) and American Association of Endocrine Surgeons (AAES) during the 2017 data period. Student's t-test and Analysis of Variance (ANOVA) were used to compare percentages of female surgeons. We analyzed data by geographical regions, excluding states where data was unreported/unavailable. RESULTS During this period, there were 25,022 general surgeons. Of these, 5157 (20.6%) were female. There were 513 endocrine surgeons, of which 179 (34.8%) were female (p < 0.001). Across the US, endocrine surgery had the greatest percentage of female surgeons (34.8%) compared to other surgical subspecialties (p < 0.001). When comparing geographical regions, the Northeast (22.8%) and West (22.8%) contained the highest percentages of female general surgeons, while the South comprised the greatest proportion of female endocrine surgeons (38.7%). CONCLUSIONS Endocrine surgery has the most gender diversity of all studied surgical subspecialties. The Southern US has the greatest proportion of female endocrine surgeons.
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Cultural Barriers for Women in Surgery: How Thick is the Glass Ceiling? An Analysis from a Low Middle-Income Country. World J Surg 2020; 44:2870-2878. [PMID: 32372142 DOI: 10.1007/s00268-020-05544-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND This study aimed to highlight cultural barriers faced by surgeons pursuing a surgical career faced by surgeons at a tertiary care hospital in Pakistan. As more females opt for a surgical career, barriers faced by female surgeons are becoming increasingly evident, many of which are rooted in cultural norms. In Pakistan, a predominantly Muslim-majority, low middle-income country, certain societal expectations add additionally complexity and challenges to existing cultural barriers. METHODS A cross-sectional survey was administered via e-mail to the full-time faculty and trainees in the Department of Surgery at the Aga Khan University Hospital, Karachi, Pakistan, from July 2019 to November 2019. RESULTS In total, 100 participants were included in this study, with the majority being residents (55.6%) and consultants (33.3%). 71.9% of female surgeons felt that cultural barriers towards a surgical career existed for their gender, as compared to 25.4% of male surgeons (p < 0.001). 40.6% of females reported having been discouraged by family/close friends from pursuing surgery, as compared to only 9.0% of males (p < 0.001). Moreover, a greater percentage of females surgeons were responsible for household cooking, cleaning and laundry, as compared to male surgeons (all p < 0.001). Lastly, 71.4% of female surgeons felt that having children had hindered their surgical career, as compared to 4.8% of males (p < 0001). CONCLUSION Our study shows that significant cultural barriers exist for females pursuing a surgical career in our setting. Findings such as these emphasize the need for policy makers to work towards overcoming cultural barriers.
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Matot I, De Hert S, Cohen B, Koch T. Women anaesthesiologists' attitudes and reported barriers to career advancement in anaesthesia: a survey of the European Society of Anaesthesiology. Br J Anaesth 2020; 124:e171-e177. [PMID: 31980158 DOI: 10.1016/j.bja.2020.01.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/02/2020] [Accepted: 01/03/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Previous studies have confirmed gender imbalance in anaesthesia leadership. Whether women anaesthesiologists aspire to career advancement has not been reported. This European Society of Anaesthesiology (ESA) survey explored anaesthesiologists' motivation to advance their careers into leadership positions, and to identify reported barriers to advancement. METHODS ESA members (n=10 033, 5245 men, 3759 women, 1029 undefined) were invited to complete a 25-item, Internet-based survey, and responses were analysed thematically. RESULTS In total, 3048 ESA members (1706 women, 1342 men, 30% of all members) responded to the survey. The majority were specialists, married or with a partner, and have children; 47% of women and 48% of men wish to pursue a leadership career. Barriers to career promotion noted by women were primarily attributed to work-private time considerations (extra workload and less personal time [84%], responsibility for care of family [65%], lack of part-time work opportunities [67%]), and the shift away from clinical work [59%]). Men respondents indicated the same barriers although the proportions were significantly lower. Considerations related to the partner (lack of support, career development of partner) were last on the list of variables reported by women as barriers. Importantly, many women noted deficiencies in leadership (68%) and research education (55%), and women role models (41%) and self-confidence (44%). CONCLUSIONS This is the largest survey to date of women anaesthesiologists' view on career advancement. Despite the many barriers noted by women, they are as eager as men to assume leadership positions. The survey results help in identifying possible areas for intervention to assist in career development.
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Affiliation(s)
- Idit Matot
- Division of Anaesthesia, Intensive Care and Pain Medicine, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Stefan De Hert
- Department of Anaesthesiology and Perioperative Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Barak Cohen
- Division of Anaesthesia, Intensive Care and Pain Medicine, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH, USA
| | - Thea Koch
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universität, Dresden, Germany
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