1
|
Faria I, Canizares S, Viana P, Kueht M. Navigating the changing landscape of transplant research: Trends, topics, and gender disparities. Am J Surg 2024:116003. [PMID: 39424459 DOI: 10.1016/j.amjsurg.2024.116003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 09/04/2024] [Accepted: 10/03/2024] [Indexed: 10/21/2024]
Abstract
BACKGROUND Transplantation is a rapidly evolving field, reflecting advances in medical science and changing healthcare needs. This study aims to elucidate shifts in research focus over a decade, providing insights into emerging trends in transplant research. METHODS We conducted a comprehensive analysis of 9,250 articles published in five high-impact transplant journals from 2012 to 2021. Article titles were processed to extract keywords using R Studio (v. 4.3.0). STATA 18 was used for t-tests and logistic regressions, with significance set at p < 0.05. RESULTS Emerging topics over the decade included outcomes and survival, surgical innovations, and lung transplantation. There was a downward trend in research on immunosuppression, genetics, and immunology. Over the decade, the odds of women's first authorship were higher for subjects such as public health, pediatric transplantation, infectious diseases, renal transplantation, and psychological aspects. Similarly, there were lower odds for women as first authors on surgical innovations, organ preservation, living donor transplantation, liver and lung transplantation, and multiorgan transplantation. Senior women authors had higher odds of publishing on the same topics as first author, plus immunology, kidney and heart transplantation. There were lower odds that a woman would be last author of regenerative medicine and xenotransplantation. Over the decade, there were higher odds of funding for research published on xenotransplantation, regenerative medicine, and immunology. Living donor, infectious diseases, and liver transplantation had lower odds of being funded over time. CONCLUSION This cross-sectional study highlights the dynamic nature of transplant research, underscoring the importance of continuous observation of trends to anticipate future directions and needs in the field. The emergence of new focal areas, especially those related to technological advancements and social issues, reflects a broader trend in medical research responding to evolving challenges and opportunities. Notably, women's authorship was more prevalent in public health but less in surgical innovation. These insights can guide future research priorities, funding allocation, and clinical practices in transplantation.
Collapse
Affiliation(s)
- Isabella Faria
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, United States.
| | - Stalin Canizares
- Escuela de Medicina, Universidad San Francisco de Quito, Quito, Ecuador
| | - Patricia Viana
- Universidade do Extremo Sul Catarinense School of Medicine, Criciúma, Santa Catarina, Brazil
| | - Michael Kueht
- Division of Transplant, Department of Surgery, University of Texas Medical Branch, Galveston, TX, United States
| |
Collapse
|
2
|
Faria I, Montalvan A, Kazimi M, Martins PN, Eckhoff D. Representation of Women Authorship in the Top 5 Transplantation Journals in the United States. Transplantation 2024; 108:802-812. [PMID: 37917944 DOI: 10.1097/tp.0000000000004844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND In the United States, only 13% of transplant surgeons are women. We evaluated gender distribution and trends of American authorship over the past 10 y in high-impact solid organ transplantation journals to gain insight into the current status of women authorship in transplantation. METHODS Original articles from 2012 to 2021 from the 5 highest-impact solid organ transplantation journals were extracted from Scopus. First and last author's gender was predicted using Genderize.io. Data of first and last authors, article type and topic, location, citation, and funding metrics were analyzed. Chi-square, logistic regression, and trend tests were performed where appropriate. Statistical significance was set at <0.05. RESULTS Women's first and last authorship increased over time among all journals. There was an increase in women first authors in the American Journal of Transplantation and in senior women authors in Liver Transplantation and Transplantation . Significant differences in gender authorship in lung, intestine, pancreas, general, and islet cell transplantation were found. Women's last authorship was associated with 1.69 higher odds of having a woman first author when adjusting for year and journal. There was an increase in the rate of women's first and last author collaborations over the years. Women last authors had 1.5 higher odds of being funded by the National Institutes of Health over the years. CONCLUSIONS Despite an increase in women transplant surgeons and physicians, the gap in women authorship in transplantation persists. Women's last authorship was associated with higher odds of having a woman first author, pointing to the importance of mentorship for women joining the transplant academia.
Collapse
Affiliation(s)
- Isabella Faria
- Division of Transplant Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Adriana Montalvan
- Division of Transplant Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Marwan Kazimi
- Division of Transplant Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Paulo N Martins
- Division of Organ Transplantation, Department of Surgery, University of Massachusetts, Worcester, MA
| | - Devin Eckhoff
- Division of Transplant Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| |
Collapse
|
3
|
MacDonald SM, Malik RD. The Gender Gap in Promotions: Inhibitors and Catalysts, Strategies to Close the Gap. Urol Clin North Am 2023; 50:515-524. [PMID: 37775210 DOI: 10.1016/j.ucl.2023.07.001] [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: 10/01/2023]
Abstract
The gender gap is an amalgam of gender disparity issues in the workplace ranging from fewer opportunities to network, decreased funding for research, microaggressions, nebulous promotional criteria and difficulty achieving the perception of professionalism because of inherent gender bias. Contributing home factors include more substantial household duties for women typically, spouses who also have a career, and the inherent delay associated with maternity leave for those who choose to have children. This article subdivides gender disparity that impedes promotion into experiences inside and outside the workplace. Disparities within the workplace are divided into directly quantified versus qualitative differences.
Collapse
Affiliation(s)
- Susan M MacDonald
- Department of Urology, Penn State Health Milton S. Hershey Medical Center, Mail Code H055, 500 University Drive, Hershey, PA 17033, USA.
| | - Rena D Malik
- Division of Urology, VA Long Beach Health System, 5901 East 7th Street, Long Beach, CA 90822, USA
| |
Collapse
|
4
|
Sundel MH, Blackburn KW, Seyoum N, Morton C, Swartzberg A, Bafford AC. Lessons in liability: Examining medical malpractice suits against general surgeons in Maryland. Am J Surg 2023; 225:748-752. [PMID: 36414471 PMCID: PMC10033332 DOI: 10.1016/j.amjsurg.2022.11.008] [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: 06/11/2022] [Revised: 10/14/2022] [Accepted: 11/09/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Although medical malpractice lawsuits pose a significant burden, there is a paucity of research on physician-specific characteristics influencing lawsuits against surgeons. Our objective was to identify factors associated with general surgeons being named in malpractice cases. METHODS This was a cross sectional study of Maryland general surgeons, using malpractice data from a publicly accessible judiciary database. Case number per decade and lifetime lawsuit status were modeled with linear and logistic regression. RESULTS Male surgeons had a higher average lawsuit volume (p = 0.002) and were more likely to be named in a malpractice case (p < 0.001). In regression analysis, a second graduate degree was a predictor of average cases per 10 years (p = 0.008) and male gender predicted lifetime lawsuit status (OR = 1.73, p = 0.046). CONCLUSIONS Male gender was associated with increased odds of being named in a malpractice lawsuit. Identifying this difference is a preliminary step in developing interventions to reduce lawsuits amongst surgeons.
Collapse
Affiliation(s)
- Margaret H Sundel
- University of Maryland, Department of Surgery, 22 South Greene Street, Baltimore, MD, 21201, United States.
| | - Kyle W Blackburn
- University of Maryland, Department of Surgery, 22 South Greene Street, Baltimore, MD, 21201, United States
| | - Nahom Seyoum
- University of Maryland, School of Medicine, 655 West Baltimore Street, Baltimore, MD, 21201, United States
| | - Claire Morton
- University of Maryland, School of Medicine, 655 West Baltimore Street, Baltimore, MD, 21201, United States
| | - Allyson Swartzberg
- Wake Forest University, College of Arts and Sciences, 1834 Wake Forest Road, Winston-Salem, NC, 27109, United States
| | - Andrea C Bafford
- University of Maryland, Department of Surgery, 22 South Greene Street, Baltimore, MD, 21201, United States
| |
Collapse
|
5
|
Alam Khan MT, Patnaik R, Laffoon AN, Krokar L, Ince SR, Hurtado E, Kitano M, Fritze DM, Dent DL. Gender Discrepancies in Middle Author Publications in US Academic General Surgery. J Surg Res 2023; 288:43-50. [PMID: 36948032 DOI: 10.1016/j.jss.2023.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/30/2023] [Accepted: 02/19/2023] [Indexed: 03/24/2023]
Abstract
INTRODUCTION To explore gender discrepancies in publications at general surgery departments, we performed a cross-sectional comparing the number of women and men at each academic rank and their number of first author (FA), middle author (MA), last author (LA), and total publications. METHODS Thirty academic general surgery departments were randomly selected. For each faculty, we tabulated: first, middle, last names, gender, academic rank, educational leadership, year of medical school graduation, and additional graduate degrees. Bibliography, H-index, and citations were downloaded from the Scopus database. RESULTS One thousand three hundred twenty-six faculty sampled, 881 (66.4%) men and 445 (33.5%) women. Men outnumbered women at all ranks, with increasing disparity at higher ranks. Men outnumbered women in all subspecialties-largest difference in transplant surgery (84.4% versus 15.6%, P < 0.001). Men at all ranks had more MA publications: assistant professor (rate ratio 1.20; 95% confidence interval, 1.01-1.43, P = 0.024), associate professor (1.65; 1.31-2.06, P < 0.001), and professor (1.50; 1.20-1.91, P = 0.008). Men associate professors had more LA publications (1.74; 1.34-2.37, P < 0.001). No differences found in FA publications at any rank, nor LA publications at assistant professor and professor ranks. At subspecialty level, men in surgical oncology (1.95; 1.55-2.45, P < 0.001) and transplant surgery (1.70; 1.09-2.66, P = 0.02) had more MA publications. CONCLUSIONS While FA and LA publications did not differ significantly across genders, the largest difference lies in MA publications, beginning at junior ranks and persisting with seniority. Discrepancies in MA publications may reflect gender discrepancies in collaborative opportunities, hence total publications should be used cautiously when determining academic productivity.
Collapse
Affiliation(s)
| | - Ronit Patnaik
- Department of Surgery, University of Texas Health San Antonio, San Antonio, Texas
| | - Allison N Laffoon
- Department of Surgery, University of Texas Health San Antonio, San Antonio, Texas
| | - Lucijana Krokar
- Long School of Medicine, University of Texas Health San Antonio, San Antonio, Texas
| | - Spencer R Ince
- Long School of Medicine, University of Texas Health San Antonio, San Antonio, Texas
| | | | - Mio Kitano
- Department of Surgery, University of Texas Health San Antonio, San Antonio, Texas
| | - Danielle M Fritze
- Department of Surgery, University of Texas Health San Antonio, San Antonio, Texas
| | - Daniel L Dent
- Department of Surgery, University of Texas Health San Antonio, San Antonio, Texas
| |
Collapse
|
6
|
Gender equity in surgical literature authorship: Are we there yet? Am J Surg 2022; 224:1215-1216. [DOI: 10.1016/j.amjsurg.2022.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 11/19/2022]
|
7
|
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.
Collapse
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.
| |
Collapse
|
8
|
Disparities in Research during Plastic Surgery Training: How Can We Level the Playing Field? Plast Reconstr Surg Glob Open 2022; 10:e4301. [PMID: 35539293 PMCID: PMC9076450 DOI: 10.1097/gox.0000000000004301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/17/2022] [Indexed: 11/26/2022]
Abstract
Background: Methods: Results: Conclusions:
Collapse
|
9
|
MacDonald SM, Malik RD. Women in Academic Urology: A Qualitative Analysis of the Relationship Between Pregnancy, Parenting and Delayed Promotion. Urology 2022; 168:13-20. [PMID: 35469801 DOI: 10.1016/j.urology.2022.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/17/2022] [Accepted: 02/15/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the role that the burden of childbearing, including pregnancy and maternity leave, play in academic promotion for women in urology, which has been shown to be delayed as compared to their male counterparts. METHOD Female academic urologists of varying academic rank who have children were invited to participate in a semi-structured interview. A representative sample from multiple subspecialties and geographic locations were targeted. Topics addressed included pregnancy, maternity leave, parenting, and promotion in academic urology. Transcripts of the interview were analyzed using grounded theory methodology. RESULTS Eleven participants were interviewed, including 3 assistant, 5 associate, and 3 full professors. The majority of participants chose to time pregnancy with training either during less strenuous portions or avoiding residency altogether. Nearly half endorsed self-inflicted hardships during pregnancy or early postpartum to prevent inconveniencing colleagues or to "pull their weight" in accordance with surgical culture. Outsourcing of childcare and household duties, along with spousal support, were discussed as contributing to success. Lack of transparency for promotional criteria was identified as a significant obstacle to promotion. Sponsorship and self-motivated information gathering were identified as critical components to success in promotion. CONCLUSION A culture of support created by administration and colleagues is critical for a positive experience with childbearing, and return to clinical practice or training postpartum. Explicit promotional criteria that are accessible in early career development and sponsorship from members of the academic department or subspecialty community are crucial for all urologists, but for women in particular.
Collapse
Affiliation(s)
- Susan M MacDonald
- The Pennsylvania State University College of Medicine, Department of Urology, Hershey, PA.
| | - Rena D Malik
- University of Maryland School of Medicine, Department of Surgery, Division of Urology, Baltimore, MD, USA
| |
Collapse
|
10
|
Abstract
BACKGROUND Over the past twenty years explicit gender bias towards women in surgery has been replaced by more subtle barriers, which represent indirect forms of discrimination and prevents equality. OBJECTIVE The aim of our scoping review is to summarize the different forms of discrimination towards women in surgery. METHODS The database search consisted of original studies regarding discrimination towards female surgeons. RESULTS Of 3,615 studies meeting research criteria, 63 were included. Of these articles, 11 (18%) were focused on gender-based discrimination, 14 (22%) on discrimination in authorship, research productivity and research funding, 21 (33%) on discrimination in academic surgery, 7 (11%) on discrimination in surgical leadership positions and 10 (16%) on discrimination during conferences and in surgical societies. The majority (n = 53, 84%) of the included studies were conducted in the U.S.A. According to our analysis, female surgeons experience discrimination from male colleagues, healthcare workers, but also from patients and trainees. Possible solutions may include acknowledgement of the problem, increased education of diversity and integration for the younger generations, mentorship, coaching and more active engagement by male and female partners to support women in the surgical field. CONCLUSIONS Gender-based discrimination toward women in the field of surgery has evolved over the past twenty years, from an explicit to a more subtle attitude. A work-environment where diversity and flexibility are valued would allow female surgeons to better realize their full potential.
Collapse
|