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Miao X, Sarsour R, Givant M, Spartz H. Exploring the gender gap: A nationwide comparative analysis of general surgery residency program leadership. Surg Open Sci 2024; 20:57-61. [PMID: 38911054 PMCID: PMC11190743 DOI: 10.1016/j.sopen.2024.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 05/24/2024] [Indexed: 06/25/2024] Open
Abstract
Background The gender disparity in surgery leadership roles is well-reported. However, the effect of program type and region on mean number of men or women occupying a particular leadership role has yet to be explored. This study aims to investigate the gender disparity of leadership positions in different types of General Surgery Residency Programs (GSRPs). Methods Leadership roles of the general surgery departments were collected from the Fellowship and Residency Electronic Interactive Database Access System (FREIDA) database. Each GSRP was categorized by region and program type using FRIEDA. Analysis of the mean number of men and women holding various leadership positions by program type and region was conducted using one-way ANOVA with post-hoc tests. Results A total of 345 GSRPs were analyzed. The mean number of women occupying various leadership roles was significantly higher at university-based programs when compared to community-based programs. No significant difference in mean number of women leaders was observed by region. Conclusions Women consistently occupy a lower number of GSRP leadership positions when compared to men, regardless of program type or region. University-based GSRP leadership positions have significantly greater gender inclusion compared to community-based GSRPs. Key messages University-based general surgery residency programs had a higher mean number of women in all leadership roles compared to other program types. In comparison, region did not appear to be a significant factor impacting the leadership gender disparity. Improvement is needed in community-based general surgery residency programs to bridge the gender gap in leadership roles.
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Affiliation(s)
- Xinfei Miao
- California University of Science and Medicine, 1501 Violet St, Colton, CA, United States of America
| | - Reem Sarsour
- California University of Science and Medicine, 1501 Violet St, Colton, CA, United States of America
| | - Madeleine Givant
- California University of Science and Medicine, 1501 Violet St, Colton, CA, United States of America
| | - Helena Spartz
- California University of Science and Medicine, 1501 Violet St, Colton, CA, United States of America
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Dias R, Herzog I, Alomary S, Beebe KS. Is Program Director Gender Associated With Gender Diversity Among Orthopaedic Surgery Residency Programs? Clin Orthop Relat Res 2024; 482:1351-1357. [PMID: 39031037 PMCID: PMC11272353 DOI: 10.1097/corr.0000000000003070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/08/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND Women remain underrepresented in leadership roles, faculty roles, and among residents in orthopaedic surgery. It has been suggested that having women in leadership positions in orthopaedic surgery may help to increase the gender diversity of residency programs. However, to our knowledge, no study has explored the relationship, if any, between the gender of the residency program director and the percentage of women in the residency program. QUESTIONS/PURPOSES (1) Is the program director's gender associated with differences in the percentage of women orthopaedic surgery residents? (2) Do women and men differ in the time to appointment of program director? METHODS A list of 207 orthopaedic surgery residencies was obtained from the Accreditation Council for Graduate Medical Education (ACGME) website for the academic year 2021 to 2022. The study excluded 6% (13) of programs; 4% (8) were those without ACGME accreditation and those with initial accreditation, and 2% (5) did not have updated 2021 to 2022 resident lists. Descriptive information on 194 programs was obtained from publicly accessible resources from July 2021 through July 2022. The institution's website and the American Medical Association's (AMA) Fellowship and Residency Electronic Interactive Database (FREIDA) was used to collect residency program characteristics and resident demographics [ 2 ]. Doximity, Healthgrades, and LinkedIn were used to further collect current orthopaedic surgery residency program director demographics, including gender, age, and education/training history. To determine gender, photographs and pronouns (she/her/hers or he/him/hers) used in their biographies were used first. To confirm this, secondary sources were used including their NPI profile, which lists gender; Doximity; and their LinkedIn profile. Scopus was used to analyze research output by the program directors-using the Hirsch index (h-index) as the primary bibliometric metric. A total of 194 program directors were identified, of whom of 12% (23) were women and 88% (171) were men. Of the 4421 total residents among these programs, 20% (887) were women and 80% (3534) were men. A univariate analysis comparing program directors was conducted, with continuous variables analyzed using an independent-sample t-test and categorical variables analyzed using a Pearson chi-square test. With the numbers available, a post hoc statistical power calculation indicated that we could detect an 32% difference in the percentage of women in a program as significant with 80% power at the p < 0.05 level, whereas we might have been underpowered to discern smaller differences than that. RESULTS With the numbers available, we found no difference in the percentage of women in residency programs run by women program directors than in programs in which the program director was a man (22% [125 of 558] versus 20% [762 of 3863], mean difference 2% [95% CI -1.24% to 7.58%]; p = 0.08). Comparing women to men program directors, women had fewer years between residency completion and appointment to the position of program director (8 ± 2 years versus 12 ± 7 years, mean difference 4 years [95% CI 2.01 to 7.93 years]; p = 0.02) and had a lower mean h-index (7 ± 4 versus 11 ± 11, mean difference 4 [95% CI 1.70 to 6.56]; p = 0.03) and number of publications (24 ± 23 versus 41 ± 62, mean difference 17 [95% CI 3.98 to 31.05]; p = 0.01), although they did not differ in terms of their advanced degrees, duration of training, or likelihood of having taken a fellowship. CONCLUSION Orthopaedic residency programs that were run by women did not contain a higher percentage of women residents, suggesting that the gender of the individual in that role may not be as important as has been speculated by others. Future studies should investigate the intersectionality of gender, race, and ethnicity of residents, program directors, and current faculty. CLINICAL RELEVANCE The fact that women were placed in program director roles earlier in career may also carry special jeopardy for them. Those roles are difficult and can impair a faculty member's ability to conduct individual research, which often is key to further academic promotions. Given that and the fact that the gender of the program director was not associated with differences in gender composition of residency programs, we believe that increasing mentorship and access to pipeline programs will help promote diversity in residency programs.
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Affiliation(s)
- Rosamaria Dias
- Department of Orthopaedics, Rutgers University New Jersey Medical School, Newark, NJ, USA
| | - Isabel Herzog
- Department of Orthopaedics, Rutgers University New Jersey Medical School, Newark, NJ, USA
| | - Simona Alomary
- Department of Orthopaedics, Rutgers University New Jersey Medical School, Newark, NJ, USA
| | - Kathleen S. Beebe
- Department of Orthopaedics, Rutgers University New Jersey Medical School, Newark, NJ, USA
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Parks MA, Gaskins JT, Jin A, Galandiuk S, Kavalukas SL. You Want to be a Surgical Leader? Consider Training Elsewhere - An Observation of How Training Background May Impact Leadership Selection. JOURNAL OF SURGICAL EDUCATION 2024; 81:564-569. [PMID: 38388306 DOI: 10.1016/j.jsurg.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/15/2023] [Accepted: 12/22/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVE The significance of thought differences has always held importance in medicine, but it could be considered as increasingly acknowledged and valued to a greater extent in recent times as more emphasis is placed on diversity, equity, and inclusion. These unique perspectives have been examined according to race, gender, and ethnicity, but there is limited published data examining the prevalence of leadership roles within surgical departments in terms of training background. Our main objective is to identify trends in surgical leaders' education, and emphasize training diversity in surgical leadership. DESIGN A descriptive study of the training background of all surgical academic leaders. SETTING This internet search was performed at a tertiary care, academic medical center. PARTICIPANTS Academic chairpersons, division directors, and program directors. RESULTS 124 programs had pertinent information available. There was a mean of 7.6 leaders per institute examined: total 939 positions (119 chairs, 704 division directors, 116 program directors). 90/119 (76%) of the Chairs led at institutions outside of the places they completed their training. 4/119 (3%) did all their training at the same institution they chaired. 25/119 (21%) completed at least some but not all their training there, and later rose to the role of Chair. Among division directors, 217/704 (31%) did some training at that institution, and program directors were significantly more likely to have completed some training at their current institute (53/116, 46%; p = 0.001). There were no statistically significant differences when examined geographically. Women made up 18% of the leaders and were significantly more likely to lead as program director rather than a chair or division director (p < 0.001). CONCLUSION A majority of surgery chairs hold positions at institutions where they did not complete their medical training. This suggests that outside perspective could be a contributing factor when searching for this position.
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Affiliation(s)
- Mary Alex Parks
- University of Louisville, Department of Surgery, Louisville, Kentucky
| | - Jeremy T Gaskins
- University of Louisville, Department of Bioinformatics & Biostatistics, Louisville, Kentucky
| | - Allie Jin
- University of Louisville, Department of Surgery, Louisville, Kentucky
| | - Susan Galandiuk
- University of Louisville, Department of Surgery, Louisville, Kentucky
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Vought R, Vought V, Lin M, Nguyen H, Szirth B, Khouri AS, Habiel M. Gender Representation Among Ophthalmology Fellowship Directors in 2022. Am J Ophthalmol 2024; 259:166-171. [PMID: 37944687 DOI: 10.1016/j.ajo.2023.11.001] [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: 06/29/2023] [Revised: 10/29/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE Women are underrepresented in several medical specialties, including ophthalmology. Reducing disparities is critical in diversifying perspectives and increasing equity within ophthalmology, both of which can ultimately improve care delivery. We examined ophthalmic fellowship programs directors in the United States to investigate gender disparities by subspecialty. DESIGN Cross-sectional study. METHODS This was a retrospective cross-sectional study of ophthalmology fellowship program directors in academic medical centers. The primary outcome measure was a descriptive analysis of current fellowship directors in 2022 when stratified by subspecialty and demographic features. RESULTS Analysis was conducted on 358 fellowship directors in the United States. Twenty-nine percent of directors were women. Female directors had significantly fewer years since residency graduation compared with male peers (17 vs 24; P < .001); however, no differences were observed by program type (P = .896) or location (P = 0.104). Differences in female director representation were observed by subspecialty (P < .001), with the greatest percentage of women in pediatric ophthalmology (54%), other (oncology and pathology) fellowships (50%), and medical retina (40%). The subspecialties with the lowest percentage of female directors were oculoplastic and reconstructive surgery (13%) surgical retina and vitreous (16%). CONCLUSION There are disparities in female representation in academic leadership positions across ophthalmic subspecialties. Addressing this difference may have critical impacts on career advancement and opportunities available for marginalized groups in medicine.
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Affiliation(s)
- Rita Vought
- From the Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Victoria Vought
- From the Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Myriam Lin
- From the Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Helen Nguyen
- From the Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Bernard Szirth
- From the Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Albert S Khouri
- From the Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Miriam Habiel
- From the Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
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Brooks NE, Maskal S, Essani V, Chang JH, Hernandez Dominguez O, French JC, Lipman JM. Female Representation at the Association of Program Directors in Surgery Annual Meeting: Moving Towards Gender Equality. JOURNAL OF SURGICAL EDUCATION 2023; 80:1592-1601. [PMID: 37442699 DOI: 10.1016/j.jsurg.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/11/2023] [Accepted: 06/11/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE This study aims to evaluate the state and changes over time of female representation in Association of Program Directors in Surgery (APDS) leadership and annual meeting presenters and session leaders. DESIGN, SETTING, AND PARTICIPANTS APDS conference programs from 2013 to 2022 were reviewed to identify society leadership and meeting presenters and session leaders. Verified online profiles were used to gather professional role and reported gender. Descriptive statistics and t-tests compared female representation in the first half (2013-2017, prior) and second half of data (2018-2022, current). RESULTS Leadership of APDS was an average 22% women, increasing from 13% in 2013 to 37% in 2022, and significantly increased from prior to current period (p = 0.0004). Conference presenters and session leaders were 42% women overall, increasing from 30% in 2013 to 52% in 2022. An average 33% staff surgeons, 54% trainees, 64% education scientists, and 51% medical student participants were female. Staff were 44% female in 2022 from 24% in 2013, significantly increased from prior to current period (p = 0.021). Comparing prior and current period cohorts, female presenters for paper sessions increased from 38% to 55% (p = 0.011), moderators from 15% to 39% (p = 0.046), and last author listed on presentation sessions from 18% to 32% (p = 0.010), while panelists, workshop directors, and presenters at all sessions increased without statistical significance. Female poster presenters decreased over time. CONCLUSIONS Female representation at APDS meetings has increased over time. Women are well represented compared to the 2022 member population of 36% women. While positions typically held by more senior members, such as leadership, panelists, moderators, and last authors remain lower than other roles, increases over time are encouraging. APDS female representation compares favorably to many other surgical societies. Translation of successful practices regarding gender representation utilized by APDS to other surgical organizations could expedite progress toward gender parity in the field.
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Affiliation(s)
- Nicole E Brooks
- Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio.
| | - Sara Maskal
- Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - Varisha Essani
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Jenny H Chang
- Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Judith C French
- Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | - Jeremy M Lipman
- Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
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Yong V, Rostmeyer K, Deng M, Chin K, Graves EKM, Ma GX, Erkmen CP. Gender differences in cardiothoracic surgery letters of recommendation. J Thorac Cardiovasc Surg 2023; 166:1361-1370. [PMID: 37156362 PMCID: PMC10592592 DOI: 10.1016/j.jtcvs.2023.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/20/2023] [Accepted: 03/27/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE To investigate whether or not gender influences letters of recommendation for cardiothoracic surgery fellowship. METHODS From applications to an Accreditation Council Graduate Medical Education cardiothoracic surgery fellowship program between 2016 and 2021, applicant and author characteristics were examined with descriptive statistics, analysis of variance, and Pearson χ2 tests. Linguistic software was used to assess communication differences in letters of recommendation, stratified by author and applicant gender. An additional higher-level analysis was then performed using a generalized estimating equations model to examine linguistic differences among author-applicant gender pairs. RESULTS Seven hundred thirty-nine recommendation letters extracted from 196 individual applications were analyzed; 90% (n = 665) of authors were men and 55.8% (n = 412) of authors were cardiothoracic surgeons. Compared with women authors, authors who are men wrote more authentic (P = .01) and informal (P = .03) recommendation letters. When writing for women applicants, authors who are men were more likely to display their own leadership and status (P = .03) and discuss women applicants' social affiliations (P = .01), like occupation of applicant's father or husband. Women authors wrote longer letters (P = .03) and discussed applicants' work (P = .01) more often than authors who are men. They also mentioned leisure activities (P = .03) more often when writing for women applicants. CONCLUSIONS Our work identifies gender-specific differences in letters of recommendation. Women applicants may be disadvantaged because their recommendation letters are significantly more likely to focus on their social ties, leisure activities, and the status of the letter writer. Author and reviewer awareness of gender-biased use of language will aid in improvements to the candidate selection process.
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Affiliation(s)
- Valeda Yong
- Department of Surgery, Temple University Hospital, Philadelphia, Pa
| | - Kaleb Rostmeyer
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pa
| | - Mengying Deng
- Fox Chase Cancer Center, Temple University Health Systems, Philadelphia, Pa
| | - Kristine Chin
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pa
| | - Erin K M Graves
- Department of Neurosurgery, Temple University Hospital, Philadelphia, Pa
| | - Grace X Ma
- Center for Asian Health, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa
| | - Cherie P Erkmen
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa.
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