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Devi J, Butt AS, Rai L, Kumar J, Memon S. Gender disparities in gastroenterology and hepatology conferences: The journey towards equality. Indian J Gastroenterol 2024:10.1007/s12664-024-01591-5. [PMID: 38935228 DOI: 10.1007/s12664-024-01591-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 04/11/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND This study scrutinizes gender representation in invited faculty and conference committee leadership at key gastroenterology and hepatology conferences in Pakistan over five years, exploring the impact of the "glass ceiling" and "sticky floor" phenomena on gender diversity within academic medicine. METHODS This cross-sectional study was conducted between January and March of 2023. The three major national societies of gastroenterology and hepatology in Pakistan that had been established for more than 10 years and the scientific programs of their annual conferences, which were publicly accessible, were included and coded as Society 1, Society 2 and Society 3 to maintain anonymity. The scientific programs for the last five years (2018-2022) were retrieved. The roles of invited faculties were identified as invited speakers, moderators, chairs/panelists, presidents and chairs of organizing or scientific committees and the gender makeup of the faculty was compared. Regression analysis was used to evaluate the trends for female representation over time for each role. RESULTS Significant gender disparity was evident by an extremely lower cumulative proportion of female invited faculty compared to males (211 [11.9%] vs. 1567 [88.1%], p 0.001). The predominance of invited male faculty was observed across all societies as well as in various roles of invited faculty (p 0.01). A significant disparity has also been observed in leadership positions of all three societies (43 [95.5%] males vs. 2 [4.5%] females, p 0.001), while the trend of women's underrepresentation across all societies remained almost unchanged over time (slope = 0.08, R2 = - 0.078, p-value = 0.875). CONCLUSION Our study unveils striking gender disparities in women's representation as invited speakers and other roles at the annual scientific conferences of major gastroenterology and hepatology. Additionally, male dominance remains entrenched, notably in leadership positions, necessitating a proactive, multifaceted approach to rectify gender inequities.
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Affiliation(s)
- Jalpa Devi
- Division of Gastroenterology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Amna Subhan Butt
- Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Karachi, Sindh, Pakistan.
| | - Lajpat Rai
- Department of Gastroenterology, Jinnah Postgraduate Medical Center, Karachi, Sindh, Pakistan
| | - Jatin Kumar
- Liaquat University of Medical and Health Sciences, Hyderabad, Sindh, Pakistan
| | - Sadik Memon
- Gastroenterology, Asian Institute of Medical & Health Sciences, Hyderabad, Sindh, Pakistan
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2
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Venezia L, Labarile N, Maselli R, Benedetti A, Annibale B, Parodi MC, Soncini M, Zingone F. Women in Gastroenterology: What Is the Current Situation? Results of an Italian National Survey. Dig Dis Sci 2024; 69:1990-1995. [PMID: 38637458 PMCID: PMC11162355 DOI: 10.1007/s10620-024-08407-8] [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: 12/10/2023] [Accepted: 03/26/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Many women grow up dreaming of becoming doctors, preferring specialties that allow more focus on time outside the hospital and on family life. Nowadays, specialties, like gastroenterology, have still a significant gender gap. METHODS Based on this known discrepancy, a web-based questionnaire was designed by the Young Component of the Scientific Committee of the Federation of Italian Scientific Societies of Digestive Diseases 2023 (FISMAD) to examine the current situation of female gastroenterologists in Italy. The survey, designed specifically for this study, was sent by email to all female gastroenterologists and residents gastroenterologists, members of the three major Italian societies of Gastroenterology. RESULTS A total of 423 female physicians responded to the survey: 325 (76.8%) had full-time employment, and only a few had an academic career (7.2%). The main occupations were outpatient clinics (n = 288, 68%) and diagnostic endoscopy (n = 289, 68.3%); only 175 (41.3%) performed interventional endoscopy. One hundred and forty-seven (34.7%) had the chance to attend a master in advanced or interventional endoscopy, while 133 (31.4%) faced disadvantages that enabled them to attend. Of the 244 (58%) who reported feeling underappreciated, 194 (79.5%) said it was due to gender bias. We found that women doctors considered themselves disadvantaged compared with men doctors due to career opportunities (n = 338), salary negotiations (n = 64), and training opportunities (n = 144). CONCLUSIONS In conclusion, gastroenterology still has a long way to go before approaching greater gender parity.
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Affiliation(s)
- Ludovica Venezia
- Gastroenterology Unit, Department of Oncological and Specialty Medicine, Azienda Ospedaliero-Universitaria 'Maggiore Della Carità', Novara, Italy
| | - Nunzia Labarile
- National Institute of Gastroenterology - IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Roberta Maselli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan, Italy
| | - Antonio Benedetti
- Department of Clinic and Molecular Sciences, Polytechnic University of Marche, Via Tronto 10, Ancona, Italy
| | - Bruno Annibale
- Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Teaching Hospital, Sapienza University of Rome, Rome, Italy
| | - Maria Caterina Parodi
- Department of Gastroenterology and Digestive Endoscopy, IRCCS Teaching Hospital San Martino, Genoa, Italy
| | - Marco Soncini
- Department of Internal Medicine, A. Manzoni Hospital, Lecco, Italy
| | - Fabiana Zingone
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
- Gastroenterology Unit, Azienda Ospedale - Università Padova, Via Giustiniani 2, Padua, Italy.
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Farha N, Bhama A, Tizzano A, Asfaw S, Kim MK, Burke CA. Impostor Phenomenon and Microaggressions in Gastroenterology: Exposing the Tip of the Iceberg. Gastroenterology 2024; 166:11-15.e1. [PMID: 38128970 DOI: 10.1053/j.gastro.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Affiliation(s)
- Natalie Farha
- Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio
| | - Anuradha Bhama
- Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Anthony Tizzano
- Department of Surgery, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Sofya Asfaw
- Department of General Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Michelle Kang Kim
- Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio
| | - Carol A Burke
- Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio
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Farha N, Bhama A, Tizzano A, Asfaw S, Kim MK, Burke CA. Impostor Phenomenon and Microaggressions in Gastroenterology: Exposing the Tip of the Iceberg. Clin Gastroenterol Hepatol 2024; 22:3-8.e1. [PMID: 38135356 DOI: 10.1016/j.cgh.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 12/24/2023]
Affiliation(s)
- Natalie Farha
- Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio
| | - Anuradha Bhama
- Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Anthony Tizzano
- Department of Surgery, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Sofya Asfaw
- Department of General Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Michelle Kang Kim
- Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio
| | - Carol A Burke
- Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio
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Mansour M, Denha E, Rida A, Meram T, Abushukur Y, Salgia R. Female Presidents in American Gastroenterology Societies: An Upward Trend. GASTRO HEP ADVANCES 2023; 2:898-901. [PMID: 39130766 PMCID: PMC11308086 DOI: 10.1016/j.gastha.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 05/12/2023] [Indexed: 08/13/2024]
Affiliation(s)
- M.R. Mansour
- Department of Medical Education, Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - E.J. Denha
- Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan
| | - A.M. Rida
- Department of Medical Education, Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - T.D. Meram
- Department of Medical Education, Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Y. Abushukur
- Department of Medical Education, Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - R.J. Salgia
- Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, Michigan
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GIE Editorial Board Top 10: advances in GI endoscopy in 2021. Gastrointest Endosc 2022; 96:1062-1070. [PMID: 35948180 DOI: 10.1016/j.gie.2022.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/01/2022] [Indexed: 12/11/2022]
Abstract
The 9-member Editorial Board of the American Society for Gastrointestinal Endoscopy performed a systematic literature search of original articles published during 2021 in Gastrointestinal Endoscopy and 10 other high-impact medical and gastroenterology journals on endoscopy-related topics. Votes from each editorial board member were tallied to identify a consensus list of the 10 most significant topic areas in GI endoscopy over the calendar year of study, with a focus on 3 criteria: significance, novelty, and global impact on clinical practice. The 10 areas identified collectively represent advances in the following endoscopic topics: colonoscopy optimization, bariatric endoscopy, endoscopic needle sampling and drainage, peroral endoscopic myotomy, endoscopic defect closure, meeting systemic challenges in endoscopic training and practice, endohepatology, FNA versus fine-needle biopsy sampling, endoscopic mucosal and submucosal procedures, and cold snare polypectomy. Each board member contributed a summary of important articles relevant to 1 to 2 of the consensus topic areas, leading to a collective summary that is presented in this document of the "top 10" endoscopic advances of 2021.
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Luo Y, Dixon RE, Shah BJ, Keefer LA. Gastroenterology Trainees' Attitudes and Knowledge towards Patients with Disorders of Gut-Brain Interaction. Neurogastroenterol Motil 2022; 34:e14410. [PMID: 35608084 DOI: 10.1111/nmo.14410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/28/2022] [Accepted: 05/09/2022] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Disorders of gut-brain interaction (DGBI) are highly prevalent, estimated to affect about 40% of the global population. Patients with DGBI are still inadequately treated and face stigma which adversely impacts their disease course. METHODS A 12-question multiple-choice anonymous survey was distributed electronically to all adult gastroenterology fellowship program directors across the United States. Data were collected on demographics, training, attitudes, and knowledge in managing patients with DGBI. RESULTS 9.8% and 15.9% of all trainees reported that their attendings and peers often demonstrated a dismissive attitude towards patients with DGBI, respectively. 21.4% of all trainees often felt frustrated or burned out when seeing patients with DGBI with increasing odds of burnout by years of training (OR 4.4 for F3 trainees, trainees in their third year of training). Significantly, more female trainees reported frustration and burnout when seeing patients with DGBI (p = 0.005). 28.6% of all trainees report they often do not want to see patients with DGBI in their outpatient GI practice, including 39.6% of F3 trainees. 27.1% of F3 trainees reported that they were uncomfortable with titrating neuromodulators and only 31.6% of all trainees were comfortable knowing when to refer to a gastropsychologist. DISCUSSION Many trainees expressed some unwillingness and discomfort in managing patients with DGBI. Potential interventions will require a multi-pronged and longitudinal approach with education and training initiatives at the trainee level and beyond and exploring systemic healthcare delivery innovations to remove barriers.
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Affiliation(s)
- Yuying Luo
- The Henry D. Janowitz Division of Gastroenterology, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rebekah E Dixon
- The Henry D. Janowitz Division of Gastroenterology, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Brijen J Shah
- The Henry D. Janowitz Division of Gastroenterology, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Laurie A Keefer
- The Henry D. Janowitz Division of Gastroenterology, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Advani R, Arjonilla M, Guerson A, Taub E, Monzur F. Gender-Specific Attitudes of Internal Medicine Residents Toward Gastroenterology. Dig Dis Sci 2022; 67:5044-5052. [PMID: 35596822 DOI: 10.1007/s10620-022-07541-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/23/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIMS Female representation among gastroenterology (GI) fellows has remained around 30%, yet women comprise over 50% of internal medicine (IM) residents. We aim to identify the gender-specific barriers of IM residents toward pursuing GI. METHODS We surveyed IM residents in the Northeast by emailing 168 IM programs a survey link to be distributed to their residents. A 4-point Likert barrier scale and bivariate analysis were performed with "yes" and "no," where "yes" was analyzed as "somewhat of a barrier" and above. Females received a third table assessing female-specific barriers. Significance was set at < 0.05. RESULTS Of 215 survey responses, 56.3% (n = 121) were female. Response rate could not be determined due to resident identity protection and inconsistent responses of survey dissemination from programs. Females had significantly greater concerns about fertility, maternity leave, radiation exposure, work-life balance, stress, and burnout compared to males (p < 0.05). For females, 48.7% felt a lack of gender diversity in GI, 54.6% felt a lack of female GI mentors, and 43.7% felt there is a lack of respect as a female in GI. No gender differences existed in motivation to pursue GI, exposure to GI, and access to GI mentors, or GI-related research. CONCLUSIONS Our study reveals that female IM trainees had greater concerns surrounding fertility, radiation exposure, and maternity leave compared to male IM trainees. Lack of gender diversity and lack of female GI mentors were noted barriers for female IM trainees. Addressing these barriers may help increase female representation in GI.
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Affiliation(s)
- Rashmi Advani
- Division of Gastroenterology and Hepatology, Stony Brook University Hospital, Renaissance School of Medicine at Stony Brook, 101 Nicolls Road, HSC T17-060, Stony Brook, NY, 11794-8173, USA.
| | - Marta Arjonilla
- Department of Medicine, Stony Brook University Hospital, Renaissance School of Medicine at Stony Brook, Stony Brook, USA
| | - Arcelia Guerson
- Division of Gastroenterology and Hepatology, Stony Brook University Hospital, Renaissance School of Medicine at Stony Brook, 101 Nicolls Road, HSC T17-060, Stony Brook, NY, 11794-8173, USA
| | - Erin Taub
- Department of Epidemiology and Population Health, Stony Brook University Hospital, Renaissance School of Medicine at Stony Brook, Stony Brook, USA
| | - Farah Monzur
- Division of Gastroenterology and Hepatology, Stony Brook University Hospital, Renaissance School of Medicine at Stony Brook, 101 Nicolls Road, HSC T17-060, Stony Brook, NY, 11794-8173, USA
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9
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Noronha B, Fuchs A, Zdravkovic M, Berger-Estilita J. Gender balance in the medical workplace – A snapshot into anesthesia. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2022. [DOI: 10.1016/j.tacc.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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When Fair Is Not Foul: Promoting Female Authorship in Gastroenterology Journals. Dig Dis Sci 2022; 67:377-379. [PMID: 34008114 DOI: 10.1007/s10620-021-07028-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 12/09/2022]
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11
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Gender Disparity in Academic Gastroenterology: Beginning of the End of the Underrepresentation of Women? Dig Dis Sci 2022; 67:380-387. [PMID: 33141389 DOI: 10.1007/s10620-020-06692-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 10/22/2020] [Indexed: 12/09/2022]
Abstract
BACKGROUND Though there are an increasing number of female medical graduates, women remain underrepresented in academic medicine. There have been several reasons to explain this gender disparity, including marital status, number of children, number of hours worked, job flexibility, perceptions of women as inferior leaders, gender bias, sexual harassment, and unsupportive academic climates. AIMS This study aimed to investigate the relationship between scholarly productivity and the representation of female gastroenterologists in academia. Specifically, scholarly productivity measured by the h-index and academic rank were explored to determine if there were gender disparities in academic productivity and rank in gastroenterology. METHODS Gastroenterology departmental listings were obtained from the Fellowship and Residency Interactive Database of the American Medical Association. The Scopus database was used to record each physician's h-index. Statistical analyses were conducted with Wilcoxon rank-sum test, which compared matched samples by academic rank, and ANOVA tests, which compared multiple academic ranks. RESULTS Out of 1703 academic gastroenterologists, women account for 25% of academic physicians. Women have statistically lower h-indices at the level of Assistant Professor (p = 0.0012), and at the level of Chair (p = 0.01). There was no difference in h-indices between male and female at the rank of Associate Professor and Professor. CONCLUSIONS While these results mirror patterns appreciated in other fields of medicine, the results at the rank of Chair may suggest that despite the lower h-index compared to their male counterparts, females are perceived as having strong inherent leadership skills outside of academic productivity that are also conducive to leading a department and may be contributing to their rise to Chair.
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Khan Z, Rukhshan R, Bhatt A, Guha S, Ramireddy S, Patil P, Badillo R, DaVee RT, Thosani N. (#WomeninDDW) Persistent Speaker Gender Gap at the Premier Digestive Disease Event. Dig Dis Sci 2022; 67:390-396. [PMID: 35094252 PMCID: PMC8800828 DOI: 10.1007/s10620-021-07366-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/13/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Over the last few decades, advances have been made regarding gender equality starting from medical students to trainees, to leadership in academics. The female representation in specialty academic conferences not only reflects the existing gender disparities in that specialty but also can influence young female trainees to join that field. Digestive Disease Week (DDW) is the premier digestive disease event. We aimed to calculate the proportion of female representation among speakers and moderators at the DDW meetings held from 2018 to 2020. METHODS The data for DDW 2018-2020 were collected via the online web-based planner. The gender of speakers of presentations and moderators of sessions were identified by a google search. We further categorized the data by each participating society (AGA, ASGE, AASLD, and SSAT), by presentation track, by session track, and total overall representation in each year. RESULTS Despite the subject of the gender gap being in focus, the proportion of female moderators and speakers was low in DDW in the last 3 years. The female speakers constituted 31.6% in 2018, 33.8% in 2019 and 34.6% in 2020. There was slightly improved female representation in sessions of Inflammatory Bowel Disease, Stomach, and Small Bowel Disorders, Microbiome in GI & Liver disease, and Basic Science over the last 3 years. CONCLUSION Based on our study and those referenced in this article, we believe that strategies to promote the inclusivity of female moderators and speakers at DDW provide a huge opportunity to influence gender equity within GI.
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Affiliation(s)
- Zubair Khan
- Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX 77030 USA
| | - Rabia Rukhshan
- Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX 77030 USA
| | - Asmeen Bhatt
- Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX 77030 USA
| | - Sushovan Guha
- Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX 77030 USA
| | - Srinivas Ramireddy
- Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX 77030 USA
| | - Prithvi Patil
- Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX 77030 USA
| | - Ricardo Badillo
- Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX 77030 USA
| | - Roy Tomas DaVee
- Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX 77030 USA
| | - Nirav Thosani
- Interventional Gastroenterology at the University of Texas (iGUT), McGovern Medical School at UTHealth, 6400 Fannin, Suite 1400, Houston, TX 77030 USA
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Ong J, Ong AML, Ong S, Xin X, Lee YY, Pausawasdi N, De Lusong MA, Makmun D, Chong VH, Ho SH, Lim W, Ong D, Dan YY, Khor C. The impact of the coronavirus disease 2019 pandemic on gastroenterologists in Southeast Asia: A mixed-methods study. J Gastroenterol Hepatol 2021; 36:3056-3068. [PMID: 34159640 DOI: 10.1111/jgh.15594] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/24/2021] [Accepted: 06/20/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIM The coronavirus disease 2019 pandemic has impacted gastroenterology practices worldwide; however, its protracted effects within Southeast Asia were unknown. The primary aim of the study was to determine the impact of the pandemic on clinical demands including burnout among gastroenterologists within the region. The secondary aim was to identify risk factors for burnout and determine regional stressors. METHODS This was a mixed-methods study. Gastroenterologists were surveyed electronically between September 1 and December 7, 2020, via gastroenterology and endoscopy societies of Brunei, Indonesia, Malaysia, Philippines, Singapore, and Thailand. Quantitative and qualitative data were collected. The 22-item Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to detect burnout. Quantitative data were non-parametric; non-parametric methods were used for statistical comparisons. Logistic regression was used to determine risk factors for burnout. Content analysis method was used to analyze qualitative data. Ethical approval was obtained. RESULTS A total of 73.0% reported that they were still significantly affected by the pandemic. Of these, 40.5% reported increased workload and 59.5% decreased workload. Statistically significant differences in weekly working hours, endoscopy, and inpatient volumes were present. No differences were observed in outpatient volumes, likely because of telemedicine. Burnout was common; however, 50.1% of gastroenterologists were unaware of or did not have access to mental health support. This, as well as depression, being a trainee, and public sector work, increased burnout risk significantly. CONCLUSION The effects of the pandemic are multifaceted, and burnout is common among Southeast Asian gastroenterologists. Safeguards for mental health are suboptimal, and improvements are urgently needed.
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Affiliation(s)
- John Ong
- Department of Medicine, National University of Singapore, Singapore.,Department of Engineering, University of Cambridge, Cambridge, UK
| | - Andrew Ming Liang Ong
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Sharon Ong
- Department of Surgical Intensive Care, Singapore General Hospital, Singapore.,Department of Anaesthesiology, Sengkang General Hospital, Singapore
| | - Xiaohui Xin
- Health Services Research Unit, Singapore General Hospital, Singapore
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,GI Function and Motility Unit, Hospital Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Nonthalee Pausawasdi
- Division of Gastroenterology, Department of Medicine, Mahidol University Faculty of Medicine at Siriraj Hospital, Bangkok, Thailand
| | - Mark Anthony De Lusong
- Section of Advanced Endoscopy, Division of Gastroenterology, Department of Medicine, Philippine General Hospital, Manila, Philippines
| | - Dadang Makmun
- Faculty of Medicine, Division of Gastroenterology, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Vui Heng Chong
- Gastroenterology Unit, Department of Medicine, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam.,Institute of Health Sciences, PAPRSB Universiti of Brunei Darussalam, Bandar Seri Begawan, Brunei Darussalam
| | - Shiaw Hooi Ho
- Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wanyen Lim
- Department of Anaesthesiology, Sengkang General Hospital, Singapore.,Department of Anaesthesiology, Singapore General Hospital, Singapore
| | - David Ong
- Department of Medicine, Division of Gastroenterology and Hepatology, National University Hospital, Singapore
| | - Yock Young Dan
- Department of Medicine, National University of Singapore, Singapore.,Department of Medicine, Division of Gastroenterology and Hepatology, National University Hospital, Singapore
| | - Christopher Khor
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore
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14
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Survey Finds Gender Disparities Impact Both Women Mentors and Mentees in Gastroenterology. Am J Gastroenterol 2021; 116:1876-1884. [PMID: 34140455 DOI: 10.14309/ajg.0000000000001341] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/06/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Gastroenterologists at all levels of practice benefit from formal mentoring. Much of the current literature on mentoring in gastroenterology is based on expert opinion rather than data. In this study, we aimed to identify gender-related barriers to successful mentoring relationships from the mentor and mentee perspectives. METHODS A voluntary, web-based survey was distributed to physicians at 20 academic institutions across the United States. Overall, 796 gastroenterology fellows and faculty received the survey link, with 334 physicians responding to the survey (42% response rate), of whom 299 (90%; 129 women and 170 men) completed mentorship questions and were included in analysis. RESULTS Responses of women and men were compared. Compared with men, more women preferred a mentor of the same gender (38.6% women vs 4.2% men, P < 0.0001) but less often had one (45.5% vs 70.2%, P < 0.0001). Women also reported having more difficulty finding a mentor (44.4% vs 16.0%, P < 0.0001) and more often cited inability to identify a mentor of the same gender as a contributing factor (12.8% vs 0.9%, P = 0.0004). More women mentors felt comfortable advising women mentees about work-life balance (88.3% vs 63.8%, P = 0.0005). Nonetheless, fewer women considered themselves effective mentors (33.3% vs 52.6%, P = 0.03). More women reported feeling pressured to mentor because of their gender (39.5% vs 0.9% of men, P < 0.0001). Despite no gender differences, one-third of respondents reported negative impact of the COVID-19 pandemic on their ability to mentor and be mentored. DISCUSSION Inequities exist in the experiences of women mentees and mentors in gastroenterology, which may affect career advancement and job satisfaction.
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Feld LD, Mergener K, Rubin DT, Rao VL. Management of code status in the periendoscopic period: a national survey of current practices and beliefs of U.S. gastroenterologists. Gastrointest Endosc 2021; 94:172-177.e2. [PMID: 33476610 DOI: 10.1016/j.gie.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/08/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS This study aims to assess current practices and perspectives of gastroenterologists on approaches to code status before inpatient endoscopy. METHODS Self-reported data were obtained through a voluntary, anonymous survey of gastroenterologists and gastroenterology trainees in the United States. The survey assessed respondents' approach to, beliefs, and knowledge regarding inpatient periprocedural code status discussions. RESULTS Four hundred thirty-six gastroenterologists and 83 trainees completed the survey. For patients with an existing do not resuscitate (DNR) order, respondents reversed the code status before endoscopy either all (40.8%, n = 212) or most of the time (18.3%, n = 95). When asked their personal opinion, 32.6% (n =169) supported automatic DNR reversal to full resuscitation attempt during a procedure, 18.5% (n = 96) supported that DNR orders could be sustained, and 48.7% (n = 253) supported offering limited resuscitation. Many gastroenterologists were unaware of institutional (40.7%, n = 211) or national (80.7%, n = 419) policies, and a majority reported that a gastroenterology-specific guideline would be helpful (88.6%, n = 460). CONCLUSIONS Although most of the gastroenterologists reverse DNR orders more than 75% of the time before endoscopy, many also believe patients should be allowed to remain DNR during a procedure and supported a third option for limited resuscitation. Most gastroenterologists were unaware of institutional policies or existing national guidelines. These findings suggest considerable variation in knowledge and current approaches regarding periendoscopic code status reversal.
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Affiliation(s)
- Lauren D Feld
- Division of Gastroenterology, University of Washington, Seattle, Washington, USA
| | - Klaus Mergener
- Department of Gastroenterology, MultiCare Tacoma General Hospital, Tacoma, Washington, USA
| | - David T Rubin
- Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medicine, Chicago, Illinois, USA; MacLean Center for Clinical Medical Ethics, University of Chicago Medicine, Chicago, Illinois, USA
| | - Vijaya L Rao
- Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medicine, Chicago, Illinois, USA; MacLean Center for Clinical Medical Ethics, University of Chicago Medicine, Chicago, Illinois, USA
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Rabinowitz LG, Rabinowitz DG. Women on the Frontline: A Changed Workforce and the Fight Against COVID-19. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:808-812. [PMID: 34031302 PMCID: PMC8140642 DOI: 10.1097/acm.0000000000004011] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
COVID-19 is a worldwide pandemic, with frontlines that look drastically different than in past conflicts: that is, women now make up a sizeable majority of the health care workforce. American women have a long history of helping in times of hardship, filling positions on the home front vacated by men who enlisted as soldiers during World War I and similarly serving in crucial roles on U.S. military bases, on farms, and in factories during World War II. The COVID-19 pandemic has represented a novel battleground, as the first in which women have taken center stage, not only in their roles as physicians, respiratory therapists, nurses, and the like, but also by serving in leadership positions and facilitating innovations in science, technology, and policy. Yet, the pandemic has exacerbated multiple pain points that have disproportionally impacted women in health care, including shortages in correctly sized personal protective equipment and uniforms, inadequate support for pregnant and breastfeeding providers, and challenges associated with work-life balance and obtaining childcare. While the pandemic has facilitated several positive advancements in addressing these challenges, there is still much work to be done for women to achieve equity and optimal support in their roles on the frontlines.
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Affiliation(s)
- Loren Galler Rabinowitz
- L.G. Rabinowitz is a fellow, Department of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York; ORCID: http://orcid.org/0000-0002-6673-4096
| | - Danielle Galler Rabinowitz
- D.G. Rabinowitz is resident physician, Boston Combined Residency Program, Boston Children’s Hospital and Boston Medical Center, Harvard Medical School, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-5437-5719
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Jamorabo DS, Chen R, Gurm H, Jahangir M, Briggs WM, Mohanty SR, Renelus BD. Women remain underrepresented in leadership positions in academic gastroenterology throughout the United States. Ann Gastroenterol 2021; 34:316-322. [PMID: 33948055 PMCID: PMC8079863 DOI: 10.20524/aog.2021.0597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 12/06/2020] [Indexed: 11/25/2022] Open
Abstract
Background Publication history is a key factor in securing academic promotion, but historical underrepresentation of women in gastroenterology may be an ongoing obstacle to achieving gender parity in leadership positions. Methods We carried out a cross-sectional study of gastroenterology programs in the United States, with data including faculty and trainee names, leadership positions, Hirsch indices, and year of first gastroenterology certification gathered from 1 February 2020 to 1 March 2020. Our outcomes of interest were: 1) sex representation in various leadership positions in academic gastroenterology departments; and 2) mean difference in Hirsch indices between men and women, for which we used univariate and multivariate regression models. Results Our cohort included 3655 faculty members and trainees across 163 academic gastroenterology programs in the United States. Women comprised 28.7% (1049/3655) of the cohort, including 713/2657 (26.8%) of faculty and 56/289 (19.4%) of all fellowship program directors and divisional/departmental chairs and chiefs. Male faculty had higher mean Hirsch indices compared to women (11.4 vs. 5.5, P<0.001), and when adjusted for year of first gastroenterology certification, men had a larger Hirsch index by 2.8 (95% confidence interval 1.3-4.1, P<0.001). Women were also underrepresented in various subspecialties of gastroenterology, particularly advanced endoscopy. Conclusions Women in academic gastroenterology remain underrepresented in leadership positions and have lower Hirsch indices than men. Our findings may stem not only from differences in mentorship and career goals, but also from underlying structural factors that disadvantage women.
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Affiliation(s)
- Daniel S Jamorabo
- Division of Gastroenterology and Hepatology, Stony Brook Medicine, Stony Brook, NY (Daniel S. Jamorabo)
| | - Richy Chen
- Department of Gastroenterology and Hepatology, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY (Richy Chen, Smruti R. Mohanty)
| | - Hashroop Gurm
- Division of Gastroenterology and Hepatology, University of Oklahoma College of Medicine, Oklahoma City, OK (Hashroop Gurm)
| | - Muntasir Jahangir
- Department of Internal Medicine, Memorial Hermann Hospital, Houston, TX (Muntasir Jahangir)
| | - William M Briggs
- Department of Biostatistics, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY (William M. Briggs)
| | - Smruti R Mohanty
- Department of Gastroenterology and Hepatology, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY (Richy Chen, Smruti R. Mohanty)
| | - Benjamin D Renelus
- Division of Gastroenterology and Hepatology, Morehouse School of Medicine, Atlanta, GA (Benjamin D. Renelus), USA
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Perez Gutierrez O, Anandasabapathy S. Endoscopist gender and patient impact: much more than meets the eye. Gastrointest Endosc 2021; 93:1169-1170. [PMID: 33600805 DOI: 10.1016/j.gie.2021.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/09/2021] [Indexed: 12/11/2022]
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Gender dynamics in education and practice of gastroenterology. Gastrointest Endosc 2021; 93:1047-1056.e5. [PMID: 32858002 DOI: 10.1016/j.gie.2020.08.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/21/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS With an increasing number of women joining procedural fields, including gastroenterology, optimizing the work environment for learning, teaching, and clinical practice is essential to the well-being of both physicians and their patients. We queried female and male gastroenterologists on their beliefs toward the endoscopy suite environment, as well as their experiences in learning and teaching endoscopic skills. METHODS We distributed a web-based survey to 403 gastroenterology fellows and practicing gastroenterologists at 12 academic institutions and 3 large private practices. We used univariate and multivariate analysis to compare the responses of female and male gastroenterologists. RESULTS The overall response rate was 32% (n = 130); 54 women and 61 men completed the survey in its entirety and were included in the analysis (15 respondents did not meet the inclusion criteria). Baseline demographics were comparable between the groups. Overall, fewer women than men were trained using tactile instruction (41% vs 67%; P = .004). Of those trained using tactile instruction, 60.3%, with no gender differences, felt it was also important for endoscopic learning. More women reported experiencing gender bias toward themselves during training (57.4% vs 13.1%; P = .001) as well as in their current careers (50.0% vs 9.8%; P = .001). When queried on treatment of gastroenterologists by endoscopy staff, 75.9% of women reported that men were treated more favorably, whereas 70.5% of men felt that both male and female gastroenterologists were treated equally. CONCLUSIONS Inequities exist with regard to the experience of men and women in gastroenterology, and specific challenges for women may have an impact on their career choices and ability to safely and effectively learn, teach, and practice endoscopy.
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Adams MA. Don't fix the women, fix the system: recognizing and addressing implicit gender bias in gastroenterology training and practice. Gastrointest Endosc 2021; 93:1057-1059. [PMID: 33685625 DOI: 10.1016/j.gie.2020.10.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 10/17/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Megan A Adams
- VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, USA; Division of Gastroenterology, Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA; Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan, USA
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Rabinowitz LG, Grinspan LT, Kim MK. Gender in the endoscopy suite. Lancet Gastroenterol Hepatol 2020; 5:1032-1034. [PMID: 33181083 DOI: 10.1016/s2468-1253(20)30297-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/21/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022]
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