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Suraju MO, McElroy L, Moten A, Obeng-Gyasi S, Alimi Y, Carter D, Foretia DA, Stapleton S, Yilma M, Reid VJ, Tetteh HA, Khabele D, Rodriguez LM, Campbell A, Newman EA. A framework to improve retention of Black surgical trainees: A Society of Black Academic Surgeons white paper. Am J Surg 2023; 226:438-446. [PMID: 37495467 DOI: 10.1016/j.amjsurg.2023.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/19/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023]
Abstract
Attrition is high among surgical trainees, and six of ten trainees consider leaving their programs, with two ultimately leaving before completion of training. Given known historically and systemically rooted biases, Black surgical trainees are at high risk of attrition during residency training. With only 4.5% of all surgical trainees identifying as Black, underrepresentation among their peers can lend to misclassification of failure to assimilate as clinical incompetence. Furthermore, the disproportionate impact of ongoing socioeconomic crisis (e.g., COVID-19 pandemic, police brutality etc.) on Black trainees and their families confers additional challenges that may exacerbate attrition rates. Thus, attrition is a significant threat to medical workforce diversity and health equity. There is urgent need for surgical programs to develop proactive approaches to address attrition and the threat to the surgical workforce. In this Society of Black Academic Surgeons (SBAS) white paper, we provide a framework that promotes an open and inclusive environment conducive to the retention of Black surgical trainees, and continued progress towards attainment of health equity for racial and ethnic minorities in the United States.
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Affiliation(s)
- Mohammed O Suraju
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Lisa McElroy
- Department of Surgery, Duke University Hospital, Durham, NC, United States
| | - Ambria Moten
- Department of Surgery, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Samilia Obeng-Gyasi
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Yewande Alimi
- Department of Surgery, Georgetown University School of Medicine, Washington, DC, United States
| | - Damien Carter
- Department of Surgery, Maine Medical Center, Portland, ME, United States
| | - Denis A Foretia
- Department of Surgery, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Sahael Stapleton
- Department of Surgery, Kaiser Permanente Vacaville Medical Center, Vacaville, CA, United States
| | - Mignote Yilma
- Department of Surgery, University of California San Francisco, San Francisco, CA, United States
| | - Vincent J Reid
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, United States; Department of Surgery, Mercy Medical Center Cedar Rapids, Cedar Rapids, IA, United States
| | - Hassan A Tetteh
- Department of Surgery, Uniformed Services University, Bethesda, MD, United States
| | - Dineo Khabele
- Division of Gynecologic Oncology, Washington University School of Medicine, And Alvin J. Siteman Cancer Center, St Louis, MO, United States
| | - Luz M Rodriguez
- Gastrointestinal and Other Cancers Research Group, Division of Cancer Prevention, NCI, NIH, Bethesda, MD, United States; Department of Surgery, Walter Reed National Military Medical Center (WRNMM) Uniformed Services University (USU), Bethesda, MD, United States
| | - Andre Campbell
- Department of Surgery, University of California San Francisco, San Francisco, CA, United States
| | - Erika A Newman
- Section of Pediatric Surgery, Department of Surgery, CS Mott Children's Hospital, The University of Michigan Medical School, United States.
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Choudhry HS, Patel AM, Choudhry HS, Gumina K, Cui D, Sequeira L, Patel K, Sangani R, Seery CW, Khouri AS. Predictive value of medical school ranking in the academic scholarship of ophthalmology residents. Surg Open Sci 2023; 14:103-108. [PMID: 37577255 PMCID: PMC10413141 DOI: 10.1016/j.sopen.2023.07.013] [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: 04/19/2023] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 08/15/2023] Open
Abstract
Objective To determine whether a resident's medical school ranking predicts their scholarship during residency. Design The authors stratified ophthalmology residents in ACGME accredited programs into tiers based off their medical school background's US News & World Report ranking: T1 (schools 1-20), T2 (21-50), and T3 (51-90). Investigators queried PubMed and Scopus for number of total publications, first/second author publications, publications in the top 10 impact factor journals in ophthalmology, and publications with the senior author affiliated with the resident's residency program/medical school. Authors collected data from start of ophthalmology residency to December 5th, 2021, and performed Pearson chi squared, ANOVA, Eta squared, Tukey, and multivariable logistic regression tests. Results 1054 residents were included for analysis, with 370 from T1 schools, 296 from T2 schools, and 388 from T3 schools. T3 residents had a significantly decreased likelihood of publishing at least one (OR = 0.659;95%CI = 0.481,0.905;p = .010), two (OR = 0.643;95%CI = 0.436,0.949;p = .026), or five (OR = 0.407;95%CI = 0.187,0.886;p = .024) total publications compared to T1 residents. T3 residents also were partially predicted to publish fewer first author works, high impact journal articles, and articles with senior authors affiliated with their medical school. T2 residents were more likely to publish at least one second author work than T1 residents (OR = 1.604;95%CI = 1.101,2.337;p = .014). There was no significant difference between tiers in publications with senior authors affiliated with the same residency program. Conclusions The authors observed little difference in scholarship between residents from T1 and T2 schools, but some differences may exist between T3 and T1/T2 residents. Merit of rankings should be further explored.
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Affiliation(s)
- Hassaam S. Choudhry
- Rutgers New Jersey Medical School, 185 S Orange Avenue, Newark, NJ 07103, United States of America
| | - Aman M. Patel
- Rutgers New Jersey Medical School, 185 S Orange Avenue, Newark, NJ 07103, United States of America
| | - Hannaan S. Choudhry
- Rutgers New Jersey Medical School, 185 S Orange Avenue, Newark, NJ 07103, United States of America
| | - Kyrie Gumina
- Rutgers New Jersey Medical School, 185 S Orange Avenue, Newark, NJ 07103, United States of America
| | - Danielle Cui
- Rutgers New Jersey Medical School, 185 S Orange Avenue, Newark, NJ 07103, United States of America
| | - Lionel Sequeira
- Rutgers New Jersey Medical School, 185 S Orange Avenue, Newark, NJ 07103, United States of America
| | - Keya Patel
- Rutgers New Jersey Medical School, 185 S Orange Avenue, Newark, NJ 07103, United States of America
| | - Roshun Sangani
- Rutgers New Jersey Medical School, 185 S Orange Avenue, Newark, NJ 07103, United States of America
| | - Christopher W. Seery
- Rutgers New Jersey Medical School, 185 S Orange Avenue, Newark, NJ 07103, United States of America
| | - Albert S. Khouri
- Rutgers New Jersey Medical School, 185 S Orange Avenue, Newark, NJ 07103, United States of America
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Dudas LM, Khan US, Borgstrom DC. Mastering the Match: Recruiting a Successful Surgery Resident. CURRENT SURGERY REPORTS 2021; 9:27. [PMID: 34729254 PMCID: PMC8552621 DOI: 10.1007/s40137-021-00304-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW The objective of general surgery residency is to produce competent surgeons. At a minimum this requires being procedurally and clinically capable and able to pass the board exams. Recruitment is designed to select those residents who can successfully do so. But there is more to being a successful resident than that. In this review, we attempt to define a "successful resident" and how to attract them to your program. RECENT FINDINGS Resident applicants are still most concerned with matching to a program that will prepare them for a surgery career. Though there is variation of importance for different applicants, resident life, comradery, and relationships with faculty or mentors do factor into residency ranking. The program website remains the most utilized resource for applicants. However, social media (SM) has an increasing role in applicants' evaluation of a program. SM and the preinterview gathering seem to expose the subjective aspects of a program most effectively. Additional assessments evaluating personality, grit or career goals may assist in screening applicants for good "fit." SUMMARY In order to recruit successful residents, it is necessary to determine which applicant attributes are important to the program. Additionally, a program must maintain an updated website with clearly delineated resident expectations and program strengths. The screening and interview process must be maximized to target residents with career goals complimentary to available program opportunities. If SM is utilized, post should be frequent with relevant information pertaining to both resident life and educational or clinical opportunities.
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Affiliation(s)
- Lauren M. Dudas
- Department of Surgery, Division of Trauma, Emergency Surgery & Surgical Critical Care, West Virginia University, 1 Medical Center Drive, PO Box 9238, Morgantown, WV 26506 USA
| | - Uzer S. Khan
- Department of Surgery, Allegheny Health Network, Pittsburgh, PA USA
| | - David C. Borgstrom
- Department of Surgery, Division of Trauma, Emergency Surgery & Surgical Critical Care, West Virginia University, 1 Medical Center Drive, PO Box 9238, Morgantown, WV 26506 USA
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DiPasquale L, Libera R, Do-Nguyen CC, Brehman E, Tatagari V, Waring H, Appelt D, Sesso A. The Philadelphia surgery conference: a value analysis of a hands-on surgical skill-building event. J Osteopath Med 2021; 121:271-280. [PMID: 33635958 DOI: 10.1515/jom-2020-0179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Context Limited opportunities exist to practice technical skills and to be exposed to various surgical specialties during preclinical medical education. Objectives To assess the value of workshop-based educational opportunities to medical students during preclinical training. Methods One hundred and 75 medical and physician assistant students from 10 medical schools attended the 2019 Philadelphia Surgery Conference. All students received STOP THE BLEED® bleeding control training and participated in four workshops, chosen from a list of 23, that demonstrated a variety of surgical skills. Data collection was accomplished using both a pre- and postconference survey to assess changes in confidence of personal capabilities, knowledge base, and opinions regarding preclinical medical training. Results Preconference survey results indicated low baseline confidence in personal surgical skills (mean [SD], 1.9 [1.0], on a Likert scale of 1-5), and knowledge of various surgical specialties (2.7 [1.0]). Students highly valued skill-building experiences (mean [SD], 4.2 [1.1]) and face-to-face interactions with resident and attending physicians (4.4 [0.9]). Postconference survey analysis demonstrated increased confidence in surgical ability by 52.6% (mean [SD], 2.9 [1.0]; p<0.001) and knowledge base by 34.6% (3.5 [0.8]; p<0.001). Value scores increased for both preclinical surgical skill-building opportunities (mean [SD], 4.4 [0.9]; p=0.014) and interactions with resident and attending physicians (4.7 [0.6]; p=0.002). Conclusions The Philadelphia Surgery Conference provided a highly valuable experience to participating students, increasing confidence in personal knowledge base and surgical skills while facilitating a collaboration between students and resident and attending physicians from various surgical specialties.
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Affiliation(s)
- Luke DiPasquale
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Robert Libera
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | | | | | | | - Heather Waring
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Denah Appelt
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Arthur Sesso
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
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Career Research Productivity Correlates With Medical School Ranking Among Cardiothoracic Surgeons. J Surg Res 2021; 264:99-106. [PMID: 33794390 DOI: 10.1016/j.jss.2021.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 01/10/2021] [Accepted: 01/15/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The foundation for a successful academic surgical career begins in medical school. We examined whether attending a top-ranked medical school is correlated with enhanced research productivity and faster career advancement among academic cardiothoracic (CT) surgeons. MATERIALS AND METHODS Research profiles and professional histories were obtained from publicly available sources for all CT surgery faculty at accredited US CT surgery teaching hospitals in 2018 (n = 992). We focused on surgeons who completed medical school in the United States during or after 1990, the first-year US News & World Report released its annual medical school research rankings (n = 451). Subanalyses focused on surgeons who completed a research fellowship (n = 299) and those who did not (n = 152). RESULTS A total of 124 surgeons (27.5%) attended a US News & World Report top 10 medical school, whereas 327 (72.5%) did not. Surgeons who studied at a top 10 medical school published more articles per year as an attending surgeon (3.2 versus 1.9; P < 0.0001), leading to more total publications (51.5 versus 27.0; P < 0.0001) and a higher H-index (16.0 versus 11.0; P < 0.0001) over a similar career duration (11.0 versus 10.0 y; P = 0.1294). These differences in career-long research productivity were statistically significant regardless of whether the surgeons completed a research fellowship or not. The surgeons in both groups, however, required a similar number of years to reach associate professor rank (P = 0.6993) and full professor rank (P = 0.7811) after starting their first attending job. CONCLUSIONS Attending a top-ranked medical school is associated with enhanced future research productivity but not with faster career advancement in academic CT surgery.
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Hope C, Reilly JJ, Griffiths G, Lund J, Humes D. Factors Associated with Attrition and Performance Throughout Surgical Training: A Systematic Review and Meta-Analysis. World J Surg 2020; 45:429-442. [PMID: 33104833 PMCID: PMC7773620 DOI: 10.1007/s00268-020-05844-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2020] [Indexed: 11/18/2022]
Abstract
Background Attrition within surgical training is a challenge. In the USA, attrition rates are as high as 20–26%. The factors predicting attrition are not well known. The aim of this systematic review is to identify factors that influence attrition or performance during surgical training. Method The review was performed in line with PRISMA guidelines and registered with the Open Science Framework (OSF). Medline, EMBASE, PubMed and the Cochrane Central Register of Controlled Trials were searched for articles. Risk of bias was assessed using the Newcastle–Ottawa scale. Pooled estimates were calculated using random effects meta-analyses in STATA version 15 (Stata Corp Ltd). A sensitivity analysis was performed including only multi-institutional studies. Results The searches identified 3486 articles, of which 31 were included, comprising 17,407 residents. Fifteen studies were based on multi-institutional data and 16 on single-institutional data. Twenty-nine of the studies are based on US residents. The pooled estimate for overall attrition was 17% (95% CI 14–20%). Women had a significantly higher pooled attrition than men (24% vs 16%, p < 0.001). Some studies reported Hispanic residents had a higher attrition rate than non-Hispanic residents. There was no increased risk of attrition with age, marital or parental status. Factors reported to affect performance were non-white ethnicity and faculty assessment of clinical performance. Childrearing was not associated with performance. Conclusion Female gender is associated with higher attrition in general surgical residency. Longitudinal studies of contemporary surgical cohorts are needed to investigate the complex multi-factorial reasons for failing to complete surgical residency. Electronic supplementary material The online version of this article (10.1007/s00268-020-05844-0) contains supplementary material, which is available to authorised users.
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Affiliation(s)
- Carla Hope
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, DE22 3NE, UK.
| | - John-Joe Reilly
- Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | | | - Jon Lund
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, DE22 3NE, UK
| | - David Humes
- Division of Epidemiology and Public Health, Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK.,National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust, E Floor West Block, QMC Campus, Nottingham, NG7 2UH, UK
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Patti MG, Kibbe MR. Surgery 2019: an existential crisis. Updates Surg 2019; 71:201-203. [PMID: 31228103 DOI: 10.1007/s13304-019-00664-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 06/14/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Marco G Patti
- Department of Medicine, University of North Carolina at Chapel Hill, 4030 Burnett Womack Building, 101 Manning Drive, CB 7081, Chapel Hill, NC, 27599-7081, USA.
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Melina R Kibbe
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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