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Benyamein P, Sheahan L, Becker M, Ewing E, Bajaj A, Gallus K, Gosman A. A Work in Progress: Women's Status in the Plastic Surgery Workforce and Recommendations for Success. Aesthet Surg J 2024:sjae121. [PMID: 38913350 DOI: 10.1093/asj/sjae121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND Only 20% of the current plastic surgery workforce is female, but since 2022, most matched applicants in integrated plastic surgery programs have been women. This study aimed to examine current practice models among female plastic surgeons, including those outside of academia, as the field continues to evolve. OBJECTIVES This study surveyed female plastic surgeons in different practice models to elicit perspectives, career path advice, characterize/project trends, and provide recommendations for success. METHODS A 37-question survey focusing on demographics, practice models, career paths, desire for practice changes and advice for women trainees was emailed to 1342 members of the American Society of Plastic Surgeons and The Aesthetic Society. Chi square analyses compared practice type characteristics (academia, employed roles, private practice), at a significance level of 0.05. RESULTS Response rate was 53%. Most respondents were age 35-45, in solo practice, trained via traditional pathways, without fellowships, and lacked female mentors. Private practice surgeons were very satisfied in their career, employed surgeons were moderately satisfied and academic surgeons were mildly satisfied. Academic surgeons reported a higher number of working hours (>60) and cases per month (20-30) than employed or private practice surgeons. Recommendations for success included seeking female mentorship, enhancing business skills and building a social media platform during training. CONCLUSIONS Results highlight the importance of female mentorship, acquiring business skills, and indicate private practice leads to greater career satisfaction. Training programs should consider accounting for these factors to better promote women's success and improve equity in academic practice.
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Affiliation(s)
- Paige Benyamein
- Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, CA
| | - Lucy Sheahan
- Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, CA
| | - Miriam Becker
- University of California San Diego, School of Medicine, San Diego, CA
| | - Emily Ewing
- University of Alabama, Department of Psychology, Birmingham, AL
| | | | | | - Amanda Gosman
- Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, CA
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Leong NL, Morcos G, Jiang J, O'Hara N. Social Media Influence and Gender Are Correlated with Industry Payments to Orthopaedic Sports Surgeons. J Knee Surg 2024; 37:275-281. [PMID: 36963429 DOI: 10.1055/a-2062-0365] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
Abstract
Social media, specifically Twitter, has become an increasingly used tool in academic orthopaedic surgery to help surgeons connect with patients and peers. This study seeks to understand correlations among social medial influence, academic influence, and gender among academic orthopaedic sport surgeons. A list of all orthopaedic sports surgeons serving as faculty of sports fellowships in the United States was compiled, along with publicly available demographic information. Their Hirsh indices (h-indices) were obtained using the Scopus database. The Physician Payments Sunshine Act Web site was used to determine their industry payments from 2014 through 2020. The number of Twitter followers was used as a measure of social media influence. Multivariable linear regression models were employed to explore the associations between these parameters and industry payments. Of the 633 surgeons, 33% had a Twitter account. Surgeons with > 1,000 followers (7.3%) were awarded 186% more in nonresearch funding (p = 0.01) and had a higher probability of receiving industry research funding compared with those with no followers (p = 0.03). Sports surgeons had an average h-index of 16, with 44% having ≤ 20 publications and 21% having ≥ 100 publications. Surgeons with ≥ 100 publications were awarded 453% more in nonresearch funding (p = 0.001) and had a 32% higher probability of receiving industry research funding (p < 0.001) when compared with their colleagues with ≤ 20 publications. Female sports surgeons accounted for only 7.9% of surgeons included in the study, and were awarded 65% less in industry nonresearch funding compared with their male colleagues (p = 0.004) when controlling for other factors. Both number of publications and a high level of Twitter activity (> 1,000 followers) had the strongest associations with the quantity of industry nonresearch funding and the highest probability of industry research funding. Female sports surgeons received significantly less industry nonresearch funding compared with their male colleagues. Future studies further exploring gender disparities in industry funding for orthopaedic surgeons may be warranted. LEVEL OF EVIDENCE: Prognostic, Level III.
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Affiliation(s)
- Natalie L Leong
- VA Medical Center, VA Maryland Healthcare System, Baltimore, Maryland
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - George Morcos
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jie Jiang
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Nathan O'Hara
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
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Aziz H, Hockett D, Feng L, Kane S, Segalini N, Hase N, Kapadia MR, Shelton J. Financial Relationships in General Surgery Education: Recent Trends in Industry Payments to General Surgery Residency Leadership. JOURNAL OF SURGICAL EDUCATION 2024; 81:210-218. [PMID: 38160119 DOI: 10.1016/j.jsurg.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 10/16/2023] [Accepted: 11/01/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Residency programs and their directors frequently receive funding from industry payers. Both general surgery residency program directors (PDs) and assistant program directors (APDs) receive industry funding for various reasons, including educational advancement. This study investigates recent trends in industry payments to both PDs and APDs to better understand the financial relationships among leaders in residency education. METHODS We compared industry payments to general surgery residency PDs and APDs from 2019 to 2021 utilizing the U.S. Centers for Medicare & Medicaid Services (CMS) open payments database. In addition, secondary analyses were performed among PDs to assess differences based on gender, practicing surgical specialty, and geographical region. RESULTS During the study period (2019-2021), PDs received payments amounting to 2,882,821 USD. PDs were found to receive more funding than APDs, with each receiving average funding of 10,045 vs. 323 USD (p < 0.01), respectively, over the study period. There was a significant decrease in total payments from 2019 to 2020 (1,512,190 vs. 868,811 USD; p < 0.01). Total payments made in 2021 were similar compared to 2020 (905,836 vs. 868,811 USD; p = 0.1). We found that male PDs received significantly more in-industry payments when compared to female PDs (11,702 USD per PD vs. 3971 USD per PD, p < 0.01). CONCLUSION This study presents initial data that residency program leadership has robust biomedical industry relationships, and further research is warranted to investigate the impacts of these payments on program resources, educational opportunities for residents, and program outcomes. Male PDs received significantly more industry payments when compared to female PDs. Leaders in the surgical training community must cautiously ensure that these industry relationships are appropriately navigated.
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Affiliation(s)
- Hassan Aziz
- Department of Surgery, University of Iowa Hospital and Clinics, Iowa City, Iowa.
| | - Diana Hockett
- Department of Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts
| | - Lawrence Feng
- Department of Surgery, University of Iowa Hospital and Clinics, Iowa City, Iowa
| | - Shriya Kane
- Department of Surgery, University of Iowa Hospital and Clinics, Iowa City, Iowa
| | | | - Niklas Hase
- Tufts University School of Medicine, Boston, Massachusetts
| | - Muneera R Kapadia
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Julia Shelton
- Department of Surgery, University of Iowa Hospital and Clinics, Iowa City, Iowa
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Murayama A, Kamamoto S, Kugo H, Saito H, Ozaki A. Research and Nonresearch Industry Payments to Nephrologists in the United States between 2014 and 2021. J Am Soc Nephrol 2023; 34:1709-1720. [PMID: 37488676 PMCID: PMC10561777 DOI: 10.1681/asn.0000000000000172] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 05/29/2023] [Indexed: 07/26/2023] Open
Abstract
SIGNIFICANCE STATEMENT Concerns about the financial relationships between nephrologists and the health care industry have been reported in the United States over the past decade. However, since the 2014 launch of the federal transparency database, Open Payments, few documents have explored the whole picture of research and nonresearch payments to US nephrologists from industry sources. In this study, the authors found that 87% of nephrologists have received nonresearch payments, and the aggregate amount of these payments has been increasing since 2014. Only 12% of nephrologists received research payments; these recipients were disproportionately male. In addition, the top 5% of nephrologists receiving nonresearch funds received 81% of all such payments. Nonresearch payments were larger among male nephrologists than among female nephrologists and increased by 8% annually among male nephrologists between 2014 and 2019. BACKGROUND Financial relationships between nephrologists and the health care industry have been a concern in the United States over the past decade. METHODS To evaluate industry payments to nephrologists, we conducted a cross-sectional study examining nonresearch and research payments to all US nephrologists registered in the National Plan and Provider Enumeration System between 2014 and 2021, using the Open Payments database. Payment data were descriptively analyzed on the basis of monetary value, and payment trends were evaluated by using a generalized estimating equations model. RESULTS From 2014 through 2021, 10,463 of 12,059 nephrologists (87%) received at least one payment from the US health care industry, totaling $778 million. The proportion of nephrologists who did not receive nonresearch payments varied each year, ranging from 38% to 51%. Nonresearch payments comprised 22% ($168 million) of overall industry payments in monetary value but 87% in the number of payments. Among those receiving payments, the median per-physician 8-year aggregated payment values were $999 in nonresearch payments and $102,329 in associated research payments. Male nephrologists were more likely than female nephrologists to receive research payments, but the per-physician amount did not differ. However, nonresearch payments were three times larger for male nephrologists and increased by 8% annually between 2014 and 2019 among male nephrologists but remained stable among female nephrologists. The top 5% of nephrologists receiving nonresearch payments received 81% of all such payments. CONCLUSIONS Between 2014 and 2021, 87% of US nephrologists received at least one payment from the health care industry. Notably, nonresearch payments to nephrologists have been increasing since the Open Payments database's 2014 launch. Male nephrologists were more likely than female nephrologists to receive research payments.
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Affiliation(s)
- Anju Murayama
- School of Medicine, Tohoku University, Sendai, Japan
| | - Sae Kamamoto
- School of Medicine, Hamamatsu University, Hamamatsu, Japan
| | - Hinari Kugo
- School of Medicine, Tohoku University, Sendai, Japan
| | - Hiroaki Saito
- Medical Governance Research Institute, Tokyo, Japan
- Department of Internal Medicine, Soma Central Hospital, Fukushima, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Tokyo, Japan
- Department of Breast and Thyroid Surgery, Jyoban Hospital, Fukushima, Japan
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Iwai Y, Yu AYL, Thomas SM, Fayanju OA, Sudan R, Bynum DL, Fayanju OM. Leadership and Impostor Syndrome in Surgery. J Am Coll Surg 2023; 237:585-595. [PMID: 37350479 PMCID: PMC10846669 DOI: 10.1097/xcs.0000000000000788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
BACKGROUND Impostor syndrome is an internalized sense of incompetence and not belonging. We examined associations between impostor syndrome and holding leadership positions in medicine. STUDY DESIGN A cross-sectional survey was distributed to US physicians from June 2021 to December 2021 through medical schools and professional organizations. Differences were tested with the chi-square test and t -test for categorical and continuous variables, respectively. Logistic regression was used to identify factors associated with holding leadership positions and experiencing impostor syndrome. RESULTS A total of 2,183 attending and retired physicians were included in the analytic cohort; 1,471 (67.4%) were in leadership roles and 712 (32.6%) were not. After adjustment, male physicians were more likely than women to hold leadership positions (odds ratio 1.4; 95% CI 1.16 to 1.69; p < 0.001). Non-US citizens (permanent resident or visa holder) were less likely to hold leadership positions than US citizens (odds ratio 0.3; 95% CI 0.16 to 0.55; p < 0.001). Having a leadership position was associated with lower odds of impostor syndrome (odds ratio 0.54; 95% CI 0.43 to 0.68; p < 0.001). Female surgeons were more likely to report impostor syndrome compared to male surgeons (90.0% vs 67.7%; p < 0.001), an association that persisted even when female surgeons held leadership roles. Similar trends were appreciated for female and male nonsurgeons. Impostor syndrome rates did not differ by race and ethnicity, including among those underrepresented in medicine, even after adjustment for gender and leadership role. CONCLUSIONS Female physicians were more likely to experience impostor syndrome than men, regardless of specialty or leadership role. Although several identity-based gaps persist in leadership, impostor syndrome among racially minoritized groups may not be a significant contributor.
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Affiliation(s)
- Yoshiko Iwai
- From the University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (Iwai)
| | - Alice Yunzi L Yu
- Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, IL (Yu)
| | - Samantha M Thomas
- Duke Cancer Institute (Thomas), Duke University School of Medicine, Durham, NC
- Departments of Biostatistics and Bioinformatics (Thomas), Duke University School of Medicine, Durham, NC
| | - Oluseyi A Fayanju
- Department of Medicine, Stanford University, Palo Alto, CA (QA Fayanju)
| | - Ranjan Sudan
- Surgery (Sudan), Duke University School of Medicine, Durham, NC
| | - Debra L Bynum
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (Bynum)
| | - Oluwadamilola M Fayanju
- Department of Surgery, Perelman School of Medicine (OM Fayanju), The University of Pennsylvania, Philadelphia, PA
- Penn Center for Cancer Care Innovation (PC3I) (OM Fayanju), The University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics (LDI) (OM Fayanju), The University of Pennsylvania, Philadelphia, PA
- Rena Rowan Breast Center, Abramson Cancer Center, Philadelphia, PA (OM Fayanju)
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Slama EM, Arjani S, Sulciner ML, Riner AN, Yu YR, Maxwell J. The Gender Gap in Surgeon Salaries - Striving to achieve pay equity. Am J Surg 2023; 225:436-438. [PMID: 36175195 DOI: 10.1016/j.amjsurg.2022.09.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 08/26/2022] [Accepted: 09/18/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Eliza M Slama
- Association of Women Surgeons Publication Committee, USA; Department of Surgery, Ascension Saint Agnes Hospital, 900 South Caton Avenue, Baltimore, MD, 21229, USA.
| | - Simran Arjani
- Association of Women Surgeons Publication Committee, USA; Rutgers New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA
| | - Megan L Sulciner
- Association of Women Surgeons Publication Committee, USA; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Andrea N Riner
- Association of Women Surgeons Publication Committee, USA; Department of Surgery, University of Florida College of Medicine, Gainesville, FL, 32610, USA
| | - Yangyang R Yu
- Association of Women Surgeons Publication Committee, USA; Department of Surgery and Division of Pediatric Surgery, Children's Hospital of Orange County, University of California Irvine, Orange, CA, 92868, USA
| | - Jessica Maxwell
- Association of Women Surgeons Publication Committee, USA; Department of Surgery, University of Nebraska Medical Center, Omaha, NE, 68105, USA
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Smith RM, Rathore S, Donnelly D, Nicksic PJ, Poore SO, Dingle AM. Diversity Drives Innovation: The Impact of Female-Driven Publications. Aesthet Surg J 2022; 42:1470-1481. [PMID: 35640257 DOI: 10.1093/asj/sjac137] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Gender disparities are pervasive in academic plastic surgery. Previous research demonstrates articles authored by women receive fewer citations than those written by men, suggesting the presence of implicit gender bias. OBJECTIVES The aim of this study was to describe current citation trends in plastic surgery literature and assess gender bias. The expectation was that women would be cited less frequently than their male peers. METHODS Articles published between 2017 and 2019 were collected from 8 representative plastic surgery journals stratified by impact factor. Names of primary and senior authors of the 50 most cited articles per year per journal were collected and author gender was determined via online database and internet search. The median numbers of citations by primary and senior author gender were compared by Kruskal-Wallis test. RESULTS Among 1167 articles, women wrote 27.3% as primary author and 18% as senior author. Women-authored articles were cited as often as those authored by men (P > 0.05) across all journal tiers. Articles with a female primary and male senior author had significantly more citations than articles with a male primary author (P = 0.038). CONCLUSIONS No implicit gender bias was identified in citation trends, a finding unique to plastic surgery. Women primary authors are cited more often than male primary authors despite women comprising a small fraction of authorship overall. Additionally, variegated authorship pairings outperformed homogeneous ones. Therefore, increasing gender diversity within plastic surgery academia remains critical.
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Affiliation(s)
- Rachel M Smith
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Srishti Rathore
- University of Wisconsin School of Medicine and Public Health Division of Plastic Surgery, Madison, WI, USA
| | - D'Andrea Donnelly
- University of Wisconsin School of Medicine and Public Health Division of Plastic Surgery, Madison, WI, USA
| | - Peter J Nicksic
- University of Wisconsin School of Medicine and Public Health Division of Plastic Surgery, Madison, WI, USA
| | - Samuel O Poore
- University of Wisconsin School of Medicine and Public Health Division of Plastic Surgery, Madison, WI, USA
| | - Aaron M Dingle
- University of Wisconsin School of Medicine and Public Health Division of Plastic Surgery, Madison, WI, USA
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McGrath MH. Commentary on: Gender Disparity in 2013-2018 Industry Payments to Plastic Surgeons. Aesthet Surg J 2021; 41:1321-1322. [PMID: 33590854 DOI: 10.1093/asj/sjaa404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mary H McGrath
- Division of Plastic Surgery, University of California San Francisco, San Francisco, CA, USA
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