Women in medicine: historical perspectives and recent trends

Gender Disparities in Surgical Subspecialties: A CMS Data Analysis

INTRODUCTION

The persistent under-representation of women in surgery remains a critical concern within the medical profession, prompting a need for a nuanced analysis of gender distribution. Despite advancements in medical education, historical gender disparities in surgery persist, necessitating an exploration of the specific realms where gaps are most pronounced. Leveraging the 2023 Center for Medicare & Medicaid Services National Downloadable Database, this study aims to contribute insights into the multifaceted dynamics of gender representation within surgical disciplines.

METHODS

Data from 1,168,064 physicians in the 2023 Center for Medicare & Medicaid Services National Downloadable Database were analyzed to distinguish between surgeons and physicians in medicine subspecialties. Univariable and multivariable logistic regression explored demographic variables, practice settings, and temporal trends to comprehensively understand factors contributing to the observed gender gap.

RESULTS

The analysis revealed a statistically significant gender difference, with only 16.7% of surgeons identified as female. Temporal trends indicated a slow increase in female surgeon representation, and specialty-specific analysis unveiled variations, such as lower likelihoods of females in cardiac surgery and higher likelihoods in colorectal surgery. Multivariable logistic regression emphasized factors influencing the odds of physicians practicing surgery, with female physicians exhibiting a lower likelihood. Regional and graduation year variations also played roles in surgical practice.

CONCLUSIONS

This study provides evidence-based insights into the persistent gender gap within surgical specialties, emphasizing the need for targeted interventions to enhance inclusivity and equity in the surgical workforce. The findings highlight intricate interplays of demographic, temporal, and specialty-specific factors, laying a foundation for future initiatives promoting a more diverse and inclusive surgical environment.

Women Anesthesiologists in Sub-Saharan Africa in the Pre-COVID Era: A Multinational Demographic Study

BACKGROUND

Gender imbalance and poor representation of women complicate the anesthesiology workforce crisis in sub-Saharan Africa (SSA). This study was performed to obtain a better understanding of gender disparity among medical graduates and anesthesiologists in SSA.

METHODS

Using a quantitative, participatory, insider research study, led by female anesthesiologists as the national coordinators in SSA, we collected data from academic or national health authorities and agencies. National coordinators were nominees of anesthesiology societies that responded to our email invitations. Data gathered from 13 countries included information on medical graduates, anesthesiologists graduating between 1998 and 2021, and number of anesthesiologists licensed to practice in 2018. We compared data between Francophone and Anglophone countries, and between countries in East Africa and West Africa/Central Africa. We calculated anesthesiology workforce densities and compared representation of women among graduating anesthesiologists and medical graduates.Data analysis was performed using linear regression. We used F-tests on regression slopes to assess the trends in representation of women over the years and the differences between the slopes. A value of P < .050 was considered statistically significant.

RESULTS

Over a 20-year period, the representation of female medical graduates in SSA increased from 29% (1998) to 41% (2017), whereas representation of female anesthesiologists was inconsistent, with an average of 25%, and lagged behind. Growth and gender disparity patterns were different between West Africa/Central Africa and East Africa. Representation of female anesthesiologists was higher in East Africa (39.4%) than West Africa/Central Africa (19.7%); and the representation of female medical graduates in East Africa (42.5%) was also higher that West Africa/Central Africa (33.1%).

CONCLUSIONS

On average, in SSA, female medical graduates (36.9%), female anesthesiologists (24.9%), and female anesthesiology residents projected to graduate between 2018 and 2022 (25.2%) were underrepresented when compared to their male counterparts. Women were underrepresented in SSA, despite evidence that their representation in medicine and anesthesiology in East African countries was rising.

Ophthalmology Census 2021: A Demographic Characterisation of Ophthalmologists in Portugal

INTRODUCTION

Human resources in ophthalmology have recently received particular attention, and it has been questioned whether there is a sufficient number of workers. The aim of this study was to analyze and characterize Portugal's ophthalmologist population.

METHODS

In this descriptive, cross-sectional study, an online questionnaire was sent to all ophthalmologists registered with the Portuguese College of Ophthalmology in December 2021. Information on the following variables was collected and analyzed: demographic factors, professional qualifications, professional activity, weekly professional activity and medium-term plans.

RESULTS

Among the 910 registered ophthalmologists, a response rate of 64.7% was achieved. There were 0.9 ophthalmologists for every 10 000 inhabitants, 0.45:10 000 working in the public sector (0.35:10 000 full-time equivalent). Among the respondents, 57.6% were over 50 years old (59.6% male), 97.3% were Portuguese, 46.7% completed their residency in the Lisbon region, 27.3% complemented their programme with additional training, 9.5% had a PhD and approximately 58% lived and worked in large urban centres. Regarding professional activity, 58.5% of the respondents worked in the public sector (4.2% exclusively), while 67.9% worked in different economic sectors. The median number of weekly working hours reported was 45 hours, with those in the public sector reporting 35 hours. Private/social sector work and public sector work accounted for 12 926 hours/week and 10 808 hours/week, respectively. It was found that 31.4% of the respondents provided emergency medical services and that 52.8% performed surgical procedures more than once a week. Looking ahead, 38.7% of the ophthalmologists intended to reduce their workload within the next five years due to family reasons, fatigue and demotivation. The projected rate of retirement or cessation of activity in the next five years was estimated to be 1.7%, while an average of 20 new ophthalmologists are expected to enter the profession annually, resulting in a generational balance of 0.8%.

CONCLUSION

While the number of ophthalmologists in Portugal meets the international recommendations, there is a shortage in the public sector and most ophthalmologists work in large urban centres. The number of ophthalmologists in Portugal is expected to be stable for the next five years.

"Women's work": Gender and the physician workforce

Historically, the physician professional identity and the organizational structure of Western medicine have been defined by masculine norms such as authority and assertiveness. The past five decades have seen a rapid shift in the demographics of attendees as medical schools, with equal numbers of women and men matriculants for nearly twenty years. Gender as a social, cultural, and structural variable continues to influence the physician workforce. The entry of women into medicine, has had far reaching effects on the expectations of patients, the interactions of physicians with other members of the healthcare team, and the delivery of care. Redefining the culture of medicine to accommodate the diversity of the modern workforce may benefit all physician and improve the delivery of healthcare.

Gender distribution in surgical pathology journal publications and editorial boards

AIMS

To investigate trends in representation of women among authors and editorial boards of surgical pathology journals over the last two decades.Secondary aims: to identify barriers and potential solutions.

METHODS

The names and gender of first, middle, last authors and editorial board members were obtained from original articles from seven pathology journals from various geopolitical regions in 2002, 2011 and 2021. The proportion of women first, middle, last authors and editorial board members were compared over time.

RESULTS

1097 publications and 8012 individual authors were extracted. In 2002, 2011 and 2021, respectively, the percentage of women first authors were 28.3% (257 of 907), 31.9% (566 of 1773) and 41.1% (1421 of 3457); women middle authorship rates were 30.0% (159 of 530), 32.8% (375 of 1145) and 40.9% (1067 of 2609) and women last authors were 18.0% (34 of 188), 26.0% (82 of 315) and 36.0% (152 of 422). Women representation on editorial boards has increased (11.3%, 15.8%, 26.5%), but of the chief editors, there was only one woman in 2021, while all were men in 2002 and 2011.

CONCLUSIONS

To our knowledge, this study is the first to document under-representation of women among authors and editorial boards of surgical pathology journals. While women representation has increased over time, predominance of men remains relative to workforce proportions. Our findings are comparable to those from other medical fields and prompt the need to investigate the underlying causes for this imbalance and implement strategies to promote diversity, equity and inclusion in academic surgical pathology.

Gender and Racialization Status of Medical Eponym Namesakes: Cross-sectional Study

BACKGROUND

Many medical eponyms were established when women and racialized individuals were excluded from medicine. The objective of this study was to determine the gender and racialization status of individuals whose names are incorporated in medical eponyms.

METHODS

This study is a cross-sectional analysis of gender and racialization of medical eponym namesakes. The main outcome measures were the study of gender and racialization of medical eponym namesakes found in Whonamedit, Mosby's Medical Dictionary, and the International Classification of Diseases (version 10). The gender and whether the individual was a racialized person were determined using pictures and other available information.

RESULTS

We identified 3484 unique eponyms. White men represented the majority of medical eponym namesakes (2190 of 2327, 94.1%) followed by white women (85 of 2327, 3.7%), racialized men (49 of 2327, 2.1%), and racialized women (3 of 2327, 0.1%). In the ICD-10 sub-analysis, white men represented the majority of medical eponym namesakes (476 of 514, 92.6%) followed by white women (22 of 514, 4.3%), racialized men (14 of 514, 2.7%), and racialized women (2 of 514, 0.4%).

CONCLUSION

Most medical eponyms represent men and white individuals, highlighting the underrepresentation of women and racialized individuals. This indicates a need to re-examine the ongoing use of medical eponyms which may entrench sexism and racism in medicine and contribute to an environment that makes some feel unwelcome or undervalued.

Beyond the tip of the iceberg: A meta-analysis of the anatomy of the clitoris

An understanding of ranges in clitoral anatomy is important for clinicians caring for patients including those who have had female genital mutilation, women seeking genital cosmetic surgery, or trans women seeking reconstructive surgery. The aim of this meta-analysis is to investigate the ranges in clitoral measurements within the literature. A meta-analysis was performed on Ovid Medline and Embase databases following the PRISMA protocol. Measurements of clitoral structures from magnetic imaging resonance, ultrasound, cadaveric, and living women were extracted and analyzed. Twenty-one studies met the inclusion criteria. The range in addition to the average length and width of the glans (6.40 mm; 5.14 mm), body (25.46 mm; 9.00 mm), crura (52.41 mm; 8.71 mm), bulb (52.00 mm; 10.33 mm), and prepuce (23.19 mm) was calculated. Furthermore, the range and average distance from the clitoris to the external urethral meatus (22.27 mm), vagina (43.14 mm), and anus (76.30 mm) was documented. All erectile and non-erectile structures of the clitoris present with substantial range. It is imperative to expand the literature on clitoral measurements and disseminate the new results to healthcare professionals and the public to reduce the sense of inadequacy and the chances of iatrogenic damage during surgery.

The gender composition of the members of the editorial board of toxicology journals: Assessment of gender equality

In many areas of medicine, gender equality has not yet been fully adopted despite recent developments. The inequality of gender in various areas of medicine is still debated. In this study, we analysed the gender composition of the editorial boards of toxicology journals in the Science Citation Index-Expanded (SCI-E) databases and the factors affecting this composition. The genders of the participants were determined by the data obtained from the official websites of the journals in September 2023. We analysed the journal metrics and publisher properties using Mann-Whitney U, Fisher's exact, Chi-square tests and Spearman's correlation coefficient. We used logistic regression analysis to reveal the independent factors related to gender parity. The representation rates of women were 28.62% on all editorial boards and 23.33% in editor-in-chief positions. The 'Neuroscience' (OR, 2.46 95%CI, 1.68-3.60, p < 0.001), 'Reproductive Biology'(OR, 2.05 95%CI, 1.22-3.42, p = 0.006) and 'Public, Environmental & Occupational Health'(OR, 1.49 95%CI, 1.18-1.88, p = 0.001) as a coverage category, the United States as a journal country (OR, 1.21, 95%CI, 1.04-1.40, p = 0.001), 5-year-IF≥3.6(OR, 1.54, 95%CI, 1.27-1.86, p < 0.001), 5-year H index≥29 (OR, 1.23, 95%CI, 1.01-1.49, p = 0.037) were the independent factors for gender parity. However, 'Oncology' (OR, 0.08 95%CI, 0.01-0.55, p = 0.011), 'Biochemistry, Molecular Biology' (OR, 0.62 95%CI, 0.44-0.86, p = 0.005) and 'Pharmacology & Pharmacy' (OR, 0.69 95%CI, 0.59-0.82, p < 0.001) as a coverage category, Japan as a publisher country (OR, 0.52 95%CI, 0.35-0.77, p = 0.001), and Switzerland as a journal country (OR, 0.61, 95%CI, 0.46-0.81, p = 0.001) were related to gender disparity. Greater endeavours are needed to reduce gender discrimination in toxicology. Toxicology authorities should continuously improve existing policies by optimising the analysis of objective information to eliminate barriers for toxicologists in terms of gender equality.

Support of parenting in undergraduate medical training in New Zealand

PURPOSE

This research assessed support for parents studying undergraduate medicine at a New Zealand medical school and identified requirements for additional support.

METHOD

Support documentation was sourced from Student Affairs and university and medical school websites. The Medical Deans of Australia and New Zealand Medical Students Outcome and Longitudinal tracking Project was retrospectively examined for data specific to medical student parents. Student parents and medical school staff were also surveyed for their knowledge and perceptions around organisation and effectiveness of available support, and suggestions for additional support.

RESULTS

Parents and expectant parents formed a consistent, likely growing sub-group studying medicine from 2008 to 2020, yet no formal student parent support policy existed until 2019. Prior to this, 67% of student parents and 47% of staff lacked knowledge of available support. Since 2020, calls for greater visibility of parenting policies and flexibility in the curriculum have been operationalised by the medical school.

CONCLUSION

Formalising policies and procedures, maximising access to parenting support resources and introducing flexibility in medical curricula can help students balancing families and medical training. This is relevant for sustainability of medicine as a career option for medical students wanting children, especially considering over half of all medical students are female.

The Presence of Women in the Dental Profession: A Global Survey

OBJECTIVES

The aim of this research was to acquire knowledge about the female dental workforce, identifying factors to pursue specialty training and career choices and working in dental institutions/associations.

METHODS

An original online questionnaire was developed, validated (n = 22), and sent to 189 member associations in 133 countries of the Women Dentists Worldwide section of the FDI World Dental Federation.

RESULTS

In all, 3232 female dentists from 81 countries participated. Results were divided into 5 geographic areas by continent. Difference in proportion amongst questionnaire items was evaluated with χ2 test or Fisher exact test. Ordinal multinomial linear regression analysis was performed to evaluate the association of questionnaire items with total work experience in dentistry (in years), motivation to study dentistry, type of specialisation, working hours per week, perception of female dentists about working hours, sex-based inequalities, job security after maternity leaves, as well as involvement in political organisations within their country of residence and their role in dental associations. A majority of participating female dentists are self-employed (57.7%), and 60.0% have 10 to 30 years of experience. The most popular form of practice is the single private practice (29.7%), followed by the group private practice (28.8%). Further, 44.8% work 31 to 40 h/wk, 29.1% part-time up to 30 h/wk, and 26.0% more than 40 h/wk.

CONCLUSIONS

Women are still poorly represented in professional organisations, and few are officers in representative assemblies, members of the board, or president. Family life with children influences perceptions and has an impact on professional life, especially in academia and political/professional associations, so that taking on leadership positions poses additional challenges.

A Systematic Review of Gender Disparity in the Authorship of Clinical Trials and Clinical Practice Guidelines in Various Medicine Subspecialties

Authorship in clinical trials and clinical practice guidelines is considered prestigious and is associated with broader peer recognition. This systematic review investigated female representation among studies reporting authorship trends in clinical trials or clinical practice guidelines in different medicine subspecialties. Our search strategy yielded 836 articles, of which 30 met the inclusion criteria. Our findings indicate that females are severely underrepresented in authorship of clinical trials and clinical practice guidelines. Although the proportions of females may have improved in the past decade, the gains are marginal. Notably, studies in this domain predominantly focus on first/last authorship positions, and whether females are underrepresented in other positions as collaborative partners is currently unknown. Also, authorship trends in clinical trials or clinical practice guidelines of most medicine subspecialties besides cardiovascular medicine remain under-researched. Hence, standardizing the methodology for studying gender disparity in research output for comparative analysis between different subspecialties is as urgent as addressing the gender disparity in authorship.

Early Australian neuroscientists and the tyranny of distance

Australian neuroscientists at the turn of the twentieth century and in the succeeding decades faced formidable obstacles to communication and supply due to their geographical isolation from centers of learning in Europe and North America. Consequently, they had to spend significant periods of their lives overseas for training and experience. The careers of six pioneers-Laura Forster, James Wilson, Grafton Elliot Smith, Alfred Campbell, Raymond Dart, and John Eccles-are presented in the form of vignettes that address their lives and most enduring scientific contributions. All six were medically trained and, although they never collaborated directly with one another, they were linked by their neuroanatomical interests and by shared mentors, who included Nobelists Ramon y Cajal and Charles Sherrington. By the 1960s, as the so-called "tyranny of distance" was overcome by advances in communication and transport technology, local collaborative groups of neuroscientists emerged in several Australian university departments that built on the individual achievements of these pioneers. This in turn led to the establishment of the Australasian Neuroscience Society in 1981.

Association between hours of work and subjective well-being. How do physicians compare to lawyers and accountants?

Analyses of physician well-being typically rely on small and unrepresentative samples. In April 2011, the UK Office for National Statistics incorporated subjective well-being metrics (SWB) into the Annual Population Survey (APS), a well-established survey. This survey includes variables from the labor market, making APS an ideal source for measuring the association between work hours and SWB metrics and comparing among different professionals. Using APS data from 2011/12 to 2014/15, this study examined the association between SWB levels and work hours using multiple linear models for physicians (primary care physicians and hospital doctors), lawyers, and accountants. Of the 11,810 observations, physicians were more satisfied, happier, and less anxious; females were more stressed (10.7%); and age was negatively associated with happiness and satisfaction. Incorporating information on preferences to work more hours (underemployment) did not affect physicians' but worsened the well-being of other professionals (lawyers and accountants). Surveyed physicians were less anxious, happier, and more satisfied than lawyers or accountants before Covid. Although the total work hours did not alter the SWB metrics, overtime hours for other professionals did. Increasing the working hours of underemployed physicians (with appropriate compensation) could be a relatively inexpensive solution to tackle the shortage of health workers in the short run.

Trends in the proportion of women speakers at North American Allergy and Immunology conferences, 2008 to 2020

BACKGROUND

Women in medicine continue to be underrepresented at medical conferences. Previous studies have evaluated the proportion of invited female speakers across multiple specialties and evaluated factors that may have led to this disparity. The field of Allergy and Immunology has often been excluded and analyses have not illustrated how the trends have changed over the past decade.

OBJECTIVE

To evaluate the distribution of invited speakers by gender over time at the 3 largest North American Allergy and Immunology conferences.

METHODS

This retrospective longitudinal analysis used conference programs from 2008 to 2020 from the American Academy of Allergy, Asthma, and Immunology (AAAAI), the American College of Allergy, Asthma, and Immunology (ACAAI), and the Canadian Society of Allergy and Clinical Immunology (CSACI). The gender (binary definition, man or woman, based on names, photos, pronouns, from conference programs and institutional profiles) of invited speakers was analyzed as the primary outcome, and planning committee members, and multispeaker sessions as secondary outcomes. These data were compared with publicly available data on the composition of the specialty by gender in the United States and Canada.

RESULTS

Women speakers at AAAAI, ACAAI, and CSACI conferences have historically been lower than male speakers and underrepresented compared with specialty composition. However, there has been a significant increase in the proportion of women speakers over time for all 3 conferences individually (AAAAI: 23.7% in 2008, 41.1% by 2020; ACAAI: 16.7% in 2008, 37.3% by 2020; CSACI: 19.4% in 2008, 54.8% by 2020; P < .001 for each) and combined (21.3% in 2008, 40.7% by 2020, P < .001). This trend coincides with a significant increase in women on the planning committee (all conferences: 20% in 2008, 50.6% by 2020; P < .001). There is also a decreasing trend over time for men-only multispeaker sessions.

CONCLUSION

This study sheds light on the trends of women speaker representation at Allergy and Immunology conferences and provides clarity on future needs to reach equal representation in this field.

Trends and determinants of GPs' work hours in the UK: a quantitative study

BACKGROUND

Information on the hours of work of UK doctors is limited, and what exists relies on self-designed questionnaires in England.

AIM

To understand trends in the annual stock of physicians' hours and their main determinants.

DESIGN & SETTING

A quantitative study in which data were collected from the Quarterly Labour Force Survey (QLFS) between 1998 and 2020, under the End User Licence (EUL), in the UK.

METHOD

Descriptive and linear regression models of labour supply for doctors (pooled), GPs, and hospital doctors.

RESULTS

Between 1998 and 2020, while the headcount of doctors grew by 128.79% for hospital doctors and 45.28% for GPs, hours of work dropped by 20.80% for hospital doctors and 25.37% for GPs. Hence, the annual stock of hours grew by 81.20% for hospital doctors but by a modest 8.42% for GPs. Female doctors worked 8.68 fewer hours than males, with GPs reporting the largest reduction (-11.82 hours, 95% confidence interval [CI] = -13.31 to -10.33 and -6.75, 95% CI = -9.32 to -4.19, in the full specification). Family decisions are associated with a fall in doctors' work hours and modest growth in the annual stock of hours. These determinants and overtime are drivers of part-time work.

CONCLUSION

Despite the increase in the headcount of GPs, their hours of work dropped over the study period, generating a more steady and modest growth in their total annual stock of hours compared with hospital doctors. Female GPs work fewer hours than male GPs and are more likely to work part-time due to childbearing, marriage/co-habitation, and overtime work.

Delving into New Frontiers: assessing ChatGPT's proficiency in revealing uncharted dimensions of general surgery and pinpointing innovations for future advancements

PURPOSE

The advent of artificial intelligence (AI) has significantly influenced various medical domains, including general surgery. This research aims to assess ChatGPT, an AI language model, in its ability to shed light on the historical facets of general surgery and pinpoint opportunities for innovation.

METHODS

A series of 7 pertinent questions on field of general surgery was posed to ChatGPT. The AI-generated responses were meticulously examined for their relevance, accuracy, and novelty. Additionally, the study explored the AI's ability to recognize knowledge gaps and propose inventive solutions. Expert general surgeons and general surgical residents possessing comprehensive research experience assessed ChatGPT's answers by comparing them to established guidelines and existing literature.

RESULTS

ChatGPT presented information that was relevant and accurate, albeit superficial. However, it exhibited convergent thinking and was unable to produce truly groundbreaking ideas to transform general surgery. Instead, it pointed to current popular trends with significant potential for further development. It failed to provide references when prompted and even created references that could not be verified in exhibiting databases.

CONCLUSION

While ChatGPT demonstrated a comprehensive understanding of existing general surgical knowledge and the capacity to generate relevant, evidence-based material, it displayed limitations in producing truly groundbreaking concepts or discoveries beyond current knowledge. These results highlight the necessity of enhancing AI-driven models to facilitate the emergence of new insights and promote synergistic, human-AI partnerships for expediting advancements within the general surgery domain.

The level of the gender gap in academic publishing varies by country and region of affiliation: A cross-sectional study of articles published in general medical journals

BACKGROUND

Women are generally under-represented as authors of publications, and especially as last authors, but this under-representation may not be uniformly distributed across countries. We aimed to document by country and region the proportion of female authors (PFA) in high-impact general medical journals.

METHODS

We used PyMed, a Python library that provides access to PubMed, to retrieve all PubMed articles published between January 2012 and December 2021 in the fifty general internal medicine journals with the highest 2020 impact factor according to Journal Citation Reports. We extracted first/last authors' main country of affiliation for all these articles using regular expressions and manual search, and grouped the countries into eight regions (North/Latin America, Western/Eastern Europe, Asia, Pacific, Middle East, and Africa). We used NamSor to determine first/last authors' gender and computed the PFA for each country/region.

RESULTS

We retrieved 163,537 publications for first authors and 135,392 for last authors. Gender could be determined for 160,891 and 133,373 publications, respectively. The PFA was 41% for first authors and 33% for last authors, but it varied widely by country (first authors: >50% for eight countries, maximum = 63% in Romania, minimum = 19% in Japan; last authors: >50% for two countries, maximum = 53% in Romania, minimum = 9% in Japan). The PFA also varied by region. It was highest for Eastern Europe (first authors = 53%, last authors = 40%), and lowest for Asia (36% and 29%) and the Middle East (35% and 27%).

CONCLUSION

We found that the PFA varied widely by country and region, and was lowest in Asia, particularly Japan, and the Middle East. The under-representation of women as authors of publications, especially in these two regions, needs to be addressed and correcting persistent gender discrimination in research should be a top priority.

Prioritizing women's choices, consent, and bodily autonomy: From a continuum of violence to women-centric reproductive care

Obstetric violence is a product of medical institutions' failure to prioritize women-centric reproductive care. Through interviews with local activists and leaders in Oaxaca, Mexico, as well as analysis of primary and secondary sources, we find that women-centric reproductive care is hindered by three barriers that are a part of a continuum of violence. These barriers include the cultural and religious norms surrounding reproductive care, the medical community and medical profiteers' opposition to combatting obstetric violence, and the state's resistance to women's human rights policy changes. Shifting to a women-centric reproductive care model requires: the life of the woman to be prioritized in reproductive care, the criminalization of obstetric violence, improved training for the medical community, reduced monetary incentives for unnecessary cesarean sections, and the respectful inclusion of indigenous and midwife knowledge and practices. Our study's theoretical and empirical contributions add to the scholarly research regarding the systemic causes of obstetric violence and the care ethic required for transformative change. Our recommendations can be applied across contexts with locally developed and culturally inclusive models of women-centric reproductive care.

Regional distribution in female representation in US otolaryngology faculty

Objectives

To quantify the current proportion of women in otolaryngology at different levels of professorship and determine whether these proportions differ by US region.

Methods

Academic rank and gender at all ACGME-accredited otolaryngology programs in the United States were determined from departmental websites, Doximity, and LinkedIn from November 2021 to March 2022. Individuals were then further organized using US Census Bureau-designated regions.

Results

Among the 2682 faculty positions at 124 ACGME-accredited programs, women held 706 (26.3%) of these positions. Female representation was highest at the assistant professorship level, with women holding 286 (37.2%) positions out of a total 769. At the associate professorship level, women held 141 (27.6%) of the 511 total positions. The largest gender disparity is seen at the full professorship level; only 69 (13.6%) positions out of 508 were held by women. Out of every region and rank, only assistant professorship in the West had no significant difference in percentages of men and women (p = .710). Female representation of professors in the Northeast was significantly lower than that of our reference group (the South; β = -10.9, p = .020).

Conclusions

Otolaryngology has exhibited great progress in increasing female representation, with assistant professorship in the West reaching gender parity. However, the gender gap at other faculty levels still leaves much to be desired, particularly in senior ranks. The lack of otolaryngologists at senior ranks is detrimental to mentorship of junior faculty, residents, and medical students. Renewed efforts should be made to decrease the gender disparity in the South, Northeast, and particularly at the professorship level.

Exploring gender differences in uptake of GP partnership roles: a qualitative mixed-methods study

BACKGROUND

The unadjusted gender pay gap in general practice is reported to be 33.5%. This reflects partly the differential rate at which women become partners, but evidence exploring gender differences in GPs' career progression is sparse.

AIM

To explore factors affecting uptake of partnership roles, focusing particularly on gender differences.

DESIGN AND SETTING

Convergent mixed-methods research design using data from UK GPs.

METHOD

Secondary analysis of qualitative interviews and social media analysis of UK GPs' Twitter commentaries, which informed the conduct of asynchronous online focus groups. Findings were combined using methodological triangulation.

RESULTS

The sample comprised 40 GP interviews, 232 GPs tweeting about GP partnership roles, and seven focus groups with 50 GPs. Factors at individual, organisational, and national levels influence partnership uptake and career decisions of both men and women GPs. Desire for work-family balance (particularly childcare responsibilities) presented the greatest barrier, for both men and women, as well as workload, responsibility, financial investment, and risk. Greater challenges were, however, reported by women, particularly regarding balancing work-family lives, as well as prohibitive working conditions (including maternity and sickness pay) and discriminatory practices perceived to favour men and full-time GPs.

CONCLUSION

There are some long-standing gendered barriers that continue to affect the career decisions of women GPs. The relative attractiveness of salaried, locum, or private roles in general practice appears to discourage both men and women from partnerships presently. Promoting positive workplace cultures through strong role models, improved flexibility in roles, and skills training could potentially encourage greater uptake.

Medical Faculty Perspectives Toward Cadaveric Dissection as a Learning Tool for Anatomy Education: A Survey Study in India

Cadaveric dissection, as a learning tool, has been a part of Indian medical education. Worldwide, with reforms in medical education and the introduction of new learning modalities, cadaveric dissection has been complemented with other modalities such as living anatomy and virtual anatomy. This study aims to collect the feedback of faculty members regarding the role of dissection in the present context of medical education. The method of the study involved a 32-item questionnaire to collect responses; they were collected using the 5-point Likert scale along with two open-ended questions. In general, the closed questions covered these sections: learning styles, interpersonal skills, teaching and learning, dissection, and other learning modes. The principal component analysis was used to explore the multivariate relationships among the items' perceptions. The multivariate regression analysis was conducted between the construct and the latent variable to develop the structural equation model. Four themes, PC1 (learning ability with structural orientation), PC2 (interpersonal skill), PC3 (multimedia-virtual tool), and PC5 (associated factors) had positive relation and were treated as a latent variable motivation for dissection, and theme 4 (PC4, safety) had a negative correlation and was treated as a latent variable repulsion for dissection. It was found that the dissection room is an important place for learning clinical and personal skills, along with empathy, in anatomy education. Safety issues and implementation of stress-coping activities during the induction phase are required. There is also a need to use mixed-method approaches that integrate technology-enhanced learning such as virtual anatomy, living anatomy, and radiological anatomy with cadaveric dissection.

Are We Facing a Radical Change in the Migration Behavior of Medical Graduates from Less Developed Countries? Demographic Profile vs. Social Push Factors

The phenomenon of migration among medical personnel from less developed countries is a large one, with negative effects on the origin country, but more worrying is graduates' propensity to migrate during or immediately after university studies. The analysis of the labor market in the health sector from the last two decades shows us greater attractiveness of employment in (more) economically developed states compared to the demand from the health sector in graduates' origin countries. This research's purpose is to identify the determinants of the propensity to study and work abroad of medical students as a defined factor for better employment, and to identify the push factors in the origin country. As a result of the dichotomous nature of the dependent variables, logistic regression was applied. The independent variables (gender, residence, medical specialization, grades and perceived economic status) were used to identify the odds of the intention to migrate for studies. The results highlighted a higher propensity to migrate for studies among medical students, with opportunities offered by universities differing across countries and geographical areas. Moreover, students with a lower level of household income have openness to migrate, the tuition fees being managed through part-time/temporary employment during studies.

"A cross-sectional study of burnout among Australian general practice registrars"

OBJECTIVE(S)

To identify if gender and parenting factors are associated with burnout in Australian general practice (GP) registrars.

DESIGN

Cross sectional study. The main outcome measure was the Maslach Burnout Inventory, included as part of the GPRA (General Practice Registrars Australia) biannual online survey.

PARTICIPANTS

GP registrars, 2019 cohort, undertaking fellowship training in Australia.

RESULTS

In 2019 a total of 366 GP registrars completed the online survey. Over 75% of registrars experienced moderate to high levels of burnout (emotional exhaustion scale). Several demographic factors were associated with an increased risk for reporting higher levels of burnout. Increasing age was associated with lower levels of personal accomplishment (P-value < 0.01), being female was associated with higher levels of emotional exhaustion (p-value < 0.001) and increasing numbers of children were associated with lower levels of burnout, independent of hours worked (p-value < 0.001).

CONCLUSION

This study suggests that being a parent is associated with a reduced risk of burnout, irrespective of hours worked. However, being female and increased age were associated with increased levels of burnout. With increasing numbers of females entering medical training, and the decreasing desirability of general practice training, this paper reviews the complexities around parenting during training and associations with burnout. There is a need to examine this interaction further to understand the causation for these findings, and to ensure appropriate policies, opportunities and workplace supports are developed to ensure GP training is optimised to attract and support the next generation.

Design, Implementation, and Evaluation of an Intensive Course on Issues in Women's Health and Gender-Based Medicine

OBJECTIVES

Sex and gender have profound effects on disease prevalence, presentation, and outcome, but these issues are not covered in depth in standard medical school curricula. To improve understanding of women's health, an intensive 1-month class was offered to fourth-year medical students.

METHODS

The class combined background lectures on the biological and social determinants of women's health with presentations on specific medical conditions by practicing clinicians and students. Students' anonymous responses to end-of-class evaluation used by Stony Brook University School of Medicine as well as pre- and post-class answers to the question "why are women twice as likely to go to the doctor" were analyzed using quantitative, descriptive, and qualitative approaches.

RESULTS

The class was given between 2017 and 2022 to a total of 154 students. Course evaluations were submitted by 133 students. Over 80% of responders ranked the class as good or excellent and many expressed surprise about how much sex and gender influence health. Furthermore, before taking the class responders favored gender stereotypes (82%) and OB/GYN visits (56%) as the main reasons why women utilize healthcare more often than men, whereas only 31% of post-class answers included these factors (p < .0001), which were replaced by others including misdiagnosis, high rate of adverse effects of medications, implicit bias, and longevity.

CONCLUSION

A dedicated class given to students at the end of their undergraduate medical training increased awareness and knowledge of the effects of sex and gender on women's health.

Enhancing Equity in a Widening Participation Scheme for School Students

OBJECTIVES

The Royal College of Surgeons (RCS) Diversity Review 2021 found that premedical school students from ethnic minority backgrounds were dissuaded from pursuing a surgical career. Gloucestershire is in the bottom 20% of disadvantaged counties; there is no widening participation (WP) scheme in the county. We implemented a fully inclusive WP scheme in Gloucester, with means of accessing virtual and face-to-face work experience, to enhance the equity of work experience.

METHODS

A three-stage project was conducted. Stage 1; two separate virtual Q and A sessions, to allow students to ask questions about life as a doctor. Stage 2; conversation between student and patient held virtually, to gain insight into working as a doctor to help determine whether medicine is the career for them. Stage 3; face-to-face work experience. Distribution sent to all 58 schools (state and private) in the county, targeted at secondary school children.

RESULTS

One hundred twenty-nine people attended the Q and A; 70 feedback responses received. Of the total, 86% female and 56% of ethnic minority background. 26% did not have an immediate family member that attended university, 10% had care-giving responsibilities. Eighty-one percent rated the session >8/10 for usefulness. Twenty-seven undertook the virtual conversation, feedback from 11; 91% female, 45% of ethnic minority background, and 27% did not have an immediate family member that attended university. All rated the session 10/10 for usefulness. 10 attended the face-to-face experience, 50% from an ethnic minority background.

CONCLUSION

The RCS Report identified barriers to aspiring students from less-privileged backgrounds pursuing a medical career. More needs to be done with WP schemes to promote equity. Targeted distribution of WP schemes to all schools, utilization of a variety of means of offering work experience, and accessibility to any school-aged student were aspects of our WP to improve exposure to the medical profession.

Women’s visibility at European Society for Clinical Nutrition and Metabolism congresses from 2011 to 2019: Is the floor yours?

Purpose

Participating in international conferences is an essential way to promote scholarly work. We aimed to assess the trend of women’s visibility at the European Society for Clinical Nutrition and Metabolism (ESPEN) congress by describing the evolution of the proportion of women speakers between 2011 and 2019.

Materials and methods

This is a retrospective study including public data obtained from the 2011, 2015, and 2019 ESPEN congresses. The primary endpoint was the percentage of women speakers in major oral sessions (oral communications and specific conferences including prestigious lectures). The secondary endpoints were the proportion of women in other high-visibility positions (moderators, industry-led symposia interventions) and countries of origin.

Results

The proportion of women speakers in oral communications remained stable between 2011 and 2019 [43% (43/100) vs. 41% (46/111), respectively; p = 0.89]. The proportion of women moderators in oral communications sessions significantly increased between 2011 and 2019 [13% (6/45) vs. 41% (19/46), respectively; p = 0.004]. The percentage of women speakers and moderators in industry-led symposia significantly increased between 2011 and 2019 [11% (2/18) vs. 41% (11/27), p = 0.05; 0% (0/6) vs. 60% (6/10), p = 0.03, respectively]. The percentage of women moderators in educational sessions also remained stable during the period with a marked under-representation of women in 2015. During all three congresses, women from the host countries were over-represented as moderators compared to women from other countries.

Conclusion

The percentage of women speakers in oral communications remained stable in the last 8 years at ESPEN congresses, although women’s representation in other high-visibility positions has increased. As men remained over-represented, women should be more encouraged to promote their academic work in the field of clinical nutrition, particularly during this international congress.

Perception of COVID-19 pandemic restrictions on dental researchers

BACKGROUND/OBJECTIVES

Historical evidence shows a gender-based disproportionate effect of pandemics across different populations. In 2020, the coronavirus disease 2019 (COVID-19) pandemic began spreading its devastating effects worldwide. The goal of the present study was to investigate the effect of the COVID-19 pandemic on research productivity, work-life arrangements, and mental health of dental professionals worldwide with focus on gender differences.

METHODS

A 38-item survey, concerning demographics, career stage, employer support, family structure, mental health, and relationships, was distributed to 7692 active members of the International Association for Dental Research. Bivariate associations between independent variables and the primary outcome variable were tested using Spearman's correlation test. A logistic regression model was used to assess the simultaneous, independent associations between each variable and researcher productivity.

RESULTS

A total of 722 responses were obtained, indicating a 9.4% response rate. Higher productivity was reported by male respondents (p = 0.021), and by those in senior career stages (p = 0.001). Institutional support was associated with higher productivity (p < 0.0001). Lower productivity was reported by younger researchers (p = 0.003). Remote work negatively affected productivity (p < 0.0001) and female respondents reported working more hours, regardless of work location (p = 0.004). Poor mental health was associated with low productivity (p < 0.0001).

CONCLUSIONS

Our results showed that the COVID-19 pandemic significantly affected dental professionals' perceived productivity and mental health around the globe. Younger individuals and women were disproportionally affected, and institutional support had a significant influence to mitigate effects of the pandemic for dental researchers.

Understanding the invisible workforce: lessons for general practice from a survey of receptionists

Introduction

The significance of the role of receptionists during the recent shift to remote triage has been widely recognised and they will have a significant role to play in UK general practice as it continues to cope with a huge increase in demand exacerbated by the COVID-19 pandemic. To maximise their contribution, it is important the social and occupational characteristics of the modern receptionist are understood, alongside their attitudes towards the role and their perceptions of the support and training they receive .

Methods

We used convenience and cross-sectional sampling to survey the demographic characteristics of receptionists and various aspects of their role and responsibilities. This included the training received, specific tasks performed, job satisfaction, the importance of the role, and their interaction with clinical and non-clinical colleagues. We also captured data on the characteristics of their practice including the number of GPs and location.

Results

A total of 70 participants completed the survey (16 postal and 54 online responses) of whom the majority were white (97.2%), female (98.6%), and aged 40 and over (56.7%). The majority of the training focussed on customer service (72.9%), telephone (64.3%), and medical administration skills (58.6%). Just over a quarter had received training in basic triage (25.7%). A standard multiple regression model revealed that the strongest predictor of satisfaction was support from practice GPs (β = .65, p <.001) there were also significant positive correlations between satisfaction and appreciation from GPs, r(68) = .609, p < .001.

Conclusion

This study has provided a much-needed update on the demographics, duties, and job satisfaction of GP receptionists. The need for diversification of the workforce to reflect the range of primary care patients warrants consideration in light of continuing variation in access along lines of gender andethnicity. Training continues to focus on administrative duties not on the clinically relevant aspects of their role such as triage.

Women's contribution to medicine in Bahrain: leadership and workforce

BACKGROUND

Women make up a significant proportion of workforce in healthcare. However, they remain underrepresented in leadership positions relating to healthcare for a multitude of reasons: balancing personal and work duties, favoritism toward men, lack of support from colleagues and mentors, as well as other factors. This study aims to recognize the contribution made by women in the Bahraini healthcare sector by determining the gender distribution in Bahrain's medical schools, government hospitals, Ministry of Health, and National Health Regulatory Authority.

METHODS

Data were collected from the Bahraini Ministry of Health, National Health Regulatory Authority, Salmaniya Medical Complex, King Hamad University Hospital, Bahrain Defence Force Royal Medical Services, the College of Medicine and Medical Sciences in the Arabian Gulf University, and the Royal College of Surgeons in Ireland-Bahrain. Only physicians who held a Bachelor of Medicine and Surgery and a valid license to practice from NHRA were eligible to participate. Descriptive statistics were used to derive the frequencies and percentages of physicians with the following leadership positions: (1) top administrative positions (e.g., Chief executive officer); (2) heads of departments; (3) heads of committees; and (4) academic positions (e.g., Professor). Data were also collected from the two medical schools in Bahrain to see the trend in female enrollment into medical schools since 2004.

RESULTS

The results of the study indicated that leadership positions were mostly held by males in Bahrain (59.4% vs. 40.6%). However, Bahraini males and females equally dominated academic positions. Male physicians also dominated surgical specialties; however, female Bahraini physicians slightly surpassed male Bahraini physicians at the specialist and consultant levels (female to male: 11.9% vs. 10.4% and 33.2% vs. 30.4%, respectively). Furthermore, more females were reported to have general licenses. A trend analysis since 2004 showed that female medical students' representation was higher than males over the years.

CONCLUSIONS

This study highlights the increasing trend of women's participation and contribution to medicine in Bahrain. The data indicated continued growth in the number of female medical students and physicians. As such, it is likely that females will have a bigger impact on healthcare in the future with potential to hold more leadership positions in Bahrain.

Survey showed that very few paediatric residents in Southwest Nigeria were interested in specialising in gastroenterology

AIM

Paediatric gastroenterology remains an under-recognised sub-speciality in Africa. We determined the preferred sub-specialities among paediatric residents in Southwest Nigeria and what influenced whether they chose paediatric gastroenterology.

METHODS

This was a cross-sectional survey of paediatric residents in seven teaching hospitals in Southwest Nigeria. A self-administered questionnaire was used to obtain information on their socio-demographics, educational attainment, choice of sub-speciality and the factors influencing that choice.

RESULTS

Of 144 eligible paediatric residents, 124 (86.1%) completed the survey. Their mean age was 35.0 ± 1.7 years and 83 (66.9%) were females. The majority (94.4%) had already chosen their sub-speciality and nearly two-thirds (65.0%) made the decision during training. The most popular sub-speciality was neonatology (30.6%) and only three (2.4%) residents chose gastroenterology. Factors influencing the choice of sub-speciality were perceived ability (85.3%) and academic experience (83.8%). Financial reasons were less frequent (32.5%). Lack of diagnostic equipment (30.6%) and role models (21.0%) were the most frequent reasons for residents being disinterested in paediatric gastroenterology.

CONCLUSION

Few residents were interested in paediatric gastroenterology and there is a need to encourage interest in this subject at an early stage in their training and provide more diagnostic equipment and greater mentorship.

Is Urology a gender-biased career choice? A survey-based study of the Italian medical students' perception of specialties

Background

Despite the well-established worldwide phenomenon of “the feminisation of medicine,” in Italy, Urology remains a male-dominated field.

Objective

The aims of our work are to assess data on medical students' choice of surgical specialty in Italy to investigate if a gender-biased trend exists and to find the key points that influence the decision-making process when choosing a specialty, with a focus on Urology.

Design

Data about access to residency programs in 2017–2020 were analysed through descriptive statistics. Investigations concerning the decision-making process were carried through distribution of an online anonymous survey to Italian medical students.

Results

Urology was among the specialties with the lowest proportion of female residents in Italy in the last 4 years: 37 (29.4%) in 2017, 27 (21.4%) in 2018, 40 (26.7%) in 2019, and 57 (25.2%) in 2020. The total number of participants of the survey was 1409, of which only 341 declared being keen to pursue a career path in surgery. Out of the 942 students not interested in surgery, 46.2% females and 22.5% males indicated a “sexist environment” as one of the reasons. Overall, the main reason for medical students not choosing Urology is the lack of interest in the specialty. Furthermore, there is a different perception of Urology as a sexist environment between female (23.4%) and male (3.2%, p < 0.001) medical students, which may influence their decision-making process.

Conclusions

In Italy, the prevalence of female medical graduates does not mirror the proportion of female doctors choosing a career in some surgical specialties, including Urology. Our survey results clearly identified that a large proportion of medical graduates are not choosing urology because of the perception of a sexist environment. While the reasons for this phenomenon remain unclear, the presence of a gender-biased perception of a sexist environment represents a possible explanation.

Rank and Tenure Amongst Faculty at Academic Medical Centers: A Study of More Than 50 Years of Gender Disparities

PURPOSE

To investigate progress toward gender equality in academic medicine through a longitudinal analysis of gender parity among faculty at medical schools.

METHOD

The authors conducted a retrospective analysis of Association of American Medical Colleges Faculty Roster data on gender, tenure status, and academic rank of faculty in basic science (BSc) and clinical science (CSc) departments from 1966 to 2019. They expressed data as whole numbers and percent female. A trend analysis projected time to gender parity across rank and tenure categories, and cross-tabulation analysis revealed the relative odds of females being in a rank and tenure position relative to males.

RESULTS

A 12-fold increase in the number of faculty occurred from 1966 to 2019, driven largely by increases in non-tenure track faculty. Female tenured and tenure track numbers increased at consistent rates (121 and 174 per year; P < .001). Female non-tenure track rates mirrored those for males, both changing in 2000. Odds ratios in 2019 for BSc and CSc females to be in tenure track versus non-tenure track positions compared with males were 0.83/0.98 and to be tenured were 0.63/0.44. Odds ratios in 2019 for BSc and CSc females to be full professors versus assistant or associate professors compared with males were 0.55/0.42. BSc assistant and associate professor percent female rates increased linearly from 1966 to 2019, while full professor rates increased in 1986. Transition points between periods of linear change were seen later in CSc departments (1977, 1980, 1985, 1994). Best fit line models indicated gender parity will be reached for BSc/CSc faculty in 2034/2023, 2047/2033, and 2065/2053 for assistant, associate, and full professors, respectively.

CONCLUSIONS

These findings suggest large historical changes in medical school expansion, medical education, and economics have shifted gender curves at all academic ranks. To achieve gender parity, additional national changes are needed.

Political Campaign Contributions of Surgeons in the United States Throughout the 2020 Election Cycle

Importance

Political engagement by the physician workforce is necessary to ensure continued representation of their interests in health care legislation. Limited data are available pertaining to the political involvement of US surgeons.

Objective

To analyze the magnitude and distribution of political donations made by all US surgeons throughout the 2020 election cycle.

Design, Setting, and Participants

Partisan and geographical differences in surgeon contributions by aggregating data (January 1 through December 31, 2020) from the US Federal Election Commission database were analyzed. Contributions were labeled as Republican, Democrat, or independent depending on the committee they were designated to.

Main Outcomes and Measures

Differences in contributions to Republicans, Democrats, and independent candidates for all US surgeons and for subgroups.

Results

For the 2020 election year, a total of 53 944 donations were made by surgeons in the United States, amounting to $9 223 350.68. Among all surgical specialties, the top 5 highest number of contributions were made from orthopedic surgeons (n = 15 081), ophthalmic surgeons (n = 14 836), neurological surgeons (n = 7481), urologists (n = 4544), and plastic surgeons (n = 4060). Of these donations, 59.46% (n = 32 107) were made to the Republican party ($5 420 326), 30.83% (n = 16 644) were made to the Democratic party ($1 612 775), and 9.71% (n = 5243) were made to nonpartisan (ie, independent) organizations ($2 190 250). Overall, pediatric surgeons reported the lowest mean contribution amount of $59.43, whereas thoracic surgeons reported the highest mean contribution amount of $225.19.

Conclusions and Relevance

Health care legislation has an immense impact on how medicine is practiced and utilized. This analysis reveals a high degree of political activity of surgeons across different specialties and geographic regions.

Profile and Migration of Members of Residency Programs in Family Medicine

OBJECTIVE

To describe the sociodemographic profile and analyze the migratory characteristics of the members of the Residency Programs in Family Medicine in 2020 in Brazil.

METHODS

The study follows a cross-sectional observational design of a quantitative nature from the perspective of the members of the Residency Programs in Family Medicine. Questionnaires adapted for each participating group were developed, applied through an online platform.

RESULTS

Most participants are female and white. Most supervisors and preceptors were residents of Residency Programs in Family Medicine, however, there are some who are not specialists in the field. Most participants are based in capitals or metropolitan regions. In relation to retention, 41.1% of supervisors and 73.1% of preceptors are affiliated to a program in the same municipality where they lived. For most resident physicians, the place of residence coincides with the place of birth and/or graduation (57.4%), and 48.5% are in the same place of graduation.

CONCLUSIONS

The research reinforces the need for policies to promote the migration of residents to Residency Programs in Family Medicine outside capital cities and metropolitan regions, as well as encouraging the retention of graduates trained outside large urban centers so that they can contribute to distribution and provision of doctors where they are still needed.

How accurate are gender detection tools in predicting the gender for Chinese names? A study with 20,000 given names in Pinyin format

Objective

We recently showed that the gender detection tools NamSor, Gender API, and Wiki-Gendersort accurately predicted the gender of individuals with Western given names. Here, we aimed to evaluate the performance of these tools with Chinese given names in Pinyin format.

Methods

We constructed two datasets for the purpose of the study. File #1 was created by randomly drawing 20,000 names from a gender-labeled database of 52,414 Chinese given names in Pinyin format. File #2, which contained 9,077 names, was created by removing from File #1 all unisex names that we were able to identify (i.e., those that were listed in the database as both male and female names). We recorded for both files the number of correct classifications (correct gender assigned to a name), misclassifications (wrong gender assigned to a name), and nonclassifications (no gender assigned). We then calculated the proportion of misclassifications and nonclassifications (errorCoded).

Results

For File #1, errorCoded was 53% for NamSor, 65% for Gender API, and 90% for Wiki-Gendersort. For File #2, errorCoded was 43% for NamSor, 66% for Gender API, and 94% for Wiki-Gendersort.

Conclusion

We found that all three gender detection tools inaccurately predicted the gender of individuals with Chinese given names in Pinyin format and therefore should not be used in this population.

Role models as a factor influencing career choice among female surgical residents in Saudi Arabia: a cross-sectional study

BACKGROUND AND PURPOSE

Role models in the medical field are professional and experienced persons whose actions unconsciously inspire juniors to strive to be like them. To our knowledge, no studies have examined whether having a female surgical role model has influenced women to pursue a surgical career in Saudi Arabia. Hence, we sought to evaluate whether identifying role models in surgery influences career choice and defined the ideal qualities of a surgical role model as perceived by newly qualified doctors.

METHODS

We employed a cross-sectional, survey- based study design, conducted between June 2020 and January 2021, in which female surgical residents completed a questionnaire about their perceptions and influence of role models in general surgery specialty at the time they pursue a career in surgery.

RESULTS

A total of 51 respondents completed the questionnaire. The majority of them (78.4%) had a role model and (19.6%) indicated that their role model was a female. Of those who had a role model, (67.5%) agreed that they experienced a positive influence on their surgical career choice. Clinical and operation skills were reported as the most remarkable factor to be considered in their role models. Working directly with a male surgical consultant and female surgical residents imprinted a positive influence but this did not reach a statistical significance.

CONCLUSION

The findings of this article contribute empirically to the strong effects of the same-sex role models and highlight the curial role of surgical residents in influencing female's career choices in general surgery as an achievable and attainable domain. Which encourage the creation of national mentorship programs and exploring more in barriers for pursuing a surgical career.

Impact of Mentorship, by Gender, on Career Trajectory in an Academic Anesthesiology Department: A Survey Study

INTRODUCTION

Mentorship has been identified as a key component of success in business and in academic medicine.

METHODS

After institutional review board approval of the study, an email survey was sent to anesthesiologists in one anesthesiology department to assess mentorship status. A survey link was sent to nonrespondents at 2 weeks and 4 weeks. All participants were deidentified. The identification of a mentor was compared by gender, academic rank, and years of practice.

RESULTS

Among 233 anesthesiologists, 103 (44.2%) responded to the survey. More than 90% of survey respondents agreed or strongly agreed that having a mentor is important to career success. Of the 103 respondents, 31 (30%) indicated they had a mentor. Overall, 84% of the identified mentors were men; however, this percentage differed significantly between men and women respondents (95% versus 60%; P = .03). Characteristics associated with having a mentor included younger age (P = .007), fewer years since finishing training (P = .004), and working full time (P = .02). For respondent age and years since finishing training, there was some evidence that the association was dependent on the gender of the respondent (age-by-gender interaction, P = .08; experience-by-gender interaction, P = .08).

DISCUSSION

Anesthesiologists in this department believed that mentorship led to more academic success. Few women mentors were reported, and women were unlikely to identify a mentor once advanced past an assistant professor rank. Most respondents believed that mentorship was important for overall career success, but only approximately one-third identified a mentor at the time of the survey.

Epidemiological Study on Burnout in Spanish Dentists: Underlying Psychological Factors

The aim of this work is to study the personality factors and coping styles of Spanish dentists when facing burnout syndrome, through epidemiological work. An epidemiological study of 1928 Spanish dentists was undertaken through an online survey, which registered the age and gender, and three questionnaires: NEO-FFI (personality traits), Brief COPE (coping styles), and MBI-HSS (burnout questionnaire). A multivariate analysis and an explanatory binary logistic regression model were used to estimate the presence of burnout. Neuroticism turned out to be the strongest indicator (OR 1.10; IC 95% 1.09–1.14), while extraversion (OR 0.93; IC 95% 0.91–0.95) and agreeableness (OR 0.94; IC95% 0.92–0.98) showed an inverse relationship with the occurrence of burnout, as did age (OR 0.9; IC95% 0.96–0.99). Conscientiousness (OR 1.0; IC95% 1.00–1.06) had a direct relationship with the presence of burnout. An avoidant coping style was the only indicative coping style (OR 1.04 IC95% 1.02–1.06). Approximately 70% of the dentists scored high on one of the three dimensions of burnout. No differences were found in the degree of burnout according to gender. Certain personality factors (neuroticism, extraversion, agreeableness, and conscientiousness), the avoidant coping style, and age are powerful indicators to attempt to forecast the presence of burnout syndrome in dentists.

Evaluating knowledge retention and perceived benefits of medical webinar for professional development among Indonesian physicians

PURPOSE

To assess knowledge retention of physicians after participating in a webinar series and its perceived benefits on daily practice and career development.

METHODS

The webinar series comprised six separate webinars about daily practice. Online questionnaires were sent to all participating physicians via email 3 months after the webinars. The questionnaire assessed knowledge retention through the difference between initial and follow-up post-test as well as the webinar series' benefits on daily practice and career development. Participants' demographic information, including their age, gender, education, year of graduation, and work details, were collected to compare outcomes between demographic groups.

RESULTS

A total of 689 responses were gathered, and 622 were analyzed. At follow-up, the median knowledge score was significantly lower than the initial median knowledge score (Z=-6.973, p<0.001). Participants' perception of the webinar series' benefits on daily practice and career development was very positive. A significant weak negative correlation was found between age and knowledge score at follow-up (rs=-0.157, p<0.001). Physicians who graduated more recently and worked for less than 3 years scored significantly higher on knowledge tests at follow-up. Meanwhile, perception score towards webinar series' benefits on daily practice was significantly higher among physicians with more extended work history. Male physicians scored significantly higher on perception score towards webinar series' benefits on career development.

CONCLUSION

Online continuing medical education programs like webinars can encourage physicians to maintain their competence, but further research on improving knowledge retention over time is necessary. Overall, physicians perceived webinars to be beneficial for their professional development.

Unique perspective of Muslim patients on gender preference for GI endoscopists: a multicenter survey

BACKGROUND AND AIMS

Patient preference for a healthcare professional is mediated by physician gender. The primary aim of this study was to assess gender preference for an endoscopist in a cohort of Muslim patients. The secondary aim was to identify factors that influence gender preference.

METHODS

This was a multicenter cross-sectional study conducted at 3 tertiary care hospitals in Pakistan. Consecutive patients scheduled for elective outpatient upper endoscopy or colonoscopy were asked to complete a questionnaire immediately before and after the procedure. Data collected included patient demographics, occupation, education level, procedure type, gender preference, and reason for preference.

RESULTS

A total of 1078 patients completed the questionnaire (age 43.5 ± 15.8 years; 53.2% men). Upper endoscopy was the most frequent procedure, performed in 84% of patients. Gender preference was expressed by 707 patients (65.6%), of which 511 (72.3%) were willing to wait for an average of 7 days for an endoscopist of the preferred gender. Male patients' preferences (45.1% male endoscopist, 17.1% female endoscopist, 37.8% no preference) differed from female participants' (16.9% male endoscopist, 52.6% female endoscopist, and 30.5% no preference; P < .00001). No education was associated with having a gender preference (odds ratio, .55; 95% confidence interval, .37-.81; P = .003). Reasons for gender preference included religious values and family pressure, which were more frequently expressed by women (P < .0001).

CONCLUSIONS

Most Muslims in Pakistan expressed a gender preference, and both female and male patients showed a preference for a same-gender endoscopist. No education was associated with having a gender preference.

Systematic review of academic bullying in medical settings: dynamics and consequences

PURPOSE

To characterise the dynamics and consequences of bullying in academic medical settings, report factors that promote academic bullying and describe potential interventions.

DESIGN

Systematic review.

DATA SOURCES

We searched EMBASE and PsycINFO for articles published between 1 January 1999 and 7 February 2021.

STUDY SELECTION

We included studies conducted in academic medical settings in which victims were consultants or trainees. Studies had to describe bullying behaviours; the perpetrators or victims; barriers or facilitators; impact or interventions. Data were assessed independently by two reviewers.

RESULTS

We included 68 studies representing 82 349 respondents. Studies described academic bullying as the abuse of authority that impeded the education or career of the victim through punishing behaviours that included overwork, destabilisation and isolation in academic settings. Among 35 779 individuals who responded about bullying patterns in 28 studies, the most commonly described (38.2% respondents) was overwork. Among 24 894 individuals in 33 studies who reported the impact, the most common was psychological distress (39.1% respondents). Consultants were the most common bullies identified (53.6% of 15 868 respondents in 31 studies). Among demographic groups, men were identified as the most common perpetrators (67.2% of 4722 respondents in 5 studies) and women the most common victims (56.2% of 15 246 respondents in 27 studies). Only a minority of victims (28.9% of 9410 victims in 25 studies) reported the bullying, and most (57.5%) did not perceive a positive outcome. Facilitators of bullying included lack of enforcement of institutional policies (reported in 13 studies), hierarchical power structures (7 studies) and normalisation of bullying (10 studies). Studies testing the effectiveness of anti-bullying interventions had a high risk of bias.

CONCLUSIONS

Academic bullying commonly involved overwork, had a negative impact on well-being and was not typically reported. Perpetrators were most commonly consultants and men across career stages, and victims were commonly women. Methodologically robust trials of anti-bullying interventions are needed.

LIMITATIONS

Most studies (40 of 68) had at least a moderate risk of bias. All interventions were tested in uncontrolled before-after studies.