Gender Differences in Publication Productivity, Academic Rank, and Career Duration Among U.S. Academic Gastroenterology Faculty

Mentorship effect for PAs at an academic medical center and its healthcare system

PURPOSE

Mentorship has many notable benefits. Research about mentorship for physician associates/assistants (PAs) is limited. This study sought to uncover more detailed information on mentorship and its effect on PAs.

METHODS

A survey was sent via email to all PAs and advanced practice registered nurses at our institution. Subgroup analysis was performed on PA respondents, including satisfaction and independent predictors associated with mentorship.

RESULTS

Of the 295 PAs, 63 (21.4%) identified having a mentor. Those with a mentor were statistically more likely to function as a mentor (OR 2.7 [95% CI 1.5-4.9], P = .001), have an academic rank of assistant professor or higher (OR 2.7 [95% CI 1.3-5.5], P = .007), be under age 45 years (OR 6.1 [95% CI 2.1-17.4], P = .008), be less than 10 years into their career (OR 3.1 [95% CI 1.7-5.7], P = .002), and be satisfied with mentorship (88.9% versus 23.9%, P < .001).

CONCLUSIONS

Mentorship for PAs is crucial and can boost academic promotion and career satisfaction.

Assessment of h-index and associated demographic and academic parameters for academic hematologists in Canada

Introduction

The h-index measures researchers' productivity by assessing simultaneously the number of publications and citations. We aimed to assess the factors that could influence h-index for hematologists practicing in academic institutions in Canada.

Methods

We identified universities with a hematology residency training programs/fellowships using the Canadian Resident Matching Service (CaRMS) website. We obtained the listing of faculty, sex, and academic ranks by consulting faculty directories or by contacting respective departments/universities, when directories were unavailable or incomplete. For each faculty member, we obtained years since Royal College of Physicians' and Surgeons of Canada certification or equivalent, receipt of Canadian Institute of Health Research (CIHR) grants within the last 5 years, attainment of graduate degrees (M.Sc., Ph.D., other), and the h-index.

Results

The data included information collected from 372 individuals (171 females) across Canada (Atlantic Provinces: 13; Quebec: 89; Ontario: 182; Prairie Provinces: 59; British Columbia: 29). Univariate analysis showed that male sex, practicing in British Columbia, longer duration since specialty certification, completion of an M.Sc. or a Ph.D. degree, attaining a higher academic rank and receiving CIHR funding were associated with higher h-index. The results of the univariate analysis were concordant with the multivariate analysis, except that practicing in Ontario was also associated with higher h-index.

Conclusion

This study provides details on the h-index curve/parameters for academic productivity of hematologists in Canada. Importantly, based on multivariate analysis, higher h-index was associated with male sex, location of practice, years since certification, attainment of M.Sc. or Ph.D. degrees, academic rank, and recent CIHR funding.

Research productivity and gender of research award recipients in international ophthalmology societies

PURPOSE

The purpose of this study is to assess the research productivity and gender of award recipients of ophthalmology research awards in international societies.

METHODS

This is a retrospective, observational study. The study population included award recipients of research awards from 36 ophthalmologic societies (listed on the International Council of Ophthalmology database) in 99 years (1922-2021). A gender-specific pronoun and a photograph of each award recipient were extracted from professional websites to assign their gender. Research productivity levels were retrieved from the Elsevier Scopus author database. The main outcome measures were gender distribution of award recipients per year, mean h-index per year, mean m-quotient per year, mean h-index by society, and mean m-quotient by society.

RESULTS

Out of 2506 recipients for 122 awards, 1897 (75.7%) were men and 609 (24.3%) were women. The proportion of woman recipients increased from 0% in 1922 to 41.0% in 2021. Compared with 2000-2010 (19.8%, 109 of 550), women received a greater proportion of awards (48.4%, 459 of 949) in the last decade, from 2011 to 2021. Furthermore, men more often had greater h-index scores and m-quotient scores.

CONCLUSIONS

Women received awards (24.3%) at a lower rate than men (75.7%) while also exhibiting lower productivity, supporting the existence of a gender disparity. Our study found that women are under-represented in research awards, and further investigation into award selection processes and gender membership data is recommended.

Questionable research practices of medical and dental faculty in Pakistan - a confession

PURPOSE

Intellectual honesty and integrity are the cornerstones of conducting any form of research. Over the last few years, scholars have shown great concerns over questionable research practices (QRPs) in academia. This study aims to investigate the questionable research practices amongst faculty members of medical and dental colleges in Pakistan.

METHOD

A descriptive multi-institutional online survey was conducted from June-August 2022. Based on previous studies assessing research misconduct, 43 questionable research practices in four domains: Data collection & storage, Data analysis, Study reporting and Collaboration & authorship were identified and investigated. Descriptive (Frequencies, Percentages, Mean, SD) and Inferential (chi square) statistics were calculated.

RESULTS

A total of 654 faculty members responded. Every respondent reported committing at least one QRP in their career. The most common QRPs included deliberately failing to mention funding, publishing program evaluation data not meant for research purposes or approved by an ethical body, inappropriately storing identifiable information and non-disclosure of any conflicts. There was significant association of age, gender and academic rank with QRPs in 'Data collection and storage' and 'Data Analysis' domains.

CONCLUSION

Medical and dental faculty members participating in this study are involved in a range of questionable research practices (QRPs) in Pakistan. Their confession might have contributed to the faculty developing self-awareness and reinforcing academic integrity. There is a need for reviewing policies and practices to improve research culture. Future research should explore the factors resulting in such practices.

Speaker Diversity and Audience Ratings at a National Inflammatory Bowel Diseases Conference

BACKGROUND

There is a need to improve speaker diversity at gastroenterology conferences, but little public data exist to quantify this. In addition, the perception of diverse speakers by conference audiences is not appreciated. We sought to identify time trends in speaker profiles and audience ratings at a national inflammatory bowel diseases conference.

METHODS

Faculty profiles and audience feedback forms from 2014 to 2020 were reviewed for an annual inflammatory bowel diseases meeting. Speaker demographics including gender, race, and years of experience post-training were collected. Continuing medical education surveys were examined for audience ratings of speakers' knowledge level and teaching ability.

RESULTS

Six years of data were collected, including 560 main program faculty and 13 905 total feedback forms. The percentage of female speakers increased from 25% in 2016 to 39% in 2020. All-male panels decreased from 47% in 2014 to 2017 to 11% in 2018 to 2020. Racial diversity of speakers remained unchanged (13% Asian, 5% Hispanic/Latinx, 1% Black). In audience feedback forms, female speakers from all sessions were perceived as having equal knowledge base and teaching ability compared with male speakers. However, speakers with <10 years of experience post-training were viewed as less knowledgeable and with poorer teaching abilities compared with more senior faculty.

CONCLUSIONS

Gender diversity at inflammatory bowel disease conferences is improving. However, there remain significant gaps, particularly in racial diversity and improving perceptions of early-career speakers. These data should inform program committees for future gastroenterology conferences.

Time for a Gut Check: A Qualitative Study of Proposed Interventions to Address Gender Inequality in Gastroenterology

Background

Gender inequalities persist in medicine, particularly in some speciality fields where fewer women are employed. Although previous research has suggested potential interventions to broadly address gender inequality in medicine, no research has focused on interventions in the field of gastroenterology. The purpose of this research was to engage women in the field of gastroenterology in Canada, to identify interventions with potential to be effective in addressing gender inequality.

Methods

A World Café was hosted in 2019 to discuss gender inequality and interventions in gastroenterology. Twelve women employed in the field of gastroenterology (i.e. physicians, nurses, research staff, and trainees) were purposively recruited and participated in the event. The discussion rounds were audio-recorded, transcribed, and thematic analyses was conducted using Braun and Clarke's principles.

Results

Three key themes identifying potential interventions to address gender inequality in gastroenterology were generated: (1) Education; (2) Addressing institutional structures and polices; and 3) Role modelling and mentorship. Participants indicated that interventions should target various stakeholders, including both women and men in gastroenterology, young girls, patients, and administrators.

Conclusion

Many of the interventions identified by participants correspond with existing research on interventions in general medicine, suggesting that institutional changes can be made for maximum effectiveness. Some novel interventions were also identified, including publicizing instances of gender parity and supporting interventions across the educational and professional lifecourse. Moving forward, institutions must assess their readiness for change and evaluate existing policies, programs, and practices for areas of improvement.

Psychologists' Role in Addressing Healthcare Provider Burnout and Well-Being

Burnout in health care has received considerable attention; widespread efforts to implement burnout reduction initiatives are underway. Healthcare providers with marginalized identities may be especially at risk. Health service psychologists are often key members of interprofessional teams and may be asked to intervene with colleagues exhibiting signs of burnout. Consequently, psychologists in these settings can then find themselves in professional quandaries. In the absence of clear guidelines, psychologists are learning to enhance their scope of practice and navigate ethical guidelines while supporting colleagues and simultaneously satisfying organizational priorities. In this paper we (a) provide an overview of burnout and its scope, (b) discuss ethical challenges health service psychologists face in addressing provider burnout, and (c) present three models to employ in healthcare provider burnout and well-being.

An Evaluation of Research Publications for General Surgery Residents And its Influence on the Future Pursuit of Fellowship or Academic Career

INTRODUCTION

Traditionally, the Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to implement research and other scholarly activities into their training curriculum. Encouraging residents to publish during residency is believed to promote research throughout their careers; however, the rate of research outcomes among general surgery residents remains unknown. Our study aims to determine associated factors that influence publication rates before, during, and after general surgery residency.

METHODS

This observational study employed a cross-sectional design. We examined whether research outcomes during general surgery residency was associated with academic advancement or continued research involvement after residency. We identified 321 general surgery residency programs on the Doximity website and randomly selected 50 to include in our sample. Of these programs, graduate rosters for 31 programs were located and subsequently included. Of the 405 residency graduates identified, we recorded the number of peer-reviewed publications, H-indices, fellowships, and whether the graduate pursued a career in private practice or academia.

RESULTS

Among the 405 physicians analyzed, 3815 total publications were identified with a mean of 9.4 (SD 11.8) per person. The most reported study design was observational studies (46.5%; 1775/3815) and the least reported was systematic reviews/meta-analyses (1.4%; 52/3815). The number of publications before residency positively correlated with having a higher h-index (r = 0.4). We also found that physicians who completed a fellowship had more publications during residency (mean = 4.7, SD = 6.5) than those not pursuing a fellowship (mean = 1.5, SD = 2.7; t= -4.3. p ≤ 0.001). We observed a statistically significant increase in the likelihood a physician pursued a career in academic medicine if they pursued a fellowship (OR: 3.77, 95% CI: 2.0-7.2) and if they had published research as a primary author (OR 1.25, 95% CI: 1.0-1.5).

CONCLUSION

Increased research productivity was associated with continued academic pursuits and an increased likelihood of pursuing fellowship training after residency.

Gender Disparities in Physician Assistant Educator Promotion and Compensation: A Mixed Methods Approach

INTRODUCTION

The gender wage gap is well documented in many industries. A disparity in salary between female and male physician assistant (PA) educators has been demonstrated, but disparities in academic rank have not been shown. The purpose of this study was to re-examine gender disparities in compensation to PA educators and to explore whether gender-based disparities exist in promotion to higher academic rank in this field.

METHODS

An explanatory sequential mixed-methods design was used to determine differences in salary and rank by gender. PA Education Association Faculty and Directors Survey data from 2014, 2017, and 2019 were analyzed. A focus group was conducted to explain the findings and understand the barriers to promotion for female faculty.

RESULTS

Female PA faculty members earn $7573 less than their male colleagues when controlling for all other variables. Female faculty members have an increased likelihood (RR 1.150) for being in early career stage versus late career stage. Obtaining a doctoral degree decreased the risk for being in an early career stage (RR 0.567) with men twice as likely to have a doctoral degree as women.

DISCUSSION

Rank and salary disparities exist in PA faculty by gender. Female faculty are less likely to hold doctoral degrees or to be promoted to higher academic ranks, and they earn less than men. Degree level and career track are themes unique to the PA education profession, and further research is needed to understand their impact. With more women entering PA education, pay equity and promotion need to be addressed.

Measuring h-index and scholarly productivity in academic dermatology in Canada

Promotion in academia heavily relies on research productivity. The h-index is a standardized metric used to quantify research productivity at the individual level. We evaluated factors associated with h -index in dermatology across select Canadian academic centers with special focus on sex and academic rank. Medical academic centers throughout Canada with dermatology training programs were included. For each faculty member, we extracted the following data from public sources: sex, graduate degree, academic rank, years since the Fellow of the Royal College of Physicians and Surgeons of Canada (FRCPC) certification or equivalent, recent Canadian Institutes of Health Research (CIHR) funding and H-index (based on Scopus author profile). Log-linear univariate and multivariate regression analyses were performed to evaluate the association between h-index and these factors. An ordinal logistic regression was performed to explore sex differences in academic ranking. Our results showed that out of 300 faculty members across Canada, 155 were females (51.67%) and 145 were male (48.33%). H-index was available for 279 dermatologists. The average h-index was 8.35 (SD 11.53) and the median was 4.00 (1st quartile = 2.00, 3rd quartile = 10.00). Higher h-index was associated with more years since dermatology certification, successive academic rank, graduate degree and recent CIHR funding, but not with sex. In conclusion, h-index was not associated with sex when controlling for potential confounders. These results could reflect recent demographic changes in the field with an increase in newly appointed female dermatologists. Longitudinal assessment of academic productivity in dermatology is needed to assess the impact of continued efforts to promote equal opportunities in the field.

Perceived Barriers to Professional Equality Among Women in Gastroenterology

Although significant progress relating to professional equality among men and women in medicine has been made over the past few decades, evidence derived from the medical literature suggests that inequity persists with respect to income, attainment of leadership positions, and professional advancement. These inequities have been observed to be more pronounced in gastroenterology. Literature relating to gender-specific barriers to professional equity in gastroenterology is limited. This qualitative study explored perceived barriers to professional equality among women in gastroenterology in Canada through focus groups using a World Café Approach. Several perceived barriers to professional equality were identified. Identification of barriers to professional equality is an important first step to creating meaningful interventions that address the root causes of gender-related inequity in gastroenterology.

Family Supportive Supervisor Behaviors Moderate Associations between Work Stress and Exhaustion: Testing the Job Demands-Resources Model in Academic Staff at an Austrian Medical University

The time-intensive work of publishing in scientific journals is an important indicator of job performance that is given much weight during promotion procedures for academic positions. The current study applied the job demands–resources model and analyzed whether family supportive supervisor behaviors (FSSB) moderated associations between work stress and feelings of exhaustion as a job resource and whether feelings of exhaustion ultimately mediated the link between work stress and academic employees’ publication activity. The current online cross-sectional questionnaire study was conducted in 133 academic employees (65.4% women, 34.6% men; M_age = 41.9, SD = 10.1) at an Austrian medical university and assessed employees’ numbers of publications, H-index, work stress, feelings of exhaustion, FSSB, and work–family services used. Manifest path models revealed that FSSB moderated the link between experiencing high levels of work stress and strong feelings of exhaustion, especially in employees who had at least one child below the age of 18. Part-time employment was most strongly linked with lower numbers of publications and lower H-index levels. The finding that FSSB acted as a job resource mostly for employees with at least one child below 18 underlines the fact that FSSB is different from other forms of supervisor support. The current study supports recommendations to increase the amount of work–family services and to change organizational norms to be supportive of the successful management of family and work obligations.

Female Surgeons for Obesity Treatment: a Snapshot Sampling in Academic Productivity : The Role of Women in Obesity Surgery

The proportion of females choosing a career in surgery is lower than that of males. Through the Obesity Surgery and SOARD journals of 2018-2020, the number of articles with female first/senior authors was identified and their characteristics were assessed. Almost 40% of the published papers were written by females, being mostly original and from University Hospitals, although the difference in the numbers between journals was prominent (p = 0.011). Articles with a female as first author had a female or male as senior, at a ratio 1:2, while less than 10% of female senior authors had a male as first. The number of females as corresponding authors in SOARD was significantly higher (p < 0.001). The findings of the present study underline the existing gender inequity in bariatric surgery.

Impact of Mentoring on Academic Career Success for Women in Medicine: A Systematic Review

PURPOSE

Research has shown that barriers to career success in academic medicine disproportionately affect women. These barriers include inadequate mentoring, which may perpetuate the underrepresentation of women in senior leadership positions. The purpose of this review was to summarize the qualitative and quantitative evidence of the impact of mentoring on women's career outcomes and to inform future interventions to support the promotion and retention of women in academic medicine.

METHOD

The authors conducted a systematic review of original research published in English-language, peer-reviewed journals through March 20, 2020. Search terms related to mentorship, women, and academic medicine. The authors searched MEDLINE, Embase, Scopus, Current Contents Connect via Web of Science, Cochrane Library, and PsycINFO. They excluded studies not specifically addressing women and those without gender-stratified outcomes. They extracted and analyzed the following data: study design, population, sample size, response rate, participant age, percentage of women, mentoring prevalence, and outcomes.

RESULTS

Of 2,439 citations identified, 91 studies met the inclusion criteria, including 65 quantitative and 26 qualitative studies. Mentoring was associated with objective and subjective measures of career success. Women perceived mentorship to be more valuable to their career development yet were more likely to report having no mentor. Additionally, women were more likely to report lower levels of research productivity, less career satisfaction, and greater barriers to promotion. Qualitative results indicated that women had less access to informal mentoring and family responsibilities had a greater effect on their career outcomes. Professional networking, female mentors, and relational aspects of mentoring were common themes.

CONCLUSIONS

This review examined gender disparities in mentoring and the impact on research productivity, promotion success, and career satisfaction for women in academic medicine. Institution-supported mentoring programs are needed to facilitate identification of appropriate mentors and promotion of a more equitable academic career environment for women.

Small female citation advantages for US journal articles in medicine

Female under-representation continues in senior roles within academic medicine, potentially influenced by a perception that female research has less citation impact. This article provides systematic evidence of (a) female participation rates from the perspective of published journal articles in 46 Scopus medical subject categories 1996–2018 and (b) gender differences in citation rates 1996–2014. The results show female proportion increases 1996–2018 in all fields and a female majority of first-authored articles in two-fifths of categories, but substantial differences between fields. A paper is 7.3 times more likely to have a female first author in Obstetrics and Gynaecology than in Orthopaedics and Sports Medicine. Only three fields had a female last author majority by 2018, a probable side effect of ongoing problems with appointing female leaders. Female first-authored research tended to be more cited than male first-authored research in most fields (59%), although with a maximum difference of only 5.1% (log-transformed normalised citations). In contrast, male last-authored research tends to be more cited than female last-authored research, perhaps due to cases where a senior male has attracted substantial funding for a project. These differences increase if team sizes are not accounted for in the calculations. Since female first-authored research is cited slightly more than male first-authored research, properly analysed bibliometric data considering career gaps should not disadvantage female candidates for senior roles.

Gender disparities in the National Institutes of Health funding for hematologic malignancies and cellular therapies

We investigated gender inequality in the National Institutes of Health (NIH) funding for hematologic malignancies and cellular therapies (HMCT). The data were retrieved from the NIH Research Portfolio Online Reporting Tools (RePORT). In 2018-2019, 1834 grants totaling $799 million were awarded (men 71% vs. women 29%) to 975 principal investigators (PIs), including 680 (70%) male PIs and 295 (30%) female PIs. There was no significant gender difference in the mean grant amount per PI. Male PIs as compared to female PIs had a higher h-index (44 vs 31, p < 0.001), a higher number of publications (159.5 vs 94, p < 0.001), and higher years of active research (26 vs 21, p < 0.001). In multivariate analyses, a higher h-index independently predicted a higher mean grant amount per PI (p = 0.010), and female PIs were independently less likely to have a higher h-index (p < 0.001). Our study shows significant gender disparity in the NIH funding for HMCT research.

Gender Disparity in Academic Gastroenterology: Beginning of the End of the Underrepresentation of Women?

BACKGROUND

Though there are an increasing number of female medical graduates, women remain underrepresented in academic medicine. There have been several reasons to explain this gender disparity, including marital status, number of children, number of hours worked, job flexibility, perceptions of women as inferior leaders, gender bias, sexual harassment, and unsupportive academic climates.

AIMS

This study aimed to investigate the relationship between scholarly productivity and the representation of female gastroenterologists in academia. Specifically, scholarly productivity measured by the h-index and academic rank were explored to determine if there were gender disparities in academic productivity and rank in gastroenterology.

METHODS

Gastroenterology departmental listings were obtained from the Fellowship and Residency Interactive Database of the American Medical Association. The Scopus database was used to record each physician's h-index. Statistical analyses were conducted with Wilcoxon rank-sum test, which compared matched samples by academic rank, and ANOVA tests, which compared multiple academic ranks.

RESULTS

Out of 1703 academic gastroenterologists, women account for 25% of academic physicians. Women have statistically lower h-indices at the level of Assistant Professor (p = 0.0012), and at the level of Chair (p = 0.01). There was no difference in h-indices between male and female at the rank of Associate Professor and Professor.

CONCLUSIONS

While these results mirror patterns appreciated in other fields of medicine, the results at the rank of Chair may suggest that despite the lower h-index compared to their male counterparts, females are perceived as having strong inherent leadership skills outside of academic productivity that are also conducive to leading a department and may be contributing to their rise to Chair.

An analysis of publication trends of orthopedic surgery residency graduates in relation to academic achievement

CONTEXT

Traditionally, the Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to implement research and other scholarly activities into their training curriculum. Encouraging residents to publish during residency is believed to promote research throughout their careers; however, no study has attempted to quantify research productivity among orthopedic surgery residents before, during, and after residency.

OBJECTIVES

To determine whether publishing in peer-reviewed journals during orthopedic residencies was an indicator of continued academic achievement after graduation.

METHODS

This study was observational in nature and employed a cross-sectional design. We examined whether research outcomes during orthopedic residency was associated with academic advancement or continued research involvement after residency. We identified 201 orthopedic residency programs on the Doximity website and randomly selected 50 to include in our sample. Of these programs, graduate rosters for 31 programs were located and subsequently included. Of the 341 graduates identified, we recorded the number of peer-reviewed publications, H-indices, fellowships, and whether the graduate pursued a career in private practice or academia.

RESULTS

Orthopedic residency graduates from 31 programs published a total of 1923 peer-reviewed manuscripts. On average, residents had a total of 5.6 publications and an h-index of 3.2. Residents entering academia and pursuing fellowships had a significantly higher total number of publications, higher number of first-author publications, and greater H-indices compared to those who did not enter academia or pursue a fellowship.

CONCLUSIONS

Increased research productivity was associated with continued academic pursuits and an increased likelihood of pursuing fellowship training after residency.

The Under-representation of Canadian Women in Gastroenterology from Residency to Leadership

Background

To determine representation of women in gastroenterology (GI) at residency and leadership levels in Canada.

Methods

The Canadian Resident Matching Service provided data for internal medicine (IM), general surgery (GS), GI and cardiology applicant cycles 2014 to 2018. Z-tests were used to compare proportion of women entering each residency program. An internet search was conducted to calculate percentages of women as GI association presidents, residency program directors, division heads and oral speakers at conferences.

Results

IM residency had on average of 1789 applicants with 487 matched (49.4% versus 49.5% women). GS residency had on average 357 applicants with 90 matched (41% versus 54.4% women). GI residency had on average 46 applicants with 34 matched (37% versus 35.3% women). Cardiology residency had on average 76 applicants with 54 matched (29% versus 27.8% women).

The Canadian Association of Gastroenterology (CAG) has had two out of 47 (4.2%) women presidents. The Ontario Association of Gastroenterology (OAG) has had no women presidents (0/9). The Association des gastro-entérologues du Québec (AGEQ) has had two out of 15 (13%) women presidents. The Alberta Society of Gastroenterology (ASG) has had one out of five (20%) women presidents. From 2018 to 2020, university division heads ranged from 0% to 13.3% women (0 to 2/15). University GI training program directors ranged from 28.6% to 35.7% (4 to 5/14). Women speakers at CAG’s annual conference varied 27% to 42% from 2016 to 2020, averaging 32.7%. Women speakers at OAG’s, AGEQ’s and ASG’s annual conferences averaged 23.3%, 24.1% and 35%, respectively.

Conclusion

Women gastroenterologists display low representation at multiple levels along the GI career pathway.

Provision of Onsite Childcare in US Academic Health Centers: What Factors Make a Difference?

INTRODUCTION

Challenges to work-life balance, including childcare, have been cited as major barriers to career advancement for women in academic medicine.

METHODS

We performed a cross-sectional study to investigate the availability of onsite childcare at academic health centers (AHCs) for US medical schools and examined institutional characteristics associated with its provision. Data from the Association of American Medical Colleges (AAMC) were used to identify US medical schools by region, type (private vs. public, community-based vs. not), financial relationship to the university, and numbers of female medical students, faculty, chairs, and deans. We assessed onsite childcare from publicly available information on institutional websites, plus phone calls to human resources departments at medical centers and/or medical schools.

RESULTS

Our study identified 144 US medical schools from the AAMC database and collected complete data for 136 (95%). Most AHCs offered onsite childcare (62%, 84/136). AHCs in the Midwest (78%) were most likely to have onsite childcare, whereas AHCs in the Southwest were least likely (14%, p < .001). No associations were demonstrated between onsite childcare and the proportion of female chairs or female faculty, or the AHC's financial relationship with the parent university.

CONCLUSIONS

Although accessible childcare is critical to the upward mobility of women in medicine, more than a third of AHCs do not offer onsite childcare. As more women in medicine navigate childcare demands, the expansion of accessible, quality onsite childcare at AHCs is needed to promote a diverse academic workforce.

Representation by Gender of Recognition Award Recipients from Gastroenterology and Hepatology Professional Societies

Background: Recognition awards from professional medical societies play an important role in physicians' career advancement. Our aim was to evaluate the gender representation of award recipients from gastroenterology and hepatology societies. Methods: We analyzed the lists of award recipients from the American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy and determined the gender of these award recipients. The primary outcome was the overall representation of women physician award recipients as compared with the representation of women in the specialty. Results: Between 1941 and 2019, there were 921 awards, of which 77 (8.4%) were given to women and 844 (91.6%) to men. There was a significant increase in the proportion of women recipients over time, from 0% in 1970-1984 to 22.0% in 2015-2019 (p for trend <0.0001). Compared with the concurrent representation of women in the specialty, women physician recipients were underrepresented from 1970 to 1981 and 1984 to 2015, equitably represented from 1981 to 1984, and overrepresented from 2015 to 2019. Of the total number of awards in each category, women received 13.8% of teaching/mentorship awards and 3.8% of the highest achievement awards (p = 0.002). The proportion of women recipients varied among the societies, from 6.8% to 14.5%. Conclusions: The representation of women physician recipients of gastroenterology and hepatology society recognition awards has generally been low until most recently, when it has surpassed the proportion of women in the specialty. Because award recognition is important to career development, professional societies should have transparent processes that aim to identify and reduce various forms of bias, including gender-related bias, in all phases of award recognition.

Gender inequalities on editorial boards of indexed pediatrics journals

BACKGROUND

The presence of women in decision-making positions, such as on editorial committees of biomedical journals, is not the same as that of men. This paper analyzes the gender composition of editorial committees (EBMs) and editors-in-chief (ECs) positions of pediatric journals.

METHODS

The gender of EBMs and ECs of 125 journals classified in the pediatrics area of the Journal Citation Report (JCR) was analyzed. The following indicators were calculated: gender distribution of ECs and EBMs by journal, publisher, subject speciality, country, quartile of the journal in JCR and country of affiliation of the members.

RESULTS

The total number of EBMs was 4242. The distribution by sex of the ECs was 19.44% women and 80.56% men, while that of the EBMs were 33.05% women and 66.95% men. Twenty journals exhibited a greater representation of women than of men, and in four there was parity. Journals with greater participation of women specialized in nursing and physical therapy and were related to nutrition (lactation and breastfeeding).

CONCLUSIONS

Only one-fifth of ECs and one-third of EBMs are females. Women's participation is higher in journals related to nursing, physical and occupational therapy, and nutrition. The United States has the highest number of EBMs, followed by the European Union.

IMPACT

Only one-fifth of Editors-in-chief in pediatrics journals are female. Only one-third of Editorial Board Members in pediatrics journals are female. Women's participation is higher in editorials committees in pediatrics journals related to nursing, physical and occupational therapy, and nutrition. Medical and pediatric associations and societies must work together to eliminate the disparities that exist between women and men. Achieving gender equity and empowering all women is one of the World Health Organization's Sustainable Development Goals.

Gender dynamics in education and practice of gastroenterology

BACKGROUND AND AIMS

With an increasing number of women joining procedural fields, including gastroenterology, optimizing the work environment for learning, teaching, and clinical practice is essential to the well-being of both physicians and their patients. We queried female and male gastroenterologists on their beliefs toward the endoscopy suite environment, as well as their experiences in learning and teaching endoscopic skills.

METHODS

We distributed a web-based survey to 403 gastroenterology fellows and practicing gastroenterologists at 12 academic institutions and 3 large private practices. We used univariate and multivariate analysis to compare the responses of female and male gastroenterologists.

RESULTS

The overall response rate was 32% (n = 130); 54 women and 61 men completed the survey in its entirety and were included in the analysis (15 respondents did not meet the inclusion criteria). Baseline demographics were comparable between the groups. Overall, fewer women than men were trained using tactile instruction (41% vs 67%; P = .004). Of those trained using tactile instruction, 60.3%, with no gender differences, felt it was also important for endoscopic learning. More women reported experiencing gender bias toward themselves during training (57.4% vs 13.1%; P = .001) as well as in their current careers (50.0% vs 9.8%; P = .001). When queried on treatment of gastroenterologists by endoscopy staff, 75.9% of women reported that men were treated more favorably, whereas 70.5% of men felt that both male and female gastroenterologists were treated equally.

CONCLUSIONS

Inequities exist with regard to the experience of men and women in gastroenterology, and specific challenges for women may have an impact on their career choices and ability to safely and effectively learn, teach, and practice endoscopy.

Does provider gender matter in endoscopy? An international perspective

There is a growing body of literature on the importance of provider gender on patient-related metrics, including satisfaction, compliance, follow-up, and health-related outcomes. Studies have shown that female patients are more likely to factor gender when choosing their physicians than male patients and are much more likely to choose female physicians when provided the option of selecting providers. Early studies in this field have consistently demonstrated a significant gender preference for female endoscopists by female patients. In this perspective, we review findings from United States and international literature on patient-provider gender concordance for endoscopic procedures. We present the current state, describe our experience in an international setting in the Middle East, and offer strategies to promote the advancement of women in gastroenterology, many of which have been successfully implemented to address the health preferences and needs of our female patients.

Comparing the gender diversity and affiliation trends of the authors for two orthopaedics journals from the Arab world

OBJECTIVES

Authorship trends, female authors' contributions, and the collaboration among institutions have been a concern in the medical field. This study primarily aims to report and compare the number of authors per article and the prevalence of female authors by comparing two orthopaedics journals from the Arab world. The secondary objective of this study is to evaluate the characteristics of the authors' affiliations and the pattern in institutions' collaborations and contributions to the published articles.

METHODS

This cross-sectional study reviewed all articles (until July 2020) published in the Archives of the Egyptian Orthopaedic Journal (EOJ) (the official journal of the Egyptian Orthopaedic Association) and the Journal of Musculoskeletal Surgery and Research (JMSR) (the official journal of the Saudi Orthopaedic Association).

RESULTS

We evaluated 383 and 122 articles from the EOJ and JMSR, respectively. The average number of authors per article was significantly higher for JMSR (4.3 ± 1.7) than EOJ (2.0 ± 1.0); p = 0.000. There was a significantly larger number of contributions by female authors in JMSR (75, 14.2%) than EOJ (2, 0.3%); p = 0.000. The average number of institutions per article was significantly larger for JMSR (2.1 ± 1.2) than EOJ (1.1 ± 0.3); p = 0.000. For the JMSR, the incidence of national institutions' cooperation (27.9%) and international institutions' contributions (53.3%) were significantly higher than their counterparts for the EOJ-6% and 4.7%, respectively; p = 0.000.

CONCLUSION

The JMSR showed superiority regarding the number of authors per article and the prevalence of female authors. The incidence of national institutions' cooperation and international contributions were higher in the JMSR compared with the EOJ.

Gender gap in mental health research productivity: Results from Qatar

OBJECTIVES

Qatar's contribution to biomedical research has increased significantly in the past couple of decades, but the exact participation of women researchers remains obscure. This study aims to explore the gender gap in research production of Qatar in the field of mental health.

METHODS

The authors searched five databases for published articles from Qatar in the field of mental health from 2015 to 2019. The authors examined the retrieved articles for the gender gap in 1) the number of researchers. 2) the numbers of articles produced by men-only research teams vs. the research teams included women. 3) h-index. 4) foreign collaboration. 5) research design and themes.

RESULTS

The authors identified 152 published articles in the field of mental health. Men researchers outnumbered women researchers (124 vs. 81). Men had statistically significant higher h-index compared to women (14.6 ± 1.4 vs 4.6 ± 0.9; p < 0.001). Research teams that included women had produced fewer articles compared to men-only groups (41.4 %), they also had less foreign collaborators (68 % vs. 91 %, p = 0.001). They were less involved in experimental research and more involved in observational research compared to male-only research groups (15.90 % vs. 38.6 % and 47.6 % vs. 25 % respectively; p = 0.034). In articles with women authors, women were the first authors in 50.8 % of the articles, and men were the senior authors in 79.4 % of them.

CONCLUSION

The study identifies gender gaps in some aspects of research productivity in Qatar. This data will provide a benchmark for future research in the field.

Racial and gender disparities in neurology

INTRODUCTION

The USA is a diverse society with representation from different ethnic and racial backgrounds, resulting in under-represented minorities (URMs) in various specialties of medicine. Our objective was to find the statistical ratio of URMs in the academic faculty of neurology.

METHODS

This was a retrospective analysis of the American Association of Medical College database. The database covered neurology faculty members from 2006 to 2017.

RESULTS

This study shows a significant change in racial representation in faculty ranks over the last 12 years. At chairperson rank, white people decreased from 86.4% to 79.8% whereas Asian, Hispanic and multiple races (non-Hispanic) simultaneously increased from 6.4% to 9.3%, 0.9% to 3.1% and 1.8% to 4.7%, respectively. At the professor rank, white people decreased from 87.4% to 81.6%, while Asians and Hispanics increased from 7.1% to 10.5% and from 0.7% to 2.1%, respectively. At the rank of associate professor, white people decreased from 81.1% to 68.3% whereas Asians, Hispanics and unknown races increased from 10.3% to 19.0%, 1.6% to 3.1% and from 2.1% to 3.5%, respectively. For the rank of assistant professor, white people decreased from 64.7% to 56.9% and Asians increased from 20.5% to 25.9%. Gender differences (men vs women) for the ranks of chairperson, professor, associate professor, assistant professor and instructors were 90.3% and 9.7%, 83.1% and 16.9%, 67.1% and 32.9%, 56.8% and 43.2%, and 48.1% and 51.9%, respectively.

CONCLUSION

Over a period of 12 years the racial proportion in academic neurology has changed, but it is not proportionate to their respective increase in the population of the USA. Moreover, the portion of female faculty increased, but they are still under-represented in leadership roles. This racial and gender disparity can be addressed by well-planned interventions.

Gender gap in medical research: a bibliometric study in Swiss university hospitals

Several studies explored gender inequalities in research, but only limited data are available concerning general internal medicine and family medicine. We aimed to assess the level of gender inequalities in Swiss academic medical research. In this bibliometric study conducted in March 2020, we selected all senior hospital physicians practicing internal medicine or family medicine in the six Swiss university hospitals. The list of these physicians was extracted from the hospitals’ websites. We recorded their socio-demographic characteristics. Then, using Web of Science, we retrieved the number of publications (overall, as first author, per year, per year as first author), the proportion of publications as first author, the number of citations (overall, per year, per publication) and the h-index, and we compared the data by gender. 367 senior physicians were included in the study [female physicians: 172 (47%), internal medicine: 187 (51%)]. Female physicians were four times less likely to be a professor (5% vs. 20%, p value < 0.001) and half as often heads of division or staff physicians (19% vs. 40%, p value < 0.001). The proportion of physicians having published at least one article was lower among women than men (79% vs. 90%, p value 0.003). Finally, all bibliometric indices were associated with male gender (incident rate ratios ranging from 1.9 [(95% CI 1.3–2.8), p value 0.001] for number of citations per publication to 9.3 [(95% CI 5.3–16.2), p value < 0.001] for number of citations), except the proportion of publications as first author that was associated with female gender [odds ratio 1.7 (95% CI 1.2–2.3), p value 0.003). Our data suggest a “leaky pipeline” phenomenon (a lower proportion of women moving up the academic ladder). In addition, with the exception of the proportion of publications as first author, all bibliometric indices were lower for female than male physicians.

Gender Disparity Among American Medicine and Surgery Physicians: A Systematic Review

BACKGROUND

Disparity exists between men and women physicians. We aimed to examine changes in gender disparity in the medical profession over the last two decades. The study reviewed publications on gender differences and the measures which have been implemented or suggested to rectify these disparities.

METHODS

Pubmed, Embase, Scopus, and The Cochrane Library were searched in December 2019 using ("gender disparity" OR "gender gap" OR "pay gap" OR "gender discrimination") from 1998-2019. The sources list of reviewed articles was also used to retrieve more relevant articles. Articles about physicians in the United States were included, and Critical Appraisal Skills Programme (CASP) was used to evaluate the quality of the articles.

RESULTS

In this systematic review that includes 49 studies, there is still disparity and discrimination in research, leadership, and pay between male and female physicians. Women have less leadership roles and progress at a slower rate to associate and full professor. Women publish less articles and have a lower h-index than men. Men earn $20,000 more a year after salary adjustment. More women than men experience negative comments about their gender (36% vs 4%), experience gender discrimination (65% vs 10%) and sexual harassment (30% vs 6%).

CONCLUSIONS

Although substantial research exists on this topic, there remains significant room for improvement to achieve gender equality. Institutions and individuals should implement interventions to rectify this disparity .

Analysis of academic publishing output among 1634 successful applicants in the 2011-2018 neurosurgery residency match

BACKGROUND

Research productivity is a key criterion for applicant selection reported by residency program directors. Research volume reported on neurosurgery residency applications has risen steadily over the past decade.

OBJECTIVE

Perform retrospective bibliographic searches of successful applicants who matched into U.S. neurosurgery residency programs from 2011 to 2018, and assess the relationship between academic publishing and residency placement.

METHODS

Gender, MD/PhD status, U.S. News research ranking of medical school, and international medical graduate status (IMG) were determined for 1634 successful applicants from 2011 to 2018. Indexed publications before and after the start of residency were tabulated by Scopus®. Publication counts were stratified by first author, basic/clinical science, case reports, reviews, or other research. We then compared publishing trends across demographic variables and match cohorts.

RESULTS

Average pre-residency publications increased from 2.6 [1.7, 3.4] in 2011 to 6.5 [5.1, 7.9] in 2018. Men, PhD-holders, Top 20 and Top 40 U.S. medical school graduates, and IMGs had higher pre-residency publication counts overall. After stratifying by match cohort, however, there was no significant effect of gender on pre-residency publications. Applicants matching into residency programs with highly ranked affiliated hospitals had significantly higher pre-residency publications.

CONCLUSION

Publishing volume of successful neurosurgery applicants in the U.S. has risen recently and is associated with the stature of matched residency programs. Given the gap between verifiable and claimed research on residency applications, attention is needed to objectively evaluate research credentials in the selection process. The impending phase out of USMLE step 1 scores may increase emphasis on academic productivity.

Gender Differences in Hepatology Medical Literature

BACKGROUND

Studies suggest that gender differences in academic medicine exist. Men frequently have better measures of performance such as number of publications, number of citations, remuneration, and funding.

AIMS

To evaluate whether a gender disparity in authorship exists.

METHODS

We recorded the gender of first and senior authors of original papers, editorials/reviews from liver-related manuscripts in Gastroenterology, Hepatology, Transplantation, American Journal of Gastroenterology, and Liver Transplantation from January 2014 to 2016.

RESULTS

Of 2424 articles reviewed, we excluded 232 (10%) due to inability to determine gender. Among papers analyzed, 72.0% were original and 28.1% reviews/editorials with 65.1% of first authors being male and 34.9% female. Only 20.3% of papers with multiple authors had a female senior author. The proportion of male first and senior authorship between original papers and reviews/editorials was comparable. 72% of original papers had a male as first or senior author, but only 28% females. 71% of review/editorial papers had a male as first or senior author, but only 29% females. When the senior author of an original paper was female, 47.1% of first authors were male and 52.9% female. When the senior author was male, 67.1% of first authors were male and 32.9% female (p < 0.00001).

CONCLUSIONS

A significant gender difference exists in Hepatology publications. Female authorship mirrors the percentage of female AASLD membership; however, female senior authorship remains disproportionate. In general, funding for male authors is greater. Fewer women are first authors when the senior author is male, highlighting the importance of female mentorship in Hepatology.

Does academic authorship reflect gender bias in pediatric surgery? An analysis of the Journal of Pediatric Surgery, 2007-2017

BACKGROUND

Gender representation in academic publications has been considered a surrogate for gender equity in medicine, although this concept has not been evaluated in pediatric surgery.

METHODS

First and last author genders for Journal of Pediatric Surgery articles from United States and/or Canadian institutions (2007, 2012, 2017) were identified. These data were compared to gender proportions for applicants to and matriculants in pediatric surgery fellowships as well as among American Pediatric Surgical Association (APSA) members.

RESULTS

Authorship gender was identified for 632/640 primary articles (98.8%). From 2007 to 2017, the proportion of women as first authors increased from 33.0% to 53.9% (p < 0.001) and as last authors from 16.2% to 26.4% (p = 0.01). The proportion of women fellowship applicants rose from 35.9% to 57.6% (p < 0.001); among those who successfully matched the rise was nonlinear (20.5%-34.0%, p = 0.16). APSA junior and senior women membership proportions rose during the study period [from 28.1% to 43.4% (p = 0.06 for linear trend) and 17.9% to 24.4% (p = 0.005 for linear trend), respectively].

CONCLUSIONS

Over the past decade, the overall proportion of women authors in a leading academic pediatric surgery journal has increased significantly, although representation among last authors remains disproportionately low. The numbers of women applicants to pediatric surgery fellowship increased but there was not a concordant rise in the number of women accepted into training positions.

TYPE OF STUDY

Bibliometric analysis.

LEVEL OF EVIDENCE

n/a.

Gender discrimination against female surgeons: A cross-sectional study in a lower-middle-income country

Introduction

Although gender discrimination and bias (GD/bias) experienced by female surgeons in the developed world has received much attention, GD/bias in lower-middle-income countries like Pakistan remains unexplored. Thus, our study explores how GD/bias is perceived and reported by surgeons in Pakistan.

Method

A single-center cross-sectional anonymous online survey was sent to all surgeons practicing/training at a tertiary care hospital in Pakistan. The survey explored the frequency, source and impact of GD/bias among surgeons.

Results

98/194 surgeons (52.4%) responded to the survey, of which 68.4% were males and 66.3% were trainees. Only 19.4% of women surgeons reported 'significant' frequency of GD/bias during residency. A higher percentage of women reported 'insignificant' frequency of GD/bias during residency, as compared to males (61.3% vs. 32.8%; p = 0.004). However, more women surgeons reported facing GD/bias in various aspects of their career/training, including differences in mentorship (80.6% vs. 26.9%; p < 0.005) and differences in operating room opportunities (77.4% vs. 32.8%; p < 0.005). The source was most frequently reported to be co-residents of the opposite gender. Additionally, a high percentage of female surgeons reported that their experience of GD/bias had had a significant negative impact on their career/training progression, respect/value in the surgical team, job satisfaction and selection of specialty.

Conclusion

Although GD/bias has widespread impacts on the training/career of female surgeons in Pakistan, most females fail to recognize this GD/bias as "significant". Our results highlight a worrying lack of recognition of GD/bias by female surgeons, representing a major barrier to gender equity in surgery in Pakistan and emphasizing the need for future research.

Publication Productivity and Academic Rank in Medicine: A Systematic Review and Meta-Analysis

PURPOSE

Academic medical faculty members are assessed on their research productivity for hiring, promotion, grant, and award decisions. The current work systematically reviews, synthesizes, and analyzes the available literature on publication productivity by academic rank across medical specialties.

METHOD

The authors searched PubMed for medical literature, including observational studies, published in English from 2005 to 2018, using the term "h-index," on July 1, 2018. Studies had to report on h-indices for faculty in academic medicine and, if available, other publication metrics, including number of citations, number of publications, and m-indices, stratified by academic rank. The DerSimonian and Laird method was used to perform meta-analyses for the primary (h-index) and secondary (m-index) outcome measures.

RESULTS

The systematic review included 21 studies. The meta-analysis included 19 studies and data on 14,567 academic physicians. Both h- and m-indices increased with academic rank. The weighted random effects summary effect sizes for mean h-indices were 5.22 (95% confidence interval [CI]: 4.21-6.23, n = 6,609) for assistant professors, 11.22 (95% CI: 9.65-12.78, n = 3,508) for associate professors, 20.77 (95% CI: 17.94-23.60, n = 3,626) for full professors, and 22.08 (95% CI: 17.73-26.44, n = 816) for department chairs. Mean m-indices were 0.53 (95% CI: 0.40-0.65, n = 1,653) for assistant professors, 0.72 (95% CI: 0.58-0.85, n = 883) for associate professors, 0.99 (95% CI: 0.75-1.22, n = 854) for full professors, and 1.16 (95% CI: 0.81-1.51, n = 195) for department chairs.

CONCLUSIONS

Both h- and m-indices increase with successive academic rank. There are unique distributions of these metrics among medical specialties. The h- and m-indices should be used in conjunction with other measures of academic success to evaluate faculty members for hiring, promotion, grant, and award decisions.

Sex Differences in Authorship of Major Gastroenterology Society Guidelines and Technical Reviews

OBJECTIVES

To analyze the proportion of gastroenterology society guidelines and technical reviews with female authors.

METHODS

Retrospective study of the sex of authors of American Association for the Study of Liver Disease (AASLD), American College of Gastroenterology (ACG) and American Gastroenterological Association (AGA) guidelines and technical reviews.

RESULTS

Between 2007 and 2019, 21% of authors of AASLD, ACG and AGA guidelines, and technical reviews were female. Eighteen percent of first authors were female. There was a statistically significant increase in female authorship over the past 10 years only for AASLD guidelines.

CONCLUSIONS

There were fewer female authors of AASLD, ACG and AGA guidelines, and technical reviews than males. This disparity decreased over time only in AASLD guidelines. Addressing disparities in guideline and technical review authorship may promote academic advancement for female gastroenterologists.

Gender and Invited Authorship in the Journal of Pediatric Urology

OBJECTIVE

To evaluate the evolving role of gender in invited authorship and editorial positions in the Journal of Pediatric Urology.

MATERIALS AND METHODS

We recorded editorial board members and first and senior authors for all editorials and invited commentaries for all issues of the Journal of Pediatric Urology from 2005 to August 2018. We also recorded first and senior authors for original research articles from selected years for comparison. Gender was confirmed for each individual by visiting institutional websites and performing internet searches. The same was done for the Societies for Pediatric Urology membership.

RESULTS

A total of 143 editorials and 162 invited commentaries were identified within the study period, with numbers increasing each year. Overall, these publications had 448 first and senior authorships, of which 10% were female. Of the 898 editorial board positions over the study period, 7% were held by females. The proportion of female authorships increased over time (P = .04), while the proportion of female board members did not (P = .9).

CONCLUSIONS

Female invited authorship has increased over the past 13 years in the Journal of Pediatric Urology. However, editorial board membership has lagged, indicating an opportunity for improvement.

Gender gap in research: a bibliometric study of published articles in primary health care and general internal medicine

BACKGROUND

Many studies examined gender inequalities in research, but only a few data are available for general biomedical journals. We assessed the prevalence of female first authorship in general biomedical journals and examined its variations across a number of author, article and journal characteristics.

METHODS

This study was nested within a larger project designed to analyze the bibliometric characteristics of scientific articles. We retrieved 767 randomly selected articles published in 2016 in high impact factor journals of primary healthcare (n = 9) and general internal medicine (n = 9). We extracted the following data: author (gender, number of publications and affiliation of the first author), paper (number of authors, number of participants and study design) and journal characteristics (journal discipline and 2015 impact factor). We compared the proportion of articles authored by women and men using univariate and multivariate logistic regressions adjusted for intra-cluster correlations.

RESULTS

The female authorship proportion was 48% (63% for primary healthcare and 33% for general internal medicine, P-value < 0.001). In multivariate analysis, women published fewer articles (<5 versus >15 publications: OR 1.6 [95% CI 1.1-2.4]), were more often affiliated with institutions in the Western world (OR 2.2 [95% CI 1.2-3.9]), were more likely to publish qualitative studies (versus systematic reviews or experiments: OR 2.7 [95% CI 1.5-4.8]) and to publish in primary healthcare journals (OR 1.7 [95% CI 1.1-2.7]).

CONCLUSIONS

The underrepresentation of women in articles published by general internal medicine journals, in articles from the non-Western world and in systematic reviews and trials should be addressed.

Workplace resources, mentorship, and burnout in early career physician-scientists: a cross sectional study in Japan

BACKGROUND

Physician-scientists are a vital segment of the healthcare workforce, but they may face significant challenges balancing and integrating clinical responsibilities, scientific research, and domestic responsibilities. This study investigates factors associated with burnout among highly successful early career physician-researchers in Japan.

METHOD

Among 1790 physician awardees of Grant-in-Aid for Young Scientists by the Japanese Ministry in 2014-2015, 490 participated in this cross-sectional survey in 2016 (usable response rate 23.8%). The primary outcome was psychological burnout, measured by the Copenhagen Burnout Inventory (i.e., personal burnout, work-related burnout, and patient-related burnout). "Workplace resources" in our study refers to the presence of career education in the workplace, promotion of gender equity, well-being consultation services on "career and work," "research," "harassment," and/or "mental health," as well as the presence of a role model in the workplace who has perceived good work-life balance.

RESULTS

Among 408 physician-researchers (75% male, mean age 37 yrs), personal burnout scores were slightly higher in women than in men (mean score, 41.9 points vs. 36.7 points, difference, 5.2, 95% confidence interval, 0.5-9.9, p = 0.029), but work-related and patient-related burnout scores did not differ significantly between genders. Over half of women (64%) and men (58%) had a mentor (p = 0.374). In multivariable general linear regression models, personal burnout scores were higher for women (β = 4.98, p = 0.045), and lower among those who had a mentor (β = - 5.82, p = 0.010) and whose workplaces had well-being consultation services (β = - 0.79, p = 0.022). Work-related burnout scores were lower among those with larger amounts of grant funding (β = - 4.70, p = 0.013), a mentor (β = - 6.12, p = 0.002), well-being consultation services (β = - 0.78, p = 0.008) and a role model with a perceived good work-life balance (β = - 4.00, p = 0.038). Patient-related burnout scores were higher among physician-scientists aged older than 37 years (β = 6.25, p = 0.002) and those who had board certification (β = 9.01, p = 0.017), while these scores were lower among those had larger amounts of funding (β = - 5.01, p = 0.006) or a mentor (β = - 5.35, p = 0.006).

CONCLUSIONS

Workplace resources and mentorship appear to be associated with lower levels of psychological burnout for both men and women early career physician-scientists.

Gender Can Influence Student Experiences in MD-PhD Training

Background: Female physician-scientists have led major advances in medicine broadly and particularly in women's health. Women remain underrepresented in dual MD-PhD degree programs that train many physician-scientists despite gender parity among medical and biomedical research students. Materials and Methods: To explore how the training environment might be experienced differently for male and female students in one MD-PhD program, the authors analyzed gender differences in annual symposium speakers with exact binomial tests, student participation as question-askers at a weekly seminar with logistic regression, and number of publications with quasi-Poisson generalized linear models. They compared male and female students' perceptions of gender-based discrimination using a survey, including qualitative analysis of free text responses. The program consisted of 71 total students in the 2017-2018 and 2018-2019 academic years. Female students comprised 42.0% (81/191) of program matriculants from 1997 to 2019. Results: Male and female students were equally likely to present at the annual program symposium, but faculty (p = 0.001) and keynote (p = 0.012) presenters were more likely to be male. Compared with male counterparts, female students asked fewer seminar questions (p < 0.005) and female speakers received more questions (p = 0.03). Female students perceived less support and differed from men in reasons for asking or not asking seminar questions. Free text responses described repeated small acts of discrimination toward women with cumulative impact. Positive program changes followed presentation of findings to program leaders and students. Conclusions: The authors identified several aspects of one MD-PhD program that could discourage career or training persistence of female students. Increasing awareness of these issues was temporally related to positive programmatic changes.

An Analysis of Publication Productivity During Residency for 1506 Neurosurgical Residents and 117 Residency Departments in North America

BACKGROUND

Bibliometrics is defined as the study of statistical and mathematical methods used to quantitatively analyze scientific literature. The application of bibliometrics in neurosurgery continues to evolve.

OBJECTIVE

To calculate a number of publication productivity measures for almost all neurosurgical residents and departments within North America. These measures were correlated with survey results on the educational environment within residency programs.

METHODS

During May to June 2017, data were collected from departmental websites and Scopus to compose a bibliometric database of neurosurgical residents and residency programs. Data related to authorship value and study content were collected on all articles published by residents. A survey of residency program research and educational environment was administered to program directors and coordinators; results were compared with resident academic productivity.

RESULTS

The median number of publications in residency was 3; median h-index and Resident index were 1 and 0.17 during residency, respectively. There was a statistically significant difference in academic productivity among male neurosurgical residents compared with females. The majority of articles published were tier 1 clinical articles. Residency program research support was significantly associated with increased resident productivity (P < .001). Scholarly activity requirements were not associated with increased resident academic productivity.

CONCLUSION

This study represents the most comprehensive bibliometric assessment of neurosurgical resident academic productivity during training to date. New benchmarks for individual and department academic productivity are provided. A supportive research environment for neurosurgical residents is associated with increased academic productivity, but a scholarly activity requirement was, surprisingly, not shown to have a positive effect.

Setting the Standards: Examining Research Productivity Among Academic Urologists in the USA and Canada in 2019

BACKGROUND

Research productivity among academic urologists is strongly encouraged, but little data are available on productivity metrics within the field.

OBJECTIVE

To provide the first comprehensive survey of research productivity among academic urologists in the USA and Canada.

DESIGN, SETTING, AND PARTICIPANTS

Using the Accreditation Council for Graduate Medical Education, the Canadian Resident Matching Service, and individual program websites, all active accredited urology faculties were identified. For each individual, we collected data on American Urological Association section, title, gender, fellowship training, Scopus H-index, and citations. Comprehensive searches were completed during March-May 2019.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Descriptive statistics for demographic comparisons were performed using analysis of variance for continuous variables and chi-square test for categorical variables. Multivariable logistic regressions were used to identify the predictors of H-index greater than the median.

RESULTS AND LIMITATIONS

A total of 2214 academic urology faculties (2015 in USA and 199 in Canada) were identified. The median and mean H-indices for the entire cohort of physicians were 11 and 16.1, respectively. On multivariable analysis, physicians in the North Central and Western Sections (vs mid-Atlantic), who were fellowship trained (vs no fellowship training), and of higher academic rank (professor and associate professor vs clinical instructor) were more likely to have H-index values greater than the median. Additionally, female physicians (vs male) were more likely to have H-index values less than the median.

CONCLUSIONS

This study represents the first comprehensive assessment of research productivity metrics among academic urologists. These represent key benchmarks for trainees considering careers in academics and for practicing physicians gauging their own productivity in relation to their peers.

PATIENT SUMMARY

In this study, we provide the first comprehensive assessment of research productivity among academic urologists in the USA and Canada. Our results help provide key benchmarks for trainees considering careers in academics and for practicing physicians gauging their own productivity in relation to peers.

Issues Faced by Senior Women Physicians: A National Survey

Background: As the first large numbers of female physicians complete their careers, information is needed to enable institutions and individuals to optimize the final career phase and transition to retirement of these women, as well as to help younger women physicians prepare for later phases of their careers. Materials and Methods: To identify the leading issues for older female physicians, a 34-item electronic questionnaire covering heath, finances, preparation for and attitudes about retirement, caretaking responsibilities, life-work integration, various aspects of discrimination and harassment, professional isolation, and work-related stress and burnout-incorporating standardized measures of career satisfaction was distributed through the Kansas Medical Society and nationally through the American Medical Association Senior Physicians Section newsletter to female physicians older than 60 years in 2018. A total of 155 physicians self-identified as eligible and completed at least half of the survey. Results: Respondents were 60-87 years of age, mean 70.4 (±6.4) years. The majority reported good health and being financially well prepared for retirement. Twenty percent were caretakers for grandchildren, parents, or spouses. Measures of career and job satisfaction were reasonably high, despite negative work environment and burnout scores. Problems with family/career balance, age- and gender-based discrimination and harassment, salary inequity, and professional isolation persisted throughout their careers, but diminished in frequency for senior women. Conclusions: Issues faced by younger women physicians do not disappear with age or seniority. To recruit and support female physicians, issues such as balancing family/work responsibilities, combating harassment and bias, and promoting healthy work environments must be addressed throughout their entire careers.

A gender comparison of motivations for seeking leadership positions among gastroenterologists

BACKGROUND AND AIMS

A gender gap exists in leadership positions in gastroenterology. However, individual motivations for seeking leadership positions within the gastroenterology community among men and women have not been explored. The primary aim of this study was to determine whether motivations for pursuing and attaining leadership positions in gastroenterology differ by gender.

METHODS

A 20-question survey was created by the authors and shared with gastroenterologists electronically via a social media group (Facebook) and emails gathered through publicly available society websites and professional and social contacts. Data gathered from the survey included demographics, practice characteristics, presence of spouse or domestic partner, past and present leadership positions, motivations for pursuit of leadership positions, and reasons for lack of desire for a leadership position.

RESULTS

The survey was sent to 981 gastroenterologists (679 women, 302 men). The overall response rate was 21.4% (n = 210) (20.9% for women, 22.5% for men). Overall, 41% of respondents (84 of 206) currently hold a leadership position, including more males than females (52% vs 36%, respectively; P = .03). However, among those who completed their training in the past 5 years, more women than men hold a current leadership role (25% vs 6%; P = .11). Other factors associated with currently holding a leadership position included age and years since completion of training, practice type, full-time status, and having a spouse who is not a physician. The positive factors of leadership cited most frequently were (1) ability to effect change, (2) furthering the goals of the organization, and (3) opportunity for career advancement. The negative factors cited most frequently were increased workload and decreased time for personal life. These reported positive and negative factors were similar for male and female respondents. Forty-nine respondents did not desire a leadership position now or in the future. The most common reason cited was lack of interest in the responsibilities, long hours, or stress that accompanies a leadership position (22 of 42, 52%). The second most common reason was that respondents were too busy at home or work to take on the extra responsibilities.

CONCLUSIONS

A gender gap in gastroenterology leadership exists but is closing. There is fairly equal representation of men and women in leadership positions among those who completed training in the last 5 years. Many gastroenterologists are motivated for a leadership position and at the same time, many qualified individuals do not desire a leadership position because of factors that affect work-life balance. Ongoing efforts to engage motivated individuals into leadership positions and to revise the nature of leadership positions may allow for a larger talent pool from which to recruit.