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Wei W, Cai Z, Ding J, Fares S, Patel A, Khosa F. Organizational Leadership Gender Differences in Medical Schools and Affiliated Universities. J Womens Health (Larchmt) 2024; 33:662-670. [PMID: 38061046 DOI: 10.1089/jwh.2023.0326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Objective: To compare gender compositions in the leadership of the top 25 medical schools in North America with the leadership of their affiliated university senior leadership and other faculties. Materials and Methods: This retrospective cross-sectional observational study used publicly available gender data from 2018 to 2019 of universities drawn from the U.S. News Best Global Universities for Clinical Medicine Ranking report. Gender compositions in eight leadership tiers from senior leadership to medical school department directors were analyzed. Data analysis included gender compositions by leadership tier and faculty. Results: Male representation is greater at higher leadership tiers, with the largest imbalance being at the level of medical school department heads. The faculty of medicine has more men in leadership positions than the average of the other faculties (p = 0.02), though similar to schools of engineering, business, dentistry, and pharmacy. Across the eight leadership tiers, a significant trend exists between tier and proportions, indicating that male representation was greater at higher tiers (p < 0.001). No correlation was found between a university's leadership gender composition and its ranking. Conclusion: The under-representation of women is greater in medical school leadership than the leadership of their affiliated universities. The faculty of medicine has greater male over-representation than the average of the other faculties.
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Affiliation(s)
- William Wei
- Department of Medicine, The University of British Columbia, Vancouver, Canada
| | - Zhenglun Cai
- Department of Statistics, The University of British Columbia, Vancouver, Canada
| | - Jeffrey Ding
- Department of Medicine, The University of British Columbia, Vancouver, Canada
| | - Saleh Fares
- Centre for Emergency Preparedness and Response at the Department of Emergency Medicine, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Amy Patel
- Department of Radiology, The University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Faisal Khosa
- Department of Radiology, Vancouver General Hospital, The University of British Columbia, Vancouver, Canada
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Burg ML, Kohli P, Ha N, Mora R, Kurup T, Sidhu H, Rodman J, Cacciamani GE, Samplaski MK. Gender disparities among publications within international sexual medicine urology journals and the impact of blinding in the review process. J Sex Med 2024; 21:117-121. [PMID: 38128068 DOI: 10.1093/jsxmed/qdad152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 10/14/2023] [Accepted: 10/23/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND While female urologists are known to publish at less frequency than their male peers, The Journal of Sexual Medicine was reported to have among the highest growth in female authorship from 2002 to 2020 in urology journals. AIM We sought to assess the frequency of female authorship in sexual medicine journals worldwide and the factors that affect this, including the blinded/unblinded review process. METHODS Eleven sexual medicine journals were assessed for geographic location, peer review method, and SCImago Journal Rank citation index (a metric of citation frequency and prestige). Journals were grouped into top, middle, and bottom quartiles based on metric score. Web of Science was used to access the publications' first, second, last, and corresponding authors from the past 5 years. An internet search or Gender-API.com was used to determine the gender identities of authors. Univariate and multivariable logistic regression models were performed. OUTCOMES Outcomes included the likelihood of female authorship (first, second, last, and corresponding) based on journal location and ranking, the clustering of female authors, the journal's peer review process, and the frequency of female editorial board members. RESULTS Overall, 8938 publications were identified. Women represented 30.7%, 31.3%, 21.3%, and 18.7% of the first, second, last, and corresponding authors, respectively; gender was unable to be assessed for 2.6%, 17.2%, 7.3%, and 2.7%. On univariate analysis, journals from North America, in the top quartile, and with a double-blind review process were more likely to have female authors (P < .001). On multivariate analysis, articles were more likely to have a female first author if they had a double-blind peer review process (odds ratio [OR], 1.20; 95% CI, 1.02-1.40), a female second author (OR, 2.54; 95% CI, 2.26-2.85), or a female corresponding author (OR, 7.80; 95% CI, 6.69-9.10). CLINICAL IMPLICATIONS Gender-concordant mentoring and universal double-blind manuscript review processes may minimize the impact of gender bias and increase female authorship rates, in turn producing more diverse research. STRENGTHS AND LIMITATIONS This is the first study assessing female authorship in sexual medicine journals. Limitations include not assessing every author listed on articles and being unable to determine gender identities for some authors. CONCLUSION Female authorship rates are higher than reported rates of practicing female urologists but still lower than their male peers. Female authors were more likely to be published in journals with double-blind peer review processes and when publishing with additional female authors.
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Affiliation(s)
- Madeleine L Burg
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
| | - Priya Kohli
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
| | - Nhi Ha
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
| | - Richard Mora
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
| | - Trisha Kurup
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
| | - Hannah Sidhu
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
| | - Jack Rodman
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA 90033, United States
| | - Giovanni E Cacciamani
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
- European Association of Urology-Young Academic Urologists, Arnhem, NL-6803, the Netherlands
| | - Mary K Samplaski
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
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Fakunle DR, Ammann AM, Sisak S, Delman AM, Vaysburg DM, Lemon K, Silski L, Holm T, Shah SA, Quillin RC. Sex Disparities in Academic Productivity and Rank Among Abdominal Transplant Faculty in the United States. Transplant Proc 2024; 56:260-264. [PMID: 38267336 DOI: 10.1016/j.transproceed.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/30/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND The aim of this study was to examine sex differences in academic rank and productivity among members of the American Society of Transplant Surgeons in the United States. METHODS Cross-sectional, focusing on current board-certified abdominal transplant surgeons in the United States. Demographic factors such as sex, region, and faculty rank were collected from institutional websites. Academic metrics, including H-index, total publications, and relative citation ratio, were collected from Scopus and iCite. RESULTS We identified 536 surgeon members of the American Society of Transplant Surgeons with an academic institution. The majority were men (83%). Men were in practice longer than women (17.9 ± 11 vs 11.7 ± 9 years, P < .0001) and had higher academic metrics, including H-index (25.6 ± 20 vs16.4 ± 14, P < .0001) and total publications (110 ± 145 vs 58.8 ± 69, P < .0001). There was a significant difference in faculty appointments by sex (P < .05), with men showing evidence of increased academic advancement. After adjusting for academic rank, PhD status, and location of medical school and residency, women remained associated with a lower H-index on multivariate analysis (P < .01). CONCLUSION Sex disparities in academic rank and achievement are present among transplant surgical faculty in the United States, and future efforts are needed to promote sex equity in transplant surgery academia.
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Affiliation(s)
- Damilola R Fakunle
- Cincinnati Research and Education in Surgical Training, Department of Surgery, University of Cincinnati, Cincinnati, Ohio; University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Allison M Ammann
- Cincinnati Research and Education in Surgical Training, Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Stephanie Sisak
- Cincinnati Research and Education in Surgical Training, Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Aaron M Delman
- Cincinnati Research and Education in Surgical Training, Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Dennis M Vaysburg
- Cincinnati Research and Education in Surgical Training, Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Kristina Lemon
- Division of Transplantation, Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Latifa Silski
- Division of Transplantation, Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Tammy Holm
- Cincinnati Research and Education in Surgical Training, Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Shimul A Shah
- Division of Transplantation, Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Ralph C Quillin
- Cincinnati Research and Education in Surgical Training, Department of Surgery, University of Cincinnati, Cincinnati, Ohio; Division of Transplantation, Department of Surgery, University of Cincinnati, Cincinnati, Ohio.
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Eruchalu CN, Etheridge JC, Hammaker AC, Kader S, Abelson JS, Harvey J, Farr D, Stopenski SJ, Nahmias JT, Elsaadi A, Campbell SJ, Foote DC, Ivascu FA, Montgomery KB, Zmijewski P, Byrd SE, Kimbrough MK, Smith S, Postlewait LM, Dodwad SJM, Adams SD, Markesbery KC, Meister KM, Woeste MR, Martin RCG, Callahan ZM, Marks JA, Patel P, Anstadt MJ, Nasim BW, Willis RE, Patel JA, Newcomb MR, Stahl CC, Yafi MA, Sutton JM, George BC, Quillin RC, Cho NL, Cortez AR. Racial and Ethnic Disparities in Operative Experience Among General Surgery Residents: A Multi-Institutional Study from the US ROPE Consortium. Ann Surg 2024; 279:172-179. [PMID: 36928294 PMCID: PMC11104265 DOI: 10.1097/sla.0000000000005848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To determine the relationship between race/ethnicity and case volume among graduating surgical residents. BACKGROUND Racial/ethnic minority individuals face barriers to entry and advancement in surgery; however, no large-scale investigations of the operative experience of racial/ethnic minority residents have been performed. METHODS A multi-institutional retrospective analysis of the Accreditation Council for Graduate Medical Education case logs of categorical general surgery residents at 20 programs in the US Resident OPerative Experience Consortium database was performed. All residents graduating between 2010 and 2020 were included. The total, surgeon chief, surgeon junior, and teaching assistant case volumes were compared between racial/ethnic groups. RESULTS The cohort included 1343 residents. There were 211 (15.7%) Asian, 65 (4.8%) Black, 73 (5.4%) Hispanic, 71 (5.3%) "Other" (Native American or Multiple Race), and 923 (68.7%) White residents. On adjusted analysis, Black residents performed 76 fewer total cases (95% CI, -109 to -43, P <0.001) and 69 fewer surgeon junior cases (-98 to -40, P <0.001) than White residents. Comparing adjusted total case volume by graduation year, both Black residents and White residents performed more cases over time; however, there was no difference in the rates of annual increase (10 versus 12 cases per year increase, respectively, P =0.769). Thus, differences in total case volume persisted over the study period. CONCLUSIONS In this multi-institutional study, Black residents graduated with lower case volume than non-minority residents throughout the previous decade. Reduced operative learning opportunities may negatively impact professional advancement. Systemic interventions are needed to promote equitable operative experience and positive culture change.
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Affiliation(s)
- Chukwuma N Eruchalu
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - James C Etheridge
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Ariadne Labs, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, Boston, MA
| | - Austin C Hammaker
- Department of Surgery, Cincinnati Research on Education in Surgical Training (CREST), University of Cincinnati, Cincinnati, OH
| | - Sarah Kader
- Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA
| | - Jonathan S Abelson
- Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA
| | - Jalen Harvey
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Deborah Farr
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Jeffry T Nahmias
- Department of Surgery, University of California Irvine, Orange, CA
| | - Ali Elsaadi
- Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX
| | - Samuel J Campbell
- Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX
| | - Darci C Foote
- Department of Surgery, Beaumont Health, Royal Oak, MI
| | | | | | - Polina Zmijewski
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Samuel E Byrd
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Mary K Kimbrough
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR
| | | | | | | | - Sasha D Adams
- Department of Surgery, McGovern Medical School at UTHealth, Houston, TX
| | | | | | | | | | | | - Joshua A Marks
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Purvi Patel
- Department of Surgery, Loyola University, Maywood, IL
| | | | - Bilal Waqar Nasim
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Ross E Willis
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Jitesh A Patel
- Department of Surgery, University of Kentucky, Lexington, KY
| | | | | | - Motaz Al Yafi
- Department of Surgery, University of Toledo, Toledo, OH
| | - Jeffrey M Sutton
- Department of Surgery, Medical University of South Carolina, Division of Oncologic and Endocrine Surgery, Charleston, SC
| | - Brian C George
- Department of Surgery, Center for Surgical Training and Research (CSTAR), University of Michigan, Ann Arbor, MI
| | - Ralph C Quillin
- Department of Surgery, Cincinnati Research on Education in Surgical Training (CREST), University of Cincinnati, Cincinnati, OH
| | - Nancy L Cho
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Alexander R Cortez
- Department of Surgery, Cincinnati Research on Education in Surgical Training (CREST), University of Cincinnati, Cincinnati, OH
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Hunt KM, Foley M, Connors LA, Hildebrand KJ, Ellis AK. Trends in the proportion of women speakers at North American Allergy and Immunology conferences, 2008 to 2020. Ann Allergy Asthma Immunol 2023; 131:728-736. [PMID: 37689114 DOI: 10.1016/j.anai.2023.08.607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/14/2023] [Accepted: 08/28/2023] [Indexed: 09/11/2023]
Abstract
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.
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Affiliation(s)
- Kristin M Hunt
- Department of Pediatrics, Queen's University, Kingston, Ontario, Canada; Division of Allergy and Immunology The Hospital for Sick Children, Toronto, Ontario, Canada.
| | - Mary Foley
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Lori A Connors
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kyla J Hildebrand
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Anne K Ellis
- Division of Allergy and Immunology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
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Bryan DS, Debarros M, Wang SX, Xie Y, Mazzola E, Bueno R, Marshall MB. Gender trends in cardiothoracic surgery authorship. J Thorac Cardiovasc Surg 2023; 166:1375-1384. [PMID: 36878749 DOI: 10.1016/j.jtcvs.2022.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/18/2022] [Accepted: 12/13/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE In recent years, the historically low proportion of women cardiothoracic surgeons and trainees has been a subject of intense focus. Publications remain a key metric of academic success and career advancement. We sought to identify trends in the gender of first and last author publications in cardiothoracic surgery. METHODS We searched for publications between 2011 and 2020 in 2 US cardiothoracic surgery journals, identifying those with Medical Subject Heading publication types of clinical trials, observational studies, meta-analyses, commentary, reviews, and case reports. A commercially available, validated software (Gender-API) was used to associate gender with author names. Association of American Medical Colleges Physician Specialty Data Reports were used to identify concurrent changes in the proportion of active women in cardiothoracic surgery. RESULTS We identified 6934 (57.1%) pieces of commentary; 3694 (30.4%) case reports; 1030 (8.5%) reviews, systematic analyses, meta-analyses, or observational studies; and 484 (4%) clinical trials. In total, 15,189 total names were included in analysis. Over the 10-year study period, first authorship by women rose from 8.5% to 16% (0.42% per year, on average), whereas the percentage of active US women cardiothoracic physicians rose from 4.6% to 8% (0.42% per year). Last authorship was generally flat over the decade, going from 8.9% in 2011% to 7.8% in 2020 and on average, increased at just 0.06% per year (P = .79). CONCLUSIONS Over the past decade, authorship by women has steadily increased, more so at the first author position. Author-volunteered gender identification at the time of manuscript acceptance may be useful to more accurately follow trends in publication.
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Affiliation(s)
- Darren S Bryan
- Section of Thoracic Surgery, University of Chicago, Chicago, Ill.
| | - Mia Debarros
- Department of Thoracic Surgery, Madigan Army Medical Center, Tacoma, Wash
| | - Sue X Wang
- Division of Thoracic and Cardiac Surgery, Brigham and Women's Hospital, Boston, Mass
| | - Yue Xie
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Mass
| | - Emanuele Mazzola
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Mass
| | - Raphael Bueno
- Division of Thoracic and Cardiac Surgery, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - M Blair Marshall
- Division of Thoracic and Cardiac Surgery, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
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Abstract
BACKGROUND Diversity in leadership drives innovation; however, women are underrepresented in leadership positions across academic medicine. The aim of this study was to assess the current gender representation in hand surgery leadership positions. METHODS This was a cross-sectional analysis of leaders in hand surgery. Leaders were defined as President, Board and Committee members of the American Society for Surgery of the Hand and the American Association for Hand Surgery, as well as hand surgery fellowship program directors and physician lead editors of peer-reviewed hand journals. The representation of women in leadership was compared to the percentage of female hand fellows over the same period. Years in practice, academic rank, additional degrees, h-index, m-index, National Institutes of Health (NIH) funding, publications, and citations were compared between male and female leaders. RESULTS Twenty-nine of 213 leadership positions (13.6%) are held by women which is fewer than would be expected based on hand surgery fellowship composition. Female leaders were earlier in practice than their male counterparts (13.5 ± 5.7 versus 20.8 ± 11.1 years, P < .01). Women were more likely to hold position of assistant professor and less likely to be full professors (P < .05). There was no gender difference in NIH funding, h-index, m-index, publications, or citations. The greatest gender disparity was at the level of National Society President, which is a title held by only 2 women and 119 men. CONCLUSIONS Gender disparities in hand surgery exist and are accentuated at the leadership level. Further work is needed to decrease leadership promotion disparities between men and women.
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Santamaria-Barria JA, Nelson H, Jiang H, Dougherty CE, Jadhav S, Watanabe-Galloway S, Mammen JMV, Mercer DW. Open Payments Data Analysis of General and Fellowship-trained Surgeons Receiving Industry General Payments From 2016 to 2020: Payment Disparities and COVID-19 Pandemic Impact. Ann Surg 2023; 278:396-407. [PMID: 37314222 DOI: 10.1097/sla.0000000000005951] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To characterize industry nonresearch payments made to general and fellowship-trained surgeons between 2016 and 2020. BACKGROUND The Centers for Medicare & Medicaid Services Open Payments Data (OPD) reports industry payments made to physicians related to drugs and medical devices. General payments are those not associated with research. METHODS OPD data were queried for general and fellowship-trained surgeons who received general payments from 2016 to 2020. Payments' nature, amount, company, covered product, and location were collected. Surgeons' demographics, subspecialty, and leadership roles in hospitals, societies, and editorial boards were evaluated. RESULTS From 2016 to 2020, 44,700 general and fellowship-trained surgeons were paid $535,425,543 in 1,440,850 general payments. The median payment was $29.18. The most frequent payments were for food and beverage (76.6%) and travel and lodging (15.6%); however, the highest dollar payments were for consulting fees ($93,128,401; 17.4%), education ($88,404,531; 16.5%), royalty or license ($87,471,238; 16.3%), and travel and lodging ($66,333,149; 12.4%). Five companies made half of all payments ($265,654,522; 49.6%): Intuitive Surgical ($128,517,411; 24%), Boston Scientific ($48,094,570; 9%), Edwards Lifesciences ($41,835,544, 7.8%), Medtronic Vascular ($33,607,136; 6.3%), and W. L. Gore & Associates ($16,626,371; 3.1%). Medical devices comprised 74.7% of payments ($399,897,217), followed by drugs and biologicals ($33,945,300; 6.3%). Texas, California, Florida, New York, and Pennsylvania received the most payments; however, the top dollar payments were in California ($65,702,579; 12.3%), Michigan ($52,990,904, 9.9%), Texas ($39,362,131; 7.4%), Maryland ($37,611,959; 7%), and Florida ($33,417,093, 6.2%). General surgery received the highest total payments ($245,031,174; 45.8%), followed by thoracic surgery ($167,806,514; 31.3%) and vascular surgery ($60,781,266; 11.4%). A total of 10,361 surgeons were paid >$5000, of which 1614 were women (15.6%); in this group, men received higher payments than women (means, $53,446 vs $22,571; P <0.001) and thoracic surgeons received highest payments (mean, $76,381; NS, P =0.14). A total of 120 surgeons were paid >$500,000 ($203,011,672; 38%)-5 non-Hispanic White (NHW) women (4.2%) and 82 NHW (68.3%), 24 Asian (20%), 7 Hispanic (5.8%), and 2 Black (1.7%) men; in this group, men received higher payments than women (means, $1,735,570 vs $684,224), and NHW men received payments double those of other men (means, $2,049,554 vs $955,368; NS, P =0.087). Among these 120 highly paid surgeons (>$500,000), 55 held hospital and departmental leadership roles, 30 were leaders in surgical societies, 27 authored clinical guidelines, and 16 served on journal editorial boards. During COVID-19, 2020 experienced half the number of payments than the preceding 3 years. CONCLUSIONS General and fellowship-trained surgeons received substantial industry nonresearch payments. The highest-paid recipients were men. Further work is warranted in assessing how race, gender, and leadership roles influence the nature of industry payments and surgical practice. A significant decline in payments was observed early during the COVID-19 pandemic.
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Affiliation(s)
- Juan A Santamaria-Barria
- Department of Surgery, Division of Surgical Oncology, University of Nebraska Medical Center, Omaha, NE
| | - Hannah Nelson
- College of Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Heng Jiang
- College of Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Collin E Dougherty
- Department of Surgery, Division of Surgical Oncology, University of Nebraska Medical Center, Omaha, NE
| | - Snehal Jadhav
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Shinobu Watanabe-Galloway
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Joshua M V Mammen
- Department of Surgery, Division of Surgical Oncology, University of Nebraska Medical Center, Omaha, NE
| | - David W Mercer
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE
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Mavedatnia D, Payandeh J, Neocleous P, Davidson J, Dzioba A, Strychowsky JE, Graham ME. Gender differences in publication rates at Canadian Society of Otolaryngology-Head and Neck Surgery annual meetings: an 11-year analysis. J Otolaryngol Head Neck Surg 2023; 52:10. [PMID: 36759903 PMCID: PMC9909880 DOI: 10.1186/s40463-022-00612-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 12/06/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Evaluating gender differences in publication rates after conference presentations is an avenue to assess women's contributions to academic medicine. The objective of this study was to assess gender differences in publication rates, time to publication, and subspeciality of publication of abstracts presented at Canadian otolaryngology conferences over an 11-year period. METHODS Cross-sectional data was obtained from online conference schedules of annual Canadian Society of Otolaryngology-Head and Neck Surgery national meetings between 2009 and 2020. A total of 2111 abstract titles were searched in MedLine via PubMed. Gender of the first and senior author, publication status of presented work, and subspeciality of publication were extracted. RESULTS Of 2111 scientific abstracts presented between 2009 and 2020, female first and senior authors accounted for 29.0% and 12.8% of published abstracts, respectively. There was a significant difference in the publication rate of senior authors by gender (p < 0.01). Male senior authors had a 9.70% higher rate of publication compared to female senior authors. Posters with a female first author were 33.0% (OR: 0.67; 95% CI 0.49-0.91) less likely to be published compared to posters with a male first author. Similarly, posters with a female senior author were 34.0% (OR: 0.66; 95% CI 0.45-0.96) less likely to be published. There was a significant difference in discipline of publication by gender of the senior author (p < 0.001). Male senior authors were more likely to supervise projects in otology while female senior authors were more likely to supervise projects in education and pediatrics. The time to publication and impact factor of the journal of publication did not differ by gender. CONCLUSION Gender disparities exist in the publication rates of first and senior authors at Canadian otolaryngology meetings. Female senior authors have significantly lower publication rates compared to their male colleagues and differences exist in publication rates after poster presentations. Investigation of gender gaps in academic medicine, research productivity, and publications is essential for development of a diverse, equitable, and inclusive workforce in otolaryngology.
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Affiliation(s)
- Dorsa Mavedatnia
- grid.28046.380000 0001 2182 2255Faculty of Medicine, University of Ottawa, Ottawa, ON Canada
| | - Jennifer Payandeh
- grid.410356.50000 0004 1936 8331Faculty of Medicine, Queen’s University, Kingston, ON Canada
| | - Penelope Neocleous
- grid.39381.300000 0004 1936 8884Schulich School of Medicine and Dentistry, London, ON Canada
| | - Jacob Davidson
- grid.39381.300000 0004 1936 8884Schulich School of Medicine and Dentistry, London, ON Canada ,grid.39381.300000 0004 1936 8884Division of Pediatric Surgery, Children’s Hospital at London Health Sciences Center, Schulich School of Medicine, London, ON Canada
| | - Agnieszka Dzioba
- grid.39381.300000 0004 1936 8884Department of Otolaryngology-Head and Neck Surgery, Children’s Hospital at London Health Sciences Center, Schulich School of Medicine, 800 Commissioners Road E, London, ON N6A 5W9 Canada
| | - Julie E. Strychowsky
- grid.39381.300000 0004 1936 8884Schulich School of Medicine and Dentistry, London, ON Canada ,grid.39381.300000 0004 1936 8884Department of Otolaryngology-Head and Neck Surgery, Children’s Hospital at London Health Sciences Center, Schulich School of Medicine, 800 Commissioners Road E, London, ON N6A 5W9 Canada
| | - M. Elise Graham
- grid.39381.300000 0004 1936 8884Schulich School of Medicine and Dentistry, London, ON Canada ,grid.39381.300000 0004 1936 8884Department of Otolaryngology-Head and Neck Surgery, Children’s Hospital at London Health Sciences Center, Schulich School of Medicine, 800 Commissioners Road E, London, ON N6A 5W9 Canada
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10
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Burg ML, Sholklapper T, Kohli P, Kaneko M, Maria Autran A, Teoh J, Murphy DG, Samplasky M, Psutka SP, Loeb S, Ribal MJ, Cacciamani GE. Gender Disparities Among Editorial Boards of International Urology Journals. Eur Urol Focus 2022; 8:1840-1846. [PMID: 35504837 DOI: 10.1016/j.euf.2022.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/04/2022] [Accepted: 04/19/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Gender composition among surgical academic leadership, including academic medical journals, disproportionately favors men and may inadvertently introduce a bias. An understanding of the factors associated with gender representation among urologic journals may aid in prioritizing an equitable balance. OBJECTIVE To evaluate female representation on editorial boards of pre-eminent international urologic journals. DESIGN, SETTING, AND PARTICIPANTS The names and position descriptions of urologic journal leadership appointees were collected in October 2021. Gender was assessed using gender-api.com or through personal title, as available. Journal characteristics were summarized using SCImago, a bibliometric indicator database extracted from Scopus journal data. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS A multivariate logistic regression analysis was performed to describe associations between SCImago Journal Rank (SJR) quartile and geographic region with female gender representation. Quartile 1 (Q1) was considered the top quartile and Q4 the bottom quartile concordant with journal impact factor. RESULTS AND LIMITATIONS A total of 105 urology-focused journals were identified with 5989 total editorial board members, including 877 (14.6%) female, 5112 (85.4%) male, and two nonbinary persons. Female representation differed significantly by journal leadership position, SJR quartile, and geographic region. On the multivariate analysis of overall female representation, Q1 journals had higher odds of female representation than Q2 and Q3 journals, and had no significant difference from Q4 journals. Additionally, compared with Western Europe, North American journals had 78% higher odds while Asiatic journals had 50% lower odds of female representation. This study is limited by the inability to account for outside factors that lead to invitation or acceptance of journal leadership positions. CONCLUSIONS Contemporary female leadership at urology journals is about six times less common than male leadership across all journals, although trends in their proportion were noted when assessed by journal quartile and region. Addressing this gender imbalance represents an important step toward achieving gender equity in the field of urology. PATIENT SUMMARY In this study, we looked at the gender balance of academic journal leaders who serve as gatekeepers for sharing urologic research with the public. We found that the most prestigious journals and those in western countries tended to have the highest female representation. We hope that these findings help the academic community recognize and improve gender representation.
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Affiliation(s)
- Madeleine L Burg
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Tamir Sholklapper
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Priya Kohli
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Masatomo Kaneko
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ana Maria Autran
- Oficina de Investigacion CAU (Confederacion Americana de Urologia), Madrid, Spain
| | - Jeremy Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Mary Samplasky
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sarah P Psutka
- Department of Urology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Stacy Loeb
- Departments of Urology and Population Health, New York University Langone Health, New York, NY, USA; Manhattan Veterans Affairs Medical Center, New York, NY, USA
| | - Maria J Ribal
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Giovanni E Cacciamani
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; European Association of Urology - Young Academic Urologist (EAU-YAU), Arnhem, The Netherlands.
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11
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Kono E, Isozumi U, Nomura S, Okoshi K, Yamamoto H, Miyata H, Yasufuku I, Maeda H, Sakamoto J, Uchiyama K, Kakeji Y, Yoshida K, Kitagawa Y. Surgical Experience Disparity Between Male and Female Surgeons in Japan. JAMA Surg 2022; 157:e222938. [PMID: 35895067 PMCID: PMC9330354 DOI: 10.1001/jamasurg.2022.2938] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Question Does gender disparity exist in the number of surgical experiences among male and female surgeons in Japan? Findings In this cross-sectional study covering 1 147 068 total operations in 6 surgical fields performed between 2013 and 2017, surgical experience was classified by surgeons’ gender and years of experience. The number of operations per surgeon was lower for female compared with male surgeons, except in the first 2 years after medical registration; this gender gap widened as the difficulty level of surgery increased. Meaning The findings indicate a marked disparity in the surgical experience of female and male surgeons in Japan. Importance Women are vastly underrepresented in surgical leadership and management in Japan. The lack of equal opportunities for surgical training is speculated to be the main reason for this disparity; however, this hypothesis has not been investigated thus far. Objective To examine gender disparity in the number of surgical experiences among Japanese surgeons. Design, Setting, and Participants This retrospective, multicenter cross-sectional study used data from the National Clinical Database, which contains more than 95% of all surgical procedures in Japan. Participants included male and female gastroenterological surgeons who performed appendectomy, cholecystectomy, right hemicolectomy, distal gastrectomy, low anterior resection, and pancreaticoduodenectomy between January 1, 2013, and December 31, 2017. Exposures Differences in the number of surgical experiences between male and female surgeons. Main Outcomes and Measures The primary outcomes were the total number of operations and number of operations per surgeon by gender and years of experience. Data were analyzed from March 18 to August 31, 2021. Results Of 1 147 068 total operations, 83 354 (7.27%) were performed by female surgeons and 1 063 714 (92.73%) by male surgeons. Among the 6 operative procedures, the percentage of operations performed by female surgeons were the highest for appendectomy (n = 20 648 [9.83%]) and cholecystectomy (n = 41 271 [7.89%]) and lowest for low anterior resection (n = 4507 [4.57%]) and pancreaticoduodenectomy (n = 1329 [2.64%]). Regarding the number of operations per surgeon, female surgeons had fewer surgical experiences for all 6 types of operations in all years after registration, except for appendectomy and cholecystectomy in the first 2 years after medical registration. The largest gender disparity for each surgical procedure was 3.17 times more procedures for male vs female surgeons for appendectomy (at 15 years after medical registration), 4.93 times for cholecystectomy (at 30-39 years), 3.65 times for right hemicolectomy (at 30-39 years), 3.02 times for distal gastrectomy (at 27-29 years), 6.75 times for low anterior resection (at 27-29 years), and 22.2 times for pancreaticoduodenectomy (at 30-39 years). Conclusions and Relevance This cross-sectional study found that female surgeons had less surgical experience than male surgeons in Japan, and this gap tended to widen with an increase in years of experience, especially for medium- and high-difficulty operations. Gender disparity in surgical experience needs to be eliminated, so that female surgeons can advance to leadership positions.
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Affiliation(s)
- Emiko Kono
- Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Urara Isozumi
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sachiyo Nomura
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kae Okoshi
- Department of Surgery, Japan Baptist Hospital, Kyoto, Japan
| | - Hiroyuki Yamamoto
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroaki Miyata
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Itaru Yasufuku
- Department of Gastroenterological and Pediatric Surgery, Gifu University School of Medicine, Gifu, Japan
| | | | | | - Kazuhisa Uchiyama
- Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Yoshihiro Kakeji
- Database Committee, The Japanese Society of Gastroenterological Surgery, Tokyo, Japan
| | - Kazuhiro Yoshida
- Department of Gastroenterological and Pediatric Surgery, Gifu University School of Medicine, Gifu, Japan
| | - Yuko Kitagawa
- The Japanese Society of Gastroenterological Surgery, Tokyo, Japan
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12
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Eruchalu CN, He K, Etheridge JC, Wu C, Ashley SW, Nitzschke SL, Smink DS, Cho NL. Gender and Racial/Ethnic Disparities in Operative Volumes of Graduating General Surgery Residents. J Surg Res 2022; 279:104-112. [PMID: 35759927 DOI: 10.1016/j.jss.2022.05.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/25/2022] [Accepted: 05/22/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Gender disparities in resident operative experience have been described; however, their etiology is poorly understood, and racial/ethnic disparities have not been explored. This study investigated the relationship between gender, race/ethnicity, and surgery resident case volumes. MATERIALS AND METHODS A retrospective analysis of graduating general surgery resident case logs (2010-2020) at an academic medical center was performed. Self-reported gender and race/ethnicity data were collected from program records. Residents were categorized as underrepresented in medicine (URM) (Black, Hispanic, Native American) or non-URM (White, Asian). Associations between gender and URM status and major, chief, and teaching assistant (TA) mean case volumes were analyzed using t-tests. RESULTS The cohort included 80 residents: 39 female (48.8%) and 17 URM (21.3%). Compared to male residents, female residents performed fewer TA cases (33 versus 47, P < 0.001). Compared to non-URM residents, URM residents graduated with fewer major (948 versus 1043, P = 0.008) and TA cases (32 versus 42, P = 0.038). Male URM residents performed fewer TA cases than male non-URM residents (32 versus 50, P = 0.031). Subanalysis stratified by graduation year demonstrated that from 2010 to 2015, female residents performed fewer chief (218 versus 248, P = 0.039) and TA cases (29 versus 50, P = 0.001) than male residents. However, from 2016 to 2020, when gender parity was achieved, no significant associations were observed between gender and case volumes. CONCLUSIONS Female and URM residents perform fewer TA and major cases than male non-URM residents, which may contribute to reduced operative autonomy, confidence, and entrustment. Prioritizing gender and URM parity may help decrease case volume gaps among underrepresented residents.
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Affiliation(s)
- Chukwuma N Eruchalu
- Harvard Medical School, Boston, Massachusetts; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Katherine He
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - James C Etheridge
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Ariadne Labs, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, Boston, Massachusetts
| | - Christine Wu
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Stanley W Ashley
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Stephanie L Nitzschke
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Douglas S Smink
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nancy L Cho
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
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13
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Lucidi D, Parini S, Reale M, Azzolina D, Verdi D, Spolverato G. Women in Surgery Italia: what are the opportunities in the operatory room? Results from a nationwide interdisciplinary survey. Updates Surg 2022; 74:803-816. [PMID: 35657559 DOI: 10.1007/s13304-022-01304-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Abstract
Many studies documented the "glass ceiling" effect for women in surgery: achievements in academic and leadership positions are not consistent with the percentage of female surgeons in practice. A solid surgical case volume and expertise in high-complexity cases are required to pursue leadership positions. The aim of the study was to determine whether part of the difficulties encountered by female surgeons may lie in reduced surgical opportunities. This is the first study to investigate this issue in Italy. An online survey, conceived and promoted by Women in Surgery Italia, was administered through the RedCap platform, between November and December 2020, and female surgeons actively working in Italian academic and non-academic hospitals were invited to answer anonymously. A multivariate analysis was performed to evaluate the role of different factors on two main variables: overall procedures done and a sub-analysis of complex cases performed as first surgeon. 1810 respondents were included; the women who responded participated in 3% fewer cases on average, when compared to the mean staff case volume, and were significantly more often listed as the assistant surgeon and as primary surgeons in low-complexity cases. 36.5% of the respondents declared that at least one female physician on staff had to abandon the operatory room (OR) and does not regularly perform any surgical procedure. 73% female surgeons would like to spend more hours in the OR. While acquiring skills and surgical autonomy, many obstacles still exist for female surgeons. A portion of women are relegated to non-surgical activities, irrespective of their specialty, and these results confirm the theory that gender-biased underemployment still exists in surgical fields.
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Affiliation(s)
- Daniela Lucidi
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Sara Parini
- Department of Thoracic Surgery, Ospedale Maggiore della Carità di Novara, Novara, Italy
| | - Marella Reale
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy.
| | - Danila Azzolina
- Department of Medical Science, University of Ferrara, Ferrara, Italy
| | - Daunia Verdi
- Department of Surgery, Mirano Hospital, Mirano, Italy
| | - Gaya Spolverato
- Department of Surgical Oncological and Gastrointestinal Sciences, University of Padova, Padua, Italy
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14
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Bennett CL, Ling AY, Agrawal P, Pierce A, Pasao MA, Ray D, Cleveland Manchanda EC. How we compare: Society for Academic Emergency Medicine faculty membership demographics. AEM EDUCATION AND TRAINING 2022; 6:S93-S96. [PMID: 35783079 PMCID: PMC9222880 DOI: 10.1002/aet2.10747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/31/2021] [Accepted: 08/03/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Society for Academic Emergency Medicine (SAEM) has a core value to promote a diverse workforce for patients, providers, and learners. Understanding the organization's membership demographics and how that compares to the academic emergency medicine (EM) workforce is prerequisite to the success of this core value. METHODS We obtained 2020 faculty membership data sets from the Association of American Medical Colleges (AAMC) and SAEM; data included self-reported sex, race and ethnicity, and academic rank (professor, associate professor, assistant professor, and instructor). We employed standardized mean difference (SMD) to quantify difference in proportions between data sets. RESULTS We identified 5874 (AAMC) and 2785 (SAEM) faculty. The AAMC (38.3%) and the SAEM (41.3%) had similar proportions of overall female faculty (SMD 0.063) although SAEM (compared to AAMC) had a higher proportion of female full (25.5% vs. 20.5%, SMD 0.121) and assistant (46.5% vs. 41.2%, SMD 0.106) professors. With the exception of Hispanic instructors, SAEM (compared to AAMC) also had higher proportions of Black and Hispanic female faculty at all ranks (SMD ranging from 0.109 to 0.777). CONCLUSION SAEM faculty demographics generally reflect that of the academic EM workforce demographics reported in the AAMC database and that overall, the proportions of female, Black, and Hispanic faculty in SAEM are slightly larger than those in the AAMC database. However, faculty who identify as Black or Hispanic in both the AAMC and the SAEM databases (compared to the overall U.S. population) are dramatically underrepresented.
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Affiliation(s)
| | - Albee Y. Ling
- Quantitative Sciences UnitStanford School of MedicinePalo AltoCaliforniaUSA
| | - Pooja Agrawal
- Department of Emergency MedicineYale UniversityNew HavenConnecticutUSA
| | - Ava Pierce
- Department of Emergency MedicineUT Southwestern Medical CenterDallasTexasUSA
| | - Melissa A. Pasao
- Department of Emergency MedicineStanford School of MedicinePalo AltoCaliforniaUSA
| | - Douglas Ray
- Society for Academic Emergency MedicineDes PlainesIllinoisUSA
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15
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Mejía-Fernández L, Romero-Hernández F, López-Ruiz A, Lopez-Verdugo F, Sanchez-Garcia J, Martinez-Ordaz JL, Moreno-Paquentin E, Lopez-Gavito E. Role of Female Research at the Asociacion Mexicana de Cirugia General Annual Meeting: A Retrospective Analysis From 2013 to 2019. Front Surg 2022; 9:900076. [PMID: 36034390 PMCID: PMC9406406 DOI: 10.3389/fsurg.2022.900076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/21/2022] [Indexed: 11/19/2022] Open
Abstract
Background Academic surgery has been a traditionally male-dominated field. Female contribution remains challenging. In Mexico, there is no published evidence regarding gender disparity in academic surgery. We aimed to analyze the female role in clinical research submitted to the Asociación Mexicana de Cirugía General (AMCG). Methods Retrospective study evaluating abstracts submitted to AMCG annual meetings from 2013 to 2019. Categorical variables were compared using χ2 test. Univariate logistic regression was performed to calculate odds ratios (OR) followed by a log-binomial logistic regression model to obtain the adjusted relative risk (aRR) for acceptance as an oral presentation. Results Overall, 7,439 abstracts were analyzed of which 24.2% were submitted by females. Female-submitted abstracts increased from 22.5% to 25.3% during 2013–2019 (p = 0.15). The proportion of 47 abstracts submitted by females was higher in the resident group (27.7% vs. 18.8%; p < 0.001). The percentage of females’ abstracts selected for oral presentation was less than the percentage of males’ 49 abstracts selected for presentation (9% vs. 11.5%; p = 0.002). Females’ abstracts submitted have a 50 23.5% decreased chance of being selected for oral presentation (OR = 0.765, CI 95%, 0.639–0.917, 51 p = 0.003). However, after adjusting for research type and trainee status, the gender of the oral 52 presenting author showed no association (aRR = 0.95, CI 95%, 0.8–1.1, p = 0.56). Conclusion In Mexico, the female role in academic surgery is still limited. These results should 55 encourage professors and program directors to identify and address factors contributing to gender 56 disparities.
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Affiliation(s)
- Lorelí Mejía-Fernández
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, TecSalud, Monterrey, Nuevo León, México
| | | | - Ana López-Ruiz
- University of California, Los Angeles, David Geffen School of Medicine, United States
| | - Fidel Lopez-Verdugo
- Hepatobiliary Surgery and Transplant Services, Intermountain Medical Center, Salt Lake City, UT, United States
| | - Jorge Sanchez-Garcia
- Hepatobiliary Surgery and Transplant Services, Intermountain Medical Center, Salt Lake City, UT, United States
| | - Jose L. Martinez-Ordaz
- Department of General and Gastrointestinal Surgery, UMAE Hospital de Especialidades – Centro Médico Nacional Siglo XXI (Instituto Mexicano del Seguro Social, IMSS), Mexico City, Mexico
| | | | - Elena Lopez-Gavito
- Department of Surgery, Hospital Sharp Mazatlan, Mazatlan, Mexico
- Correspondence: Elena Lopez-Gavito
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Abstract
BACKGROUND Women surgeons face numerous barriers to career advancement. Inequitable citation of surgical literature may represent a contributing factor to gender disparities in academic surgery. STUDY DESIGN This was a cross-sectional analysis of publications from 50 top-ranking surgery journals in 2017 and 2018, as defined by the 2019 InCites Journal Citation Reports. The citation rate of publications by women vs men first authors was compared. Similarly, the citation rate of publications by men vs women last authors was also compared. Adjusted regression analyses of citation rates accounted for the time interval since publication as well as the journal within which the article was published, among other potential confounding factors. RESULTS A total of 19,084 publications from 48 surgery journals with a median (interquartile range) of 8 (4 to 15) citations contributing to a median (interquartile range) Journal Impact Factor of 4.0 (3.4 to 4.6) were analyzed. Compared with man-first author publications, woman-first author publications demonstrated a 9% lower citation rate (incidence rate ratio 0.91, p < 0.001). Similarly, compared with publications by man-last authors, woman-last author publications demonstrated a 4% lower citation rate (incidence rate ratio 0.96, p = 0.03). These associations persisted after multivariable adjustment for additional confounding factors, however, not on sensitivity analysis of 24 of the highest-ranking journals. CONCLUSIONS Among top-tier surgical journals, publications by women-first and -last authors were less cited compared with publications by men-first and -last authors, but not among the highest-tier surgical journals. Gender bias may exist in the citation of surgical research, contributing to gender disparities in academic surgery.
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Affiliation(s)
- William J Kane
- From the Department of Surgery, University of Virginia Health System, Charlottesville, VA
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17
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Malik RD, Salles A. Debunking Four Common Gender Equity Myths. Eur Urol 2022; 81:552-554. [DOI: 10.1016/j.eururo.2022.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/03/2022] [Accepted: 02/18/2022] [Indexed: 11/25/2022]
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Inage E, Tanaka Y, Matsui K, Yamada H, Kojima M, Toriumi S, Kudo T, Baba Y, Shimizu T. Gender disparities in the pediatric allergy-related guidelines in Japan. Pediatr Int 2022; 64:e14941. [PMID: 34329519 DOI: 10.1111/ped.14941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/07/2021] [Accepted: 07/27/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Inclusion of female authors has been noted as potentially beneficial in the development of medical guidelines. Japanese professional committees representing allergic subspecialties develop practical guidelines with recommendations to caregivers, but these committees may be influenced by their gender composition. The objective of our study was to examine the influence of gender in developing pediatric allergic disease guidelines in Japan from 1999 to 2020. METHODS We examined the gender parities among the guideline committee members in allergic rhinitis, atopic dermatitis, bronchial asthma, and food allergy guidelines in Japan. We examined the gender composition of the committees, annual trends, and differences in guideline content. RESULTS The median proportion of women members among the 22 guidelines committees was 6.6% (range: 0%-27.3%). The analysis of the quadrant period did not show a significant increase in the proportion of female members. The food allergy group had a significantly higher proportion of female members than other guidelines (P < 0.01), but the proportion decreased from 25% to 14.3% during the observation period. For the pediatric asthma guidelines, the proportion of female committee members decreased from 5.3% in the 2000 version to 0% in the most recent revision in 2017. CONCLUSIONS The proportion of women on the committees that develop pediatric guidelines continues to be low and has not improved over the past 20 years.
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Affiliation(s)
- Eisuke Inage
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Preventive Medicine for Mass Infection, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuko Tanaka
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kotoko Matsui
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiromichi Yamada
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mayuki Kojima
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shun Toriumi
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takahiro Kudo
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yosuke Baba
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Pediatrics, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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19
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Choi J, Lee JE, Choi B, Kim J, Lee SE. Experiences and Perceptions of Gender Discrimination and Equality among Korean Surgeons: Results of a Survey of the Korean Surgical Society. J Korean Med Sci 2021; 36:e323. [PMID: 34904405 PMCID: PMC8668495 DOI: 10.3346/jkms.2021.36.e323] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 10/18/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Previous studies that have focused on the challenges faced by female surgeons, such as the gender pay gap, gender biases, lower likelihood of promotion, and gender differences in the perception of discrimination against women, are reviewed. A more comprehensive understanding of explicit and implicit gender discrimination and experiences and perceptions of discrimination is needed. This study aims to determine the current prevalence and degree of gender discrimination in the Korean Surgical Society and to compare the experiences and perceptions of gender discrimination between male and female surgeons. METHODS We analyzed 400 responses from a survey sent to all members of the Korean Surgical Society. This electronic survey included 16 items on experiences of gender discrimination and 17 items on perceptions of gender discrimination. We conducted χ² tests and binary logistic regression on the data regarding these experiences and perceptions of gender discrimination. RESULTS Adjusted analyses found that female surgeons were more likely to experience gender discrimination than their male counterparts across all categories of discrimination. Further, adjusted analyses showed that female surgeons were more likely to confirm the presence of gender discrimination than male surgeons. CONCLUSION Female surgeons were more likely to experience implicit and explicit gender biases and discrimination throughout all stages of their career progression. We also discovered significant gender differences in the perception of gender discrimination, as well as the experience of it. Changing the male-dominated culture and raising awareness of gender biases and discrimination among male surgeons are crucial steps toward addressing gender discrimination in surgery.
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Affiliation(s)
| | | | | | - Jungook Kim
- School of Management and Labor Relations, Rutgers University, New Brunswick, NJ, USA
| | - Seung Eun Lee
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
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20
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Johnson-Mann CN, Butler PD, Greene WR. "Diversity in Surgery-How Do We Change the Narrative: Pipeline to Professor?". Am Surg 2021; 87:1718-1721. [PMID: 34749513 DOI: 10.1177/00031348211029874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The goal of our paper is to provide our perspectives on why there is a need to change the narrative in academic surgery to improve health equity by increasing the pipeline of pre-med students to professors. It is well documented that Health disparities hurt many different people, but they especially hurt Black, Indigenous, and People of color. Black men and women have a decreased life expectancy. Differences in care are associated with greater mortality among minority patients and that care provided to black patients by black physicians can lead to improved compliance with medications and care plans. The lack of black diversity in the medical profession proportional to the societal ethnic distribution is alarming. We have opportunities for improvement for recruitment, retention and promotion within the field of surgery.
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Affiliation(s)
| | - Paris D Butler
- Department of Surgery, 6572University of Pennsylvania, Philadelphia, PA, USA
| | - Wendy R Greene
- Department of Surgery, 1371Emory University, Atlanta, GA, USA
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21
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Women in Leadership and Their Influence on the Gender Diversity of Academic Plastic Surgery Programs. Plast Reconstr Surg 2021; 147:516-526. [PMID: 33587563 DOI: 10.1097/prs.0000000000007681] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Women seldom reach the highest leadership positions in academic plastic surgery. Contributing factors include lack of female role models/mentors and lack of gender diversity. Studies show that female role models and mentors are critical for recruiting and retaining female surgeons and that gender diversity within organizations more strongly influences women's career choices. The authors therefore sought to determine the current gender diversity of academic plastic surgery programs and investigate influences of gender and leadership on program gender composition. METHODS A cross-sectional study of U.S. plastic surgery residency programs was performed in December of 2018. Genders of the leadership were collected, including medical school dean, department of surgery chair, department/division of plastic surgery chair/chief, plastic surgery program director, plastic surgery faculty, and plastic surgery residents. Gender relationships among these groups were analyzed. RESULTS Ninety-nine residency programs were identified (79 integrated with or without independent and 20 independent). Women represented a smaller proportion of academic plastic surgeons in more senior positions (38 percent residents, 20 percent faculty, 13 percent program directors, and 8 percent chairs). Plastic surgery chair gender was significantly correlated with program director gender, and plastic surgery faculty gender was significantly associated with plastic surgery resident gender. Although not statistically significant, female plastic surgery chair gender was associated with a 45 percent relative increase in female plastic surgery residents. CONCLUSIONS Women in leadership and gender diversity influence the composition of academic plastic surgery programs. Gender disparity exists at all levels, worsening up the academic ladder. Recruitment, retention, and promotion of women is critical, as such diversity is required for continued progress in innovation and problem-solving within plastic surgery.
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22
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Landau SI, Syvyk S, Wirtalla C, Aarons CB, Butts S, Holmboe E, Kelz RR. Trainee Sex and Accreditation Council for Graduate Medical Education Milestone Assessments During General Surgery Residency. JAMA Surg 2021; 156:925-931. [PMID: 34232269 DOI: 10.1001/jamasurg.2021.3005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Importance In evaluating the effectiveness of general surgery (GS) training, an unbiased assessment of the progression of residents with attention to individual learner factors is imperative. Objective To evaluate the role of trainee sex in milestone achievement over the course of GS residency using national data from the Accreditation Council for Graduate Medical Education (ACGME). Design, Setting, and Participants This cross-sectional study evaluated female and male GS residents enrolled in ACGME-accredited programs in the US from 2014 to 2018 with reported variation in milestones performance across years in training and representation. Data were analyzed from November 2019 to June 2021. Main Outcomes and Measures Mean reported milestone score at initial and final assessment, and predicted time-to-attainment of equivalent performance by sex. Results Among 4476 GS residents from 250 programs who had milestone assessments at any point in their clinical training, 1735 were female (38.8%). Initially, female and male residents received similar mean (SD) milestone scores (1.95 [0.50] vs 1.94 [0.50]; P = .69). At the final assessment, female trainees received overall lower mean milestone scores than male trainees (4.25 vs 4.31; P < .001). Significantly lower mean milestone scores were reported for female residents at the final assessment for several subcompetencies in both univariate and multivariate analyses, with only medical knowledge 1 (pathophysiology, diagnosis, and initial management) common to both. Multilevel mixed-effects linear modeling demonstrated that female trainees had significantly lower rates of monthly milestone attainment in the subcompetency of medical knowledge 1, which was associated with a significant difference in training time of approximately 1.8 months. Conclusions and Relevance Both female and male GS trainees achieved the competency scores necessary to transition to independence after residency as measured by the milestones assessment system. Initially, there were no sex differences in milestone score. By graduation, there were differences in the measured assessment of female and male trainees across several subcompetencies. Careful monitoring for sex bias in the evaluation of trainees and scrutiny of the training process is needed to ensure that surgical residency programs support the educational needs of both female and male trainees.
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Affiliation(s)
- Sarah I Landau
- Department of Surgery, Center for Surgery and Health Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Solomiya Syvyk
- Department of Surgery, Center for Surgery and Health Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Chris Wirtalla
- Department of Surgery, Center for Surgery and Health Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Cary B Aarons
- Department of Surgery, Center for Surgery and Health Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Samantha Butts
- Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Eric Holmboe
- Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Rachel R Kelz
- Department of Surgery, Center for Surgery and Health Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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23
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Kane WJ, Berry PS, Denton AH, Schroen AT. Attainment of an Additional Graduate Degree Is Associated With Sustained Scholarly Activity Beyond Surgical Residency. JOURNAL OF SURGICAL EDUCATION 2021; 78:1189-1196. [PMID: 33349567 DOI: 10.1016/j.jsurg.2020.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/12/2020] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To determine whether attainment of an additional graduate-level degree during general surgery residency, such as an MSc, MPH, MBA, or PhD, is associated with increased research productivity beyond completion of training. DESIGN Observational cohort study comparing publication productivity of general surgery residency graduates who did and did not obtain a degree. PubMed queries and the Web of Science Core Collection were used to capture publication metrics. Graduate characteristics, including degree attainment, were obtained from an institutional database. Practice webpages were reviewed to designate an academic surgical practice, defined as an assistant, associate, or full professorship appointment. SETTING Single academic general surgery residency program. PARTICIPANTS Categorical general surgery residency graduates who performed at least 1 year of dedicated research. RESULTS 1768 total publications, representing 1500 unique publications, were authored by 54 residents, of which 18 (33.3%) residents attained an additional graduate-level degree during dedicated research. 1369 (91.3%) publications had identifiable Journal Impact Factors and citation data. Degree attainers were more likely to be female (55.6% vs. 25.0%, p = 0.03) and spend more time in dedicated research (mean 2.2 vs. 1.8 years, p = 0.02). Overall, degree attainers published more frequently during residency (median 4.4 vs. 2.1 publications/year, p < 0.001) and fellowship (median 2.0 vs. 1.0 publications/year, p = 0.046). Analysis of the first 4 post-training years demonstrated degree attainers produced 1.2 more publications per year among all graduates (2.3 vs. 1.1 publications/year, p = 0.02) and 1.6 more publications per year among graduates practicing academic surgery (3.3 vs. 1.7 publications/year, p = 0.02). There were no differences in the Journal Impact Factor or publication citations per year among degree and nondegree attaining graduates. CONCLUSIONS Attainment of an additional graduate-level degree was associated with increased research productivity that was sustained beyond surgical residency. Programs with the goal of training academic surgeons should support professional degrees during dedicated research years.
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Affiliation(s)
- William J Kane
- Department of Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Puja S Berry
- Department of Colorectal Surgery, Mayo Clinic, Rochester, Minnesota
| | - Andrea H Denton
- Claude Moore Health Sciences Library, University of Virginia, Charlottesville, Virginia
| | - Anneke T Schroen
- Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.
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24
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Fang CH, Barinsky GL, Gray ST, Baredes S, Chandrasekhar SS, Eloy JA. Diversifying Researchers and Funding in Otolaryngology. Otolaryngol Clin North Am 2021; 54:653-663. [PMID: 34024491 DOI: 10.1016/j.otc.2021.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Research productivity is a key metric used in evaluation for advancement and promotion in academic medicine. There are known gender, race, and ethnicity disparities in otolaryngology research and funding. Female academic otolaryngologists have been shown to lag in scholarly productivity, representation at national meetings, leadership positions on journal editorial boards, and National Institutes of Health and industry funding. Underrepresented minorities have been shown to be less successful at obtaining Centralized Otolaryngology Research Efforts grant funding. Directed approaches, such as research funding for women and minorities or targeted recruitment and retention of underrepresented faculty, may move the field toward parity.
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Affiliation(s)
- Christina H Fang
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Gregory L Barinsky
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Stacey T Gray
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston, MA, USA; Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, USA
| | - Soly Baredes
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Sujana S Chandrasekhar
- ENT & Allergy Associates, LLP, Zucker School of Medicine at Hofstra-Northwell, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ, USA; Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA; Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA; Department of Otolaryngology and Facial Plastic Surgery, Saint Barnabas Medical Center - RWJBarnabas Health, Livingston, NJ, USA.
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25
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Riner AN, Herremans KM, Neal DW, Johnson-Mann C, Hughes SJ, McGuire KP, Upchurch GR, Trevino JG. Diversification of Academic Surgery, Its Leadership, and the Importance of Intersectionality. JAMA Surg 2021; 156:748-756. [PMID: 33950242 DOI: 10.1001/jamasurg.2021.1546] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Diversity in academic surgery is lacking, particularly among positions of leadership. Objective To evaluate trends among racial/ethnical minority groups stratified by gender along the surgical pipeline, as well as in surgical leadership. Design, Setting, and Participants This cross-sectional and longitudinal analysis assessed US surgical faculty census data obtained from the Association of American Medical Colleges faculty roster in the Faculty Administrative Management Online User System database. Surgical faculty members captured in census data from December 31, 2013, to December 31, 2019, were included in the analysis. Faculty were identified from the surgery category of the faculty roster, which includes general surgeons and subspecialists, neurosurgeons, and urologists. Main Outcomes and Measures Gender and race/ethnicity were obtained for surgical faculty stratified by rank. Descriptive statistics with annual percentage of change in representation are reported based on faculty rank. Results A total of 15 653 US surgical faculty, including 3876 women (24.8%), were included in the data set for 2019. Female faculty from racial/ethnic minority groups experienced an increase in representation at instructor and assistant and associate professorship appointments, with a more favorable trajectory than male faculty from racial/ethnic minority groups across nearly all ranks. White faculty maintain most leadership positions as full professors (3105 of 3997 [77.7%]) and chairs (294 of 380 [77.4%]). The greatest magnitude of underrepresentation along the surgical pipeline has been among Black (106 of 3997 [2.7%]) and Hispanic/Latinx (176 of 3997 [4.4%]) full professors. Among full professors, although Black and Hispanic/Latinx male representation increased modestly (annual change, 0.07% and 0.10%, respectively), Black female representation remained constant (annual change, 0.00004%) and Hispanic/Latinx female representation decreased (annual change, -0.16%). Overall Hispanic/Latinx (20 of 380 [5.3%]) and Black (13 of 380 [3.4%]) representation as chairs has not changed, with only 1 Black and 1 Hispanic/Latinx woman ascending to chair from 2013 to 2019. Conclusions and Relevance A disproportionately small number of faculty from minority groups obtain leadership positions in academic surgery. Intersectionality may leave female members of racial/ethnic minority groups more disadvantaged than their male colleagues in achieving leadership positions. These findings highlight the urgency to diversify surgical leadership.
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Affiliation(s)
- Andrea N Riner
- Department of Surgery, University of Florida College of Medicine, Gainesville
| | - Kelly M Herremans
- Department of Surgery, University of Florida College of Medicine, Gainesville
| | - Daniel W Neal
- Department of Surgery, University of Florida College of Medicine, Gainesville
| | | | - Steven J Hughes
- Department of Surgery, University of Florida College of Medicine, Gainesville
| | - Kandace P McGuire
- Division of Surgical Oncology, Department of Surgery, Virginia Commonwealth University, Richmond
| | - Gilbert R Upchurch
- Department of Surgery, University of Florida College of Medicine, Gainesville
| | - Jose G Trevino
- Division of Surgical Oncology, Department of Surgery, Virginia Commonwealth University, Richmond
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26
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Varpio L, Harvey E, Jaarsma D, Dudek N, Hay M, Day K, Bader Larsen K, Cleland J. Attaining full professor: Women's and men's experiences in medical education. MEDICAL EDUCATION 2021; 55:582-594. [PMID: 33034082 DOI: 10.1111/medu.14392] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/09/2020] [Accepted: 10/03/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The underrepresentation of women among senior faculty members in medical education is a longstanding problem. The purpose of this international qualitative investigation was to explore women and men's experiences of attaining full professorship and to investigate why women remain underrepresented among the senior faculty ranks. METHODS Conducted within a social constructionist orientation, our qualitative study employed narrative analysis. Two female and two male participants working in medical education were recruited from five nations: Australia, Canada, the Netherlands, United Kingdom and United States. All participants held an MD or PhD. During telephone interviews, participants narrated the story of their careers. The five faculty members on the research team were also interviewed. Their narratives were included in analysis, rendering their experiences equal to those of the participants. RESULTS A total of 24 full professors working in medical education were interviewed (n = 15 females and n = 9 males). While some aspects were present across all narratives (ie personal events, career milestones and facilitating and/or impeding factors), participants' experience of those aspects differed by gender. Men did not narrate fatherhood as a role navigated professionally, but women narrated motherhood as intimately connected to their professional roles. Both men and women narrated career success in terms of hard work and overcoming obstacles; however, male participants described promotion as inevitable, whereas women narrated promotion as a tenuous navigation of social structures towards uncertain outcomes. Female and male participants encountered facilitators and inhibitors throughout their careers but described acting on those experiences differently within the cultural contexts they faced. DISCUSSION Our data suggest that female and male participants had different experiences of the work involved in achieving full professor status. Understanding these gendered experiences and their impact on career progression is an important advancement for better understanding what leads to the underrepresentation of women among senior faculty members in medical education.
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Affiliation(s)
- Lara Varpio
- Faculty of Medicine, Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Emily Harvey
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Debbie Jaarsma
- University Medical Center, University of Groningen, Groningen, The Netherlands
| | - Nancy Dudek
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Margaret Hay
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Vic., Australia
| | - Kathy Day
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Karlen Bader Larsen
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jennifer Cleland
- LKC School of Medicine, Nanyang Technological University, Singapore, Singapore
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27
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Xu RF, Varady NH, Chen AF. Disparities Among Leading Publishers of Arthroplasty Research. J Arthroplasty 2021; 36:1804-1809. [PMID: 33281019 DOI: 10.1016/j.arth.2020.11.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 11/06/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Despite the importance of diversity in advancing scientific progress, diversity among leading authors in arthroplasty has not been examined. This study aimed to identify, characterize, and assess disparities among leading authors in arthroplasty literature from 2002 to 2019. METHODS Articles published between 2002 and 2019 from 12 academic journals that publish orthopedic and arthroplasty research were extracted from PubMed. Original articles containing keywords related to arthroplasty were analyzed. Author gender was assigned using the Genderize algorithm. Gender and characterization of the top 100 male and female authors utilized available information on academic profiles. RESULTS From the 14,692 articles that met inclusion criteria, the genders of 23,626 unique authors were identified. Women were less likely than men to publish 5 years after beginning their publishing careers (adjusted odds ratio 0.51, 95% confidence interval 0.45-0.57, P < .001). Of the top 100 authors, 96 were men, while only 4 were women. Orthopedic surgeons made up 93 of 100 top authors, of which 92 were men and 1 was a woman. Among the top 10 publishing female and male authors, 10 of 10 men were orthopedic surgeons, only 2 of 10 women were physicians, and only one was an attending orthopedic surgeon. CONCLUSION While the majority of authors with high arthroplasty publication volume were orthopedic surgeons, there were significant gender disparities among the leading researchers. We should continue working to increase gender representation and supporting the research careers of women in arthroplasty.
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Affiliation(s)
- Raylin F Xu
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nathan H Varady
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Antonia F Chen
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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28
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Miller AL, Bergmark RW, Gray ST. Problematic Reporting of Gender Differences in Clinical Productivity Among Otolaryngologists-Reply. JAMA Otolaryngol Head Neck Surg 2021; 147:222. [PMID: 33300993 DOI: 10.1001/jamaoto.2020.4631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Ashley L Miller
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts
| | - Regan W Bergmark
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts.,Division of Otolaryngology-Head and Neck Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Stacey T Gray
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts
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29
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Columbus AB, Lu PW, Hill SS, Fields AC, Davids JS, Melnitchouk N. Factors Associated With the Professional Success of Female Surgical Department Chairs: A Qualitative Study. JAMA Surg 2021; 155:1028-1033. [PMID: 32857121 DOI: 10.1001/jamasurg.2020.3023] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Only 7% of US surgical department chairs are occupied by women. While the proportion of women in the surgical workforce continues to increase, women remain significantly underrepresented across leadership roles within surgery. Objective To identify commonality among female surgical chairs with attention toward moderators that appear to have contributed to their professional success. Design, Setting, and Participants A grounded theory qualitative study was conducted in academic surgical departments within the US. Participants included current and emeritus female chairs of American academic surgical departments. The study was conducted between December 1, 2018, and March 31, 2019. An eligible cohort of 26 women was identified. Interventions and Exposures Participants completed semistructured telephone interviews conducted with an interview guide. Main Outcomes and Measures Common themes associated with career success. Results Of the eligible cohort of 26 women, 20 individuals (77%) participated. Sixteen participants were serving as active department chairs and 4 were former department chairs. Mean (SD) length of time served in the chair position, either active or former, was calculated at 5.6 (2.6) years. Two major themes were identified. First, internal factors emerged prominently. Personality traits, including confidence, resilience, and selflessness, were shared among participants. Adaptability was described as a major facilitator to career success. Second, participants described 2 subtypes of external factors, overt and subtle, each of which included barriers and bolsters to career development. Overt support from mentors of both sexes was described as contributing to success. Subtle factors, such as gender norms, on institutional and cultural levels, affected behavior by creating environments that supported or detracted from career advancement. Conclusions and Relevance In this study, participants described both internal and external factors that have been associated with their advancement into leadership roles. Future attention toward encouraging intrinsic strengths, fostering environments that bolster career development, and emphasizing adaptability, along with work-system redesign, may be key components to career success and advancing diversity in surgical leadership roles.
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Affiliation(s)
| | - Pamela W Lu
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Susanna S Hill
- Department of Surgery, University of Massachusetts Memorial Hospital, Worcester, Massachusetts
| | - Adam C Fields
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jennifer S Davids
- Department of Surgery, University of Massachusetts Memorial Hospital, Worcester, Massachusetts
| | - Nelya Melnitchouk
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
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30
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Romero Arenas MA. Meeting the Educational Needs of an Increasingly Diverse Surgical Workforce. JAMA Surg 2021; 155:533. [PMID: 32186663 DOI: 10.1001/jamasurg.2020.0096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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31
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Manne-Goehler J, Kapoor N, Blumenthal DM, Stead W. Sex Differences in Achievement and Faculty Rank in Academic Infectious Diseases. Clin Infect Dis 2021; 70:290-296. [PMID: 30873556 DOI: 10.1093/cid/ciz200] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 03/06/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study assesses differences in faculty rank between female and male infectious diseases (ID) faculty with academic appointments at US medical schools. METHODS We analyzed a complete database of US physicians with medical school faculty appointments in 2014. This database consists of a linkage between the American Association of Medical Colleges faculty roster and a physician database from Doximity, and includes physician age, sex, years since residency completion, publications, National Institutes of Health grants, and registered clinical trials for all academic physicians by specialty. We used multivariable logistic regression models with medical school-specific fixed effects to assess sex differences in full professorship by specialty and the relationship between these factors and achieving the rank of full professor within ID. We compared this adjusted difference in ID to that of peer subspecialties. RESULTS Among a total of 2016 academic ID physicians, there were 742 (37%) women who together accounted for 48.1% of assistant professors, 39.7% of associate professors, and 19.2% of full professors. Women faculty had fewer total (16.3 vs 28.3, P < .001) and first/last author publications (9.8 vs 20.4, P < .001). In adjusted models, the rate of full professorship (vs assistant or associate) among female compared to male ID physicians was large and significant (absolute adjusted difference, -8.0% [95% confidence interval, -11.9% to -4.1%]). This difference was greater in ID than in cardiology. CONCLUSIONS Significant sex differences in achieving the rank of full professor exist in academic ID, after adjustment for multiple factors known to influence these outcomes. Greater efforts should be made to address equity in academic ID.
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Affiliation(s)
- Jennifer Manne-Goehler
- Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Neena Kapoor
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Daniel M Blumenthal
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Wendy Stead
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Lafaro KJ, Khithani AS, Wong P, LaRocca CJ, Warner SG, Fong Y, Melstrom LG. Academic Productivity in Hepatopancreatobiliary Surgeons: Identifying Benchmarks Associated With Rank in North America. Am Surg 2020; 87:1474-1479. [PMID: 33356426 DOI: 10.1177/0003134820966282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Academic achievement is an integral part of the promotion process; however, there are no standardized metrics for faculty or leadership to reference in assessing this potential for promotion. The aim of this study was to identify metrics that correlate with academic rank in hepatopancreaticobiliary (HPB) surgeons. MATERIALS AND METHODS Faculty was identified from 17 fellowship council accredited HPB surgery fellowships in the United States and Canada. The number of publications, citations, h-index values, and National Institutes of Health (NIH) funding for each faculty member was captured. RESULTS Of 111 surgeons identified, there were 31 (27%) assistant, 39 (35%) associate, and 41 (36%) full professors. On univariate analysis, years in practice, h-index, and a history of NIH funding were significantly associated with a surgeon's academic rank (P < .05). Years in practice and h-index remained significant on multivariate analysis (P < .001). DISCUSSION Academic productivity metrics including h-index and NIH funding are associated with promotion to the next academic rank.
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Affiliation(s)
- Kelly J Lafaro
- Department of Surgery, 1500Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Surgery, 20220City of Hope National Medical Center, Duarte, CA, USA
| | - Amit S Khithani
- Department of Surgery, 20220City of Hope National Medical Center, Duarte, CA, USA.,Miami Dade Surgical Group, Miami, FL, USA
| | - Paul Wong
- Department of Surgery, 20220City of Hope National Medical Center, Duarte, CA, USA
| | - Christopher J LaRocca
- Department of Surgery, 20220City of Hope National Medical Center, Duarte, CA, USA.,Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Susanne G Warner
- Department of Surgery, 20220City of Hope National Medical Center, Duarte, CA, USA
| | - Yuman Fong
- Department of Surgery, 20220City of Hope National Medical Center, Duarte, CA, USA
| | - Laleh G Melstrom
- Department of Surgery, 20220City of Hope National Medical Center, Duarte, CA, USA
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Zhang D, Pistorio AL, Payne D, Lifchez SD. Promoting Gender Equity in the #MeToo Era. J Hand Surg Am 2020; 45:1167-1172. [PMID: 32811692 DOI: 10.1016/j.jhsa.2020.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/25/2020] [Accepted: 07/03/2020] [Indexed: 02/02/2023]
Abstract
The recent #MeToo movement in social media has brought the important issue of gender-based violence and harassment in the workplace to the forefront of public attention. As in other fields, gender-based discrimination and sexual harassment continue to be a problem in medicine, and gender inequalities are particularly apparent in surgical specialties. Whereas the #MeToo movement has successfully raised awareness and held some perpetrators accountable, there have been unintended backlashes, including reluctance from some male surgeons to mentor female surgeons for fear of false accusations of sexual misconduct at both the trainee and the faculty levels. Gender-based neglect is harmful to the career advancement of female surgeons and threatens to continue to promote gender inequalities in surgery. We propose systems-level strategies to promote gender equity at the academic-training level and within the field of hand surgery.
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Affiliation(s)
- Dafang Zhang
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA.
| | - Ashley L Pistorio
- Department of Plastic Surgery, University of Nevada Las Vegas School of Medicine, Las Vegas, NV
| | - Diane Payne
- Department of Orthopaedics, Emory University, Atlanta, GA
| | - Scott D Lifchez
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, MD
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34
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Affiliation(s)
- Rebecca A Snyder
- Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, North Carolina
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35
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Lyons NB, Bernardi K, Olavarria OA, Shah P, Dhanani N, Loor M, Holihan JL, Liang MK. Gender Disparity Among American Medicine and Surgery Physicians: A Systematic Review. Am J Med Sci 2020; 361:151-168. [PMID: 33526213 DOI: 10.1016/j.amjms.2020.10.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/18/2020] [Accepted: 10/20/2020] [Indexed: 11/16/2022]
Abstract
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 .
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Affiliation(s)
- Nicole B Lyons
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Karla Bernardi
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Oscar A Olavarria
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Puja Shah
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Naila Dhanani
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA.
| | | | - Julie L Holihan
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Mike K Liang
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA.
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36
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Chan HF, Torgler B. Gender differences in performance of top cited scientists by field and country. Scientometrics 2020. [DOI: 10.1007/s11192-020-03733-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Equity, Diversity, and Inclusion in Academic American Surgery Faculty: An Elusive Dream. J Surg Res 2020; 258:179-186. [PMID: 33011449 DOI: 10.1016/j.jss.2020.08.069] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/09/2020] [Accepted: 08/30/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND In the context of shifting population demographics in the United States, a diverse workforce in health care can lead to improved patient outcomes and enhance access to culturally competent care for minorities. The objective of this study was to analyze and quantify the relationship of gender, race, and academic rank, tenure status, and degree in American academic surgical faculty. MATERIALS AND METHODS A 12-y retrospective cross-sectional analysis of the data from the Association of American Medical Colleges was performed. The distribution of race and gender across academic ranks, tenure, and degree types were recorded from 2007-2018. Simple descriptive statistics and chi-square analysis was used to analyze the time trends and association between gender and race across academic rank, tenure status, and degree types. RESULTS When averaged over the 12 y of this study, there were significantly more whites (69.8%) and males (74.5%) among the academic surgery faculty compared with other races and females, respectively (P value <0.05). Asians and females experienced the greatest increase in proportional representation across all academic ranks with an absolute increase of 7% and 5% in full professor, 5% and 6% in associate professor, and 7% and 3% in chairperson (P value <0.05), respectively. No significant association was observed between gender and race with tenure status or degree type. CONCLUSIONS Female and Asians are increasing in proportional representation; however, racial and gender disparities remain prevalent at higher academic ranks and positions of leadership, especially among black and Hispanic academic surgeons.
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Maxwell JH, Randall JA, Dermody SM, Hussaini AS, Rao H, Nathan AS, Malekzadeh S, Litvack JR. Gender and compensation among surgical specialties in the Veterans Health Administration. Am J Surg 2020; 220:256-261. [DOI: 10.1016/j.amjsurg.2020.02.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/17/2020] [Accepted: 02/23/2020] [Indexed: 10/24/2022]
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Krebs ED, Narahari AK, Cook-Armstrong IO, Chandrabhatla AS, Mehaffey JH, Upchurch GR, Showalter SL. The Changing Face of Academic Surgery: Overrepresentation of Women among Surgeon-Scientists with R01 Funding. J Am Coll Surg 2020; 231:427-433. [PMID: 32687880 DOI: 10.1016/j.jamcollsurg.2020.06.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/26/2020] [Accepted: 06/11/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND There has been a recent focus on sex-based disparities within the field of academic surgery. However, the proportion of female surgeons conducting NIH-funded research is unknown. STUDY DESIGN The NIH RePORTER (Research Portfolio Online Reporting Tools Expenditures and Results) was queried for R01 grants from surgery departments for which the principal investigator (PI) had a primary medical degree, as of October 2018. Characteristics of the PI and their respective grants were collected. Institutional faculty profiles were reviewed for PI and departmental characteristics. PIs were stratified by sex and compared using standard univariate statistics. RESULTS There were a total of 212 R01 grants in surgery departments held by 159 PIs. Of these, 26.4% (n = 42) of R01-funded surgeons were female compared with the reported 19% of academic surgery female faculty (as reported by the Association of American Medical Colleges; p = 0.02). Women with R01 grants were more likely to be first-time grant recipients with no concurrent or previous NIH funding (21.4% vs 8.6%; p = 0.03) and less likely to have a previous R01 or equivalent grant (54.8% vs 73.5%; p = 0.03). Women were more likely to be from departments with a female surgery chair (31.0% vs 13.7%; p = 0.01) or a department with > 30% female surgeons (35.0% vs 18.2%; p = 0.03). CONCLUSIONS Although female surgeons remain a minority in academic surgery, they hold a greater than anticipated proportion of NIH funding, with a high number of first-time grants, forming a crucial component of the next generation of surgeon-scientists.
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Affiliation(s)
- Elizabeth D Krebs
- Department of Surgery, The University of Virginia Health System, Charlottesville, VA
| | | | | | | | - J Hunter Mehaffey
- Department of Surgery, The University of Virginia Health System, Charlottesville, VA
| | - Gilbert R Upchurch
- Department of Surgery, University of Florida Health System, Gainesville, FL
| | - Shayna L Showalter
- Department of Surgery, The University of Virginia Health System, Charlottesville, VA.
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Barinsky GL, Daoud D, Tan D, Cerasiello SY, Silva NA, Grube JG, Baredes S, Gray ST, Eloy JA. Gender Representation at Conferences, Executive Boards, and Program Committees in Otolaryngology. Laryngoscope 2020; 131:E373-E379. [PMID: 32673426 DOI: 10.1002/lary.28823] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/22/2020] [Accepted: 05/17/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Women represent approximately 28.0% of academic otolaryngologists. Previous studies have shown that women in academic medicine, including surgical subspecialties, have disparate career advancement opportunities and grant funding compared to male counterparts. Representation at major academic meetings is an important career advancement opportunity. In this study, we assess the representation of women at otolaryngology conferences. STUDY DESIGN Cross-sectional analysis of otolaryngology conference programs. METHODS All publicly available scientific programs from The American Academy of Otolaryngology-Head and Neck Surgery Foundation Annual Meeting (AAO-HNSF), the Triological Society Annual Combined Sections Meeting (TS), and the Triological Society Annual Meeting at Combined Otolaryngology Spring Meetings (TS-COSM) were obtained and analyzed. Name and gender were collected, along with the type of role: speaker, panelist, oral session moderator, and other leadership positions. Yearly trends were analyzed and compared between the conferences and in aggregate. RESULTS AAO-HNSF had available scientific programs from 2012-2017, while TS and TS-COSM had programs available from 2003-2018. Across all conferences and years, 16.9% of recorded opportunities were occupied by women, with an upward trend from 2005 to 2018. Program committees had the highest proportion of women (21.4%) and presidential citation and guest of honor recipients had the lowest (9.1%). Of all panels, 87.5% did not have any women panelists in 2003, but by 2018 only 24.0% panels were male-only. There was marked repetition among women occupying roles, with only 423 unique women occupying a total of 1,733 filled spots. CONCLUSION Measured representation of women in academic otolaryngology conferences has improved from 2003-2018. Despite this improvement, gender disparity still exists. LEVEL OF EVIDENCE 5 Laryngoscope, 131:E373-E379, 2021.
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Affiliation(s)
- Gregory L Barinsky
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
| | - Deborah Daoud
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
| | - Didem Tan
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
| | - Samantha Y Cerasiello
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
| | - Nicole A Silva
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
| | - Jordon G Grube
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
| | - Soly Baredes
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.,Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
| | - Stacey T Gray
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, U.S.A.,Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Jean Anderson Eloy
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.,Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.,Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
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Abstract
A shortage of otolaryngologists is predicted for the coming decades, primarily because of an aging population and aging workforce. However, many factors affect the agility of the workforce to expand or contract. This article discusses what is known about factors of the current otolaryngology workforce, including trends in residency and fellowship training, diversity of the specialty, its geographic distribution, and the challenges of caring for an aging population. Predicting the shortage and possible solutions through modeling is complex and prone to errors caused by incomplete data and assumptions about otolaryngology's similarity to other specialties of medicine at large.
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Affiliation(s)
- Lauren M Cass
- Department of Otolaryngology Head and Neck Surgery, The University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 3010, Kansas City, KS 66106, USA.
| | - Joshua B Smith
- Department of Otolaryngology Head and Neck Surgery, The University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 3010, Kansas City, KS 66106, USA. https://twitter.com/JBSmithMD
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Horwood C, McDermott S, Gennell T, Pawlik TM, Grignol VP, Hughes TM. Letters of recommendation for surgical fellowships - Does gender make a difference? Am J Surg 2020; 221:90-94. [PMID: 32650977 DOI: 10.1016/j.amjsurg.2020.06.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/10/2020] [Accepted: 06/25/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Females comprise 1/3 of general surgery residents, 1/4 of surgical faculty and 10% of full professors. Inadequate sponsorship is one proposed mechanism for this decline. This study evaluated letters of recommendation (LOR) among applicants applying to a complex general surgical oncology (CGSO) fellowship. METHODS Linguistic analysis of LOR for CGSO applicants was conducted. Demographics of authors and features of the LOR were extracted. Differences by gender of the applicant were analyzed. RESULTS Among 340 letters, 67% were written for male and 33% written for female applicants. Males authored 84% of letters reviewed. Female authors used more grindstone adjectives than males (3.61 v 2.90). However, this difference was seen only among letters written for male applicants (3.82 v. 2.73). All other linguistic features were similar, aside from mention of physical appearance which was significantly more common in letters written about female applicants (4% v. 1%). CONCLUSIONS Female authors write substantively different letters than males. Physical appearance is a small but important difference in letters for female applicants.
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Affiliation(s)
- Chelsea Horwood
- Primary Institution of Research Conduct, The Ohio State University Wexner Medical Center, United States
| | - Sean McDermott
- Primary Institution of Research Conduct, The Ohio State University Wexner Medical Center, United States
| | - Tania Gennell
- Primary Institution of Research Conduct, The Ohio State University Wexner Medical Center, United States
| | - Timothy M Pawlik
- Primary Institution of Research Conduct, The Ohio State University Wexner Medical Center, United States
| | - Valerie P Grignol
- Primary Institution of Research Conduct, The Ohio State University Wexner Medical Center, United States
| | - Tasha M Hughes
- Primary Institution of Research Conduct, The Ohio State University Wexner Medical Center, United States.
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Robinson DBT, Powell AGMT, Hopkins L, James OP, Abdelrahman T, Egan R, Lewis WG. Proof of surgical publication prowess: prospective observational study of factors associated with surrogate markers of academic reach. BJS Open 2020; 4:724-729. [PMID: 32490575 PMCID: PMC7397360 DOI: 10.1002/bjs5.50307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 05/05/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In the UK, general surgery higher surgical trainees (HSTs) must publish at least three peer-reviewed scientific articles (as first, second or corresponding author) to qualify for certification of completion of training (CCT). This study aimed to identify the factors associated with success in this arena. METHODS Deanery rosters supplemented with data from the Intercollegiate Surgical Curriculum Programme, PubMed and ResearchGate were used to identify the profiles of consecutive HSTs. Primary outcomes were publication numbers at defined points in higher training (speciality training year (ST) 3-8); secondary outcomes were the Hirsch index and ResearchGate scores. RESULTS Fifty-nine consecutive HSTs (24 women, 35 men) were studied. The median publication number was 3 (range 0-30). At least three published articles were obtained by 30 HSTs (51 per cent), with 19 (38 per cent) of 50 HSTs achieving this by ST4 (of whom 15 (79 per cent) had undertaken out of programme for research (OOPR) time) and 24 (80 per cent) by ST6. Thirteen HSTs (22 per cent) (ST3, 6; ST4, 4; ST5, 2; ST8, 1) had yet to publish at the time of writing. OOPR was associated with achieving three publications (24 of 35 (69 per cent) versus 6 of 24 (25 per cent) with no formal research time; P = 0·001), higher overall number of publications (median 6 versus 1 respectively; P < 0·001), higher ResearchGate score (median 23·37 versus 5·27; P < 0·001) and higher Hirsch index (median 3 versus 1; P < 0·001). In multivariable analysis, training grade (odds ratio (OR) 1·89, 95 per cent c.i. 0·01 to 3·52; P = 0·045) and OOPR (OR 6·55, 2·04 to 21·04; P = 0·002) were associated with achieving three publications. CONCLUSION If CCT credentials are to include publication profiles, HST programmes should incorporate research training in workforce planning.
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Affiliation(s)
- D B T Robinson
- Health Education and Improvement Wales School of Surgery, Nantgarw, UK
| | - A G M T Powell
- Division of Cancer and Genetics, Cardiff University, Cardiff, UK
| | - L Hopkins
- Health Education and Improvement Wales School of Surgery, Nantgarw, UK
| | - O P James
- Health Education and Improvement Wales School of Surgery, Nantgarw, UK
| | - T Abdelrahman
- Health Education and Improvement Wales School of Surgery, Nantgarw, UK
| | - R Egan
- Department of Surgery, Morriston Hospital, Swansea, UK
| | - W G Lewis
- Health Education and Improvement Wales School of Surgery, Nantgarw, UK
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Marcelin JR, Manne-Goehler J, Silver JK. Supporting Inclusion, Diversity, Access, and Equity in the Infectious Disease Workforce. J Infect Dis 2020; 220:S50-S61. [PMID: 31430384 DOI: 10.1093/infdis/jiz213] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
In medicine, a wide array of evidence demonstrates the presence of gender, racial, ethnic, and other disparities in representation, compensation, and career development. These disparities also exist in the field of infectious diseases, providing important opportunities for the Infectious Diseases Society of America to identify and report its successes in and challenges to achieving equity. In this article, we review the literature documenting challenges with equity broadly in medicine and specifically in infectious diseases. We then introduce the Be Ethical Campaign, an initiative that encourages healthcare leaders to use metrics and data analysis to identify workforce equity gaps and pursue opportunities to close them.
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Affiliation(s)
| | - Jennifer Manne-Goehler
- Massachusetts General Hospital, Boston, Massachusetts.,Brigham and Women's Hospital, Boston, Massachusetts
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45
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Trends in female surgeon authorship - The role of the middle author. Am J Surg 2020; 220:1541-1548. [PMID: 32409010 DOI: 10.1016/j.amjsurg.2020.04.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 03/20/2020] [Accepted: 04/19/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND The objective of this study was to compare middle authorships between male and female general surgeons in the United States. METHODS A stratified random sample of American College of Surgeons general surgery fellows was identified. Relevant author demographic, affiliation, and publication metrics were collected and compared across cohorts to determine which demographics were prognostic for each outcome variable. The primary endpoint was the number of middle author papers between genders. RESULTS Males were more likely to enter into practice earlier (p<0.001), be fellowship-trained (p<0.001), obtain higher academic rank (p<0.001), and practice at more highly ranked academic institutions (p=0.019). Females had fewer middle author publications (p=0.044) and higher annual rates of first author publications (p=0.020) despite similar rates of total publications. CONCLUSIONS Female surgeons hold the middle author position less frequently than males despite similar total publication numbers. Reasons for this finding should be the target of future study.
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Giuffrida MA, Steffey MA, Balsa IM, Morello SL, Kapatkin AS. Gender differences in academic rank among faculty surgeons at US veterinary schools in 2019. Vet Surg 2020; 49:852-859. [PMID: 32372516 DOI: 10.1111/vsu.13440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/25/2020] [Accepted: 03/26/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe academic rank, gender, surgical career length, and publication record of academic veterinary surgeons and to estimate the association between gender and higher academic rank. STUDY DESIGN Cross-sectional study. SAMPLE Residency-trained surgeons at US veterinary schools in 2019. METHODS Surgeons were identified via institutional websites. Data including surgeon gender, academic title, and year of board certification were collected from public resources. Publication record was measured by using author h-indices obtained from Scopus. Data were analyzed with descriptive and inferential statistics. RESULTS Three hundred eighteen surgeons were identified from 30 institutions, including 162 (51%) women and 156 (49%) men. Women represented 66% of instructors and assistant professors, and men represented 60% of associate and full professors. This distribution differed significantly (P < .001). Author h-index was associated with career length but not gender. Men were 2.5 times more likely than women to be associate or full professors (odds ratio 2.52, 95% CI 1.03-6.14, P = .042) after adjustment for career length and h-index. CONCLUSION Female surgery faculty at US veterinary schools in 2019 were concentrated in lower academic ranks and were less likely than male surgery faculty to be associate or full professors after adjustment for career length and publication record. IMPACT A gender gap exists in academic veterinary surgery in the United States. It is critical to recognize that women's increasing participation in veterinary medicine has not been matched by equal representation in all areas. Additional efforts are warranted to identify contributing factors and implement strategies to improve gender inclusion.
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Affiliation(s)
- Michelle A Giuffrida
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Michele A Steffey
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Ingrid M Balsa
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Samantha L Morello
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - Amy S Kapatkin
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California
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47
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Bernardi K, Lyons NB, Huang L, Holihan JL, Olavarria OA, Loor MM, Ko TC, Liang MK. Gender Disparity Among Surgical Peer-Reviewed Literature. J Surg Res 2020; 248:117-122. [DOI: 10.1016/j.jss.2019.11.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/05/2019] [Accepted: 11/16/2019] [Indexed: 11/28/2022]
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48
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Klifto KM, Payne RM, Siotos C, Lifchez SD, Cooney DS, Broderick KP, Aliu O, Manahan MA, Rosson GD, Cooney CM. Women Continue to Be Underrepresented in Surgery: A Study of AMA and ACGME Data from 2000 to 2016. JOURNAL OF SURGICAL EDUCATION 2020; 77:362-368. [PMID: 31889693 DOI: 10.1016/j.jsurg.2019.10.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 09/16/2019] [Accepted: 10/01/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE In the past decade women have comprised nearly half of U.S. medical school graduates. However, women remain underrepresented among surgical residents and practicing surgeons. We conducted the current study to assess recent trends in the female-to-male (F:M) ratios among residents and physicians pursuing careers in surgery. DESIGN We used retrospective population statistics published by the American Medical Association and the Accreditation Council for Graduate Medical Education from 2000 to 2016. We compared trends of female-to-male ratios among residents and surgeons in surgical subspecialties to evaluate for potential differences over time. SETTING Published online population statistics. PARTICIPANTS We stratified both board-certified surgeons and surgical residents by sex and specialty. RESULTS From 2000 to 2013, the proportion of female surgeons among all female physicians remained constant (12%-13%). The proportion of board-certified female surgeons to all surgeons increased (from 15% in 2000 to 25% in 2013). The F:M ratios of board-certified surgeons in neurosurgery and orthopedic surgery were 1:10.6 and 1:13.9, with resident ratios 1:4.8 and 1:5.9, respectively. One specialty with increasingly equivalent ratios is plastic surgery with integrated resident F:M ratios of 1:3.1 in 2008 to 1:1.4 in 2015, and board-certified plastic surgeons of 1:9.2 in 2008 to 1:5.3 in 2013. CONCLUSION Although the gender gap is narrowing, women continue to be underrepresented in surgical specialties. It is important for fields with disproportionate representation to be aware of these differences and take steps toward creating and supporting a more diverse workforce.
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Affiliation(s)
- Kevin M Klifto
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rachael M Payne
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Charalampos Siotos
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Scott D Lifchez
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Damon S Cooney
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kristen P Broderick
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Oluseyi Aliu
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Michele A Manahan
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gedge D Rosson
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Carisa M Cooney
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Austin JP. Is Academic Medicine Ready for Term Limits? ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:180-183. [PMID: 31577584 DOI: 10.1097/acm.0000000000003020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The use of term limits in politics and business has been proposed as a means to refresh leadership, encourage innovation, and decrease gender and racial disparities in positions of power. Many U.S. states and the executive boards of businesses have incorporated them into their constitutions and bylaws; however, studies in politics and business have shown that implementing term limits has had mixed results. Specifically, research in politics has shown that term limits have had a minimal effect on the number of women and minorities elected to office, while research in business indicates term limits do increase innovation. Additionally, term limits may have unintended negative consequences, including inhibiting individuals from developing deep expertise in a specific area of interest and destabilizing institutions that endure frequent turnover in leaders. Given this conflicting information, it is not surprising that academic medical centers (AMCs) in the United States have not widely incorporated term limits for those holding positions of power, including deans, presidents, provosts, and department heads. Notably, a few AMCs have incorporated such limits for some positions, and faculty have viewed these positively for their ability to shape a more egalitarian and collaborative culture. Drawing on studies from academic medicine, politics, and business, the author examines arguments both for and against instituting term limits at AMCs. The author concludes that despite strong arguments against term limits, they deserve attention in academic medicine, especially given their potential to help address gender and racial disparities and to encourage innovation.
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Affiliation(s)
- Jared P Austin
- J.P. Austin is associate professor, Department of Pediatrics, Oregon Health and Science University, Portland, Oregon; ORCID: https://orcid.org/0000-0002-7868-3855
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50
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Kuo LE, Kelz RR. Procedure Mix-The Path to Pay Equity. JAMA Surg 2019; 154:1142. [PMID: 31577345 DOI: 10.1001/jamasurg.2019.3799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Lindsay E Kuo
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Rachel R Kelz
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
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