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Fan W, Chen Y, Fang X, Zhu L, Fei G, Lu J, Li X. Gender differences in gastrointestinal, biopsychosocial and healthcare-seeking behaviors in Chinese patients with irritable bowel syndrome predominant with diarrhea. BMC Gastroenterol 2024; 24:102. [PMID: 38481138 PMCID: PMC10935896 DOI: 10.1186/s12876-024-03153-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/29/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Evidences of comparison of sex difference in Chinese irritable bowel syndrome (IBS) patients were few. We aim to compare gender difference in the biopsychosocial characteristics of Chinese patients of IBS predominant with diarrhea (IBS-D). METHODS IBS-D patients meeting Rome III criteria were enrolled. We administered IBS symptom questionnaires, evaluation of psychological status (HAMD and HAMA scales) and IBS quality of life (IBS-QOL), dietary habits, healthcare seeking behaviors, and compared biopsychosocial characteristics between male and female patients. RESULTS Four hundred and ninety patients were enrolled including 299 males and 191 females. More female patients reported abdominal pain associated with defecation (84.3% vs. 74.9%, P = 0.014) while males reported more abdominal discomfort (39.8% vs. 26.7%, P = 0.003). Females had higher IBS symptom score (9.7 ± 1.7 vs. 9.4 ± 1.4, P = 0.025) and more of females had severe abdominal pain/discomfort (17.8% vs. 12.4%, P = 0.013) while there were no significant differences of other bowel symptoms. Females reported higher incidence of comorbid anxiety state (64.9% vs. 52.8%, P = 0.008) and depression state (35.6% vs. 19.7%, P < 0.001) than males. Female patients also had lower IBS-QOL score (70.2 ± 20.4 vs. 75.1 ± 16.8, P = 0.028) and more frequent consultations, as well as less response for dietary modification than males. CONCLUSIONS Chinese female patients with IBS-D had more prominent psychosocial disorders compared to male patients and their abdominal symptoms had minor differences.
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Affiliation(s)
- Wenjuan Fan
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei Province, China
| | - Yang Chen
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China
| | - Xiucai Fang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China
| | - Liming Zhu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China
| | - Guijun Fei
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China
| | - Jia Lu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China
| | - Xiaoqing Li
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China
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JohnBritto JS, Di Ciaula A, Noto A, Cassano V, Sciacqua A, Khalil M, Portincasa P, Bonfrate L. Gender-specific insights into the irritable bowel syndrome pathophysiology. Focus on gut dysbiosis and permeability. Eur J Intern Med 2024:S0953-6205(24)00105-5. [PMID: 38467533 DOI: 10.1016/j.ejim.2024.03.011] [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: 02/08/2024] [Accepted: 03/05/2024] [Indexed: 03/13/2024]
Abstract
Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder involving the brain-gut interaction. IBS is characterized by persistent abdominal pain and changes in bowel habits. IBS exerts significant impacts on quality of life and imposes huge economic costs. Global epidemiological data reveal variations in IBS prevalence, both globally and between genders, necessitating comprehensive studies to uncover potential societal and cultural influences. While the exact pathophysiology of IBS remains incompletely understood, the mechanism involves a dysregulation of the brain-gut axis, leading to disturbed intestinal motility, local inflammation, altered intestinal permeability, visceral sensitivity, and gut microbiota composition. We reviewed several gender-related pathophysiological aspects of IBS pathophysiology, by focusing on gut dysbiosis and intestinal permeability. This perspective paves the way to personalized and multidimensional clinical management of individuals with IBS.
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Affiliation(s)
- Jerlin Stephy JohnBritto
- Clinica Medica "A. Murri", Department of Precision and Regenerative Medicine and Jonian Area (DiMePre-J), University of Bari Aldo Moro, Bari, Italy
| | - Agostino Di Ciaula
- Clinica Medica "A. Murri", Department of Precision and Regenerative Medicine and Jonian Area (DiMePre-J), University of Bari Aldo Moro, Bari, Italy
| | - Antonino Noto
- Clinica Medica "A. Murri", Department of Precision and Regenerative Medicine and Jonian Area (DiMePre-J), University of Bari Aldo Moro, Bari, Italy
| | - Velia Cassano
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Mohamad Khalil
- Clinica Medica "A. Murri", Department of Precision and Regenerative Medicine and Jonian Area (DiMePre-J), University of Bari Aldo Moro, Bari, Italy
| | - Piero Portincasa
- Clinica Medica "A. Murri", Department of Precision and Regenerative Medicine and Jonian Area (DiMePre-J), University of Bari Aldo Moro, Bari, Italy.
| | - Leonilde Bonfrate
- Clinica Medica "A. Murri", Department of Precision and Regenerative Medicine and Jonian Area (DiMePre-J), University of Bari Aldo Moro, Bari, Italy
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Wang J, Lv C, Song X, Hu Y, Hao W, He L, Chen Y, Gan Y, Han X, Yan S. Current situation and needs analysis of medical staff first aid ability in China: a cross-sectional study. BMC Emerg Med 2023; 23:128. [PMID: 37919639 PMCID: PMC10623825 DOI: 10.1186/s12873-023-00891-x] [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] [Received: 06/15/2023] [Accepted: 10/03/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVES We aim to understand the current situation of the first aid ability and training needs of Chinese medical personnel to provide a scientific basis for formulating the contents and methods of emergency medical rescue training and thereby improve the first aid level of Chinese medical personnel. METHODS A cross-sectional survey was conducted between June 2022 and February 2023 using a two-stage cluster sampling method with a structured questionnaire sent to medical workers in 12 provinces in China. 14,527 questionnaires were included in this study. Data were collected on demographic characteristics, first aid knowledge and skills, and training needs. Variance analysis was used to compare the difference between the first aid ability and training needs of medical staff in different hospitals, and multiple linear regression analysis was carried out to evaluate first aid ability and training needs. RESULT The study included 6041 patients (41.6%) in tertiary hospitals, 5838 patients (40.2%) in secondary hospitals, and 2648 patients (18.2%) in primary hospitals. There were significant differences in the first aid ability and training needs of medical staff in hospitals of different levels (p < 0.001). The score of first aid knowledge and skills in tertiary hospitals was the highest (209.7 ± 45.0), and the score of training needs in primary hospitals was the highest (240.6 ± 44.0). There was a significant correlation between first aid ability and training needs score (p < 0.001). Multiple linear regression analysis shows that geographic region, age, work tenure, gender, job title, department, professional title, monthly income, and hospital level are the influencing factors of training demand. CONCLUSION Medical staff in primary hospitals generally have low first aid knowledge and skills and a strong willingness to train. Therefore, it is imperative to strengthen the training of first aid ability and research training strategies. The level of the hospital is closely related to the level of first aid, so it is necessary to recognize the commonalities and differences in medical staff's demand for first aid knowledge and skills and carry out targeted education and training.
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Affiliation(s)
- Juntao Wang
- International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
| | - Chuanzhu Lv
- Emergency Medicine Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, Hainan, China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
| | - Xingyue Song
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Yanlan Hu
- International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
| | - Wenjie Hao
- International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
| | - Lanfen He
- International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
| | - Yu Chen
- International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaotong Han
- Department of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabolomics, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, Hunan, China.
| | - Shijiao Yan
- International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China.
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, Hainan, China.
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China.
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Sebo P, Schwarz J. The level of the gender gap in academic publishing varies by country and region of affiliation: A cross-sectional study of articles published in general medical journals. PLoS One 2023; 18:e0291837. [PMID: 37733710 PMCID: PMC10513280 DOI: 10.1371/journal.pone.0291837] [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: 05/03/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Women are generally under-represented as authors of publications, and especially as last authors, but this under-representation may not be uniformly distributed across countries. We aimed to document by country and region the proportion of female authors (PFA) in high-impact general medical journals. METHODS We used PyMed, a Python library that provides access to PubMed, to retrieve all PubMed articles published between January 2012 and December 2021 in the fifty general internal medicine journals with the highest 2020 impact factor according to Journal Citation Reports. We extracted first/last authors' main country of affiliation for all these articles using regular expressions and manual search, and grouped the countries into eight regions (North/Latin America, Western/Eastern Europe, Asia, Pacific, Middle East, and Africa). We used NamSor to determine first/last authors' gender and computed the PFA for each country/region. RESULTS We retrieved 163,537 publications for first authors and 135,392 for last authors. Gender could be determined for 160,891 and 133,373 publications, respectively. The PFA was 41% for first authors and 33% for last authors, but it varied widely by country (first authors: >50% for eight countries, maximum = 63% in Romania, minimum = 19% in Japan; last authors: >50% for two countries, maximum = 53% in Romania, minimum = 9% in Japan). The PFA also varied by region. It was highest for Eastern Europe (first authors = 53%, last authors = 40%), and lowest for Asia (36% and 29%) and the Middle East (35% and 27%). CONCLUSION We found that the PFA varied widely by country and region, and was lowest in Asia, particularly Japan, and the Middle East. The under-representation of women as authors of publications, especially in these two regions, needs to be addressed and correcting persistent gender discrimination in research should be a top priority.
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Affiliation(s)
- Paul Sebo
- University Institute for Primary Care (IuMFE), University of Geneva, Geneva, Switzerland
| | - Joëlle Schwarz
- Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
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Folayan MO, El Tantawi M, Shamsoddin E, Martínez-Pérez GZ. Gender differences in dentistry and oral sciences research productivity by researchers in Nigeria. FRONTIERS IN ORAL HEALTH 2023; 4:1059023. [PMID: 37181153 PMCID: PMC10174437 DOI: 10.3389/froh.2023.1059023] [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: 09/30/2022] [Accepted: 04/12/2023] [Indexed: 05/16/2023] Open
Abstract
Background The aim of the study was to assess gender differences in the productivity, impact, collaboration pattern and author position of dentistry and oral sciences researchers in Nigeria. Methods We examined the Web of Science (WoS) publication records of dentistry and oral sciences researchers to assess gender differences in productivity, impact, collaboration and authorship pattern (first authorship, last authorship and corresponding author). The analysis included the number of publications in journals ranked based on their quartile rating amongst the journals in the subject area (Q1-Q4). Chi square was used to make gender comparisons. Significance was set at >5%. Results 413 unique authors published 1,222 articles on dentistry and oral sciences between 2012 and 2021. The number of WoS documents per female author was significantly higher than that per male author (3.7 vs. 2.6, p = 0.03). A non-significantly higher percentage of females authored papers in Q2 and Q3 journals and a higher percentage of males authored papers in Q4 journals. The number of citations per female author (25.0 vs. 14.9, p = 0.04) and the percentage of females listed as first authors (26.6% vs. 20.5%, p = 0.048) were statistically greater than men. The percentage of males listed as last authors was statistically greater than females (23.6% vs. 17.7%, p = 0.04). The correlation between the percentage of papers with researchers listed as first authors and that listed as last authors was not significant for males (p = 0.06) but was significant for females (p = 0.002). A non-significantly greater percentage of females were listed as corresponding authors (26.4% vs. 20.6%) and males were listed as international (27.4% vs. 25.1%) and domestic collaborators (46.8% vs. 44.7%). Also, there was no statistically significant gender difference in the proportion of articles published in open access journals (52.5% vs. 52.0%). Conclusion Though there were significant gender differences in the productivity, impact, and collaboration profile of dentistry and oral sciences researchers in Nigeria, the higher female research productivity and impact may be driven by cultural gender nuances that needs to be explored further.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Clinical Sciences, Nigeria Institute of Medical Research, Yaba, Nigeria
- Community Oral Health Department, Tehran University of Medical Sciences, Tehran, Iran
- Correspondence: Morenike Oluwatoyin Folayan
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Alexandria University, Alexandria, Egypt
| | - Erfan Shamsoddin
- Cochrane Iran Associate Centre, National Institute for Medical Research Development, Tehran, Iran
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Blalock AE, Leal DR. Redressing injustices: how women students enact agency in undergraduate medical education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022:1-18. [PMID: 36394683 PMCID: PMC9672615 DOI: 10.1007/s10459-022-10183-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
This study presents descriptions of epistemic injustice in the experiences of women medical students and provides accounts about how these students worked to redress these injustices. Epistemic injustice is both the immediate discrediting of an individual's knowledge based on their social identity and the act of persistently ignoring possibilities for other ways of knowing. Using critical narrative interviews and personal reflections over an eight-month period, 22 women students during their first year of medical school described instances when their knowledge and experience was discredited and ignored, then the ways they enacted agency to redress these injustices. Participants described three distinct ways they worked to redress injustices: reclaiming why they belong in medicine, speaking up and calling out the curriculum, and uplifting one another. This study has implications for recognizing medical students as whole individuals with lived histories and experiences and advocates for recognizing medical students' perspectives as valuable sources of knowledge.
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Affiliation(s)
- A Emiko Blalock
- Office of Medical Education Research and Development, Michigan State University College of Human Medicine, 964 Wilson Road, Fee Hall A214, East Lansing, MI, 48824, USA.
| | - Dianey R Leal
- Michigan State University College of Education, East Lansing, USA
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Rittenberg E, Liebman JB, Rexrode KM. Primary Care Physician Gender and Electronic Health Record Workload. J Gen Intern Med 2022; 37:3295-3301. [PMID: 34993875 PMCID: PMC9550938 DOI: 10.1007/s11606-021-07298-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 11/23/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Prior research indicates that female physicians spend more time working in the electronic health record (EHR) than do male physicians. OBJECTIVE To examine gender differences in EHR usage among primary care physicians and identify potential causes for those differences. DESIGN Retrospective study of EHR usage by primary care physicians (PCPs) in an academic hospital system. PARTICIPANTS One hundred twenty-five primary care physicians INTERVENTIONS: N/A MAIN MEASURES: EHR usage including time spent working and volume of staff messages and patient messages. KEY RESULTS After adjusting for panel size and appointment volume, female PCPs spend 20% more time (1.9 h/month) in the EHR inbasket and 22% more time (3.7 h/month) on notes than do their male colleagues (p values 0.02 and 0.04, respectively). Female PCPs receive 24% more staff messages (9.6 messages/month), and 26% more patient messages (51.5 messages/month) (p values 0.03 and 0.004, respectively). The differences in EHR time are not explained by the percentage of female patients in a PCP's panel. CONCLUSIONS Female physicians spend more time working in their EHR inbaskets because both staff and patients make more requests of female PCPs. These differential EHR burdens may contribute to higher burnout rates in female PCPs.
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Affiliation(s)
- Eve Rittenberg
- Harvard Medical School, Boston, MA, USA.
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, 02467, USA.
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Theodoulou I, Dost S, Burrows V, Lyall F, Wah TM, Makris GC. The interventional radiology gender gap: perspectives from the international IR training survey. Br J Radiol 2022; 95:20210726. [PMID: 35616650 PMCID: PMC10162054 DOI: 10.1259/bjr.20210726] [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: 06/14/2021] [Revised: 04/21/2022] [Accepted: 05/13/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This study sought to examine international interventional radiology (IR) training standards and perceptions. This survey aims to identify gender-based barriers and inequities effecting uptake, retention and experience of trainees in IR. METHODS An anonymous survey was created using Survey Monkey and distributed as a single-use weblink via eight IR national and international societies around the world. Data analysis was conducted to highlight gender-specific trends and identify any differences. RESULTS Motivation factors given for following a career in IR revealed gender differences in factors such as mentoring (8.7 F vs 21.6% M) and influence from senior colleagues (15.2 F vs 25.0% M). The overwhelming majority across both genders (82.6 F vs 81.3% M) agreed or strongly agreed that early exposure to IR training at Year 1 had a positive impact on career choice. A good work life balance was positively reported in 48.2% of female respondents compared to 45.2% in males. There were no significant differences in satisfaction with the various aspects of IR training. All differences observed between genders, exceeded the 0.05 significance level. CONCLUSION This survey offers many insights into the current international landscape of IR training. Ongoing evaluation is vital to inform recruitment practices and initiatives to bridge gender inequities and attract more females into IR. ADVANCES IN KNOWLEDGE This study has revealed that increasing and optimising mentoring opportunities may be the first step in increasing awareness of IR and maximising potential female recruits.
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Affiliation(s)
- Iakovos Theodoulou
- Department of Vascular and Interventional Radiology, Guys & St Thomas NHS Foundation Trust, London, United States
| | - Samiullah Dost
- Department of Vascular and Interventional Radiology, Guys & St Thomas NHS Foundation Trust, London, United States
| | - Victoria Burrows
- Sheffield Vascular Institute, Sheffield Teaching Hospitals, Sheffield, UK
| | - Fiona Lyall
- Imaging Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Tze Min Wah
- Diagnostic and Interventional Radiology Department, Institute of Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Adar R, Kahalon R, Ullrich J, Afek A, Eisenberg VH. Gender bias in the evaluation of interns in different medical specialties: An archival study. MEDICAL TEACHER 2022; 44:893-899. [PMID: 35316160 DOI: 10.1080/0142159x.2022.2046715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The field of medicine is characterized by within-field gender segregation: Gender ratios vary systematically by subdisciplines. This segregation might be, in part, due to gender bias in the assessment of women and men medical doctors. METHODS We examined whether the assessments, i.e. overall score, department scores and skills scores, interns receive by their superiors during their internship year, vary as a function of their gender and the representation of women in the field. We analyzed an archival data set from a large hospital in Israel which included 3326 assessments that were given to all interns who completed their internship year between 2015 and 2019. RESULTS Women received lower department scores and skills scores in fields with a low (versus high) representation of women. Men received higher scores in fields with a high (versus low) representation of men, yet there was no difference in their skills scores. CONCLUSIONS Women are evaluated more negatively in fields with a low representation of women doctors. Similarly, men are evaluated more negatively in fields with a low representation of men, yet this cannot be explained by their skills. This pattern of results might point to a gender bias in assessments. A better understanding of these differences is important as assessments affect interns' career choices and options.
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Affiliation(s)
- Roy Adar
- Department of Urology, Sheba Medical Center, Ramat Gan, Israel
| | - Rotem Kahalon
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychology, Simon Fraser University, Canada
| | - Johannes Ullrich
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Arnon Afek
- Management & research unit, Sheba Medical Center, Tel Hashomer, Israel
| | - Vered H Eisenberg
- Management & research unit, Sheba Medical Center, Tel Hashomer, Israel
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Blalock AE, Smith MC, Patterson BR, Greenberg A, Smith BRG, Choi C. "I might not fit that doctor image": Ideal worker norms and women medical students. MEDICAL EDUCATION 2022; 56:339-348. [PMID: 34862660 DOI: 10.1111/medu.14709] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 06/13/2023]
Abstract
Despite the increasing numbers of women students in medical schools, focused attention on their perceptions about medical school and the medical profession remain underexamined. These perceptions are important to understand, particularly since women students are likely burdened with a host of gender norms related to work, family, and their future roles as physicians. Early experiences in medical school offer important insights into the larger student experience and are tied to academic outcomes and feelings of belonging. To examine early experiences of women medical students, this qualitative study used sensemaking theory to describe the current context and "story" of ideal worker norms. Critical qualitative interviews of 38 women students were performed during their first 2 months of medical school and explored both how the students perceived and experienced ideal worker norms, and how they made sense of the "story" of ideal worker norms. The participants described ways they encountered gendering and ideal worker norms through displays of nurturing behaviour, expectations to balance a future family, and whether they looked or acted the part of a doctor. This article highlights the challenges women medical students are already aware they will face, the opportunities they look forward to, and the strengths they anticipate leaning on to navigate their profession. Results from this study have implications for women medical students' learning experiences and transitions into medical school and for faculty, staff, and scholars concerned with challenging gendering norms that shape medical education.
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Affiliation(s)
- A Emiko Blalock
- Office of Medical Education Research and Development, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | | | - B R Patterson
- Premed, University of North Carolina System, Chapel Hill, North Carolina, USA
| | - Amy Greenberg
- Office of Medical Education Research and Development, Office of Academic Affairs, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Brandon R G Smith
- Higher Adult and Lifelong Education, Michigan State University, East Lansing, Michigan, USA
| | - Christine Choi
- Student Affairs, Michigan State University, East Lansing, Michigan, USA
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Xiong M, Young AT, Bray SM. A survey of gender-based barriers and misconceptions in surgery. SURGERY IN PRACTICE AND SCIENCE 2022. [DOI: 10.1016/j.sipas.2021.100048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Li S, Sun VH, Galla N, Salazar G, Lewis T, Ahmed M, Daye D. Gender-based Survey Analysis of Research and Mentoring in Interventional Radiology. J Vasc Interv Radiol 2022; 33:578-585.e3. [PMID: 35114399 DOI: 10.1016/j.jvir.2022.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/14/2021] [Accepted: 01/19/2022] [Indexed: 10/19/2022] Open
Abstract
PURPOSE This study sought to define the gender-related differences in attitudes, perceptions, and aspirations among trainees interested in interventional radiology (IR) and analyze their experiences in research and mentorship. MATERIALS AND METHODS A cross-sectional survey study was conducted among members of the Society of Interventional Radiology Resident, Fellow and Student section and Medical Student Section in the summer of 2020. The anonymous, internally validated 27-item survey assessed demographics, research attitudes and experiences, mentorship, and career aspirations. Descriptive statistics were calculated using Fischer's exact analyses and student's t-tests. The Institutional Review Board approved the protocols for this study. RESULTS Of the 105 respondents who indicated their gender, 30% were women and 70% were men. Although both genders reported similar levels of research experience, female trainees were less likely to feel valued and encouraged by their institution to engage in research (2.79 vs. 3.16 out of 4, p=0.02) and were less likely to indicate that their program requires them to participate in research (2.47 vs. 3.06, p=0.01). Female residents and fellows reported more difficulty in finding a mentor (2.88 vs. 3.28, p=0.04) and received less mentorship relating to IR education (29% vs. 64%, p=0.002). CONCLUSION This work provides perspective on the obstacles faced by female trainees in pursuing research and finding effective mentorship in the field of interventional radiology. This data may guide future interventions to boost interest and engagement in IR research and residency programs in a way that promotes gender diversity and equity in the field.
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Affiliation(s)
| | | | | | | | - Trevor Lewis
- Harvard Medical School,; Beth Israel Deaconess Medical Center
| | - Muneeb Ahmed
- Harvard Medical School,; Beth Israel Deaconess Medical Center
| | - Dania Daye
- Harvard Medical School,; Massachusetts General Hospital
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13
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Jung YJ, Kim HJ, Park CH, Park SJ, Kim N. Effects of Reproductive Factors on Lauren Intestinal-Type Gastric Cancers in Females: A Multicenter Retrospective Study in South Korea. Gut Liver 2022; 16:706-715. [PMID: 35000933 PMCID: PMC9474480 DOI: 10.5009/gnl210293] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/05/2021] [Accepted: 10/21/2021] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Gastric cancers (GCs), particularly the Lauren intestinal type, show a male predominance. The aim of this study was to investigate the effects of reproductive factors on GCs in females, according to Lauren classification. Methods Medical records of 1,849 males and 424 females who underwent radical gastrectomy or endoscopic resection for GCs between 2010 and 2018 were reviewed. The incidences of intestinal-type GCs were compared between males and groups of females stratified according to postmenopausal period. Associations between reproductive factors in females and intestinaltype GCs were analyzed using multivariate models. Results The proportions of intestinal-type GCs were significantly lower in premenopausal (19%), less than 10 years postmenopausal (30.4%), and 10 to 19 years postmenopausal females (44.1%) than in males (61.0%) (p<0.05 for all). Females ≥20 years postmenopause had a proportion of intestinal-type GCs similar to that in males (60.6% vs 61.0%; p=0.948). Multivariate analysis revealed that age (odds ratio [OR], 1.075; 95% confidence interval [CI], 1.039 to 1.113; p<0.001) and parity ≥3 (OR, 1.775; 95% CI, 1.012 to 3.114; p=0.045) were positively associated with an increased risk of intestinal-type GCs in postmenopausal females, while long fertility duration (OR, 1.147; 95% CI, 1.043 to 1.261; p=0.005) was positively associated with an increased risk of intestinal-type GCs in premenopausal females. Conclusions There were no significant differences in the proportions of intestinal-type GCs between males and females ≥20 years postmenopause, suggesting that female reproductive factors play a role in the prevention of intestinal-type GC.
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Affiliation(s)
- Yoon Ju Jung
- Division of Gastrointestinal Surgery, Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Hee Jin Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Cho Hyun Park
- Division of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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14
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Bochatay N, Bajwa NM, Ju M, Appelbaum NP, van Schaik SM. Towards equitable learning environments for medical education: Bias and the intersection of social identities. MEDICAL EDUCATION 2022; 56:82-90. [PMID: 34309905 DOI: 10.1111/medu.14602] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/12/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
CONTEXT Medical educators are increasingly paying attention to how bias creates inequities that affect learners across the medical education continuum. Such bias arises from learners' social identities. However, studies examining bias and social identities in medical education tend to focus on one identity at a time, even though multiple identities often interact to shape individuals' experiences. METHODS This article examines prior studies on bias and social identity in medical education, focusing on three social identities that commonly elicit bias: race, gender and profession. By applying the lens of intersectionality, we aimed to generate new insights into intergroup relations and identify strategies that may be employed to mitigate bias and inequities across all social identities. RESULTS Although different social identities can be more or less salient at different stages of medical training, they intersect and impact learners' experiences. Bias towards racial and gender identities affect learners' ability to reach different stages of medical education and influence the specialties they train in. Bias also makes it difficult for learners to develop their professional identities as they are not perceived as legitimate members of their professional groups, which influences interprofessional relations. To mitigate bias across all identities, three main sets of strategies can be adopted. These strategies include equipping individuals with skills to reflect upon their own and others' social identities; fostering in-group cohesion in ways that recognise intersecting social identities and challenges stereotypes through mentorship; and addressing intergroup boundaries through promotion of allyship, team reflexivity and conflict management. CONCLUSIONS Examining how different social identities intersect and lead to bias and inequities in medical education provides insights into ways to address these problems. This article proposes a vision for how existing strategies to mitigate bias towards different social identities may be combined to embrace intersectionality and develop equitable learning environments for all.
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Affiliation(s)
- Naike Bochatay
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Nadia M Bajwa
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of General Pediatrics, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - Mindy Ju
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Nital P Appelbaum
- Department of Education, Innovation and Technology, Baylor College of Medicine, Houston, Texas, USA
| | - Sandrijn M van Schaik
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
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15
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Broks VM, Stegers‐Jager KM, van den Broek WW, Woltman AM. Effects of raising the bar on medical student study progress: An intersectional approach. MEDICAL EDUCATION 2021; 55:972-981. [PMID: 33978272 PMCID: PMC8361716 DOI: 10.1111/medu.14560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 06/12/2023]
Abstract
CONTEXT Medical schools seek for measures to improve their students' study progress and are responsible for a diverse student population. OBJECTIVES The effect of a stricter academic dismissal (AD) policy in medical school on short-term and long-term study progress was investigated in a longitudinal cohort study. In addition, differential effects for subgroups were assessed by intersecting gender, ethnicity and prior education (intersectional framework). METHODS Participants were first-year Bachelor students enrolled in 2011 to 2016 in a Dutch medical school. For cohorts 2011-2013, the AD policy consisted of a minimum of 67% of Year-1 credits required to remain enrolled (67%-policy, n = 1189), and for cohorts 2014-2016, this bar was raised to 100% of Year-1 credits (100%-policy, n = 1233). Outcome measures on study progress were Year-1 completion and dropout (short term) and Bachelor completion in three and four years (long term). RESULTS Overall, Year-1 completion rates increased under the 100%-policy compared to the 67%-policy (OR = 2.50, 95%-CI:2.06-3.03, P < .001). Yet, this increase was not present for students with non-standard prior education - except for males with a migration background (OR = 7.19, 95%-CI:2.33-25.73, P < .01). The dropout rate doubled under the 100%-policy (OR = 2.41, 95%-CI:1.68-3.53, P < .001). Mainly students with standard prior education dropped out more often (OR = 3.68, 95%-CI:2.37-5.89, P < .001), except for males with a migration background. Bachelor completion rates after three and four years were not positively affected by the 100%-policy. Notably, females without a migration background and with non-standard prior education suffered from the 100%-policy regarding Bachelor completion after three years (OR = 0.29, 95%-CI:0.11-0.76, P < .05). CONCLUSIONS Despite increased dropout rates, the stricter AD policy improved Year-1 completion rates - especially for under-represented subgroups, thereby improving study progress without harming student diversity on the short term. However, these positive effects did not hold regarding Bachelor completion rates indicating that long-term effects require higher performance standards throughout the Bachelor, which in turn may harm other subgroups and thereby student diversity.
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Affiliation(s)
- Vera M.A. Broks
- Institute of Medical Education Research RotterdamErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Karen M. Stegers‐Jager
- Institute of Medical Education Research RotterdamErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Walter W. van den Broek
- Institute of Medical Education Research RotterdamErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Andrea M. Woltman
- Institute of Medical Education Research RotterdamErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
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16
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Cleveland Manchanda E, Chary A, Zanial N, Nadeau L, Verstreken J, Shappell E, Macias-Konstantopoulos W, Dobiesz V. The Role of Gender in Nurse-Resident Interactions: A Mixed-methods Study. West J Emerg Med 2021; 22:919-930. [PMID: 35353996 PMCID: PMC8328169 DOI: 10.5811/westjem.2021.3.49770] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/16/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction The role of gender in interprofessional interactions is poorly understood. This mixed-methods study explored perceptions of gender bias in interactions between emergency medicine (EM) residents and nurses. Methods We analyzed qualitative interviews and focus groups with residents and nurses from two hospitals for dominant themes. An electronic survey, developed through an inductive-deductive approach informed by qualitative data, was administered to EM residents and nurses. Quantitative analyses included descriptive statistics and between-group comparisons. Results Six nurses and 14 residents participated in interviews and focus groups. Key qualitative themes included gender differences in interprofessional communication, specific examples of, and responses to, gender bias. Female nurses perceived female residents as more approachable and collaborative than male residents, while female residents perceived nurses’ questions as doubting their clinical judgment. A total of 134 individuals (32%) completed the survey. Females more frequently perceived interprofessional gender bias (mean 30.9; 95% confidence interval {CI}, 25.6, 36.2; vs 17.6 [95% CI, 10.3, 24.9). Residents reported witnessing interprofessional gender bias more frequently than nurses (58.7 (95% CI, 48.6, 68.7 vs 23.9 (95% CI, 19.4, 28.4). Residents reported that gender bias affected job satisfaction (P = 0.002), patient care (P = 0.001), wellness (P = 0.003), burnout (P = 0.002), and self-doubt (P = 0.017) more frequently than nurses. Conclusion Perceived interprofessional gender bias negatively impacts personal wellbeing and workplace satisfaction, particularly among female residents. Key institutional stakeholders including residency, nursing, and hospital leadership should invest the resources necessary to develop and integrate evidence-based strategies to improve interprofessional relationships that will ultimately enhance residency training, work climate, and patient care.
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Affiliation(s)
- Emily Cleveland Manchanda
- Massachusetts General and Brigham and Women’s Hospitals, Boston Harvard Affiliated Emergency Medicine Residency, Boston, Massachusetts; Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts
| | - Anita Chary
- Massachusetts General and Brigham and Women’s Hospitals, Boston Harvard Affiliated Emergency Medicine Residency, Boston, Massachusetts; Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts
| | - Noor Zanial
- Harvard Medical School, Program in Global Surgery & Social Change, Boston, Massachusetts
| | - Lauren Nadeau
- Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts
| | - Jennifer Verstreken
- Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts
| | - Eric Shappell
- Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts
| | - Wendy Macias-Konstantopoulos
- Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts
| | - Valerie Dobiesz
- Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts
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17
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Doraiswamy S, Chaabna K, Jithesh A, Mamtani R, Cheema S. Physician burnout in the Eastern Mediterranean region: influence of gender and related factors - Systematic review and meta-analysis. J Glob Health 2021; 11:04043. [PMID: 34326993 PMCID: PMC8285757 DOI: 10.7189/jogh.11.04043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background While recent reviews highlight high burnout prevalence among physicians in the World Health Organization's (WHO) Eastern Mediterranean Region (EMR), there has been a limited exploration into the role of gender and related factors in this problem. Methods We conducted a systematic review and meta-analysis of studies on the prevalence of physician burnout and its relationship to gender, physician specialties, and age in the WHO's EMR based on the Cochrane Handbook for Systematic Reviews. We searched PubMed, Embase, PsycINFO, Google Scholar, and Al Manhal databases and synthesized the findings from the included studies. Results Among the 78 studies included, data was available from 16/22 (72.7%) countries and territories in the EMR covering a total of 16 016 physicians. The pooled prevalence of overall burnout among physicians in the region was estimated to be 24.5%. Among the sub-components of burnout, we estimated a high pooled prevalence of 44.26% for emotional exhaustion followed by 37.83% for depersonalization and 36.57% for low personal achievement. There was a statistically significant difference in the prevalence across the countries in the EMR and among the sub-categories of specialist medical practitioners. There was no statistically significant difference across the two genders at a regionally aggregated level. Conclusions The levels of physician burnout including the three sub-components in EMR are high by any standards. Based on our review of available studies, it is difficult to ascertain gender differences with certainty in burnout levels among physicians in the EMR nations. There is a need for better quality studies in this area.
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Affiliation(s)
| | - Karima Chaabna
- Institute for Population Health, Weill Cornell Medicine - Qatar
| | - Anupama Jithesh
- Institute for Population Health, Weill Cornell Medicine - Qatar
| | | | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine - Qatar
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18
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Brower BA, Butterworth ML, Crawford ME, Jennings MM, Tan Z, Moore JD, Suzuki S, Carpenter BB. The Podiatric Medical Profession: A Gender Comparison. J Foot Ankle Surg 2021; 59:997-1007. [PMID: 32747184 DOI: 10.1053/j.jfas.2020.05.002] [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: 11/19/2018] [Revised: 08/30/2019] [Accepted: 05/04/2020] [Indexed: 02/03/2023]
Abstract
The number of women in podiatric medicine and surgery has increased steadily over the past 4 decades; however, there appears to be a large and continued gender gap with respect to representation in academic medicine and other positions of power. National and state level organizational data were obtained from multiple podiatry professional societies to evaluate the rate at which women achieved leadership roles within the podiatric profession over time. A secondary questionnaire was also developed and electronically mailed to 8684 doctors of podiatric medicine to help capture additional leadership information and to provide further insight into the trends observed. The response rate was 26% (2276/8684). Female representation in academia, research/publications, most leadership positions, and board certifications has increased over time, but at a slower rate than the number of women entering the profession. We observed a decreasing trend of females completing fellowships, speaking at national meetings, becoming residency directors, and receiving American College of Foot and Ankle Surgeons- and American Podiatric Medical Association-sponsored grants/awards. Based on the survey results, female podiatric physicians were more likely to be single, have fewer children, spend more time in a clinical setting, be less satisfied with work, and experience higher work stress levels than their male colleagues. Of the female respondents, 73% described experiencing gender discrimination at some point in their career, and 42% reported experiencing sexual harassment, compared with only 6% and 5% of men, respectively. There continues to be a gender gap in leadership roles, which may be explained partially by work/life balance issues, gender discrimination, and other issues.
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Affiliation(s)
- Brittany A Brower
- Third Year Chief Resident Physician, John Peter Smith Hospital, Fort Worth, TX.
| | | | - Mary E Crawford
- Staff Physician, Providence Regional Medical Center, Private Practice at the Ankle & Foot Clinics Northwest, Everett, WA
| | - Meagan M Jennings
- Attending, Silicon Valley Foot & Ankle Reconstructive Surgery Fellowship; Staff Surgeon, Palo Alto Medical Foundation, Mountain View, CA
| | - Zhengqi Tan
- PhD Student, Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
| | - Jonathan D Moore
- PhD Student, Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
| | - Sumihiro Suzuki
- Associate Professor and Chair, Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
| | - Brian B Carpenter
- Professor, Department of Orthopedics, University of North Texas Health Science Center, Fort Worth, TX
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19
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Riley R, Buszewicz M, Kokab F, Teoh K, Gopfert A, Taylor AK, Van Hove M, Martin J, Appleby L, Chew-Graham C. Sources of work-related psychological distress experienced by UK-wide foundation and junior doctors: a qualitative study. BMJ Open 2021; 11:e043521. [PMID: 34162634 PMCID: PMC8231022 DOI: 10.1136/bmjopen-2020-043521] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 01/27/2021] [Accepted: 03/17/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES This paper reports findings exploring work cultures, contexts and conditions associated with psychological distress in foundation and junior doctors. DESIGN Qualitative study using in-depth interviews with 21 junior doctor participants. The interviews were audio-recorded, transcribed, anonymised and imported into NVivo V.11 to facilitate data management. Data were analysed using a thematic analysis employing the constant comparative method. SETTING NHS in England. PARTICIPANTS A purposive sample of 16 female and five male junior doctor junior doctor participants who self-identified as having stress, distress, anxiety, depression and suicidal thoughts, or having attempted to kill themselves. RESULTS Analysis reported four key themes: (1) workload and working conditions; (2) toxic work cultures-including abuse and bullying, sexism and racism, culture of blaming and shaming; (3) lack of support; (4) stigma and a perceived need to appear invulnerable. CONCLUSION This study highlights the need for future solutions and interventions targeted at improving work cultures and conditions. There needs to be greater recognition of the components and cumulative effects of potentially toxic workplaces and stressors intrinsic to the work of junior doctors, such as the stress of managing high workloads and lack of access to clinical and emotional support. A cultural shift is needed within medicine to more supportive and compassionate leadership and work environments, and a zero-tolerance approach to bullying, harassment and discrimination.
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Affiliation(s)
- Ruth Riley
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Marta Buszewicz
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Farina Kokab
- School of Social Policy, University of Birmingham, Birmingham, UK
| | - Kevin Teoh
- Department of Organizational Psychology, Birkbeck University of London, London, UK
| | - Anya Gopfert
- Oxford University Hospitals NHS Trust, Oxford, UK
| | - Anna K Taylor
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Maria Van Hove
- London School of Hygiene & Tropical Medicine, London, UK
| | - James Martin
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Louis Appleby
- Psychiatry and Behavioral Sciences, University of Manchester, Manchester, UK
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20
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Al-Busaidi AS, Ganesh A, Al-Adawi S, Al-Farsi YM, Al-Rawahi MK, Al-Mawali NA, Al-Kharousi NS, Al-Alawi M, Al-Mujaini AS. Development and validation of an instrument to measure physician awareness of bioethics and medical law in Oman. BMC Med Ethics 2021; 22:65. [PMID: 34022852 PMCID: PMC8140473 DOI: 10.1186/s12910-021-00619-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 04/19/2021] [Indexed: 11/27/2022] Open
Abstract
Background A different ethos with respect to the perception of medical ethics prevails in societies in transition such as those in the Arabian Peninsula, which makes it difficult to apply international principles of bioethics in medical practice. This study aimed to develop and psychometrically test an instrument that measures physicians’ awareness of bioethics and medical law and their attitudes towards the practice of medical ethics. Additionally, it examined physician correlates influencing the awareness of bioethics. Methods Following a rigorous review of relevant literature by a panel of experts, a 13-item instrument, the Omani physicians’ bioethics and medical law awareness (OBMLA) questionnaire was developed with the aim of assessing physicians’ awareness of bioethics and medical law. The study tool’s construct validity and internal consistency reliability were examined by exploratory factor analysis (EFA) and Cronbach’s alpha. In a cross-sectional study, the questionnaire was distributed among a random sample of 200 physicians at a tertiary hospital in Muscat, Oman. Participant characteristics that may influence awareness of bioethics and medical law were explored. Results The EFA of the OBMLA questionnaire resulted in three well-loading factors: (1) Physicians’ bioethics practice subscale (2) incentive related bioethics subscale and (3) medical law awareness subscale. Internal consistency reliability ranged between Cronbach’s α: 0.73–0.8. Of the total 200 participants, 52% reported that teaching medical ethics during medical school was inadequate. The overall mean (standard deviation, SD) of the bioethics awareness score and Omani medical law awareness were 27.6 (3.5) and 10.1 (2.1) respectively. The majority of physicians (73%) reported that they frequently encountered ethical dilemmas in their practice and 24.5% endorsed the view that unethical decisions tended to occur in their practice. Conclusion The study provides an insight into the practice of bioethics, and the awareness of bioethics and medical law among physicians in a teaching hospital in Oman. The OBMLA questionnaire appears to be a valid and reliable tool to assess a physician’s awareness of bioethics and medical law. In this preliminary study, it appears that participants have suboptimal scores on the indices which measure practice and awareness of bioethics and medical law. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-021-00619-1.
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Affiliation(s)
- Ahmed S Al-Busaidi
- Directorate General of Primary Health Care, Ministry of Health, Muscat, Sultanate of Oman
| | - Anuradha Ganesh
- Department of Ophthalmology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman.
| | - Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Muscat, Sultanate of Oman
| | - Yahya M Al-Farsi
- Department of Family Medicine and Public Health, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Maryam K Al-Rawahi
- Medical Student, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Nusaiba A Al-Mawali
- Medical Student, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Nadiya S Al-Kharousi
- Department of Ophthalmology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Mohammed Al-Alawi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Muscat, Sultanate of Oman
| | - Abdullah S Al-Mujaini
- Department of Ophthalmology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
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21
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Hwang YJ, Shin DW, Kim N, Yoon H, Shin CM, Park YS, Lee DH. Sex difference in bowel preparation quality and colonoscopy time. Korean J Intern Med 2021; 36:322-331. [PMID: 32564572 PMCID: PMC7969071 DOI: 10.3904/kjim.2019.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/05/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIMS The length of colon is known to be longer in females than in males. In addition, the morphology of colon cancer is different between males and females. The aim of this study was to investigate sex differences in Boston bowel preparation score (BBPS) and colonoscopy insertion time. METHODS This study retrospectively analyzed medical records and colonoscopy readings of subjects who underwent colonoscopy at Seoul National University Bundang Hospital from March 2015 to April 2018. BPPS was used to evaluate the degree of colon cleanness before colonoscopy. Statistical analysis was performed to compare demographic, clinical, and outcome variables between two groups. RESULTS The study group consisted of a total of 12,561 patients (6,148 females and 6,413 males). Mean age was 57.8 ± 13.5 years for females and 57.5 ± 13.8 years for males (p = 0.695). Females showed better bowel preparation than males (mean total score: 7.4 ± 1.8 vs. 7.2 ± 1.9, p = 0.001; total score ≥ 6: 5,340 [86.9%] vs. 5,437 [84.8%], p = 0.001; BBPS ≥ 2 for all segments: 5,048 [82.1%] vs. 5,097 [79.5%], p < 0.001). However, cecal intubation time (8.3 ± 6.2 minutes vs. 6.2 ± 6.1 minutes, p < 0.001) and withdrawal time (7.9 ± 3.5 minutes vs. 7.4 ± 3.1 minutes, p < 0.001) were longer in males. CONCLUSION There were sex differences in BBPS, cecal intubation time, and withdrawal time for subjects undergoing colonoscopy.
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Affiliation(s)
- Young-Jae Hwang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Woo Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine and Institute of Liver Research, Seoul National University College of Medicine, Seoul, Korea
- Correspondence to Nayoung Kim, M.D. Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea Tel: + 82-31-787-7008 Fax: + 82-31-787-4051 E-mail:
| | - Hyuk Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Soo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine and Institute of Liver Research, Seoul National University College of Medicine, Seoul, Korea
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Xepoleas MD, Munabi NCO, Auslander A, Magee WP, Yao CA. The experiences of female surgeons around the world: a scoping review. HUMAN RESOURCES FOR HEALTH 2020; 18:80. [PMID: 33115509 PMCID: PMC7594298 DOI: 10.1186/s12960-020-00526-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/15/2020] [Indexed: 05/25/2023]
Abstract
INTRODUCTION The Lancet Commission for Global Surgery identified an adequate surgical workforce as one indicator of surgical care accessibility. Many countries where women in surgery are underrepresented struggle to meet the recommended 20 surgeons per 100,000 population. We evaluated female surgeons' experiences globally to identify strategies to increase surgical capacity through women. METHODS Three database searches identified original studies examining female surgeon experiences. Countries were grouped using the World Bank income level and Global Gender Gap Index (GGGI). RESULTS Of 12,914 studies meeting search criteria, 139 studies were included and examined populations from 26 countries. Of the accepted studies, 132 (95%) included populations from high-income countries (HICs) and 125 (90%) exclusively examined populations from the upper 50% of GGGI ranked countries. Country income and GGGI ranking did not independently predict gender equity in surgery. Female surgeons in low GGGI HIC (Japan) were limited by familial support, while those in low income, but high GGGI countries (Rwanda) were constrained by cultural attitudes about female education. Across all populations, lack of mentorship was seen as a career barrier. HIC studies demonstrate that establishing a critical mass of women in surgery encourages female students to enter surgery. In HICs, trainee abilities are reported as equal between genders. Yet, HIC women experience discrimination from male co-workers, strain from pregnancy and childcare commitments, and may suffer more negative health consequences. Female surgeon abilities were seen as inferior in lower income countries, but more child rearing support led to fewer women delaying childbearing during training compared to North Americans and Europeans. CONCLUSION The relationship between country income and GGGI is complex and neither independently predict gender equity. Cultural norms between geographic regions influence the variability of female surgeons' experiences. More research is needed in lower income and low GGGI ranked countries to understand female surgeons' experiences and promote gender equity in increasing the number of surgical providers.
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Affiliation(s)
- Meredith D. Xepoleas
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA USA
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
| | - Naikhoba C. O. Munabi
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, 1510 San Pablo St, Suite 415, Los Angeles, CA USA
| | - Allyn Auslander
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA USA
| | - William P. Magee
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA USA
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, 1510 San Pablo St, Suite 415, Los Angeles, CA USA
- Division of Plastic Surgery, Shriners Hospital for Children, Los Angeles, CA USA
| | - Caroline A. Yao
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, 1510 San Pablo St, Suite 415, Los Angeles, CA USA
- Division of Plastic Surgery, Shriners Hospital for Children, Los Angeles, CA USA
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23
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Banks L, Randhawa VK, Caterini J, Colella TJF, Dhanvantari S, McMurtry S, Connelly KA, Robinson L, Anand SS, Ouzounian M, Zieroth S, Mak S, Straus S, Graham MM. Sex, Gender, and Equity in Cardiovascular Medicine, Surgery, and Science in Canada : Challenges, Successes, and Opportunities for Change. CJC Open 2020; 2:522-529. [PMID: 33305212 PMCID: PMC7711008 DOI: 10.1016/j.cjco.2020.06.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/29/2020] [Indexed: 01/01/2023] Open
Abstract
Background A previous review of sex, gender, and equity within cardiovascular (CV) medicine, surgery, and science in Canada has revealed parity during medical and graduate school training. The purpose of this study was to explore sex and gendered experiences within the Canadian CV landscape, and their impact on career training and progression. Methods An environmental scan was conducted of the Canadian CV landscape, which included an equity survey using Qualtrics software. Results The environmental scan revealed that women remain underrepresented within CV training programs as trainees (12%–30%), program directors (33%), in leadership roles at the divisional level (21%), and in other professional or career-related activities (< 30%). Our analysis also showed improvements of career engagement at these levels of women at over time. The thematic analysis of the equity survey responses (n = 71 respondents; 83% female; 9.7% response rate among female Canadian Cardiovascular Society members) identified the following themes reported within the socio-ecological framework: desire to report inequities vs staying the course (individual level); desire for social support and mentorship and challenges of dual responsibilities (interpersonal level); concerns over exclusionary cliques and desire for respect and opportunity (organizational level); and increasing awareness and actions to overcome institutional barriers and accountability (societal level). Conclusions Although women face challenges and remain underrepresented in CV medicine, surgery, and science, this study highlights potential opportunities for improving access of female medical, surgical, and research trainees and professionals to specialized cardiovascular training, career advancement, leadership, and research.
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Affiliation(s)
- Laura Banks
- Cardiovascular Prevention and Rehabilitation Program, University Health Network, Toronto, Ontario, Canada.,Faculty of Health Sciences, Ontario Tech University, Ontario, Canada
| | - Varinder K Randhawa
- Department of Cardiovascular Medicine, Kaufman Center for Heart Failure and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Tracey J F Colella
- Cardiovascular Prevention and Rehabilitation Program, University Health Network, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Savita Dhanvantari
- Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
| | - Sean McMurtry
- Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada
| | - Kim A Connelly
- Department of Cardiology, St Michaels Hospital, Toronto, Ontario, Canada
| | - Lisa Robinson
- University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sonia S Anand
- Division of Cardiology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Maral Ouzounian
- University of Toronto, Toronto, Ontario, Canada.,Department of Cardiothoracic Surgery, University Health Network, Toronto, Ontario, Canada
| | - Shelley Zieroth
- Section of Cardiology, St Boniface Hospital, and University of Manitoba, Winnipeg, Canada
| | - Susanna Mak
- University of Toronto, Toronto, Ontario, Canada.,Department of Cardiology, University Health Network, Toronto, Ontario, Canada
| | - Sharon Straus
- Department of Medicine, St Michaels Hospital, Toronto, Ontario, Canada
| | - Michelle M Graham
- Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada
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24
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Spruit E, Mol MF, Bos PK, Bierma-Zeinstra SM, Krastman P, Runhaar J. Self-Assessment of Competence and Referral Behavior for Musculoskeletal Injections among Dutch General Practitioners. J Clin Med 2020; 9:jcm9061880. [PMID: 32560156 PMCID: PMC7356219 DOI: 10.3390/jcm9061880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 11/16/2022] Open
Abstract
General practitioners (GPs) are qualified and trained to administer therapeutic musculoskeletal injections when indicated. However, it is unknown to what extend Dutch GPs feel competent to administer these injections in clinical practice. Reluctance among GPs to inject might lead to unnecessary and costly referral to secondary care. An online and offline questionnaire was spread among Dutch GPs, querying demographics, GPs' self-assessment of injection competence, the number of administered/referred injections and management strategy for musculoskeletal injections. A total of 355 GPs responded. In total, 81% of the GPs considered themselves competent in administering musculoskeletal injections. Self-assessed incompetent GPs performed less injections the last month than self-assessed competent GPs (1.2 ± 1.4 vs 4.8 ± 4.6 injections, P < 0.001). Additionally, they referred four times more often to a colleague GP (0.4 ± 1.0 vs 0.1 ± 0.6 injections per month, P < 0.001) and twice as often to secondary care (1.0 ± 1.3 vs 0.5 ± 0.9 injections per month, P = 0.001). Self-assessed incompetence was associated with female sex (OR [95% CI] = 4.94 [2.39, 10.21]) and part-time work (OR [95% CI] = 2.58 [1.43, 4.66]). The most frequently addressed barriers were a lack of confidence in injection skills, lack of practical training, and uncertainty about the effectiveness and diagnosis of musculoskeletal injections. Although most GPs considered themselves competent to administer musculoskeletal injections, the referral rate to secondary care for several injections was strikingly high. To decrease secondary care referrals, addressing some of the most frequently indicated barriers is highly recommended.
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Affiliation(s)
- Emely Spruit
- Department of General Practice, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.S.); (M.F.M.); (S.M.A.B.-Z.); (P.K.)
| | - Marianne F. Mol
- Department of General Practice, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.S.); (M.F.M.); (S.M.A.B.-Z.); (P.K.)
| | - P. Koen Bos
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands;
| | - Sita M.A. Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.S.); (M.F.M.); (S.M.A.B.-Z.); (P.K.)
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands;
| | - Patrick Krastman
- Department of General Practice, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.S.); (M.F.M.); (S.M.A.B.-Z.); (P.K.)
| | - Jos Runhaar
- Department of General Practice, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.S.); (M.F.M.); (S.M.A.B.-Z.); (P.K.)
- Correspondence:
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25
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Delpech R, Bloy G, Panjo H, Falcoff H, Ringa V, Rigal L. Physicians' preventive practices: more frequently performed for male patients and by female physicians. BMC Health Serv Res 2020; 20:331. [PMID: 32312327 PMCID: PMC7168941 DOI: 10.1186/s12913-020-05136-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 03/20/2020] [Indexed: 01/01/2023] Open
Abstract
Background We sought to analyze gender differences in General Practitioners’ (GP) preventive practices: variations according to the GP’s and the patient’s genders, separately and combined, and the homogeneity of GPs’ practices according to gender. Methods Fifty-two general practitioners volunteered to participate in a cross-sectional study. A sample of 70 patients (stratified by gender) aged 40–70 years was randomly chosen from each GP’s patient panel. Information extracted from the medical files was used to describe the GPs’ preventive practices for each patient: measurements of weight, waist circumference, glucose, and cholesterol; inquiry and counseling about smoking, alcohol consumption, diet, and physical activity, and dates of cervical smears and mammographies. An aggregate preventive score was calculated to assess the percentage of these practices performed by each GP for patients overall and by gender. Mixed models were used to test for gender differences. Results Questionnaires were collected in 2008–2009 for 71% of the 3640 patients and analyzed in June 2017. Male patients and female GPs were associated with the most frequent performance of many types of preventive care. The aggregate preventive score was higher for male patients (OR = 1.60, 95% CI 1.47–1.75) and female GPs (OR = 1.35, 95% CI 1.05–1.73). There was no combined effect of the genders of the two protagonists. Female patients of male GPs appeared to receive preventive care least frequently and female GPs to deliver preventive care more consistently than their male colleagues. Conclusion Physicians need to be aware of these differences, for both patient gender and their own.
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Affiliation(s)
- Raphaëlle Delpech
- General Practice Department, Université Paris-Saclay, Le Kremlin Bicêtre, France.
| | - Géraldine Bloy
- LEDi, EA 7467, University of Burgundy Franche-Comté, Dijon, France
| | - Henri Panjo
- CESP, INSERM, Paris-Saclay University, Paris-Sud University, UVSQ, Villejuif, France.,Institut National d'Études Démographiques (INED), Paris, France
| | - Hector Falcoff
- Société de Formation Thérapeutique du Généraliste, Paris, France
| | - Virginie Ringa
- CESP, INSERM, Paris-Saclay University, Paris-Sud University, UVSQ, Villejuif, France.,Institut National d'Études Démographiques (INED), Paris, France
| | - Laurent Rigal
- General Practice Department, Université Paris-Saclay, Le Kremlin Bicêtre, France.,CESP, INSERM, Paris-Saclay University, Paris-Sud University, UVSQ, Villejuif, France.,Institut National d'Études Démographiques (INED), Paris, France
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26
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Rivera-Romano LS, Fresno C, Hernández-Lemus E, Martínez-García M, Vallejo M. Gender imbalance in executive management positions at the Mexican National Institutes of Health. HUMAN RESOURCES FOR HEALTH 2020; 18:21. [PMID: 32183819 PMCID: PMC7079344 DOI: 10.1186/s12960-020-0463-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 03/02/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Around the world, there is a significant difference in the proportion of women with access to leadership in healthcare with respect to men. This article studies gender imbalance and wage gap in managerial, executive, and directive job positions at the Mexican National Institutes of Health. METHODS Cohort data were described using a visual circular representation and modeled using a generalized linear model. Analysis of variance was used to assess model significance, and posterior Fisher's least significant differences were analyzed when appropriate. RESULTS This study demonstrated that there is a gender imbalance distribution among the hierarchical position at the Mexican National Health Institutes and also exposed that the wage gap exists mainly in the (highest or lowest) ranks in hierarchical order. CONCLUSIONS Since the majority of the healthcare workforce is female, Mexican women are still underrepresented in executive and directive management positions at national healthcare organizations.
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Affiliation(s)
| | - Cristobal Fresno
- National Institute of Genomic Medicine, Periferico Sur 4809, Mexico City, Mexico
| | | | | | - Maite Vallejo
- National Institute of Cardiology "Ignacio Chavez", Juan Badiano 1, Mexico City, Mexico.
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27
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Gender Disparity Among Leaders of Canadian Academic Radiology Departments. AJR Am J Roentgenol 2020; 214:3-9. [DOI: 10.2214/ajr.18.20992] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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28
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Valenzuela-Valenzuela AV, Cartes-Velásquez R. Ausencia de perspectiva de género en la educación médica. Implicaciones en pacientes mujeres y LGBT+, estudiantes y profesores. IATREIA 2019. [DOI: 10.17533/udea.iatreia.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
La Salud corresponde a un estado de bienestar completo, donde interactúan factores biológicos, socioculturales y psicosociales. El género es uno de ellos. Actualmente está demostrado que las diferencias entre sexos y géneros tienen efectos en múltiples enfermedades, diferencias que tienden a omitirse en la educación médica. Entre las principales consecuencias a dicha omisión se encuentra la atención inadecuada a pacientes y la existencia de distintas discriminaciones dentro de la enseñanza médica.La siguiente revisión bibliográfica abordará cómo la ausencia de perspectiva de género en la educación en la salud afecta a los pacientes y estudiantes de medicina, sean femeninas o LGBT+. Se concluye que han existido mejoras tanto en la atención como en la enseñanza, pero debe continuarse el trabajo, en particular, en la formación inicial de los profesionales de la medicina.
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29
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Kirby E, Broom A, Karikios D, Harrup R, Lwin Z. Exploring the impact and experience of fractional work in medicine: a qualitative study of medical oncologists in Australia. BMJ Open 2019; 9:e032585. [PMID: 31826894 PMCID: PMC6924865 DOI: 10.1136/bmjopen-2019-032585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Fractional (part-time) appointments are becoming more commonplace in many professions, including medicine. With respect to the contemporary oncological landscape, this highlights a critical moment in the optimisation of employment conditions to enable high-quality service provision given growing patient numbers and treatment volume intensification. Data are drawn from a broader study which aimed to better understand the workforce experiences of medical oncologists in Australia. This paper specifically aims to examine a group of clinicians' views on the consequences of fractional work in oncology. DESIGN Qualitative, one-on-one semistructured interviews. Interview transcripts were digitally audio recorded and transcribed verbatim. Data were subject to thematic analysis supported by the framework approach and informed by sociological methods and theory. SETTING New South Wales, Australia. PARTICIPANTS Medical oncologists (n=22), including 9 female and 13 male participants, at a range of career stages. RESULTS Four key themes were derived from the analysis: (1) increasing fractional employment relative to opportunities for full-time positions and uncertainty about future opportunities; (2) tightening in role diversity, including reducing time available for research, mentoring, professional development and administration; (3) emerging flexibility of medical oncology as a specialty and (4) impact of fractional-as-norm on workforce sustainability and quality of care. CONCLUSION Fractional appointments are viewed as increasing in oncology and the broader consequences of this major shift in medical labour remain unexamined. Such appointments offer potential for flexible work to better suit the needs of contemporary oncologists; however, fractional work also presents challenges for personal and professional identity and vocational engagement. Fractional appointments are viewed as having a range of consequences related to job satisfaction, burnout and service delivery. Further research is needed to provide a critical examination of the multiple impacts of workforce trends within and beyond oncology.
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Affiliation(s)
- Emma Kirby
- Centre for Social Research in Health, UNSW, Sydney, New South Wales, Australia
| | - Alex Broom
- School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Deme Karikios
- Medical Oncology, Nepean Cancer Care Centre, Nepean Hospital, Penrith, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Rosemary Harrup
- Department of Medical Oncology/Haematology, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Zarnie Lwin
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
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30
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Gutiérrez-Cirlos C, Naveja JJ, García-Minjares M, Martínez-González A, Sánchez-Mendiola M. Specialty choice determinants among Mexican medical students: a cross-sectional study. BMC MEDICAL EDUCATION 2019; 19:420. [PMID: 31727026 PMCID: PMC6854711 DOI: 10.1186/s12909-019-1830-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 10/09/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The choice of medical specialty is related to multiple factors, students' values, and specialty perceptions. Research in this area is needed in low- and middle-income countries, where the alignment of specialty training with national healthcare needs has a complex local interdependency. The study aimed to identify factors that influence specialty choice among medical students. METHODS Senior students at the National Autonomous University of Mexico (UNAM) Faculty of Medicine answered a questionnaire covering demographics, personal experiences, vocational features, and other factors related to specialty choice. Chi-square tests and factor analyses were performed. RESULTS The questionnaire was applied to 714 fifth-year students, and 697 provided complete responses (response rate 81%). The instrument Cronbach's alpha was 0.8. The mean age was 24 ± 1 years; 65% were women. Eighty percent of the students wanted to specialize, and 60% had participated in congresses related to the specialty of interest. Only 5% wanted to remain as general practitioners. The majority (80%) wanted to enter a core specialty: internal medicine (29%), general surgery (24%), pediatrics (11%), gynecology and obstetrics (11%) and family medicine (4%). The relevant variables for specialty choice were grouped in three dimensions: personal values that develop and change during undergraduate training, career needs to be satisfied, and perception of specialty characteristics. CONCLUSIONS Specialty choice of medical students in a middle-income country public university is influenced by the undergraduate experience, the desire to study a subspecialty and other factors (including having skills related to the specialty and type of patients).
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Affiliation(s)
- Carlos Gutiérrez-Cirlos
- National Institute of Medical Sciences and Nutrition “Salvador Zubirán”, Mexico City, Mexico
- Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - J. Jesús Naveja
- Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Manuel García-Minjares
- Coordinador de Desarrollo Educativo e Innovación Curricular, Universidad Nacional Autónoma de México, Circuito Centro Cultural, S/N. Edificio CIPPS, 1er Piso, Ciudad Universitaria, Del. Coyoacán, Ciudad de México, CdMx, 04510 México
| | - Adrián Martínez-González
- Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
- Coordinador de Desarrollo Educativo e Innovación Curricular, Universidad Nacional Autónoma de México, Circuito Centro Cultural, S/N. Edificio CIPPS, 1er Piso, Ciudad Universitaria, Del. Coyoacán, Ciudad de México, CdMx, 04510 México
| | - Melchor Sánchez-Mendiola
- Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
- Coordinador de Desarrollo Educativo e Innovación Curricular, Universidad Nacional Autónoma de México, Circuito Centro Cultural, S/N. Edificio CIPPS, 1er Piso, Ciudad Universitaria, Del. Coyoacán, Ciudad de México, CdMx, 04510 México
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31
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Brower BA, Jennings MM, Butterworth ML, Crawford ME. Women in Podiatry and Medicine. Clin Podiatr Med Surg 2019; 36:707-716. [PMID: 31466577 DOI: 10.1016/j.cpm.2019.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The role of female physicians has advanced among western medicine. Women now constitute a majority within medical schools, and the number of women in podiatric medicine and surgery has increased over the last 5 decades. Conversely, female physicians continue to face barriers to closing the gender gap. They have lower academic standings and fewer publications, receive less awards/grants, are underrepresented in leadership positions, have a lower incidence pursuing surgical specialties, and receive lower compensation. Women experience an increased rate of burnout, gender discrimination, and sexual harassment. Increasing awareness of the gender gap is vital to the enhancement of the medical community.
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Affiliation(s)
- Brittany A Brower
- John Peter Smith Hospital, 1500 South Main Street, Fort Worth, TX 76104, USA.
| | - Meagan M Jennings
- Silicon Valley Foot & Ankle Reconstructive Surgery Fellowship, Palo Alto Medical Foundation, 701 E. El Camino Real South Wing, Mountain View, CA 94040, USA
| | - Michelle L Butterworth
- Williamsburg Regional Hospital, 500 Thurgood Marshall Hwy, Suite B, Kingstree, SC 29556, USA
| | - Mary E Crawford
- Providence Regional Medical Center, Private Practice at the Ankle & Foot Clinics Northwest, 3131 Nassaeu Street Suite 101, Everett, WA 98291, USA
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Mainardi GM, Cassenote AJF, Guilloux AGA, Miotto BA, Scheffer MC. What explains wage differences between male and female Brazilian physicians? A cross-sectional nationwide study. BMJ Open 2019; 9:e023811. [PMID: 31048423 PMCID: PMC6502025 DOI: 10.1136/bmjopen-2018-023811] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE In many countries an increase in the number of women in medicine is accompanied by gender inequality in various aspects of professional practice. Women in medical workforce usually earn less than their male counterparts. The aim of this study was to describe the gender wage difference and analyse the associated factors in relation to Brazil's physicians. PARTICIPANTS 2400 physicians. SETTING Nationwide, cross-sectional study conducted in 2014. METHODS Data were collected via a telephone enquiry. Sociodemographic and work characteristics were considered factors, and monthly wages (only the monthly earnings based on a medical profession) were considered as the primary outcome. A hierarchical multiple regression model was used to study the factors related to wage differences between male and female physicians. The adjustment of different models was verified by indicators of residual deviance and the Akaike information criterion. Analysis of variance was used to verify the equality hypothesis subsequently among the different models. RESULTS The probability of men receiving the highest monthly wage range is higher than women for all factors. Almost 80% of women are concentrated in the three lowest wage categories, while 51% of men are in the three highest categories. Among physicians working between 20 and 40 hours a week, only 2.7% of women reported receiving >US$10 762 per month, compared with 13% of men. After adjustment for work characteristics in the hierarchical multiple regression model, the gender variable estimations (ß) remained, with no significant modifications. The final effect of this full model suggests that the probability of men receiving the highest salary level (≥US$10 762) is 17.1%, and for women it is 4.1%. Results indicate that a significant gender wage difference exists in Brazil. CONCLUSION The inequality between sexes persisted even after adjusting for working factors such as weekly workload, number of weekly on-call shifts, physician office work, length of practice and specialisation.
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Affiliation(s)
| | | | | | - Bruno A Miotto
- Medicina Preventiva, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Brazil
| | - Mario Cesar Scheffer
- Medicina Preventiva, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Brazil
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33
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Ziegler S, Krause-Solberg L, Scherer M, van den Bussche H. [Working hour preferences of female and male residents : Developments over 4 years of postgraduate medical training in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 60:1115-1123. [PMID: 28812095 DOI: 10.1007/s00103-017-2610-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This article addresses developments regarding working hours and working hour preferences of residents undergoing postgraduate training in Germany and analyses if, and for what reasons, full-time or part-time working models are preferred. METHODS The source of data is the KarMed study, which is based on yearly postal surveys carried out among graduates of the year 2008/2009 from seven medical faculties in Germany. The interviews took place during the entire postgraduate training period. Response rates were 48% in the first year, with subsequent rates of above 85%. For analysis, descriptive statistics and regression models were applied. RESULTS There is a considerable discrepancy between the actual and the preferred working hours of residents undergoing postgraduate training. Postgraduate training is mostly linked to full-time contracts, usually with additional overtime, even though a considerable proportion of doctors prefer a part-time position. More female residents want to work part-time than male doctors. The same applies for the period after medical specialism: in particular, female doctors with children, female doctors trained in former Western Germany states, and those seeking an occupation in outpatient care request part-time contracts for their professional future. A similar trend has been increasingly observed over the years for male doctors. CONCLUSION Despite the huge number of residents requesting part-time contracts - during postgraduate training and afterward - the reality is still far behind this model. It is apparent that measures should be taken for both genders. Those measures should facilitate the implementation of the favored working-time model.
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Affiliation(s)
- Stine Ziegler
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
| | - Lea Krause-Solberg
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Martin Scherer
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Hendrik van den Bussche
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
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Kristoffersson E, Diderichsen S, Verdonk P, Lagro-Janssen T, Hamberg K, Andersson J. To select or be selected - gendered experiences in clinical training affect medical students' specialty preferences. BMC MEDICAL EDUCATION 2018; 18:268. [PMID: 30453953 PMCID: PMC6245780 DOI: 10.1186/s12909-018-1361-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/26/2018] [Indexed: 05/27/2023]
Abstract
BACKGROUND The literature investigating female and male medical students' differing career intentions is extensive. However, medical school experiences and their implications for professional identity formation and specialty choice have attracted less attention. In this study we explore the impact of medical school experiences on students' specialty preferences, investigate gender similarities and differences, and discuss how both might be related to gender segregation in specialty preference. METHODS In a questionnaire, 250 Swedish final-year medical students described experiences that made them interested and uninterested in a specialty. Utilizing a sequential mixed methods design, their responses were analyzed qualitatively to create categories that were compared quantitatively. RESULTS Similar proportions of women and men became interested in a specialty based on its knowledge area, patient characteristics, and potential for work-life balance. These aspects, however, often became secondary to whether they felt included or excluded in clinical settings. More women than men had been deterred by specialties with excluding, hostile, or sexist workplace climates (W = 44%, M = 16%). In contrast, more men had been discouraged by specialties' knowledge areas (W = 27%, M = 47%). CONCLUSIONS Male and female undergraduates have similar incentives and concerns regarding their career. However, the prevalence of hostility and sexism in the learning environment discourages especially women from some specialties. To reduce gender segregation in specialty choice, energy should be directed towards counteracting hostile workplace climates that explain apparent stereotypical assumptions about career preferences of men and women.
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Affiliation(s)
- Emelie Kristoffersson
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, 901 87 Umeå, Sweden
- Umeå Centre for Gender Studies, Umeå University, 901 87 Umeå, Sweden
| | - Saima Diderichsen
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, 901 87 Umeå, Sweden
| | - Petra Verdonk
- Department of Medical Humanities, EMGO Institute for Health and Care Research, School of Medical Sciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Toine Lagro-Janssen
- Department of Primary and Community Care, unit for Gender and Women’s Health, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Katarina Hamberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, 901 87 Umeå, Sweden
| | - Jenny Andersson
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, 901 87 Umeå, Sweden
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Kim JJ, Kim N, Park JH, Kim YS, Lee SM, Lee DH, Jung HC. Comparison of Tight Junction Protein-Related Gene mRNA Expression Levels between Male and Female Gastroesophageal Reflux Disease Patients. Gut Liver 2018; 12:411-419. [PMID: 29558791 PMCID: PMC6027836 DOI: 10.5009/gnl17419] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/06/2018] [Accepted: 01/30/2018] [Indexed: 01/01/2023] Open
Abstract
Background/Aims Male predominance has been observed in the erosive reflux disease (ERD), but reverse finding in nonerosive reflux disease (NERD). This suggests sex-specific medicine approach is needed but its mechanism is remained to be elucidated. We aimed to compare clinical characteristics and mRNA expression levels of tight junction-related proteins between male and female gastroesophageal reflux disease (GERD). Methods Sixteen healthy controls, 45 ERD, and 14 NERD patients received upper endoscopies and completed questionnaires. Quantitative real-time polymerase chain reactions of occludin (OCLN), zonal occludens (ZO) 1, claudin-1 (CLDN1) and claudin-4 (CLDN4), and neurokinin 1 receptor (NK1R) were performed in the distal esophageal mucosal specimen. These results were analyzed by sex. Results Female GERD patients were affected more by reflux symptoms than males. The impairment of overall quality of life was more prominent in female patients with reflux symptoms than male patients (5.6±0.2 vs 4.9±0.6, p=0.009). The levels of OCLN mRNA expression were significantly lower in the male ERD group. On the other hand, those of CLDN1, CLDN4, and NK1R except ZO-1 were significantly higher in the male ERD group. Conclusions We demonstrated that female ERD/NERD patients were affected more by GERD and male ERD patients showed significant changes of tight junction protein mRNA expression levels.
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Affiliation(s)
- Jin Joo Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Nayoung Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Hyun Park
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Young Sun Kim
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
| | - Sun Min Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Ho Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyun Chae Jung
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Influences for Gender Disparity in the Radiology Societies in North America. AJR Am J Roentgenol 2018; 211:831-838. [DOI: 10.2214/ajr.18.19741] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Kim YS, Kim N. Sex-Gender Differences in Irritable Bowel Syndrome. J Neurogastroenterol Motil 2018; 24:544-558. [PMID: 30347934 PMCID: PMC6175559 DOI: 10.5056/jnm18082] [Citation(s) in RCA: 149] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/08/2018] [Accepted: 08/24/2018] [Indexed: 12/11/2022] Open
Abstract
Because of the sex-gender differences that are shown in a diversity of physiological and psychological factors, it can be speculated that the clinical presentation of symptoms as well as treatment strategies in women and men with irritable bowel syndrome (IBS) may differ. Studies have revealed that IBS is more common in women than men. As for the IBS subtype, IBS with constipation is significantly more prevalent among women than men. Sex hormones and gender differences may play important roles in the pathophysiology of IBS. However, its pathophysiologic mechanisms still remain largely unknown, and therapeutic implications are limited. Moreover, women IBS patients have been reported to feel more fatigue, depression, anxiety, and lower quality of life than men IBS patients. Furthermore, there has been evidence of differences in the appropriate treatment efficacy to IBS in men and women, although relatively few men are enrolled in most relevant clinical trials. A more sex-gender-oriented approach in the medical care setting could improve understanding of heterogeneous patients suffering from IBS. An individualized and multicomponent approach including sex and gender issues might help improve the treatment of IBS.
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Affiliation(s)
- Young Sun Kim
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
| | - Nayoung Kim
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Hara K, Kunisawa S, Sasaki N, Imanaka Y. Future projection of the physician workforce and its geographical equity in Japan: a cohort-component model. BMJ Open 2018; 8:e023696. [PMID: 30224401 PMCID: PMC6144402 DOI: 10.1136/bmjopen-2018-023696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The geographical inequity of physicians is a serious problem in Japan. However, there is little evidence of inequity in the future geographical distribution of physicians, even though the future physician supply at the national level has been estimated. In addition, possible changes in the age and sex distribution of future physicians are unclear. Thus, the purpose of this study is to project the future geographical distribution of physicians and their demographics. METHODS We used a cohort-component model with the following assumptions: basic population, future mortality rate, future new registration rate, and future in-migration and out-migration rates. We examined changes in the number of physicians from 2005 to 2035 in secondary medical areas (SMAs) in Japan. To clarify the trends by regional characteristics, SMAs were divided into four groups based on urban or rural status and initial physician supply (lower/higher). The number of physicians was calculated separately by sex and age strata. RESULTS From 2005 to 2035, the absolute number of physicians aged 25-64 will decline by 6.1% in rural areas with an initially lower physician supply, but it will increase by 37.0% in urban areas with an initially lower supply. The proportion of aged physicians will increase in all areas, especially in rural ones with an initially lower supply, where it will change from 14.4% to 31.3%. The inequity in the geographical distribution of physicians will expand despite an increase in the number of physicians in rural areas. CONCLUSIONS We found that the geographical disparity of physicians will worsen from 2005 to 2035. Furthermore, physicians aged 25-64 will be more concentrated in urban areas, and physicians will age more rapidly in rural places than urban ones. The regional disparity in the physician supply will worsen in the future if new and drastic measures are not taken.
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Affiliation(s)
- Koji Hara
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Advanced Research Department, Panasonic & Kyoto University, Kyoto, Japan
| | - Susumu Kunisawa
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriko Sasaki
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuichi Imanaka
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Linzer M, Harwood E. Gendered Expectations: Do They Contribute to High Burnout Among Female Physicians? J Gen Intern Med 2018; 33:963-965. [PMID: 29435727 PMCID: PMC5975148 DOI: 10.1007/s11606-018-4330-0] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/21/2017] [Accepted: 01/10/2018] [Indexed: 11/26/2022]
Abstract
Patients have differing expectations of female versus male physicians. Female patients tend to seek more empathic listening and longer visits, especially with female physicians; however, female doctors are not provided more time for this. Female doctors have more female patients than male doctors, and more patients with psychosocial complexity. We propose that gender differences in patient panels and gendered expectations of female physicians may contribute to the high rate of burnout among female clinicians, as well as to the many female physicians working part-time to reduce stress in their work lives. We propose several mechanisms for addressing this, including brief increments in visit time (20, 30 and 40 min), staff awareness, training in patient expectations during medical school, adjusting for patient gender in compensation plans, and co-locating behavioral medicine specialists in primary care settings. Beneficial outcomes could include fewer malpractice suits, greater patient satisfaction, higher quality care, and lower burnout among female physicians.
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Affiliation(s)
- Mark Linzer
- Division of General Internal Medicine, Office of Professional Worklife, Hennepin County Medical Center, Minneapolis, MN USA
| | - Eileen Harwood
- School of Public Health, University of Minnesota, Minneapolis, MN USA
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Yi S, Lin Y, Kansayisa G, Costas-Chavarri A. A qualitative study on perceptions of surgical careers in Rwanda: A gender-based approach. PLoS One 2018; 13:e0197290. [PMID: 29746556 PMCID: PMC5944995 DOI: 10.1371/journal.pone.0197290] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 04/30/2018] [Indexed: 11/25/2022] Open
Abstract
Access to surgical care in low- and middle-income countries (LMICs) remains deficient without an adequate workforce. There is limited understanding of the gender gap in surgical trainees in LMICs. In Rwanda, females fill only one of 20 positions available. Understanding surgeons’ experiences and perceptions of surgical careers may help facilitate support for females to contribute to the global surgical workforce. We performed qualitative analysis on perceptions of surgical careers through semi-structured interviews of all female surgeons (n = 6) and corresponding male surgeons (n = 6) who are training or have trained at University of Rwanda. Transcripts were analyzed with code structure formed through an integrated approach. Question categories formed the deductive framework, while theoretical saturation was reached through inductive grounded theory. Themes were organized within two key points of the career timeline. First, for developing interest in surgery, three main themes were identified: role models, patient case encounters, and exposure to surgery. Second, for selecting and sustaining surgical careers, four main themes emerged: social expectations about roles within the family, physical and mental challenges, professional and personal support, and finances. All female surgeons emphasized gender assumptions and surgical working culture as obstacles, with a corresponding strong sense of self-confidence and internal motivation that drew them to select and maintain careers in surgery. Family, time, and physical endurance were cited as persistent challenges for female participants. Our study reveals concepts for further exploration about gendered perceptions of surgical careers. Efforts to improve support for female surgical careers as a strategy for shaping surgical work culture and professional development in Rwanda should be considered. Such strategies may be beneficial for improving the global surgical workforce.
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Affiliation(s)
- Sojung Yi
- Department of Surgery, Centre Hospitalier Universitaire de Kigali, Kigali, Rwanda
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| | - Yihan Lin
- Department of Surgery, Centre Hospitalier Universitaire de Kigali, Kigali, Rwanda
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Grace Kansayisa
- Department of Surgery, Centre Hospitalier Universitaire de Kigali, Kigali, Rwanda
| | - Ainhoa Costas-Chavarri
- Department of Surgery, Centre Hospitalier Universitaire de Kigali, Kigali, Rwanda
- Department of Surgery, Rwanda Military Hospital, Kigali, Rwanda
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Bering J, Pflibsen L, Eno C, Radhakrishnan P. Deferred Personal Life Decisions of Women Physicians. J Womens Health (Larchmt) 2018; 27:584-589. [DOI: 10.1089/jwh.2016.6315] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jamie Bering
- Department of Internal Medicine, The Mayo Clinic Arizona, Scottsdale, Arizona
| | - Lacey Pflibsen
- Department of Plastic and Reconstructive Surgery, The Mayo Clinic Arizona, Scottsdale, Arizona
| | - Cassie Eno
- Office of Medical Education, Creighton University, Omaha, Nebraska
| | - Priya Radhakrishnan
- Department of Academic Affairs and Internal Medicine, HonorHealth, Scottsdale, Arizona
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42
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Roberts LC, Burrow FA. Interruption and rapport disruption: measuring the prevalence and nature of verbal interruptions during back pain consultations. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/17538068.2018.1449289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Lisa C. Roberts
- Faculty of Health Sciences, University of Southampton, Southampton, Hampshire
- Therapy Services Department, University Hospital Southampton (NHS) Foundation Trust, Southampton, Hampshire
| | - Faye A. Burrow
- Faculty of Health Sciences, University of Southampton, Southampton, Hampshire
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Smith V, Bethune C, Hurley KF. Examining Medical Student Specialty Choice Through a Gender Lens: An Orientational Qualitative Study. TEACHING AND LEARNING IN MEDICINE 2018; 30:33-44. [PMID: 28497985 DOI: 10.1080/10401334.2017.1306447] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
UNLABELLED Phenomenon: A growing number of women are entering the medical workforce, yet their distribution across medical specialties remains nonuniform. We sought to describe how culture, bias, and socialization shape gendered thinking regarding specialty choice at a Canadian undergraduate medical institution. APPROACH We analyzed transcripts from the Career Choices Project: 16 semistructured focus group discussions with 70 students graduating from Memorial University of Newfoundland in 2003, 2006, 2007, and 2008. The questions and prompts were designed to explore factors influencing specialty choice and did not specifically probe gender-based experiences. Focus groups were audio-recorded, transcribed, and deidentified before analysis. Analysis was inductive and guided by principles of orientational qualitative inquiry using a gender-specific lens. FINDINGS The pursuits of personal and professional goals, as well as contextual factors, were the major themes that influenced decision-making for women and men. Composition of these major themes varied between genders. Influence of a partner, consideration of familial commitments (both present and future), feeling a sense of connectedness with the field in question, and social accountability were described by women as important. Both genders hoped to pursue careers that would afford "flexibility" in order to balance work with their personal lives, though the construct of work-life balance differed between genders. Women did not explicitly identify gender bias or sexism as influencing factors, but their narratives suggest that these elements were at play. Insights: Our findings suggest that unlike men, women's decision-making is informed by tension between personal and professional goals, likely related to the context of gendered personal and societal expectations.
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Affiliation(s)
| | - Cheri Bethune
- c Department of Family Medicine , Memorial University , St. John's , Newfoundland , Canada
| | - Katrina F Hurley
- b Department of Emergency Medicine , Dalhousie University , Halifax , Nova Scotia , Canada
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Miao Y, Li L, Bian Y. Gender differences in job quality and job satisfaction among doctors in rural western China. BMC Health Serv Res 2017; 17:848. [PMID: 29282049 PMCID: PMC5745800 DOI: 10.1186/s12913-017-2786-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 12/07/2017] [Indexed: 11/10/2022] Open
Abstract
Background Few studies about gender differences in job quality and job satisfaction among medical professionals have been carried out in China. So the objectives of this study were to examine whether and to what extent gender differences existed in job quality and job satisfaction of doctors in rural western China. Methods From 2009 to 2011, a total of 1472 doctors from 103 selected county-level health care facilities in rural western China were recruited into the study. Information about the doctors’ demographic characteristics, job quality, and job satisfaction was collected through a designed questionnaire. Besides examining gender differences in single dimensions of job quality and job satisfaction, principal component analysis was used to construct a composite job quality index to measure the differences in the comprehensive job quality, and exploratory factor analysis was applied to evaluate the differences in the overall job satisfaction. Chi-square test was used to calculate differences between proportions, and t-test was used to compare differences between means. Results Among the doctors, there were 705 males and 767 females (ratio 1:1.09). Male doctors had significantly higher monthly salaries, longer working hours, more times of night shifts per month, longer continuous working hours, and longer years of service at current facilities, and marginally significantly higher hourly wage and longer years of service in current professions. However, female doctors showed greater overall job qualities. Significant and marginally significant gender differences were only found in satisfaction with remuneration compared to workload, the chance of promotion and working environment. But female showed greater satisfaction in the overall job satisfaction and the factor including sub-aspects of working environment, remuneration compared to workload, the chance of promotion, utilization of subjective initiative, and sense of achievement. Conclusions Gender differences in job quality and job satisfaction did exist among doctors in rural western China. The participating female doctors were shown to have better job quality and greater job satisfaction. Electronic supplementary material The online version of this article (doi: 10.1186/s12913-017-2786-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yang Miao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau, China
| | - Lingui Li
- The College of Management, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Ying Bian
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau, China.
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Choi YJ, Park YS, Kim N, Kim YS, Lee SM, Lee DH, Jung HC. Gender differences in ghrelin, nociception genes, psychological factors and quality of life in functional dyspepsia. World J Gastroenterol 2017; 23:8053-8061. [PMID: 29259381 PMCID: PMC5725300 DOI: 10.3748/wjg.v23.i45.8053] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/27/2017] [Accepted: 11/07/2017] [Indexed: 02/06/2023] Open
Abstract
AIM to evaluate gender differences in the aspect of ghrelin, nociception-related genes and psychological aspects and the quality of life (QoL) in Korean functional dyspepsia (FD) patients.
METHODS Total of 191 persons were prospectively enrolled between March 2013 and May 2016 in Seoul National Bundang Hospital, and classified into control and FD group based on ROME III criteria. Questionnaire included assessment for dyspepsia symptoms, QoL and anxiety or depression. Preproghrelin and nociception genes in the gastric mucosa and plasma acyl/des-acyl ghrelin were measured.
RESULTS Lower level of plasma acyl ghrelin in FD patients compared to control was significant only in male (15.9 fmol/mL vs 10.4 fmol/mL, P = 0.017). Significantly higher mRNA expressions of nerve growth factor and transient receptor potential vanilloid receptor 1 were observed in male (P = 0.002 and P = 0.014, respectively) than in female. In contrast, female FD patients had a higher anxiety and depression score than male FD (P = 0.029), and anxiety score was correlated with epigastric pain only in female FD patients (female: Spearman rho = 0.420, P = 0.037). The impairment of overall QoL was more prominent in female FD patients than male patients (5.4 ± 0.3 vs 6.5 ± 0.3, P = 0.020).
CONCLUSION Gender differences of ghrelin and nociception-related genes in male and psychological factors in female underlie FD symptoms. More careful assessment of psychological or emotional status is required particularly for the female FD patients.
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Affiliation(s)
- Yoon Jin Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do 13620, South Korea
| | - Young Soo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do 13620, South Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do 13620, South Korea
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, 03080, South Korea
| | - Yong Sung Kim
- Department of Gastroenterology, Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Gunpo, Gyeonggi-do 1142, South Korea
| | - Sun Min Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do 13620, South Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do 13620, South Korea
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, 03080, South Korea
| | - Hyun Chae Jung
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, 03080, South Korea
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Ziegler S, Zimmermann T, Krause-Solberg L, Scherer M, van den Bussche H. Male and female residents in postgraduate medical education - A gender comparative analysis of differences in career perspectives and their conditions in Germany. GMS JOURNAL FOR MEDICAL EDUCATION 2017; 34:Doc53. [PMID: 29226221 PMCID: PMC5704604 DOI: 10.3205/zma001130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 02/02/2017] [Accepted: 06/07/2017] [Indexed: 05/29/2023]
Abstract
Aim: This article focuses on the gender-specific career differences of residents in their postgraduate medical education in Germany. In particular the structural obstacles female physicians have to overcome during residency are investigated. Moreover, the study examines the position preferences of male and female physicians in the hospital and in how far occupational self-efficacy corresponds to the interest in a hospital leading position. Methods: The KarMed-Study's database consists of annual postal surveys throughout the entire residency of medical students, who were in their "Practical Year" in 2008/2009. Descriptive statistics and regression models were used in the analysis. Results: Male and female physicians differ in terms of their preferred work place (hospital, ambulatory care, others), hospital position and working hours. Female physicians prefer part-time work and rarely assume leading positions compared to male physicians. In addition, female physicians, especially those with children, need more time to complete their postgraduate training. Female physicians with children are burdened and disadvantaged more often than their female colleagues without children as well as male physicians in general (e.g. belated start and completion of residency, lower rate of doctorate titles, higher quota of part-time contracts, short-term employment contracts, and higher rates of residency interruption or termination). Besides gender and doctorate title, the occupational self-efficacy expectation has an influence on the preference of leading positions in hospitals. Respondents with a low occupational self-efficacy score are less likely to strive for leading positions with more responsibilities than those with a high score. Conclusion: The results demonstrate clear gender disparities in postgraduate training. Female physicians, especially those with children, are disadvantaged in various areas when compared with their male colleagues. In particular, the low rate of doctorate titles and the low score of self-efficacy expectation are associated negatively with the willingness to aim at leading positions in hospitals. Special measures and programmes should be developed for female physicians to counteract these differences.
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Affiliation(s)
- Stine Ziegler
- Universitätsklinikum Hamburg-Eppendorf, Institut für Allgemeinmedizin, Hamburg, Germany
| | - Thomas Zimmermann
- Universitätsklinikum Hamburg-Eppendorf, Institut für Allgemeinmedizin, Hamburg, Germany
| | - Lea Krause-Solberg
- Universitätsklinikum Hamburg-Eppendorf, Institut für Allgemeinmedizin, Hamburg, Germany
| | - Martin Scherer
- Universitätsklinikum Hamburg-Eppendorf, Institut für Allgemeinmedizin, Hamburg, Germany
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Male and Female Emirati Medical Clerks’ Perceptions of the Impact of Gender and Mobility on Their Professional Careers. SOCIAL SCIENCES 2017. [DOI: 10.3390/socsci6030109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Pyatigorskaya N, Madson M, Di Marco L. Women's career choices in radiology in France. Diagn Interv Imaging 2017; 98:775-783. [PMID: 28757429 DOI: 10.1016/j.diii.2017.06.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/17/2017] [Accepted: 06/27/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this study was to determine the possible effects of gender on residents' and fellows' motivations in choosing radiology as a career in France, and on choosing a practice setting later on. MATERIAL AND METHODS An online survey was sent to French residents and fellows in order to access their radiology practice and career aspirations, as well as the potential influence of their gender. Influence of being a woman on initial professional expectations, professional choices, and the evolution of career paths was investigated using the chi-square test. RESULTS Responses were collected from 206 French residents and fellows. The reasons for choosing radiology residency were, at first, mostly the same for men and women such as interest in the specialty (100% of women and men), work conditions (74% of women and men), technical aspects of the specialty (63% of men and 52% of women, P=0.11) or "reasonable" workload (29% women and 21% men, P=0.19); however, 74% of women stated that maternity might influence their career choices, and were less interested in unstable positions exclusively in private practice (45% men and 33% women, P=0.05). CONCLUSION Male and female radiologists primarily considered the same factors in choosing their specialties. However, maternity is still a source of inequality in France, including fewer opportunities for fellowship positions or academic careers. Furthermore, more women were willing to work in salaried positions to acquire a secure job, even though compensation might be lower.
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Affiliation(s)
- N Pyatigorskaya
- Department of Neuroradiology, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris, France.
| | - M Madson
- Medical University of South Carolina, Department of Library Sciences and Informatics Charleston, SC 29425-4030 MUSC Library, 171, Ashley Avenue, Suite 300, MSC 403, Charleston, SC, USA
| | - L Di Marco
- Department of Radiology, centre hospitalo-universitaire, 21000 Dijon, France
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Tran US, Berger N, Arendasy ME, Greitemeyer T, Himmelbauer M, Hutzler F, Kraft HG, Oettl K, Papousek I, Vitouch O, Voracek M. Unto the third generation: evidence for strong familial aggregation of physicians, psychologists, and psychotherapists among first-year medical and psychology students in a nationwide Austrian cohort census. BMC MEDICAL EDUCATION 2017; 17:81. [PMID: 28468682 PMCID: PMC5415715 DOI: 10.1186/s12909-017-0921-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 04/26/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Medical students present higher numbers of physician relatives than expectable from the total population prevalence of physicians. Evidence for such a familial aggregation effect of physicians has emerged in investigations from the Anglo-American, Scandinavian, and German-speaking areas. In particular, past data from Austria suggest a familial aggregation of the medical, as well as of the psychological and psychotherapeutic, professions among medical and psychology undergraduates alike. Here, we extend prior related studies by examining (1) the extent to which familial aggregation effects apply to the whole nation-wide student census of all relevant (eight) public universities in Austria; (2) whether effects are comparable for medical and psychology students; (3) and whether these effects generalize to relatives of three interrelated health professions (medicine, psychology, and psychotherapy). METHODS We investigated the familial aggregation of physicians, psychologists, and psychotherapists, based on an entire cohort census of first-year medical and psychology students (n = 881 and 920) in Austria with generalized linear mixed models. RESULTS For both disciplines, we found strong familial aggregation of physicians, psychologists, and psychotherapists. As compared with previous results, directionally opposite time trends within disciplines emerged: familial aggregation of physicians among medical students has decreased, whilst familial aggregation of psychologists among psychology students has increased. Further, there were sex-of-relative effects (i.e., more male than female physician relatives), but no substantial sex-of-student effects (i.e., male and female students overall reported similar numbers of relatives for all three professions of interest). In addition, there were age-benefit effects, i.e., students with a relative in the medical or the psychotherapeutic profession were younger than students without, thus suggesting earlier career decisions. CONCLUSIONS The familial aggregation of physicians, psychologists, and psychotherapists is high among medical and psychology undergraduates in Austria. Discussed are implications of these findings (e.g., gender equity, feminization of the medical field, ideas for curricular implementation and student counselling), study limitations, and avenues for future research.
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Affiliation(s)
- Ulrich S. Tran
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
| | - Nina Berger
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
| | | | | | - Monika Himmelbauer
- Department of Medical Education, Medical University of Vienna, Vienna, Austria
| | - Florian Hutzler
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Hans-Georg Kraft
- Division of Cell Genetics, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Karl Oettl
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Ilona Papousek
- Department of Psychology, University of Graz, Graz, Austria
| | - Oliver Vitouch
- Department of Psychology, University of Klagenfurt, Klagenfurt, Austria
| | - Martin Voracek
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
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Steklacova A, Bradac O, de Lacy P, Benes V. E-WIN Project 2016: Evaluating the Current Gender Situation in Neurosurgery Across Europe-An Interactive, Multiple-Level Survey. World Neurosurg 2017; 104:48-60. [PMID: 28456744 DOI: 10.1016/j.wneu.2017.04.094] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 04/13/2017] [Accepted: 04/15/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The proportion of women among neurosurgeons appears to be growing worldwide with time. Official data concerning the current situation across Europe have not yet been published. Thus, there are still concerns about gender inequality. The European Women in Neurosurgery Project 2016 was designed to recognize the current situation across Europe. METHODS The office holders of the national neurosurgical societies of 39 countries forming the European Association of Neurosurgical Societies were contacted to provide data stating the proportion of women in neurosurgery. Obtained data were supplied with the results of an online survey. RESULTS The response rate of national office holders was 90%. The number of reported neurosurgeons was 12,985, and overall proportion of women represented was 12%. Two hundred thirty-seven responses to online questionnaire were taken into account. The overall proportion of female respondents was 30%. There was no intergender variability in responses regarding amount of working time per week, exposure to surgeries, or administrative work. Male respondents reported dedicating significantly more time to scientific work and feeling more confident dictating own career direction. Female respondents reported being less often married, having fewer children, a stronger perception of gender significance level, and a higher appreciation of personal qualities. CONCLUSIONS Neurosurgery is a challenging field of medicine. The results of our survey did not imply an overall feeling of gender inequality among European respondents, although women believe that the gender issue to be more important than men do and that they have to sacrifice more of their personal lives.
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Affiliation(s)
- Anna Steklacova
- Department of Neurosurgery and Neurooncology, Military University Hospital and First Medical Faculty, Charles University, Prague, Czech Republic
| | - Ondrej Bradac
- Department of Neurosurgery and Neurooncology, Military University Hospital and First Medical Faculty, Charles University, Prague, Czech Republic.
| | - Patricia de Lacy
- Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Vladimir Benes
- Department of Neurosurgery and Neurooncology, Military University Hospital and First Medical Faculty, Charles University, Prague, Czech Republic
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