1
|
Buwaider A, El-Hajj VG, Mahdi OA, Iop A, Gharios M, de Giorgio A, Romero M, Gerdhem P, Jean WC, Edström E, Elmi-Terander A. Extended reality in cranial and spinal neurosurgery - a bibliometric analysis. Acta Neurochir (Wien) 2024; 166:194. [PMID: 38662229 PMCID: PMC11045579 DOI: 10.1007/s00701-024-06072-4] [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: 01/25/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE This bibliometric analysis of the top 100 cited articles on extended reality (XR) in neurosurgery aimed to reveal trends in this research field. Gender differences in authorship and global distribution of the most-cited articles were also addressed. METHODS A Web of Science electronic database search was conducted. The top 100 most-cited articles related to the scope of this review were retrieved and analyzed for trends in publications, journal characteristics, authorship, global distribution, study design, and focus areas. After a brief description of the top 100 publications, a comparative analysis between spinal and cranial publications was performed. RESULTS From 2005, there was a significant increase in spinal neurosurgery publications with a focus on pedicle screw placement. Most articles were original research studies, with an emphasis on augmented reality (AR). In cranial neurosurgery, there was no notable increase in publications. There was an increase in studies assessing both AR and virtual reality (VR) research, with a notable emphasis on VR compared to AR. Education, surgical skills assessment, and surgical planning were more common themes in cranial studies compared to spinal studies. Female authorship was notably low in both groups, with no significant increase over time. The USA and Canada contributed most of the publications in the research field. CONCLUSIONS Research regarding the use of XR in neurosurgery increased significantly from 2005. Cranial research focused on VR and resident education while spinal research focused on AR and neuronavigation. Female authorship was underrepresented. North America provides most of the high-impact research in this area.
Collapse
Affiliation(s)
- Ali Buwaider
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Omar Ali Mahdi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Maria Gharios
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Mario Romero
- KTH Royal Institute of Technology, Stockholm, Sweden
| | - Paul Gerdhem
- Department of Orthopaedics and Hand surgery, Uppsala University hospital, Uppsala, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Walter C Jean
- Division of Neurosurgery, Lehigh Valley Fleming Neuroscience Institute, Allentown, PA, USA
- Department of Neurosurgery & Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Erik Edström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Capio Spine Center Stockholm, Löwenströmska Hospital, Upplands-Väsby, Sweden
- Department of Medical Sciences, Örebro University, Örebro, Sweden
| | - Adrian Elmi-Terander
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
- Capio Spine Center Stockholm, Löwenströmska Hospital, Upplands-Väsby, Sweden.
- Department of Medical Sciences, Örebro University, Örebro, Sweden.
| |
Collapse
|
2
|
Tsukahara Y, Novak M, Takei S, Asif IM, Yamasawa F, Torii S, Akama T, Matsumoto H, Day C. International study of physicians' opinion on physician-patient sex concordance when treating athletes. PM R 2024; 16:331-338. [PMID: 37850371 DOI: 10.1002/pmrj.13086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 09/06/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND The effect of physician-patient sex concordance in medicine has been reported in many studies. Whether physicians believe that the sex concordance between physician and athlete influences treatment has not been investigated. OBJECTIVE To determine whether physicians believe that the sex concordance between physician and athlete influences treatment. DESIGN Cross-sectional study. SETTING Online survey. PARTICIPANTS One thousand one hundred ninety-three sports medicine physicians in 51 countries. Participants were sports medicine physicians trained in orthopedics (n = 443 [37.1%]) and nonorthopedics (n = 750 [62.9%]). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participants were asked to decide whether sex of the physician made them better suited to care for athletes of concordant or different sexes along with their personal background. RESULTS Orthopedic sports medicine physicians agreed less than nonorthopedic sports medicine physicians regarding the statement "MALE sports medicine physicians are better suited than their female counterparts to care for MALE athletes" (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.35-0.91, p = .02), and compared to sports medicine physicians based in Europe, those based in Asia agreed more to this statement (OR 7.91, 95% CI 4.60-13.60, p < .01). In addition, regarding the statement "FEMALE sports medicine physicians are better suited than their male counterparts to care for FEMALE athletes," compared to sports medicine physicians based in Europe, those based in Asia (OR 9.12, 95% CI 5.63-14.79, p < .01) and North America (OR 2.18, 95% CI 1.46-3.25, p < .01) agreed more and orthopedic sports medicine physicians agreed less than nonorthopedic sports medicine physicians (OR 0.61, 95% CI 0.39-0.93, p = .02) to this statement. CONCLUSIONS Sports medicine physicians trained in orthopedics felt sex concordance was less important than physicians trained in other specialties. Asian sports medicine physicians believed sex concordance was more important compared to physicians in other regions.
Collapse
Affiliation(s)
- Yuka Tsukahara
- Waseda Institute for Sport Sciences, Waseda University, Tokorozawa, Japan
- Faculty of Physical Education, Tokyo Women's College of Physical Education, Tokyo, Japan
| | - Melissa Novak
- Department of Family Medicine, Oregon Health and Science University, Portland, USA
| | - Seira Takei
- Waseda Institute of Human Growth and Development, Waseda University, Tokorozawa, Japan
| | - Irfan M Asif
- Department of Family and Community Medicine, The University of Alabama at Birmingham School of Medicine, Birmingham, USA
| | | | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Takao Akama
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Hideo Matsumoto
- Public Interest Incorporated Foundation, Japan Sports Medicine Foundation, Tokyo, Japan
| | - Carly Day
- Department of Health and Kinesiology, Purdue University, West Lafayette, USA
- Franciscan Physician Network, West Lafayette, USA
| |
Collapse
|
3
|
Aderinto N, Olatunji G, Afolabi S, Muili A, Olaniyi P, Edun M, Olakanmi D. Sleep patterns and quality among Nigerian medical students: A cross-sectional study. Medicine (Baltimore) 2024; 103:e37556. [PMID: 38518024 PMCID: PMC10956952 DOI: 10.1097/md.0000000000037556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/19/2024] [Indexed: 03/24/2024] Open
Abstract
Adequate sleep is crucial for individuals' well-being and cognitive functioning. However, medical students face unique challenges that disrupt their sleep patterns, such as a rigorous curriculum, long study hours, and high-stress levels. Understanding the sleep patterns and quality among medical students in Nigeria is important to develop targeted interventions and support their overall well-being. This study involved 802 medical students from 3 medical schools in Southwest Nigeria. Participants completed an online questionnaire that collected data on their demographic characteristics, sleep patterns and self-reported sleep quality. Descriptive statistics and correlation analysis were used to analyze the data and identify patterns and associations. Most participants were female (56.9%), with the highest representation from the UNILORIN (65.5%). The average reported sleep duration was 5.74 hours per night, indicating insufficient sleep. Irregular bedtimes and wake-up times were commonly reported. A significant proportion of students consumed coffee late at night (27.1%) and used medication to induce sleep (24.3%). Sleep patterns and behaviors, such as snoring (36.1%) and nocturnal eating (57.6%), were reported. Overall, participants reported satisfactory (28.3%) or poor (29.7%) sleep quality. Correlation analysis revealed significant associations between sleep patterns, sleep quality, academic performance, and other sleep-related factors. The study identified insufficient sleep duration, irregular bedtimes, late-night coffee consumption, and poor sleep quality. These findings emphasize the need for interventions and strategies to promote healthy sleep habits among medical students, which can positively impact their overall health and academic performance.
Collapse
Affiliation(s)
- Nicholas Aderinto
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Gbolahan Olatunji
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Samson Afolabi
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Abdulbasit Muili
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Peter Olaniyi
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Mariam Edun
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Damilare Olakanmi
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| |
Collapse
|
4
|
Núñez-Elvira A. Trends and determinants of GPs' work hours in the UK: a quantitative study. BJGP Open 2023; 7:BJGPO.2022.0173. [PMID: 37336618 PMCID: PMC11176700 DOI: 10.3399/bjgpo.2022.0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/04/2023] [Accepted: 05/02/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Information on the hours of work of UK doctors is limited, and what exists relies on self-designed questionnaires in England. AIM To understand trends in the annual stock of physicians' hours and their main determinants. DESIGN & SETTING A quantitative study in which data were collected from the Quarterly Labour Force Survey (QLFS) between 1998 and 2020, under the End User Licence (EUL), in the UK. METHOD Descriptive and linear regression models of labour supply for doctors (pooled), GPs, and hospital doctors. RESULTS Between 1998 and 2020, while the headcount of doctors grew by 128.79% for hospital doctors and 45.28% for GPs, hours of work dropped by 20.80% for hospital doctors and 25.37% for GPs. Hence, the annual stock of hours grew by 81.20% for hospital doctors but by a modest 8.42% for GPs. Female doctors worked 8.68 fewer hours than males, with GPs reporting the largest reduction (-11.82 hours, 95% confidence interval [CI] = -13.31 to -10.33 and -6.75, 95% CI = -9.32 to -4.19, in the full specification). Family decisions are associated with a fall in doctors' work hours and modest growth in the annual stock of hours. These determinants and overtime are drivers of part-time work. CONCLUSION Despite the increase in the headcount of GPs, their hours of work dropped over the study period, generating a more steady and modest growth in their total annual stock of hours compared with hospital doctors. Female GPs work fewer hours than male GPs and are more likely to work part-time due to childbearing, marriage/co-habitation, and overtime work.
Collapse
Affiliation(s)
- Alberto Núñez-Elvira
- National Institute for Health and Care Research Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK
| |
Collapse
|
5
|
Tsukahara Y, Novak M, Takei S, Asif IM, Yamasawa F, Torii S, Akama T, Matsumoto H, Day C. An international study on attitudes and opinions regarding female sports medicine physicians during pregnancy and the postpartum period. PHYSICIAN SPORTSMED 2023; 51:603-609. [PMID: 36460302 DOI: 10.1080/00913847.2022.2154624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVES Supporting female sports medicine physicians to simultaneously be mothers and pursue professional careers is crucial to maintain gender diversity in sports medicine physicians. The purpose of this study is to understand the attitudes toward female sports medicine physicians during pregnancy and postpartum. METHODS An anonymous online survey was distributed to sports medicine physicians practicing in 51 different countries. They were asked how comfortable they felt with female sports medicine physicians working on the sidelines of sporting events during pregnancy, if the female sports medicine physicians were as productive as their male counterparts after giving birth, and how satisfied they were with the percentage of female sports medicine physicians in their country. Data were analyzed using the chi-square test, and multivariate logistic regression analysis was performed to identify independent variables. RESULTS In total, 1193 physicians (380 [31.9%] female) were included for analysis. Physicians in Asia were the least comfortable with pregnant sports medicine physicians working on the sidelines and those in North America were the most comfortable (odds ratio = 0.28 and 2.51, 95% confidence interval 0.18-0.44 and 1.55-4.06, respectively). More experienced sports medicine physicians (odds ratio = 1.01, 95% confidence interval 1.00-1.03; p < 0.05) and divorced physicians (odds ratio = 0.33, 95% confidence interval 0.12-0.91; p < 0.05) were less comfortable with pregnant female sports medicine physicians working on sidelines, and those trained in orthopedics were less likely to agree that female sports medicine physicians were equally as productive as male counterparts postpartum (odds ratio = 0.29, 95% confidence interval 0.10-0.88; p < 0.05). Female physicians were less satisfied with the percentage of female sports medicine physicians in their country (odds ratio = 0.41, 95% confidence interval 0.27-0.60; p < 0.01) than their male counterparts. CONCLUSIONS Female sports medicine physicians may experience bias in their practice during pregnancy and postpartum.
Collapse
Affiliation(s)
- Yuka Tsukahara
- Waseda Institute for Sport Sciences, Waseda University, Tokorozawa, Japan
- Faculty of Physical Education, Tokyo Women's College of Physical Education, Tokyo, Japan
| | - Melissa Novak
- Department of Family Medicine, Oregon Health and Science University, Portland, ORE, USA
| | - Seira Takei
- Waseda Institute of Human Growth and Development, Waseda University, Tokorozawa, Japan
| | - Irfan M Asif
- Department of Family and Community Medicine, The University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | | | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Takao Akama
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Hideo Matsumoto
- Public Interest Incorporated Foundation, Japan Sports Medicine Foundation, Tokyo, Japan
| | - Carly Day
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, USA
- Franciscan Physician Network, West Lafayette, IN, USA
| |
Collapse
|
6
|
Ying Y, Dupre J, Bhanji F. Female surgical trainee recruitment and attrition - A 10-year national retrospective review. Am J Surg 2023; 225:282-286. [PMID: 36008168 DOI: 10.1016/j.amjsurg.2022.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 07/11/2022] [Accepted: 07/20/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Female trainees continue to be underrepresented in surgical specialties. Studies have shown lower enrollment and higher attrition of female trainees in surgery. However, there is no comprehensive data examining trends to determine if positive strides have been made towards greater equity. METHODS Retrospective cohort study examining Canadian surgical residents who began training between 2000 and 2010. Enrollment data was compared to how many of those individuals registered for their final surgical certifying examinations by 2018, which indicated completion of residency. RESULTS In the 10-year period, overall attrition rates of surgical trainees was 8%. Female residents were twice as likely to leave training compared to their male counterparts (12.4 vs 6.1% p < 0.001). Attrition rates for female residents appeared to trend downwards. Enrollment of female surgical trainees across all surgical specialties increased from 27.3% to 39.2% during this time. CONCLUSION Equity in Canadian surgical training enrollment and retention improved for those who began training from 2000 to 2010, but there continued to be differences in female trainee recruitment and attrition rates compared to their male counterparts.
Collapse
Affiliation(s)
- Yvonne Ying
- University of Ottawa, Department of Surgery, Ottawa, Canada; Department of Surgery, Children's Hospital of Eastern Ontario, Ottawa, Canada.
| | | | - Farhan Bhanji
- Royal College of Physicians and Surgeons of Canada, Ottawa, Canada; Department of Pediatrics, McGill University, Montreal, Canada.
| |
Collapse
|
7
|
Abualadas HM, Xu L. Achievement of learning outcomes in non-traditional (online) versus traditional (face-to-face) anatomy teaching in medical schools: A mixed method systematic review. Clin Anat 2023; 36:50-76. [PMID: 35969356 PMCID: PMC10087909 DOI: 10.1002/ca.23942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 12/14/2022]
Abstract
In recent years, the logistical challenges posed by the Covid-19 pandemic have prompted medical educators teaching gross anatomy to explore an expanded use of online instructional modalities. There is concern that this shift to online anatomy education in medical schools could affect long-term learning outcomes for future healthcare providers. In this systematic review, the educational effectiveness of online anatomy teaching is compared with traditional ("face-to-face") teaching methods, specifically in terms of students' academic performance and satisfaction. A search of four databases identified and screened 162 studies. Subsequently, 31 studies were analyzed, including both (a) teaching outcome measures (test scores) and (b) student satisfaction ratings. Authors chose studies, extracted data, assessed quality and examined risk of bias. Nineteen studies compared students' academic performances between online and face-to-face teaching methods. Twenty-six studies measured students' levels of satisfaction in both teaching methods. Both qualitative and quantitative analyses of the data revealed comparable academic performances with no statistical difference between the two teaching methods, but a higher level of satisfaction with face-to-face teaching. The findings confirm that students can learn from online teaching but are more satisfied with face-to-face teaching. The authors conclude that online teaching cannot replace traditional teaching and there is no preference for one type of modality over the other. Therefore, a multi-modal learning approach combining online with face-to-face educational modalities for medical students could be efficient and successful.
Collapse
Affiliation(s)
- Hana M Abualadas
- Department of Structural and Cellular Biology, School of Medicine, Tulane University, New Orleans, Louisiana, USA.,Department of Neurological Sciences, Robert Larner M.D. College of Medicine, University of Vermont, South Burlington, Vermont, USA
| | - Lu Xu
- Department of Structural and Cellular Biology, School of Medicine, Tulane University, New Orleans, Louisiana, USA
| |
Collapse
|
8
|
Senbanjo IO, Abolurin OO, Ezegamba CO, Akinbami FO, Allen SJ. Survey showed that very few paediatric residents in Southwest Nigeria were interested in specialising in gastroenterology. Acta Paediatr 2022; 111:2216-2221. [PMID: 36005899 DOI: 10.1111/apa.16529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/26/2022] [Accepted: 08/24/2022] [Indexed: 11/29/2022]
Abstract
AIM Paediatric gastroenterology remains an under-recognised sub-speciality in Africa. We determined the preferred sub-specialities among paediatric residents in Southwest Nigeria and what influenced whether they chose paediatric gastroenterology. METHODS This was a cross-sectional survey of paediatric residents in seven teaching hospitals in Southwest Nigeria. A self-administered questionnaire was used to obtain information on their socio-demographics, educational attainment, choice of sub-speciality and the factors influencing that choice. RESULTS Of 144 eligible paediatric residents, 124 (86.1%) completed the survey. Their mean age was 35.0 ± 1.7 years and 83 (66.9%) were females. The majority (94.4%) had already chosen their sub-speciality and nearly two-thirds (65.0%) made the decision during training. The most popular sub-speciality was neonatology (30.6%) and only three (2.4%) residents chose gastroenterology. Factors influencing the choice of sub-speciality were perceived ability (85.3%) and academic experience (83.8%). Financial reasons were less frequent (32.5%). Lack of diagnostic equipment (30.6%) and role models (21.0%) were the most frequent reasons for residents being disinterested in paediatric gastroenterology. CONCLUSION Few residents were interested in paediatric gastroenterology and there is a need to encourage interest in this subject at an early stage in their training and provide more diagnostic equipment and greater mentorship.
Collapse
Affiliation(s)
- Idowu O Senbanjo
- Department of Paediatrics and Child Health, Lagos State University College of Medicine, Lagos, Nigeria
| | | | - Comfort O Ezegamba
- Department of Paediatrics and Child Health, Lagos State University Teaching Hospital, Ikeja, Nigeria
| | - Felix O Akinbami
- Department of Paediatrics and Child Health, Niger Delta University, Yenagoa, Nigeria
| | - Stephen J Allen
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| |
Collapse
|
9
|
Trapp MDC, Wiskur BJ, Suh JH, Brand MW, Kuhn KG, Rojas J. Sex Differences between Medical Students in the Assessment of the Fear of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063372. [PMID: 35329060 PMCID: PMC8955011 DOI: 10.3390/ijerph19063372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 02/04/2023]
Abstract
Background: Differing expressions of the fear of COVID-19 between men and women can potentially increase both immediate and long-term physical health risks. We predicted that women students would express greater fear of COVID-19. Methods: We used an Internet-delivered Fear of COVID-19 Scale (FCV-19S) to assess fear among men (n = 100) and women (n = 272) from a larger population of academic medical center members (n = 1761). Sex differences in emotional and physical symptoms were assessed as subcategories within fear scores. Results: Women reported greater fear of COVID-19 than men (p < 0.001). Women reported greater emotional fear (p < 0.001) on specific scale items (thinking of COVID-19, watching news stories about COVID-19, and losing sleep due to fear of contracting COVID-19). Discussion/Conclusions: These results provide a better understanding of how fear of COVID-19 can differ based on sex and how that fear may be expressed differently through emotional and physical symptoms. This information will inform academic health centers of COVID-19 prevention and management policies that may include a gender-specific focus.
Collapse
Affiliation(s)
- Maria del Carmen Trapp
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA; (M.d.C.T.); (J.H.S.); (M.W.B.); (J.R.)
| | - Brandt J. Wiskur
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA; (M.d.C.T.); (J.H.S.); (M.W.B.); (J.R.)
- Academic Affairs and Faculty Development, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
- Correspondence: ; Tel.: +1-(405)-271-2359
| | - Joy H. Suh
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA; (M.d.C.T.); (J.H.S.); (M.W.B.); (J.R.)
| | - Michael W. Brand
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA; (M.d.C.T.); (J.H.S.); (M.W.B.); (J.R.)
| | - Katrin G. Kuhn
- Department of Biostatistics & Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA;
| | - Julio Rojas
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA; (M.d.C.T.); (J.H.S.); (M.W.B.); (J.R.)
| |
Collapse
|
10
|
Au S, Bellato V, Carvas JM, Córdoba CD, Daudu D, Dziakova J, Eltarhoni K, El Feituri N, Fung ACH, Fysaraki C, Gallo G, Gultekin FA, Harbjerg JL, Hatem F, Ioannidis A, Jakobsen L, Clinch D, Kristensen HØ, Kuiper SZ, Kwok AMF, Kwok W, Millan M, Milto KM, Ng HJ, Pellino G, Picciariello A, Pronin S, van Ramshorst GH, Ramser M, Jiménez-Rodríguez RM, Sainz Hernandez JC, Samadov E, Sohrabi S, Uchiyama M, Wang JHS, Younis MU, Fleming S, Alhomoud S, Mayol J, Moeslein G, Smart NJ, Soreide K, Teh C, Verran D, Maeda Y. Global parental leave in surgical careers: differences according to gender, geographical regions and surgical career stages. Br J Surg 2021; 108:1315-1322. [PMID: 34467970 DOI: 10.1093/bjs/znab275] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/24/2021] [Accepted: 07/01/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND There is a lack of information regarding the provision of parental leave for surgical careers. This survey study aims to evaluate the experience of maternity/paternity leave and views on work-life balance globally. METHODS A 55-item online survey in 24 languages was distributed via social media as per CHERRIES guideline from February to March 2020. It explored parental leave entitlements, attitude towards leave taking, financial impact, time spent with children and compatibility of parenthood with surgical career. RESULTS Of the 1393 (male : female, 514 : 829) respondents from 65 countries, there were 479 medical students, 349 surgical trainees and 513 consultants. Consultants had less than the recommended duration of maternity leave (43.8 versus 29.1 per cent), no paid maternity (8.3 versus 3.2 per cent) or paternity leave (19.3 versus 11.0 per cent) compared with trainees. Females were less likely to have children than males (36.8 versus 45.6 per cent, P = 0.010) and were more often told surgery is incompatible with parenthood (80.2 versus 59.5 per cent, P < 0.001). Males spent less than 20 per cent of their salary on childcare and fewer than 30 hours/week with their children. More than half (59.2 per cent) of medical students did not believe a surgical career allowed work-life balance. CONCLUSION Surgeons across the globe had inadequate parental leave. Significant gender disparity was seen in multiple aspects.
Collapse
Affiliation(s)
- S Au
- NHS Education for Scotland, Edinburgh, UK
| | | | | | - C D Córdoba
- University of Lausanne, Lausanne, Switzerland
| | - D Daudu
- Faculty of Health and Medical Sciences, University of Western Australia, Australia
| | - J Dziakova
- Hospital Clinico San Carlos, IDISSC, Madrid, Spain
| | | | | | - A C H Fung
- Department of Surgery, The University of Hong Kong, Hong Kong SAR, China
| | - C Fysaraki
- Urology Department, Mid Yorkshire Hospitals NHS Trust, UK
| | - G Gallo
- Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy
| | - F Ayca Gultekin
- General Surgery Department, Zonguldak Bulent, Ecevit University School of Medicine, Zonguldak, Turkey
| | - J L Harbjerg
- Department of Surgery, Research Unit C119, Aarhus University Hospital, Palle Juul-Jensens, Aarhus N, Denmark
| | - F Hatem
- Glasgow Royal Infirmary, Glasgow, UK
| | | | - L Jakobsen
- UiT, The Arctic University of Norway, University Hospital of North Norway, Tromso, Norway
| | - D Clinch
- Department of General Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - H Ø Kristensen
- Department of Surgery, Research Unit C119, Aarhus University Hospital, Palle Juul-Jensens, Aarhus N, Denmark
| | - S Z Kuiper
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands
| | | | - W Kwok
- Royal Infirmary of Edinburgh, Edinburgh, UK
| | - M Millan
- Coloproctology Unit, Department of Surgery, La Fe University Hospital, Valencia, Spain
| | - K M Milto
- NHS Education for Scotland, Edinburgh, UK
| | - H J Ng
- Royal Alexandra Hospital, NHS Greater Glasgow and Clyde, UK
| | - G Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - A Picciariello
- Department of Emergency and Organ Transplantation, University 'Aldo Moro' of Bari, Italy
| | - S Pronin
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | | | - M Ramser
- Department of Surgery, Solothurner Spitäler SoH, Bürgerspital Solothurn, Solothurn, Switzerland
| | | | - J C Sainz Hernandez
- Instituto Nacional de Ciencias Médicas y Nutrición 'Salvador Zubirán', Mexico City, Mexico
| | - E Samadov
- Surgical Department, LEYLA Medical Centre, Baku, Azerbaijan
| | | | - M Uchiyama
- Showa University School of Medicine, Tokyo, Japan
| | - J H-S Wang
- Australasian Students' Surgical Association, New Zealand
| | - M U Younis
- Mediclinic City Hospital, Dubai, United Arab Emirates
| | - S Fleming
- Barts and the London School of Medicine and Dentistry, London, UK
| | - S Alhomoud
- King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - J Mayol
- Hospital Clinico San Carlos, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense, Madrid, Spain
| | - G Moeslein
- Ev. Bethesda Khs Duisburg, University of Witten, Herdecke, Germany
| | - N J Smart
- Royal Devon & Exeter Hospital & University of Exeter Medical School, Exeter, UK
| | - K Soreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
| | - C Teh
- Department of Surgery, Makati Medical Centre, Makati, Philippines.,Department of General Surgery, National Kidney & Transplant Institute, Quezon City, Philippines
| | - D Verran
- Ramsey Health Care, Sydney, Australia
| | - Y Maeda
- Department of Colorectal Surgery, Western General Hospital and University of Edinburgh, Edinburgh, UK
| |
Collapse
|
11
|
Bielenberg J, Swisher G, Lembke A, Haug NA. A systematic review of stigma interventions for providers who treat patients with substance use disorders. J Subst Abuse Treat 2021; 131:108486. [PMID: 34217033 DOI: 10.1016/j.jsat.2021.108486] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 05/14/2021] [Accepted: 05/15/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Stigma surrounding substance use disorders (SUDs) is a frequently cited barrier to treatment engagement. Research consistently demonstrates that healthcare professionals' attitudes towards patients with addiction problems are often negative and may adversely impact service delivery. The current study presents a systematic review of stigma interventions for providers who treat patients with SUDs, in order to evaluate the quality of existing studies and potential for implementation in clinical settings. METHODS This systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases included PubMed, APA PsycInfo and the Cochrane Database of Systematic Reviews. Of the 1462 records identified between 2011 and 2019, 15 studies were eligible for inclusion. A narrative synthesis of stigma interventions summarized the change in stigmatizing attitudes held by providers. RESULTS Studies included heterogeneous and culturally diverse samples of providers (N = 1324), who varied by age, location, discipline, and experience, with the exception of primarily female providers (75%). Results delineated six types of provider stigma interventions with components including online education, in-person education, in-person contact with consumers in recovery, or some combination of these elements. The highest quality studies incorporated motivational interviewing or communication training interventions, and many interventions combined either in-person mentorship or contact with individuals in recovery. Positive effects on provider attitudes occurred at several levels of educational and consumer contact interventions. Interventions with consumer contact demonstrated long-term maintenance of attitudinal shifts. Despite significant methodological limitations and low-quality assessment ratings, several studies utilized real-world providers and patients, as well as practical, innovative, brief, and potentially cost-effective interventions, particularly in locations with limited technological resources. CONCLUSIONS Research on provider stigma interventions increased in recent years, indicating greater worldwide attention to the negative impact of stigma. While educational interventions alone can be helpful in attitudinal change, contact with individuals in recovery from SUDs is a vital component of provider stigma interventions, particularly for lasting effects. This review highlights the importance of including implementation outcomes, such as sustainability and cost-effectiveness, in the study of stigma interventions for providers of addiction treatment.
Collapse
Affiliation(s)
- Jennifer Bielenberg
- Department of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA.
| | - Gabrielle Swisher
- Department of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304, USA.
| | - Anna Lembke
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA.
| | - Nancy A Haug
- Department of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA.
| |
Collapse
|
12
|
A Descriptive-Multivariate Analysis of Community Knowledge, Confidence, and Trust in COVID-19 Clinical Trials among Healthcare Workers in Uganda. Vaccines (Basel) 2021; 9:vaccines9030253. [PMID: 33809269 PMCID: PMC8000597 DOI: 10.3390/vaccines9030253] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 12/22/2022] Open
Abstract
Background—misinformation and mistrust often undermines community vaccine uptake, yet information in rural communities, especially of developing countries, is scarce. This study aimed to identify major challenges associated with coronavirus disease 2019 (COVID-19) vaccine clinical trials among healthcare workers and staff in Uganda. Methods—a rapid exploratory survey was conducted over 5 weeks among 260 respondents (66% male) from healthcare centers across the country using an online questionnaire. Twenty-seven questions assessed knowledge, confidence, and trust scores on COVID-19 vaccine clinical trials from participants in 46 districts in Uganda. Results—we found low levels of knowledge (i.e., confusing COVID-19 with Ebola) with males being more informed than females (OR = 1.5, 95% CI: 0.7–3.0), and mistrust associated with policy decisions to promote herbal treatments in Uganda and the rushed international clinical trials, highlighting challenges for the upcoming Oxford–AstraZeneca vaccinations. Knowledge, confidence and trust scores were higher among the least educated (certificate vs. bachelor degree holders). We also found a high level of skepticism and possible community resistance to DNA recombinant vaccines, such as the Oxford–AstraZeneca vaccine. Preference for herbal treatments (38/260; 14.6%, 95% CI: 10.7–19.3) currently being promoted by the Ugandan government raises major policy concerns. High fear and mistrust for COVID-19 vaccine clinical trials was more common among wealthier participants and more affluent regions of the country. Conclusion—our study found that knowledge, confidence, and trust in COVID-19 vaccines was low among healthcare workers in Uganda, especially those with higher wealth and educational status. There is a need to increase transparency and inclusive participation to address these issues before new trials of COVID-19 vaccines are initiated.
Collapse
|
13
|
Miguel ADQC, Tempski P, Kobayasi R, Mayer FB, Martins MA. Predictive factors of quality of life among medical students: results from a multicentric study. BMC Psychol 2021; 9:36. [PMID: 33632321 PMCID: PMC7905855 DOI: 10.1186/s40359-021-00534-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 02/09/2021] [Indexed: 12/23/2022] Open
Abstract
Background Medical students have a worse perception of Quality of Life (QoL) and a high prevalence of psychosocial suffering when compared to the general population. The objective of this study was to investigate associated factors with Quality of Life of Brazilian medical students from an exploratory analysis in a cross-sectional study described in accordance with the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) guidelines. Methods This is a cross-sectional and multicenter study with national sample randomized by sex and year of the course. Data were collected between August 2011 and August 2012, using an electronic platform (VERAS platform). Our outcomes included: personal quality of life (QoLp) and quality of life related to medical course activities (QoLmc), both measured using a score ranging from 0 (worst) to 10 (best). Variables as predictors: the World Health Organization Quality of Life Assessment abbreviated version (WHOQOL-BREF); VERAS-Q (a questionnaire created to evaluate the QoL of students in health professions); Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maslach Burnout Inventory (MBI), Resilience Scale (RS-14), Interpersonal Reactivity Multidimensional Scale (IRMS) and Dundee Ready Education Environment Measure (DREEM). Results Our sample is comprised of 1350 (81.8%) medical students. When comparing predictors and both quality of life outcome measures, we found a negative correlation between QoL and the BDI, PSQI and ESS scores. Through a multiple linear regression mode we identified the median of significant predictors to higher QoL. We then run a tree regression model that demonstrated that the VERAS-Q—physical health domain (a domain assessing self-care, self-perception of health, sleep, leisure, physical activity and appearance) was the most important factor predicting QoL. Students with a VERAS-Q-physical health score ≥ 60.9 and a VERAS-Q-time management (address the management of the student's time, free time and whether he can dedicate himself to other activities besides the course) score ≥ 55.7 presented the best QoLmc (score: 8.08–9.63%). Students with a VERAS-Q-physical health score ≥ 79.7 presented the highest QoLp (score 8.93–8.74%). Conclusion Physical symptoms, self-perception of health and self-care assessed by the VERAS-Q physical domain had association with both final outcomes. Time management seems to have a protective role for better Quality of Life. These variables should be taken in consideration when designing interventions to improve Quality of Life among medical students.
Collapse
Affiliation(s)
- Alice de Queiroz Constantino Miguel
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Arnaldo 455 sala 1210, Sao Paulo, SP, 01246-903, Brazil. .,Hospital Universitário da Universidade Federal de São Carlos, São Carlos, Brazil.
| | - Patricia Tempski
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Arnaldo 455 sala 1210, Sao Paulo, SP, 01246-903, Brazil
| | - Renata Kobayasi
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Arnaldo 455 sala 1210, Sao Paulo, SP, 01246-903, Brazil
| | | | - Milton A Martins
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Arnaldo 455 sala 1210, Sao Paulo, SP, 01246-903, Brazil.,Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
14
|
Lim WH, Wong C, Jain SR, Ng CH, Tai CH, Devi MK, Samarasekera DD, Iyer SG, Chong CS. The unspoken reality of gender bias in surgery: A qualitative systematic review. PLoS One 2021; 16:e0246420. [PMID: 33529257 PMCID: PMC7853521 DOI: 10.1371/journal.pone.0246420] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/19/2021] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE This study was conducted to better understand the pervasive gender barriers obstructing the progression of women in surgery by synthesising the perspectives of both female surgical trainees and surgeons. METHODS Five electronic databases, including Medline, Embase, PsycINFO, CINAHL and Web of Science Core Collection, were searched for relevant articles. Following a full-text review by three authors, qualitative data was synthesized thematically according to the Thomas and Harden methodology and quality assessment was conducted by two authors reaching a consensus. RESULTS Fourteen articles were included, with unfavorable work environments, male-dominated culture and societal pressures being major themes. Females in surgery lacked support, faced harassment, and had unequal opportunities, which were often exacerbated by sex-blindness by their male counterparts. Mothers were especially affected, struggling to achieve a work-life balance while facing strong criticism. However, with increasing recognition of the unique professional traits of female surgeons, there is progress towards gender quality which requires continued and sustained efforts. CONCLUSION This systematic review sheds light on the numerous gender barriers that continue to stand in the way of female surgeons despite progress towards gender equality over the years. As the global agenda towards equality progresses, this review serves as a call-to-action to increase collective effort towards gender inclusivity which will significantly improve future health outcomes.
Collapse
Affiliation(s)
- Wen Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chloe Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sneha Rajiv Jain
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chia Hui Tai
- Division of Colorectal Surgery, Department of Surgery, University Surgical Cluster, National University Hospital, Singapore, Singapore
| | - M. Kamala Devi
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Dujeepa D. Samarasekera
- Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shridhar Ganpathi Iyer
- Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, University Surgical Cluster, National University Hospital, Singapore, Singapore
- Liver Transplantation, National University Centre for Organ Transplantation, National University Hospital, Singapore, Singapore
| | - Choon Seng Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Colorectal Surgery, Department of Surgery, University Surgical Cluster, National University Hospital, Singapore, Singapore
| |
Collapse
|
15
|
Shin HY, Lee HA. The current status of gender equity in medicine in Korea: an online survey about perceived gender discrimination. HUMAN RESOURCES FOR HEALTH 2020; 18:78. [PMID: 33081799 PMCID: PMC7574171 DOI: 10.1186/s12960-020-00513-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 09/14/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND Although the number of women doctors has increased in South Korea, and efforts to improve gender awareness have gained importance in recent years, the issue of gender equity in the medical field has not been fully evaluated. The aim of this study was to determine the current status of gender equity in the medical profession in Korea. METHODS An online survey on perceived gender discrimination was conducted for 2 months, with both men and women doctors participating. The results were analyzed using descriptive statistics. RESULTS A total of 1170 doctors responded to the survey (9.2% response rate). The survey found that 47.3% of the women respondents and 18.2% of the men had experienced gender discrimination in the resident selection process (P < 0.05), 17.2% of the women and 8.7% of the men had experienced discrimination during the fellowship application process (P < 0.05), and 36.2% of the women and 8.0% of the men had experienced discrimination during the professorship application process (P < 0.05). Both men and women cited the issue of childbirth and parenting as the number one cause of gender discrimination against women doctors. CONCLUSIONS This study revealed the presence of perceived gender discrimination in the Korean medical society. To address discrimination, a basic approach is necessary to change the working environment so that it is flexible for women doctors, and to change the current culture where the burden of family care, including pregnancy, childbirth, and childcare, is the primary responsibility of women.
Collapse
Affiliation(s)
- Hyun-Young Shin
- Department of Family Medicine, Myongji Hospital, College of Medicine, Hanyang University, Seoul, Gyeonggi-do, 10475, Republic of Korea.
- Korean Medical Women's Association, Seoul, Republic of Korea.
- The National Assembly of The Republic of Korea, Seoul, Republic of Korea.
| | - Hang Aie Lee
- Korean Medical Women's Association, Seoul, Republic of Korea
| |
Collapse
|
16
|
He C, McGregor AJ, Lewiss RE. Preinvisible: An Early-Career Perspective on a Midcareer Phenomenon. Perm J 2020; 24:1-4. [PMID: 33482934 DOI: 10.7812/tpp/20.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In this commentary, a female early-career academic physician reflects on her experiences with microinequities in the workplace. Using a recent publication describing the experience of midcareer academic women physicians as a launching point, the author discusses the experiences that early-career women in medicine commonly have. In training and early career, women are exposed to subtle barriers, aggressions, and inequities, which build over time. By midcareer, some women leave medicine or if they remain in medicine, they have likely not reached the salary or promotion levels of men. Ultimately, the author questions if trainees and early-career women in academic medicine are simply in a "preinvisible" phase of their careers. Ways to address the microinequities are offered.
Collapse
Affiliation(s)
- Chen He
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Alyson J McGregor
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI
| | - Resa E Lewiss
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA
| |
Collapse
|
17
|
Hoffman R, Mullan J, Nguyen M, Bonney AD. Motherhood and medicine: systematic review of the experiences of mothers who are doctors. Med J Aust 2020; 213:329-334. [PMID: 32865236 DOI: 10.5694/mja2.50747] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 03/03/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To synthesise what is known about women combining motherhood and a career in medicine by examining the published research into their experiences and perspectives. STUDY DESIGN We reviewed peer-reviewed articles published or available in English reporting original research into motherhood and medicine and published during 2008-2019. Two researchers screened each abstract and independently reviewed full text articles. Study quality was assessed. DATA SOURCES CINAHL, MEDLINE, PsycINFO, Web of Science, and Scopus abstract databases. DATA SYNTHESIS The database search identified 4200 articles; after screening and full text assessment, we undertook an integrative review synthesis of the 35 articles that met our inclusion criteria. CONCLUSIONS Three core themes were identified: Motherhood: the impact of being a doctor on raising children; Medicine: the impact of being a mother on a medical career; and Combining motherhood and medicine: strategies and policies. Several structural and attitudinal barriers to women pursuing both medical careers and motherhood were identified. It was often reported that women prioritise career advancement by delaying starting a family, and that female doctors believed that career progression would be slowed by motherhood. Few evaluations of policies for supporting pregnant doctors, providing maternity leave, and assisting their return to work after giving birth have been published. We did not find any relevant studies undertaken in Australia or New Zealand, nor any studies with a focus on community-based medicine or intervention studies. Prospective investigations and rigorous evaluations of policies and support mechanisms in different medical specialties would be appropriate. PROTOCOL REGISTRATION PROSPERO CRD42019116228.
Collapse
Affiliation(s)
- Rebekah Hoffman
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW
| | - Judy Mullan
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW
| | - Marisa Nguyen
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW
| | - Andrew D Bonney
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW
| |
Collapse
|
18
|
Lindberg O. Gender and role models in the education of medical doctors: a qualitative exploration of gendered ways of thinking. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2020; 11:31-36. [PMID: 32007950 PMCID: PMC7246110 DOI: 10.5116/ijme.5e08.b95b] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 12/29/2019] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To examine how 'gendered ways of thinking' relate to role models in medical education. METHODS This study employed an explorative, qualitative, and cross-sectional design. A total of 57 interviews were held with medical students (28 interviews) and with faculty members (29 interviews) at a Swedish medical school. Participants were asked to describe their role models and the attributes that made certain individuals role models. Data were analysed using an inductive approach in three separate steps that explored the relationship between role models and gender. RESULTS Males do not generally consider female doctors as role models, and male role models are generally viewed as more admirable than female role models. This was shown in all steps of the analysis and most prominently in how male role models were described as qualitatively more admirable than female role models. Male role models are thus more common (for male and female students) and described as more admirable. The results point to the persistence of 'gendered ways of thinking' that subtly shape medical students. CONCLUSIONS Gendering role models is disadvantageous to female doctors in several ways, so the results have implications for women's career paths and opportunities. The results can thus form a basis for discussing and teaching the importance of gender in role modelling and in medical education in general.
Collapse
Affiliation(s)
- Ola Lindberg
- Department of Education, Umeå University, Umeå, Sweden
| |
Collapse
|
19
|
Bosco L, Lorello GR, Flexman AM, Hastie MJ. Women in anaesthesia: a scoping review. Br J Anaesth 2020; 124:e134-e147. [PMID: 31983412 DOI: 10.1016/j.bja.2019.12.021] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 10/25/2022] Open
Abstract
Despite an increase in the proportion of women anaesthesiologists over time, women remain under-represented in academic and leadership positions, honour awards, and academic promotion. Current literature has identified several reasons for the observed gender disparity in anaesthesiology leadership and faculty positions, including unsupportive work environments, lack of mentorship, personal choices, childcare responsibilities, and active discrimination against women. A scoping review design was selected to examine the nature and extent of available research. Our review provides an overview of the literature that explores gender issues in anaesthesiology, identifies gaps in the literature, and appraises effective strategies to improve gender equity in anaesthesiology. We searched PubMed, MEDLINE, and EMBASE up to July 2019, and included 30 studies for analysis. Most reports used retrospective or survey methodologies. The review shows that women anaesthesiologists face gender biases in the work environment, are under-represented in various positions of leadership or influence, and as authors. Work-life demands may impose a challenge. Motivation and interest in career advancement of women anaesthesiologists have not been well studied. Several strategies have been proposed, ranging from an individual to administrative level, which may help anaesthesiologists achieve equal representation of women in the field.
Collapse
Affiliation(s)
- Laura Bosco
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Postgraduate Medical Education, Toronto, ON, Canada
| | - Gianni R Lorello
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada; Department of Anesthesiology and Pain Medicine, Toronto Western Hospital - University Health Network, Toronto, ON, Canada; The Wilson Centre, University Health Network, Toronto, ON, Canada.
| | - Alana M Flexman
- Department of Anesthesiology and Perioperative Care, Vancouver General Hospital, Vancouver, BC, Canada; Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Maya J Hastie
- Department of Anesthesiology, Columbia University, New York, NY, USA
| |
Collapse
|
20
|
Tay PKC, Ting YY, Tan KY. Sex and Care: The Evolutionary Psychological Explanations for Sex Differences in Formal Care Occupations. Front Psychol 2019; 10:867. [PMID: 31057471 PMCID: PMC6478767 DOI: 10.3389/fpsyg.2019.00867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/02/2019] [Indexed: 11/29/2022] Open
Abstract
Men and women exhibit clear differences in occupational choices. The present article elucidates sex differences in terms of formal care occupational choices and care styles based on evolutionary psychological perspectives. Broadly (1) the motivation to attain social status drives male preference for occupations that signals prestige and the desire to form interpersonal affiliation underlies female preference for occupations that involve psychosocial care for people in need; (2) ancestral sex roles leading to sexually differentiated cognitive and behavioral phenotypic profiles underlie present day sex differences in care styles where men are things-oriented, focusing on disease management while women are people-oriented, focusing on psychosocial management. The implications for healthcare and social care are discussed and recommendations for future studies are presented.
Collapse
Affiliation(s)
- Peter Kay Chai Tay
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
| | - Yi Yuan Ting
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
| | - Kok Yang Tan
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore.,Humanities and Social Sciences, Murdoch University, Singapore, Singapore
| |
Collapse
|
21
|
Blacker CJ, Lewis CP, Swintak CC, Bostwick JM, Rackley SJ. Medical Student Suicide Rates: A Systematic Review of the Historical and International Literature. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:274-280. [PMID: 30157089 DOI: 10.1097/acm.0000000000002430] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE Physician suicide rates are reportedly higher than those of the general population, but medical student suicide rates are not well studied. It is difficult to determine whether physician suicide rates can be predicted by medical student risk factors for suicide and difficult to identify those risk factors without knowing medical student suicide rates. The authors systematically reviewed the literature to collate data on medical student suicide rates. METHOD The authors searched the PubMed, Web of Science, and Library of Congress databases for papers published in any language before November 11, 2017. They identified 3,429 papers; after the initial screening process, they assessed 82 full-text articles for eligibility. Twelve ultimately met the full inclusion criteria; meta-analysis was not possible. Data regarding medical student suicide numbers and rates were extracted and compared with contemporaneous general population suicide rates using public epidemiological data, when available. RESULTS Medical student suicide rates were infrequently reported in the historical and international literature, and data collection techniques were inconsistent. Generally, U.S. medical student suicide rates were lower than those of the contemporaneous general population. Proportionate mortality of medical students (number of deaths by a particular cause such as suicide divided by total number of deaths) was not reported in the literature. CONCLUSIONS Gaps exist in knowledge of medical student suicide rates, risk factors, and targets for intervention. Significant barriers have impeded information collection. Yet, more comprehensive data collection is needed to understand suicide risk in this population and to implement and improve effective intervention strategies.
Collapse
Affiliation(s)
- Caren J Blacker
- C.J. Blacker is fellow and instructor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0003-3510-0696. C.P. Lewis is research fellow and instructor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0001-8791-657X. C.C. Swintak is assistant professor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota. J.M. Bostwick is professor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota. S.J. Rackley is assistant professor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | | | | | | | | |
Collapse
|
22
|
Tabatabai S, Javadi MA. Ophthalmic Education and Ophthalmologists Growth Trends in Iran (1979-2016). J Ophthalmic Vis Res 2019; 14:185-194. [PMID: 31114656 PMCID: PMC6504715 DOI: 10.4103/jovr.jovr_24_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To analyze the growth trends in ophthalmic education in Iran since 1979, and to discuss their implications on the profession. Methods This comprehensive national study was performed by the Academy of Medical Sciences of I.R. Iran. The data were gathered from the Specialty Training Council of the Ministry of Health and from the Medical Council of Iran. Results Our analysis revealed ten important current growth trends and seven future trends and implications. Between 1979-80 and 2015-16, the number of residents annually admitted to ophthalmology increased from 21 to 84 and related fellowships and from 0 to 34. The number of ophthalmologists graduating in the country increased from 21 (45%) in 1979 to 69 (98%) in 2015. The ratio of ophthalmologists per 100,000 people averaged 1.91 in 1979 and 3.00 in 2016. Considering migrant and retired ophthalmologists, there are approximately 2400 active ophthalmologists in Iran. In 1979, there was one active ophthalmologist per 52,112 people; in 2014, there was one per 33,333 people. This represents a per capita increase of 57%. Since 1979, the number of active ophthalmologists has increased by 234%. The number of active women ophthalmologists has increased by more than 600%, from 65 (9%) in 1979 to 470 (20%) in 2016. Conclusion Equitable geographic distribution and balanced combination of ophthalmologists (women/men and specialists/fellowships) are necessary to optimize community eye health. We propose further studies on the effects of fellowship training growth and work patterns of female and male ophthalmologists.
Collapse
Affiliation(s)
- Shima Tabatabai
- Medical Education Group, Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Javadi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
23
|
Moazam F, Shekhani S. Why women go to medical college but fail to practise medicine: perspectives from the Islamic Republic of Pakistan. MEDICAL EDUCATION 2018; 52:705-715. [PMID: 29508422 DOI: 10.1111/medu.13545] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 11/15/2017] [Accepted: 01/15/2018] [Indexed: 05/28/2023]
Abstract
CONTEXT Female medical students outnumber men in countries such as Saudi Arabia, India and Pakistan, yet many fail to practise medicine following graduation. In Pakistan, 70% of medical students are women, yet it is estimated that half of them will not pursue medicine following graduation. This is considered a major reason for physician shortages in the country. METHODS We conducted a qualitative study drawing upon the 'role strain' theory to explore the views of final-year medical students from four medical colleges in Karachi, Pakistan, on female graduates not entering the medical field. Data were obtained through 20 individual in-depth interviews and two focus group discussions. Themes were developed inductively from the data using the constant comparison method. RESULTS Pakistani parents actively channel daughters into medical education, considering medicine to be the most 'respectable' field. However, in a patrilocal society with norms of early, arranged marriages for daughters, there is a significant influence of in-laws and a husband on a woman's professional future. Parents perceive the medical degree as a 'safety net' should something go wrong with the marriage, rather than a step toward a medical career. Female respondents experience significant role conflict between their socially rooted gender roles as homemakers and mothers and their careers in medicine. Postgraduate training systems that are unfriendly to women provide further deterrents for women wishing to work. Contrary to popular belief, women not practising medicine is not the sole contributor to physician shortages. A significant factor appears to be male graduates migrating abroad for better training and financial prospects. CONCLUSIONS Acceptance of traditional cultural values, including entrenched gender roles in society, deters women from practising medicine. To enable greater participation of women in the medical field, steps are required that will allow women to better manage family and work conflicts.
Collapse
Affiliation(s)
- Farhat Moazam
- Centre of Biomedical Ethics and Culture, Deewan Farooq Medical Complex, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Sualeha Shekhani
- Centre of Biomedical Ethics and Culture, Deewan Farooq Medical Complex, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| |
Collapse
|
24
|
Affiliation(s)
- Shahina Pardhan
- Vision and Eye Research Unit (VERU); School of Medicine; Anglia Ruskin University; Cambridge UK
| |
Collapse
|
25
|
Improving female physician's careers in academic medicine: Chances and challenges. Best Pract Res Clin Anaesthesiol 2018; 32:15-23. [DOI: 10.1016/j.bpa.2018.04.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/23/2018] [Indexed: 11/23/2022]
|
26
|
Mowatt L, Gordon C, Santosh ABR, Jones T. Computer vision syndrome and ergonomic practices among undergraduate university students. Int J Clin Pract 2018; 72. [PMID: 28980750 DOI: 10.1111/ijcp.13035] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Accepted: 09/22/2017] [Indexed: 11/28/2022] Open
Abstract
AIM To determine the prevalence of computer vision syndrome (CVS) and ergonomic practices among students in the Faculty of Medical Sciences at The University of the West Indies (UWI), Jamaica. METHOD A cross-sectional study was done with a self-administered questionnaire. RESULTS Four hundred and nine students participated; 78% were females. The mean age was 21.6 years. Neck pain (75.1%), eye strain (67%), shoulder pain (65.5%) and eye burn (61.9%) were the most common CVS symptoms. Dry eyes (26.2%), double vision (28.9%) and blurred vision (51.6%) were the least commonly experienced symptoms. Eye burning (P = .001), eye strain (P = .041) and neck pain (P = .023) were significantly related to level of viewing. Moderate eye burning (55.1%) and double vision (56%) occurred in those who used handheld devices (P = .001 and .007, respectively). Moderate blurred vision was reported in 52% who looked down at the device compared with 14.8% who held it at an angle. Severe eye strain occurred in 63% of those who looked down at a device compared with 21% who kept the device at eye level. Shoulder pain was not related to pattern of use. CONCLUSION Ocular symptoms and neck pain were less likely if the device was held just below eye level. There is a high prevalence of Symptoms of CVS amongst university students which could be reduced, in particular neck pain and eye strain and burning, with improved ergonomic practices.
Collapse
Affiliation(s)
- Lizette Mowatt
- Ophthalmology Division, Department of Surgery, Radiology, Anaesthesia and Intensive Care, Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica
- Ophthalmology Division, University Hospital of the West Indies, Kingston, Jamaica
| | - Carron Gordon
- School of Physical Therapy, Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica
| | | | - Thaon Jones
- School of Dentistry, Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica
| |
Collapse
|
27
|
Abolarinwa AA, Osuoji RI. WOMEN IN SURGERY - an overview of the evolving trends in Nigeria. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2017; 7:1-17. [PMID: 30479988 PMCID: PMC6237316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Since 1974 when the first Nigerian female surgeon was produced, an increasing number of Nigerian females have qualified as surgeons and more are in the various residency training programmes in Nigeria to become surgeons. AIM To document the evolving trend of Nigerian females training as surgeons and their contribution to the surgical workforce. METHODOLOGY A questionnaire based survey of Nigerian females who are qualified surgeons and those in the surgical training programmes from June 2016 - September 2017. RESULTS Sixty questionnaires were sent out, and 54(90%) responded, with 49(91%) completely answering the questionnaire. The age range of the respondents was between 29 -72 years, with a mean age of 37.5 ± 6.2 years. Twelve (22.2%) were registrars, 18(33.3%) were senior registrars, and 24(44.4%) were specialists. One respondent (1.85%) had an academic professorial chair. The reasons for the preferred choice of subspecialty included: genuine interest 44(89.8%), availability of mentors 20(40.8%), the availability of a structured programme 14(28.62%), lifestyle friendly programmes 7(14.3%), remuneration 6(12.2%), and the duration of the training 1(2.2%). Thirty three (67.4%) were married, 11(22.5%) were single and 5(10.2%) were divorced. Twenty six (78.8%) gave birth to children during their surgical training programmes, while 12(36.4%) and 5(15.2%) gave birth to children before and after their programmes respectively. Twelve (37.5%) of the respondents who gave birth during training, had disruption in their training. Four (8.2%) of the respondents, made a career switch from Surgery. CONCLUSION The evolving interest of female doctors in Surgery in Nigeria as highlighted in this study is a welcome development and should be encouraged and sustained by mentoring of aspiring female surgeons even from the medical schools.
Collapse
Affiliation(s)
- A A Abolarinwa
- Department of Surgery, College of Medicine, Lagos State University, Ikeja, Lagos, Nigeria
| | - R I Osuoji
- Department of Surgery, College of Medicine, Lagos State University, Ikeja, Lagos, Nigeria
| |
Collapse
|
28
|
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
|
29
|
Fawzy M, Hamed SA. Prevalence of psychological stress, depression and anxiety among medical students in Egypt. Psychiatry Res 2017; 255:186-194. [PMID: 28575777 DOI: 10.1016/j.psychres.2017.05.027] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 05/04/2017] [Accepted: 05/15/2017] [Indexed: 10/19/2022]
Abstract
Poor psychological health in medical students has been reported nationwide. This study estimated the prevalence of depression, anxiety and stress symptoms among medical students who were enrolled in a public university in Upper Egypt and determine the association of these morbidities with the students' basic socio-demographic variables. This cross-sectional study included 700 students. A self-administered, questionnaire for the socio-demographic characteristics, Depression Anxiety Stress Scale (DASS 21) and Pittsburgh Sleep Quality Index (PSQI) questionnaire were used for assessment. High frequencies of depression (65%), anxiety (73%) and stress (59.9%) were reported. Stress scores were significantly higher than depression and anxiety (P=0.001). 55.7% were poor sleepers. In univarate analysis, females, those living in the University campus/students' residence facility, in the preclinical years and with lower academic achievement had higher scores of DASS and PSQI compared to their comparative partners. Significant correlations were reported between stress with depression, anxiety and PQSI scores (P=0.0001). In multivariate analysis, stress scores were significantly associated with female sex, depression and anxiety scores. We conclude that depression, anxiety and stress symptoms are common in medical students of Assiut University relative to other schools and female gender was significantly correlated with these findings.
Collapse
Affiliation(s)
- Mohamed Fawzy
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Sherifa A Hamed
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt.
| |
Collapse
|
30
|
Rodriguez Santana I, Chalkley M. Getting the right balance? A mixed logit analysis of the relationship between UK training doctors' characteristics and their specialties using the 2013 National Training Survey. BMJ Open 2017; 7:e015219. [PMID: 28801397 PMCID: PMC5724110 DOI: 10.1136/bmjopen-2016-015219] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To analyse how training doctors' demographic and socioeconomic characteristics vary according to the specialty that they are training for. DESIGN Descriptive statistics and mixed logistic regression analysis of cross-sectional survey data to quantify evidence of systematic relationships between doctors' characteristics and their specialty. SETTING Doctors in training in the United Kingdom in 2013. PARTICIPANTS 27 530 doctors in training but not in their foundation year who responded to the National Training Survey 2013. MAIN OUTCOME MEASURES Mixed logit regression estimates and the corresponding odds ratios (calculated separately for all doctors in training and a subsample comprising those educated in the UK), relating gender, age, ethnicity, place of studies, socioeconomic background and parental education to the probability of training for a particular specialty. RESULTS Being female and being white British increase the chances of being in general practice with respect to any other specialty, while coming from a better-off socioeconomic background and having parents with tertiary education have the opposite effect. Mixed results are found for age and place of studies. For example, the difference between men and women is greatest for surgical specialties for which a man is 12.121 times more likely to be training to a surgical specialty (relative to general practice) than a woman (p-value<0.01). Doctors who attended an independent school which is proxy for doctor's socioeconomic background are 1.789 and 1.413 times more likely to be training for surgical or medical specialties (relative to general practice) than those who attended a state school (p-value<0.01). CONCLUSIONS There are systematic and substantial differences between specialties in respect of training doctors' gender, ethnicity, age and socioeconomic background. The persistent underrepresentation in some specialties of women, minority ethnic groups and of those coming from disadvantaged backgrounds will impact on the representativeness of the profession into the future. Further research is needed to understand how the processes of selection and the self-selection of applicants into specialties gives rise to these observed differences.
Collapse
|
31
|
Gafson I, Currie J, O'Dwyer S, Woolf K, Griffin A. Attitudes towards attrition among UK trainees in obstetrics and gynaecology. Br J Hosp Med (Lond) 2017; 78:344-348. [DOI: 10.12968/hmed.2017.78.6.344] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Irene Gafson
- Specialty Registrar in Obstetrics and Gynaecology and Medical Education Fellow, Research Department of Medical Education, UCL Medical School, London
| | - Jane Currie
- Specialty Registrar in Obstetrics and Gynaecology and Clinical Research Fellow, Institute for Women's Health, University College London, London
| | - Sabrina O'Dwyer
- Consultant Obstetrician and Gynaecologist, Department of Obstetrics and Gynaecology, Imperial Healthcare NHS Trust, London W12 0HS
| | - Katherine Woolf
- Senior Lecturer and Deputy Lead for Research, Research Department of Medical Education, UCL Medical School, London
| | - Ann Griffin
- Director and Lead for Research, Research Department of Medical Education, UCL Medical School, London
| |
Collapse
|
32
|
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.
Collapse
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
| |
Collapse
|
33
|
Brenneisen Mayer F, Souza Santos I, Silveira PSP, Itaqui Lopes MH, de Souza ARND, Campos EP, de Abreu BAL, Hoffman II I, Magalhães CR, Lima MCP, Almeida R, Spinardi M, Tempski P. Factors associated to depression and anxiety in medical students: a multicenter study. BMC MEDICAL EDUCATION 2016; 16:282. [PMID: 27784316 PMCID: PMC5080800 DOI: 10.1186/s12909-016-0791-1] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 10/06/2016] [Indexed: 05/04/2023]
Abstract
BACKGROUND To evaluate personal and institutional factors related to depression and anxiety prevalence of students from 22 Brazilian medical schools. METHODS The authors performed a multicenter study (August 2011 to August 2012), examining personal factors (age, sex, housing, tuition scholarship) and institutional factors (year of the medical training, school legal status, location and support service) in association with scores of Beck Depression Inventory (BDI) and State Trait Anxiety Inventory (STAI). RESULTS Of 1,650 randomly selected students, 1,350 (81.8 %) completed the study. The depressive symptoms prevalence was 41 % (BDI > 9), state-anxiety 81.7 % and trait-anxiety in 85.6 % (STAI > 33). There was a positive relationship between levels of state (r = 0,591, p < 0.001) and trait (r = 0,718, p < 0.001) anxiety and depression scores. All three symptoms were positively associated with female sex and students from medical schools located in capital cities of both sexes. Tuition scholarship students had higher state-anxiety but not trait-anxiety or depression scores. Medical students with higher levels of depression and anxiety symptoms disagree more than their peers with the statements "I have adequate access to psychological support" and "There is a good support system for students who get stressed". CONCLUSIONS The factors associated with the increase of medical students' depression and anxiety symptoms were female sex, school location and tuition scholarship. It is interesting that tuition scholarship students showed state-anxiety, but not depression and trait-anxiety symptoms.
Collapse
Affiliation(s)
- Fernanda Brenneisen Mayer
- Center of Development of Medical Education, School of Medicine of Univrsity of São Paulo, Av. Dr. Arnaldo, 455, Sala 2349, 01246-903 São Paulo, SP Brazil
| | - Itamar Souza Santos
- Center of Development of Medical Education, School of Medicine of Univrsity of São Paulo, Av. Dr. Arnaldo, 455, Sala 2349, 01246-903 São Paulo, SP Brazil
| | - Paulo S. P. Silveira
- Department of Pathology, School of Medicine of University of São Paulo, Av. Dr. Arnaldo, 455, Sala 2349, 01246-903 São Paulo, SP Brazil
| | - Maria Helena Itaqui Lopes
- University of Caxias do Sul, Rua Francisco Getúlio Vargas, 1130, 95070-560 Caxias do Sul, Rio Grande do Sul Brazil
| | - Alicia Regina Navarro Dias de Souza
- Psychiatry and Legal Medicine Department, School of Medicine of the Federal University of Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco 255, 9° andar, sala 9E28, Rio de Janeiro, 21941-590 RJ Brazil
| | - Eugenio Paes Campos
- University Center of Serra dos Órgãos, Av. Alberto Torres, 111, 25964-000 Rio de Janeiro, RJ Brazil
| | | | - Itágores Hoffman II
- School of Medicine of Tocatins, Avenida NS 15, 109, sala 18, 77020-210 Palmas, TO Brazil
| | - Cleidilene Ramos Magalhães
- Department of Education and Humanities, Federal University of Health Sciences of Porto Alegre , Rua Sarmento Leite, 245, sala 412, 90050-170 Porto Alegre, RS Brazil
| | - Maria Cristina P. Lima
- Neurology and Psychiatry Department, School of Medicine of São Paulo State University, Rua Rubião Júnior, caixa-postal: 540, 18618-000 Botucatu, SP Brazil
| | - Raitany Almeida
- School of Medicine of Federal University of Rondônia , BR 364 km 9,5, 78900-000 Porto Velho, RO Brazil
| | - Mateus Spinardi
- Marília Medical School, Av. Monte Carmelo, 800, sala 17, 17519-030 São Paulo, Brazil
| | - Patricia Tempski
- Center of Development of Medical Education, School of Medicine of Univrsity of São Paulo, Av. Dr. Arnaldo, 455, Sala 2349, 01246-903 São Paulo, SP Brazil
- Center of Development of Medical Education, Avenida Dr Arnaldo, 455, 1 andar, sala 1210, 01246903 São Paulo, Brazil
| |
Collapse
|
34
|
|
35
|
Atsawarungruangkit A. Relationship of residency program characteristics with pass rate of the American Board of Internal Medicine certifying exam. MEDICAL EDUCATION ONLINE 2015; 20:28631. [PMID: 26426400 PMCID: PMC4590350 DOI: 10.3402/meo.v20.28631] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 09/08/2015] [Accepted: 09/08/2015] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To evaluate the relationship between the pass rate of the American Board of Internal Medicine (ABIM) certifying exam and the characteristics of residency programs. METHODS The study used a retrospective, cross-sectional design with publicly available data from the ABIM and the Fellowship and Residency Electronic Interactive Database. All categorical residency programs with reported pass rates were included. Using univariate and multivariate, linear regression analyses, I analyzed how 69 factors (e.g., location, general information, number of faculty and trainees, work schedule, educational environment) are related to the pass rate. RESULTS Of 371 programs, only one region had a significantly different pass rate from the other regions; however, as no other characteristics were reported in this region, I excluded program location from further analysis. In the multivariate analysis, pass rate was significantly associated with four program characteristics: ratio of full-time equivalent paid faculty to positions, percentage of osteopathic doctors, formal mentoring program, and on-site child care (OCC). Numerous factors were not associated at all, including minimum exam scores, salary, vacation days, and average hours per week. CONCLUSIONS As shown through the ratio of full-time equivalent paid faculty to positions and whether there was a formal mentoring program, a highly supervised training experience was strongly associated with the pass rate. In contrast, percentage of osteopathic doctors was inversely related to the pass rate. Programs with OCC significantly outperformed programs without OCC. This study suggested that enhancing supervision of training programs and offering parental support may help attract and produce competitive residents.
Collapse
|
36
|
Atsawarungruangkit A. Relationship of residency program characteristics with pass rate of the American Board of Internal Medicine certifying exam. MEDICAL EDUCATION ONLINE 2015; 20:28631. [PMID: 26426400 PMCID: PMC4590350 DOI: 10.3402/meo.v20.28631 10.3402/meo.v3420.28631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 09/08/2015] [Accepted: 09/08/2015] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To evaluate the relationship between the pass rate of the American Board of Internal Medicine (ABIM) certifying exam and the characteristics of residency programs. METHODS The study used a retrospective, cross-sectional design with publicly available data from the ABIM and the Fellowship and Residency Electronic Interactive Database. All categorical residency programs with reported pass rates were included. Using univariate and multivariate, linear regression analyses, I analyzed how 69 factors (e.g., location, general information, number of faculty and trainees, work schedule, educational environment) are related to the pass rate. RESULTS Of 371 programs, only one region had a significantly different pass rate from the other regions; however, as no other characteristics were reported in this region, I excluded program location from further analysis. In the multivariate analysis, pass rate was significantly associated with four program characteristics: ratio of full-time equivalent paid faculty to positions, percentage of osteopathic doctors, formal mentoring program, and on-site child care (OCC). Numerous factors were not associated at all, including minimum exam scores, salary, vacation days, and average hours per week. CONCLUSIONS As shown through the ratio of full-time equivalent paid faculty to positions and whether there was a formal mentoring program, a highly supervised training experience was strongly associated with the pass rate. In contrast, percentage of osteopathic doctors was inversely related to the pass rate. Programs with OCC significantly outperformed programs without OCC. This study suggested that enhancing supervision of training programs and offering parental support may help attract and produce competitive residents.
Collapse
|
37
|
Williams B, Webb V. A national study of paramedic and nursing students' readiness for interprofessional learning (IPL): Results from nine universities. NURSE EDUCATION TODAY 2015; 35:e31-e37. [PMID: 26047600 DOI: 10.1016/j.nedt.2015.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 05/05/2015] [Accepted: 05/14/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND The development of successful and functional interprofessional practice is best achieved through interprofessional learning (IPL). Given that many paramedic programmes still take an isolative uni-professional educational approach to their undergraduate courses, it is unclear on their preparedness for students' IPL. Therefore, the objective of this study was to assess the attitudes of undergraduate paramedic and nursing/paramedic students from nine Australian universities towards IPL over a two year period. METHODS Using a convenience sample of paramedic and nursing/paramedic students-attitudes towards IPL was measured using the Readiness for Interprofessional Learning Scale (RIPLS) 5-point Likert-scale (1=strongly disagree and 5=strongly agree). RESULTS A total of 1264 students participated (n=303 in 2011 and n=961 in 2012) in this study, consistent with a 43% response rate. Surveyed students were predominantly first year n=506 (40.03%), female n=748 (59.2%) and undertaking single paramedic degrees n=948 (75.0%). Nursing/paramedic students demonstrated significantly lower Negative Professional Identity (M=6.26, p=0.004) and Roles and Responsibilities means (M=6.87, p<0.0001) and higher Positive Professional Identity means (M=15.68, p=0.011) compared with paramedic students. CONCLUSIONS The impact of nursing/paramedic education was shown to significantly enhance student attitudes towards interprofessionalism and the individual universities involved in this study generated students at varying stages of IPL preparedness. Students' year level appeared to influence IPL readiness, yet there are compelling paradoxical arguments for both earlier and later inclusion of IPL within curricula.
Collapse
Affiliation(s)
- Brett Williams
- Department of Community Emergency Health & Paramedic Practice, Monash University, Frankston, Australia.
| | - Vanessa Webb
- Department of Community Emergency Health & Paramedic Practice, Monash University, Frankston, Australia
| |
Collapse
|
38
|
Russo G, Gonçalves L, Craveiro I, Dussault G. Feminization of the medical workforce in low-income settings; findings from surveys in three African capital cities. HUMAN RESOURCES FOR HEALTH 2015; 13:64. [PMID: 26228911 PMCID: PMC4521355 DOI: 10.1186/s12960-015-0064-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 07/22/2015] [Indexed: 05/21/2023]
Abstract
BACKGROUND Women represent an increasingly growing share of the medical workforce in high-income countries, with abundant research focusing on reasons and implications of the phenomenon. Little evidence is available from low- and middle-income countries, which is odd given the possible repercussion this may have for the local supply of medical services and, ultimately, for attaining universal health coverage. METHODS Drawing from secondary analysis of primary survey data, this paper analyses the proportion and characteristics of female physicians in Bissau, Maputo and Praia, with the objective of gaining insights on the extent and features of the feminization of the medical workforce in low- and middle-income settings. We used descriptive statistics, parametric and non-parametric test to compare groups and explore associations between different variables. Zero-inflated and generalized linear models were employed to analyse the number of hours worked in the private and public sector by male and female physicians. RESULTS AND DISCUSSION We show that although female physicians do not represent yet the majority of the medical workforce, feminization of the profession is under way in the three locations analysed, as women are presently over-represented in younger age groups. Female doctors distribute unevenly across medical specialties in the three cities and are absent from traditionally male-dominated ones such as surgery, orthopaedics and stomatology. Our data also show that they engage as much as their male peers in private practice, although overall they dedicate fewer hours to the profession, particularly in the public sector. CONCLUSIONS While more research is needed to understand how this phenomenon affects rural areas in a broader range of locations, our work shows the value of exploring the differences between female and male physicians' engagement with the profession in order to anticipate the impact of such feminization on national health systems and workforces in low- and middle-income countries.
Collapse
Affiliation(s)
- Giuliano Russo
- International Health and Biostatistics Unit, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal.
- WHO Collaborating Centre for Health Workforce Policies and Planning, Lisbon, Portugal.
- Global Health and Tropical Medicine Global Health and Tropical Medicine, GHTM, Lisbon, Portugal.
| | - Luzia Gonçalves
- International Health and Biostatistics Unit, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal.
- WHO Collaborating Centre for Health Workforce Policies and Planning, Lisbon, Portugal.
- Centro de Estatística e Aplicações da Universidade de Lisboa, Lisbon, Portugal.
| | - Isabel Craveiro
- International Health and Biostatistics Unit, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal.
- WHO Collaborating Centre for Health Workforce Policies and Planning, Lisbon, Portugal.
- Global Health and Tropical Medicine Global Health and Tropical Medicine, GHTM, Lisbon, Portugal.
| | - Gilles Dussault
- International Health and Biostatistics Unit, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal.
- WHO Collaborating Centre for Health Workforce Policies and Planning, Lisbon, Portugal.
- Global Health and Tropical Medicine Global Health and Tropical Medicine, GHTM, Lisbon, Portugal.
| |
Collapse
|
39
|
Taba ST, Atkinson SR, Lewis S, Chung KSK, Hossain L. A systems life cycle approach to managing the radiology profession: an Australian perspective. AUST HEALTH REV 2015; 39:228-239. [PMID: 25513717 DOI: 10.1071/ah14113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 10/06/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Although the medical system has expanded considerably over the past two decades in almost all countries, so too has the demand for health care. The radiology specialisation may be an early system indicator, being especially sensitive to changes in supply and demand in both rural and urban environments. The question is whether the new policies of increasing the number of radiologists can be a proper long-term solution for the imbalance of workforce supply and demand or not. METHODS Using system dynamics modelling, we present our integrated descriptive models for the supply and demand of Australian radiologists to find the actual gap. Followed by this, we pose a prescriptive model for the supply in order to lessen the identified imbalance between supply and demand. Our system dynamics models compare the demand and supply of Australian radiologists over 40 years between 2010 and 2050. RESULTS The descriptive model shows that even if the radiology training program grows at a higher rate than the medical training growth rate and its own historical growth, the system will never be able to meet demand. The prescriptive model also indicates that although changing some influential factors (e.g the intake rate) reduces the level of imbalance, the system will still stay unstable during the study period. CONCLUSION We posit that Australia may need to design a new system of radiology provision to meet future demands for high-quality medical radiation services. We also suggest some strategies, such as greater development of radiographers' role, are critical for enabling sustainable change over time. What is known about the topic? Long-term workforce planning for medical services at the national level has been very challenging for policy makers of the 21st century. The current demographic imbalance in the supply and demand of the Australian radiologist workforce makes it difficult to plan the effects of extra inflow of radiology students over time.
Collapse
Affiliation(s)
- Seyedamir Tavakoli Taba
- Complex Systems Research Group, School of Civil Engineering, Faculty of Engineering and IT, University of Sydney, Sydney, NSW 2006, Australia.
| | - Simon Reay Atkinson
- Complex Systems Research Group, School of Civil Engineering, Faculty of Engineering and IT, University of Sydney, Sydney, NSW 2006, Australia.
| | - Sarah Lewis
- Medical Imaging Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, Brain Mind Research Institute, University of Sydney, Sydney, NSW 2141, Australia. Email
| | - Kon Shing Kenneth Chung
- Complex Systems Research Group, School of Civil Engineering, Faculty of Engineering and IT, University of Sydney, Sydney, NSW 2006, Australia.
| | - Liaquat Hossain
- Complex Systems Research Group, School of Civil Engineering, Faculty of Engineering and IT, University of Sydney, Sydney, NSW 2006, Australia.
| |
Collapse
|
40
|
Jefferson L, Bloor K, Maynard A. Women in medicine: historical perspectives and recent trends. Br Med Bull 2015; 114:5-15. [PMID: 25755293 DOI: 10.1093/bmb/ldv007] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2015] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Women now outnumber men in British medical schools. This paper charts the history of women in medicine and provides current demographic trends. SOURCES OF DATA A historical literature review and routinely collected data from Department of Health and the Health and Social Care Information Centre. AREAS OF AGREEMENT Clear gender differences are apparent in working practices, including greater likelihood of working part time and specializing in certain areas of medicine. AREAS OF CONTROVERSY The increasing need to increase activity among the existing medical workforce is timely amidst a changing workforce demographic. GROWING POINTS Workforce planners, policymakers and Royal Colleges should continue to develop interventions that may reduce disparities in career choices, as well as considering ways to increase participation and activity. AREAS TIMELY FOR DEVELOPING RESEARCH Further research is needed to explore the cost-effectiveness of existing and future interventions in this field.
Collapse
Affiliation(s)
- Laura Jefferson
- Department of Health Sciences, The University of York, York, UK
| | - Karen Bloor
- Department of Health Sciences, The University of York, York, UK
| | - Alan Maynard
- Department of Health Sciences, The University of York, York, UK
| |
Collapse
|
41
|
Castillo M. The winds of change. AJNR Am J Neuroradiol 2015; 36:227-8. [PMID: 25104289 DOI: 10.3174/ajnr.a4075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
42
|
Győrffy Z, Dweik D, Girasek E. Reproductive health and burn-out among female physicians: nationwide, representative study from Hungary. BMC WOMENS HEALTH 2014; 14:121. [PMID: 25273522 PMCID: PMC4190500 DOI: 10.1186/1472-6874-14-121] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 09/23/2014] [Indexed: 11/18/2022]
Abstract
Background There is a worldwide rising tendency of women deciding to become physicians; hence, one of the most remarkable fields of investigation is the wellbeing of female doctors. The aim of this study was to describe female physicians’ reproductive health in Hungary and to explore the potential correlation between their reproductive disorders and burnout symptoms. Up to our present knowledge, there have not been any studies investigating the correlation between reproductive disorders and burnout of female physicians; therefore, our study represents a unique approach. Methods Data in this representative cross-sectional epidemiological study were obtained from online questionnaires completed by 3039 female physicians. Participants in a representative nationwide survey (Hungarostudy, 2013) served as controls (n = 1069). Differences between physicians and the control group were disclosed by chi-square test. Correlations between certain factors of reproductive health and the three dimensions of burnout were detected by Pearson correlations and X2 test. Binary logistic regression analysis was used to determine the association between burnout and reproductive health. Results Female physicians were more often characterised by time-to-pregnancy interval longer than one year (18.4% vs. 9.8%), were bearing more high-risk pregnancies (26.3% vs.16.3%), and were more likely to be undergoing infertility therapy (8.5% vs. 3.4%) and experiencing miscarriage (20.8% vs. 14.6%) during their reproductive years, compared with the general female population. With the exception of miscarriages, the difference remained significant in all comparisons with the professional control group. Both high-risk pregnancies and miscarriages of doctors were associated with depersonalisation (p = 0.028 and p = 0.012 respectively) and personal accomplishment (p = 0.016 and p = 0.008 respectively) dimensions of burnout. Results of the multivariate analysis showed that, beside traditional risk factors, depersonalisation acted as an important explanatory factor in case of high-risk pregnancies (OR = 1.086). Conclusions There is a circulatory causality between burnout and the development of reproductive disorders. Burnout is an important risk factor for high-risk pregnancies and miscarriages, and it has a negative effect on the outcome of pregnancies. At the same time, women suffering from reproductive disorders are more likely to develop burnout syndrome. Improvement of working conditions and prevention of burnout in female doctors are equally important tasks.
Collapse
Affiliation(s)
- Zsuzsa Győrffy
- Institute of Behavioural Sciences, Semmelweis University, Nagyvárad square 4, H-1089 Budapest, Hungary.
| | | | | |
Collapse
|
43
|
Győrffy Z, Girasek E. [The health of female physicians in Hungary. A longitudinal perspective]. Orv Hetil 2014; 155:993-9. [PMID: 24936575 DOI: 10.1556/oh.2014.29912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION There is a worldwide rising tendency of women who decide to become physician. One of the most remarkable fields of investigation is the well-being of female doctors. AIM To study the prevalence of somatic and reproductive morbidity in a representative sample of Hungarian female physicians and compare it with a control group of graduated women. METHOD Data for this epidemiological study were collected from 2515 female physicians in 2013. Graduated women from a representative survey (Hungarostudy 2013) served as controls. The results were compared to the previous (2003-2004) representative female physicians' survey. RESULTS We found that the prevalence of chronic somatic morbidity among female physicians was significantly higher than that in the respective control groups. A larger proportion of female medical doctors were characterized by time-to-pregnancy interval longer than one year, and undergoing infertility therapy and miscarriages, compared to the control female population, while the same prevalence of terminations of pregnancy was found. CONCLUSIONS The longitudinal perspective confirmed the existence of the "Hungarian female physicians' paradox".
Collapse
Affiliation(s)
- Zsuzsa Győrffy
- Semmelweis Egyetem, Általános Orvostudományi Kar Magatartástudományi Intézet Budapest Nagyvárad tér 4. 1089
| | - Edmond Girasek
- Semmelweis Egyetem Egészségügyi Menedzserképző Központ Budapest
| |
Collapse
|
44
|
Schroeder JE, Zisk-Rony RY, Liebergall M, Tandeter H, Kaplan L, Weiss YG, Weissman C. Medical students' and interns' interest in orthopedic surgery: the gender factor. JOURNAL OF SURGICAL EDUCATION 2014; 71:198-204. [PMID: 24602710 DOI: 10.1016/j.jsurg.2013.08.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 08/23/2013] [Accepted: 08/24/2013] [Indexed: 05/21/2023]
Abstract
OBJECTIVE There is an extremely small proportion of female medical students choosing to specialize in orthopedic surgery. The aim of the study was to assess medical students' and interns' interests and perceptions of orthopedic surgery and explore why women are not interested in orthopedic surgery. SETTING Questionnaires were distributed to final-year medical students and interns assessing their interests and perception of orthopedic surgery. PARTICIPANTS Final-year medical students and interns. RESULTS Responses were obtained from 317 students and 199 interns. Among the medical students, 15% were interested in orthopedic surgery, but only 2% were women. Both male and female students perceived orthopedics as an "action"-packed, procedure-based profession, providing instant gratification, time in the operating room, high income, and the option for private practice. Female medical students considered it boring. Among interns, 11% were interested in orthopedic surgery; however, only 2% were women. When compared with the interns who were not interested in orthopedic surgery, a greater number of the interns interested in orthopedic surgery rated time with family and a procedure-intensive profession as important. Female students and interns were also interested in other surgical fields. CONCLUSIONS The increasing majority of women among medical students will reshape the future of physician workforce by dictating changes in workforce participation, working conditions, and intercollegial relationships. Orthopedic surgery will need to adapt to these realities.
Collapse
Affiliation(s)
| | | | | | | | - Leon Kaplan
- Hospital of Special Surgery, New York, New York
| | | | | |
Collapse
|
45
|
Phillips SP. The growing number of female physicians: meanings, values, and outcomes. Isr J Health Policy Res 2013; 2:47. [PMID: 24351119 PMCID: PMC3878256 DOI: 10.1186/2045-4015-2-47] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Accepted: 11/04/2013] [Indexed: 11/10/2022] Open
Abstract
Throughout the developed world the proportion of women in professions such as medicine is increasing. This commentary uses Haklai et al's nuanced report on the feminization of medicine in Israel as a starting point. I discuss whether gender shifts are an outcome of more egalitarian attitudes towards women overall, or instead arise from men choosing other professions, the extent of the shift, and its meaning for the quantity and quality of medical care. The discussion is embedded in more fundamental concepts such as the aims of medical practice and the best indicators of effective care. I reflect on concerns about lower female physician productivity at a time when the proportion of female physicians still remains below parity in almost all countries. Medicine is embedded in the principles and expectations of the community being served. The profession's values and practices both shape and are shaped by those of that larger community. As cultures move toward equality, proportional representation of women and men in medicine will follow, while remaining limitations to gender equality will be mirrored in opportunities and restrictions for women in medicine. This is a commentary on http://www.ijhpr.org/content/2/1/37/.
Collapse
Affiliation(s)
- Susan P Phillips
- Departments of Family Medicine and Public Health Sciences, Queen's University, 220 Bagot St,, K7L 5E9, Kingston, Canada.
| |
Collapse
|
46
|
Abstract
CONTEXT Women are in the majority in terms of entry to medical schools worldwide and will soon represent the majority of working doctors. This has been termed the 'feminising' of medicine. In medical education, such gender issues tend to be restricted to discussions of demographic changes and structural inequalities based on a biological reading of gender. However, in contemporary social sciences, gender theory has moved beyond both biology and demography to include cultural issues of gendered ways of thinking. Can contemporary feminist thought drawn from the social sciences help medical educators to widen their appreciation and understanding of the feminising of medicine? DISCUSSION Post-structuralist feminist critique, drawn from the social sciences, focuses on cultural practices, such as language use, that support a dominant patriarchy. Such a critique is not exclusive to women, but may be described as supporting a tender-minded approach to practice that is shared by both women and men. The demographic feminising of medicine may have limited effect in terms of changing both medical culture and medical education practices without causing radical change to entrenched cultural habits that are best described as patriarchal. Medical education currently suffers from male biases, such as those imposed by 'andragogy', or adult learning theory, and these can be positively challenged through post-structuralist feminist critique. CONCLUSIONS Women doctors entering the medical workforce can resist and reformulate the current dominant patriarchy rather than reproducing it, supported by male feminists. Such a feminising of medicine can extend to medical education, but will require an appropriate theoretical framework to make sense of the new territory. The feminising of medical education informed by post-structuralist frameworks may provide a platform for the democratisation of medical culture and practices, further informing authentic patient-centred practices of care.
Collapse
|
47
|
Roberts T. Driven to it. Clin Med (Lond) 2012; 12:207-9. [PMID: 22783769 PMCID: PMC4953480 DOI: 10.7861/clinmedicine.12-3-207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Trudie Roberts
- Leeds Institute of Medical Education, University of Leeds.
| |
Collapse
|
48
|
Tiffin PA, Dowell JS, McLachlan JC. Widening access to UK medical education for under-represented socioeconomic groups: modelling the impact of the UKCAT in the 2009 cohort. BMJ 2012; 344:e1805. [PMID: 22511300 PMCID: PMC3328544 DOI: 10.1136/bmj.e1805] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine whether the use of the UK clinical aptitude test (UKCAT) in the medical schools admissions process reduces the relative disadvantage encountered by certain sociodemographic groups. DESIGN Prospective cohort study. SETTING Applicants to 22 UK medical schools in 2009 that were members of the consortium of institutions utilising the UKCAT as a component of their admissions process. PARTICIPANTS 8459 applicants (24,844 applications) to UKCAT consortium member medical schools where data were available on advanced qualifications and socioeconomic background. MAIN OUTCOME MEASURES The probability of an application resulting in an offer of a place on a medicine course according to seven educational and sociodemographic variables depending on how the UKCAT was used by the medical school (in borderline cases, as a factor in admissions, or as a threshold). RESULTS On univariate analysis all educational and sociodemographic variables were significantly associated with the relative odds of an application being successful. The multilevel multiple logistic regression models, however, varied between medical schools according to the way that the UKCAT was used. For example, a candidate from a non-professional background was much less likely to receive a conditional offer of a place compared with an applicant from a higher social class when applying to an institution using the test only in borderline cases (odds ratio 0.51, 95% confidence interval 0.45 to 0.60). No such effect was observed for such candidates applying to medical schools using the threshold approach (1.27, 0.84 to 1.91). These differences were generally reflected in the interactions observed when the analysis was repeated, pooling the data. Notably, candidates from several under-represented groups applying to medical schools that used a threshold approach to the UKCAT were less disadvantaged than those applying to the other institutions in the consortium. These effects were partially reflected in significant differences in the absolute proportion of such candidates finally taking up places in the different types of medical schools; stronger use of the test score (as a factor or threshold) was associated with a significantly increased odds of entrants being male (1.74, 1.25 to 2.41) and from a low socioeconomic background (3.57, 1.03 to 12.39). There was a non-significant trend towards entrants being from a state (non-grammar) school (1.60, 0.97 to 2.62) where a stronger use of the test was employed. Use of the test only in borderline cases was associated with increased odds of entrants having relatively low academic attainment (5.19, 2.02 to 13.33) and English as a second language (2.15, 1.03 to 4.48). CONCLUSIONS The use of the UKCAT may lead to more equitable provision of offers to those applying to medical school from under-represented sociodemographic groups. This may translate into higher numbers of some, but not all, relatively disadvantaged students entering the UK medical profession.
Collapse
Affiliation(s)
- Paul A Tiffin
- School for Medicine and Health, Wolfson Research Institute, Durham University Queen's Campus, Stockton-on-Tees TS17 6BH, UK.
| | | | | |
Collapse
|
49
|
Ochsmann EB. Thinking about giving up clinical practice? A gender-stratified approach to understanding junior doctors' choices. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2012; 87:91-97. [PMID: 22104056 DOI: 10.1097/acm.0b013e31823aba03] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE This study examined the association between workplace factors and thinking about leaving clinical care by junior doctors (i.e., doctors in postgraduate training) in Germany, and used a gender-stratified approach to address the so-called feminization of medicine. METHOD In this cross-sectional questionnaire study, 1,494 German junior doctors working in patient care in Bavaria in 2006-2007 were sent a questionnaire about considering leaving patient care (outcome variable). Logistic regression analyses were used to calculate the predictive influence of workplace factors on the outcome variable (adjusted odds ratio [aOR], 95% confidence interval [95% CI]). RESULTS Of the 637 responding junior doctors, altogether 52% (men 49.3%, women 54.2%) had thought about leaving clinical practice. Support of colleagues and superiors (men aOR 2.70, 95% CI 1.20-6.04; women aOR 3.46, 95% CI 1.67-7.17), performance feedback (women aOR 1.88, 95% CI 1.23-3.14), the availability of postgraduate training possibilities (men aOR 4.74, 95% CI 1.53-14.69), overtime (women aOR 1.82, 95% CI 1.02-3.25), weekend duty (men aOR: 3.58, 95% CI 1.86-6.88), and the medical specialty were found to be significant predictors for thinking about leaving clinical practice for both men and women. CONCLUSIONS Workplace factors predict the wish for leaving clinical care for junior doctors. Male and female junior doctors seem to have different priorities in the workplace, which should be addressed in order to retain them in patient care.
Collapse
Affiliation(s)
- Elke B Ochsmann
- Institute of Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Germany.
| |
Collapse
|
50
|
O'Donnell M, Noad R, Boohan M, Carragher A. Foundation programme impact on junior doctor personality and anxiety in Northern Ireland. THE ULSTER MEDICAL JOURNAL 2012; 81:19-25. [PMID: 23539378 PMCID: PMC3609677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/29/2011] [Indexed: 11/01/2022]
Abstract
OBJECTIVES The main objectives of this study were to assess personality traits and levels of anxiety in Foundation Year 2 (F2) doctors during the foundation doctor training programme in the Northern Ireland Deanery (NIMDTA). METHODS A prospective survey-based study was conducted for all F2 doctors attending the mandatory generic skills programme at NIMDTA. Anxiety was measured using the State-Trait Anxiety Inventory (STAI) while personality was assessed using the IPIP-NEO questionnaire. These previously validated questionnaires were completed at the start and again at the end of the F2 year. RESULTS 147 (M=65, F=82) and 106 (M=55, F=51) F2 doctors completed questionnaires at both time points. STAI scores suggested a moderate level of anxiety amongst both male and female doctors at baseline and at the end of the academic year. There was no difference between gender for either parameter (Baseline-State: 34.0 vs. 36.0, p=0.48 and Trait: 39.0 vs. 40.5, p=0.33) (End-State: 41.0 vs. 36.0, p=0.14 and Trait: 42.0 vs. 40.5, p=0.78). IPIP-NEO scores for F2 doctors were consistently higher in the Accommodation (93.9 & 92.3) and Consolidation (88.8 & 87.6) personality factors and lower in the Neuroticism factor (66.3 & 65.9) at both assessment time-points. Female F2 doctors scored significantly higher in the accommodation factor at the end of the academic year when compared to their male counterparts (88.0 vs. 94.0, p<0.001). There was no difference between the genders for the other personality factors at the end of the year (p>0.09). CONCLUSION This first cohort of F2 doctors were exposed to many emerging changes in their training which did not appear to have any detrimental effect on their anxiety levels or personality profiles and suggests that junior doctors may not be affected by external influences or changing educational environments.
Collapse
|