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Vasan V, Cheng CP, Fan CJ, Lerner DK, Pascual K, Iloreta AM, Babu SC, Cosetti MK. Gender Differences in Letters of Recommendations and Personal Statements for Neurotology Fellowship over 10 Years: A Deep Learning Linguistic Analysis. Otol Neurotol 2024; 45:827-832. [PMID: 39052892 DOI: 10.1097/mao.0000000000004265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
OBJECTIVE Personal statements (PSs) and letters of recommendation (LORs) are critical components of the neurotology fellowship application process but can be subject to implicit biases. This study evaluated general and deep learning linguistic differences between the applicant genders over a 10-year span. STUDY DESIGN Retrospective cohort. SETTING Two institutions. MAIN OUTCOME MEASURES PSs and LORs were collected from 2014 to 2023 from two institutions. The Valence Aware Dictionary and Sentiment Reasoner (VADER) natural language processing (NLP) package was used to compare the positive or negative sentiment in LORs and PSs. Next, the deep learning tool, Empath, categorized the text into scores, and Wilcoxon rank sum tests were performed for comparisons between applicant gender. RESULTS Among 177 applicants over 10 years, 120 were males and 57 were females. There were no differences in word count or VADER sentiment scores between genders for both LORs and PSs. However, among Empath sentiment categories, male applicants had more words of trust ( p = 0.03) and leadership ( p = 0.002) in LORs. Temporally, the trends show a consistently higher VADER sentiment and Empath "trust" and "leader" in male LORs from 2014 to 2019, after which there was no statistical significance in sentiment scores between genders, and females even have higher scores of trust and leadership in 2023. CONCLUSIONS Linguistic content overall favored male applicants because they were more frequently described as trustworthy and leaders. However, the temporal analysis of linguistic differences between male and female applicants found an encouraging trend suggesting a reduction of gender bias in recent years, mirroring an increased composition of women in neurotology over time.
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Affiliation(s)
- Vikram Vasan
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Christopher P Cheng
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | - Karen Pascual
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alfred Marc Iloreta
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Maura K Cosetti
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
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Malik D, Jacobs D, Fereydooni S, Park HS, Mehra S. Patterns of Care for T1 Glottic Squamous Cell Carcinomas from 2004-2020. Laryngoscope 2024; 134:3633-3644. [PMID: 38411338 DOI: 10.1002/lary.31363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVE(S) Describe recent national trends in overall treatment modalities for T1 glottic squamous cell carcinomas (SCC), and identify factors associated with treatment regimens. METHODS National Cancer Database from 2004-2020 was queried for all patients with glottic cT1N0M0 SCC. Treatment patterns over time were analyzed using the Cochran-Armitage test for trend. Multivariable logistic regressions were used to determine the factors associated with treatment regimens. RESULTS Of the 22,414 patients identified, most patients received RT only (57%), 21% received surgery only, and 22% received dual-modality treatment ("over-treatment"). Over the time period, there was a decreasing trend in rates of over-treatment for T1 glottic SCC (p < 0.001) and an increasing trend in surgery only (p < 0.001). Treatment in 2016-2018 (OR: 1.168 [1.004 to 1.359]), 2013-2015 (OR: 1.419 [1.221 to 1.648]), 2010-2012 (OR: 1.611 [1.388 to 1.871]), 2007-2009 (OR: 1.682 [1.450 to 1.951]), or 2004-2006 (OR: 1.795 [1.548 to 2.081]) versus 2019-2020 was associated with greater likelihood of over-treatment. T1b tumors were less likely to be over-treated (OR: 0.795 [0.707 to 0.894]) versus T1a tumors, and less likely to receive surgery first (OR: 0.536 [0.485 to 0.592]) versus T1a tumors. CONCLUSION Over-treatment for T1 glottic SCC has been declining, with increasing rates of surgery only. Year of treatment was significantly associated with the receipt of dual-modality treatment. Finally, patients with T1b disease were more likely to receive RT as the first and only treatment. LEVEL OF EVIDENCE 3 Laryngoscope, 134:3633-3644, 2024.
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Affiliation(s)
- Devesh Malik
- Yale University School of Medicine, New Haven, Connecticut, USA
| | - Daniel Jacobs
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | | | - Henry S Park
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Saral Mehra
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
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Abdallah Z, Sodhi E, Davidson J, Lawlor CM, Wilson CA, Strychowsky JE, Graham ME. Exploring Diversity in North American Academic Pediatric Otolaryngology. Otolaryngol Head Neck Surg 2024. [PMID: 39033352 DOI: 10.1002/ohn.907] [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: 03/01/2024] [Revised: 06/12/2024] [Accepted: 07/05/2024] [Indexed: 07/23/2024]
Abstract
OBJECTIVE Representation of women and minority groups is traditionally low in Otolaryngology-Head & Neck Surgery (OHNS). This cross-sectional study aims to assess the difference in gender and racial/ethnic representation within Academic North American pediatric OHNS. STUDY DESIGN Cross-sectional study of North American pediatric OHNS faculty websites. SETTING North America. METHODS Canadian and American residency program registries were searched for accredited OHNS programs. Pediatric OHNS faculty were identified through program websites. Information regarding gender, race/ethnicity, time in practice, research productivity, academic title, and leadership positions was extracted from public profiles and Scopus. Demographic and academic data was also extracted for OHNS and pediatric OHNS department/division chairs. RESULTS North American academic pediatric OHNS websites listed 516 surgeons, of whom 39.9% were women. Most surgeons were perceived as White (69.0%), followed by Asian (24.0%), Hispanic (3.7%), and Black (3.3%). Women surgeons had lower h-indices, less publications, and less citations than men (P < .001). Despite women surgeons having fewer years in practice (median 8.0 vs 13.0, P < .001), gender-differences in h-index persisted when controlling for years in practice (P < .05). Men surgeons had higher academic titles (P < .001), but there was no gender difference in leadership roles while accounting for years in practice (P = .559). White surgeons had higher academic titles than non-White surgeons (P = .018). There was no racial/ethnic difference in leadership roles (P = .392). CONCLUSION Most pediatric OHNS surgeons are men and/or White. Significant gender-differences in research productivity and academic title exist, however surgeons of racial/ethnic minority have similar research productivity as their racial/ethnic majority counterparts.
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Affiliation(s)
- Zahra Abdallah
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Emily Sodhi
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Jacob Davidson
- Division of Pediatric Surgery, Children's Hospital, London Health Sciences Centre, London, Ontario, Canada
| | - Claire M Lawlor
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia, USA
| | - Claire A Wilson
- Division of Pediatric Surgery, Children's Hospital, London Health Sciences Centre, London, Ontario, Canada
| | - Julie E Strychowsky
- Department of Otolaryngology-Head & Neck Surgery, Western University, London, Ontario, Canada
| | - M Elise Graham
- Department of Otolaryngology-Head & Neck Surgery, Western University, London, Ontario, Canada
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Tang DM, Nasrollahi TS, Vasquez M, Borrelli M, Sindwani R, Wu AW. Practice Patterns Among Fellowship-Trained Rhinologists: A Survey of Past American Rhinologic Society Fellows. Am J Rhinol Allergy 2024; 38:230-236. [PMID: 38584418 DOI: 10.1177/19458924241244888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
BACKGROUND The goals of this study were to understand the trends in recent and past rhinology fellows concerning their demographics, goals, and experiences. METHODS An anonymous web-based survey was sent to graduates of the 35 rhinology fellowship programs. The survey included questions regarding the scope of practice, research contribution, societal involvement, fellow satisfaction with training, and current practice patterns. Chi-square testing and logistic regression were used to compare variables across cohorts: 0-5 years versus 6+ years from fellowship graduation, gender, and practice settings. RESULTS Based on 171 respondents, we found no significant differences in 0-5 versus 6+ year graduates in their desire for an academic job post-fellowship. However, those who graduated 6+ years ago had significantly more success securing one (74% vs 96%, P = 0.004). Between males and females, there were no differences in goal of obtaining an academic job or success in obtaining an academic career. Females were more likely to report they attend academic society meetings regularly. Female rhinologists also reported less satisfaction with overall work-life balance and decreased satisfaction with clinical practice. Physicians in academic settings have poorer work-life balance. CONCLUSIONS Our findings suggest that finding an academic job may be more difficult for recent rhinology fellowship graduates, although still very possible for the majority of graduates. Understanding the reason for these changes may provide insight to current rhinology fellowship directors and trainees interested in pursuing fellowship training.
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Affiliation(s)
- Dennis M Tang
- Cedars-Sinai Department of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Tasha S Nasrollahi
- Cedars-Sinai Department of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Missael Vasquez
- Cedars-Sinai Department of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Michela Borrelli
- Cedars-Sinai Department of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Raj Sindwani
- Head and Neck Institute, Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | - Arthur W Wu
- Cedars-Sinai Department of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Ni G, Shah A, Polacco M, McLean C. Resources Utilized by Otolaryngology Fellowship Directors When Determining Reputations of Residency Programs. Otolaryngol Head Neck Surg 2024; 171:109-114. [PMID: 38613203 DOI: 10.1002/ohn.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 01/12/2024] [Accepted: 02/10/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE Residency program reputation is consistently reported as an important factor by fellowship directors when considering applicants. This study sets out to determine resources fellowship directors rely on when determining residency program reputation. STUDY DESIGN Cross-sectional study. SETTING Using an anonymous online survey of all 2022 Otolaryngology (OHNS) fellowship program directors. METHODS The 13-question survey sought to assess fellowship director's perspectives and resource utilization when determining residency program reputation. RESULTS Representing all OHNS fellowship program directors and co-directors (N = 287), 103 responded to our survey, response rate 35.9%. Most participants reported that residency reputation was important for fellowship candidacy. On a Likert scale of 1 to 5, 1 being most important and 5 being not important, personal knowledge of the residency program (2.03 out of 5) and program faculty/mentor reputation (2.09 out of 5) were the most important factors cited. 63% were unfamiliar with the survey methodology of Doximity Residency Navigator (DRN), while 53% contributed to DRN by filling out surveys. Nearly all fellowship directors (N = 100, 97%) reported their rank list was not influenced by DRN. Most fellowship directors reported that US News and World Report (USNWR) and DRN were neither consistent nor inconsistent with their perceptions of residency reputations (38% and 56%, respectively), suggesting ambivalence toward these resources. CONCLUSION Residency reputation is important for fellowship directors when evaluating fellowship candidates. Directors do not rely on USNWR, National Institute of Health (NIH) ranking, or DRN when gauging residency reputation, but rather personal knowledge of the applicant's residency program or reputation of the otolaryngology faculty.
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Affiliation(s)
- Garrett Ni
- Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Arnav Shah
- Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Marc Polacco
- Department of Otolaryngology-Head and Neck Surgery, Roy J. and Lucille A. Carver College of Medicine of the University of Iowa, Iowa City, Iowa, USA
| | - Caitlin McLean
- Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
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Lava CX, Hakimi AA, Parsa K, Nguyen TV, Chu EG, Reilly MJ. Factors Influencing Graduates of American Academy of Facial Plastic and Reconstructive Surgery Fellowships Career Choice of Academic or Private Practice: A 20-Year Review. Facial Plast Surg Aesthet Med 2024; 26:283-287. [PMID: 37582204 DOI: 10.1089/fpsam.2022.0378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023] Open
Abstract
Background: Absence of published literature on facial plastic and reconstructive surgery (FPRS) fellows' pursuit of academic careers hampers informed decision making for those interested in the specialty, fellowship program directors, and leaders in the American Academy of Facial Plastic and Reconstructive Surgery. Objective: To examine career choices among FPRS fellows from 2000 to 2019 and identify factors linked to academic or private practice employment after fellowship. Methods: Data from 796 fellows were analyzed, including gender, medical school, residency program, fellowship program, fellowship year, and degrees, to categorize them based on academic or nonacademic career placement. Logistic regression analyses were conducted to explore the association between demographic factors and academic career placement. Results: Forty-three percent (n = 345) obtained academic positions, with significant associations found between academic placement and additional advanced degrees, completion of fellowship training in the northeast, and residency training at an institution offering FPRS fellowship. Conclusion: Although fellows in FPRS predominantly pursue private practice, the decision to pursue academia is influenced by complex and multifactorial factors among graduates in the field.
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Affiliation(s)
- Christian X Lava
- School of Medicine, Georgetown University, Washington, District of Columbia, USA
| | - Amir A Hakimi
- Department of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
| | - Keon Parsa
- Department of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
| | | | - Eugenia G Chu
- Department of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
| | - Michael J Reilly
- Department of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
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Leyden K, Soeder M, Holdaway M, Scagnelli R, Mortensen M. Gender Disparity in Non-ACGME (Accreditation Council for Graduate Medical Education) Otolaryngology Fellowship Leadership. JOURNAL OF SURGICAL EDUCATION 2024; 81:680-687. [PMID: 38553370 DOI: 10.1016/j.jsurg.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Women are underrepresented among practicing otolaryngology physicians with increasing disparities in leadership roles and higher levels of professional attainment in academic medicine. The purpose of this study is to determine the gender gap among fellowship directors within specific otolaryngology subspecialties, and how this compares to disparities among all academic appointments held by otolaryngologists. Additionally, we seek to better understand how years practiced, H-index, professorship status, and academic productivity differ between men and women in fellowship director roles. DESIGN Cross-sectional. Publicly available data from non-ACGME accredited otolaryngology fellowships was collected from department websites and Doximity including gender, years of practice, and professor status of fellowship directors. Scopus was used to find H-index for identified fellowship directors. Fisher's Exact tests were used to determine if significant gender disparity existed between each fellowship and academic otolaryngology as whole. H-index and years of practice were plotted for men and women comparing the slope of lines of best fit as a measure of academic productivity. SETTING Non-ACGME accredited otolaryngology fellowships in the US. PARTICIPANTS Fellowship directors in non-ACGME accredited otolaryngology fellowships. RESULTS Among 174 fellowship positions in our analysis, head and neck (17.3% women), laryngology (17.2% women), rhinology (5.7% women), and facial plastics (8.1% women) had significantly lower overall women representation compared to academic otolaryngology (36.6% women) (p < 0.05). As fellowship directors, women were significantly more productive than men given years practiced and H-index (p = 0.008). CONCLUSIONS Gender disparities among otolaryngologists are amplified in the role of fellowship directors compared to broader academic otolaryngology. This is true despite women in these roles demonstrating higher academic productivity.
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Affiliation(s)
| | | | | | - Robert Scagnelli
- Albany Medical Center, Department of Otolaryngology-Head and Neck Surgery, Albany, New York
| | - Melissa Mortensen
- Albany Medical Center, Department of Otolaryngology-Head and Neck Surgery, Albany, New York.
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Haddad D, Nelson D, Sherman N, Tatusko M, DeSilva G. Gender Diversity in Orthopaedic Surgery Residencies Does Not Translate to Accreditation Council for Graduate Medical Education-Accredited Fellowships. JB JS Open Access 2024; 9:e23.00124. [PMID: 38751665 PMCID: PMC11093577 DOI: 10.2106/jbjs.oa.23.00124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
Introduction Gender representation among orthopaedic surgery applicants and residents has increased over the past two decades. The aims of this study were to evaluate trends of female fellows in ACGME-accredited orthopaedic subspecialties between 2007 and 2021, and to compare the fellowship trends of female representation to those of ACGME-accredited orthopaedic residencies. Methods We conducted a retrospective review of publicly available ACGME-accredited fellowship demographic data from 2007 to 2021. The distribution of genders (male vs. female) across subspecialties and orthopaedic surgery residency programs was compared. Chi-square, Spearman correlation, and logistic regression tests were performed to analyze the relationships between year, gender, and fellowship. Results Chi-square analysis demonstrated a significant relationship between gender and year for orthopaedic residency (p < 0.001), but not for any fellowship. There was a significant negative Spearman correlation between the two variables for hand (r(1844) = -0.06, p = 0.02) and sports medicine (r(2804) = -0.05, p = 0.01) fellowships. The negative Spearman correlation for pediatrics (r(499) = -0.09, p = 0.054) approached but did not reach statistical significance. Logistic regression analysis revealed that, holding year constant and comparing to orthopaedic residency, the odds of male participation increased by 173% (95% CI, 1.8-4.1) in spine, increased by 138% (95% CI, 1.7-3.3) in adult reconstruction, increased by 51% (95% CI, 1.3-1.7) in sports medicine, decreased by 41% (95% CI, 0.5-0.7) in hand, decreased by 36% (95% CI, 0.5-0.9) in foot and ankle, decreased by 48% (95% CI, 0.4-0.7) in musculoskeletal oncology, and decreased by 68% (95% CI, 0.3-0.4) in pediatrics. Conclusion Although the percentage of female orthopaedic residents in ACGME-accredited programs increased significantly from 2007 to 2021, this has not translated to ACGME-accredited fellowship positions. Future research optimizing methods to improve the representation of females in orthopaedic surgery should be considered. Level of Evidence III.
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Affiliation(s)
- David Haddad
- Department of Orthopaedic Surgery, The University of Arizona College of Medicine-Tucson, Tucson, Arizona
| | - Deborah Nelson
- The University of Arizona College of Medicine-Tucson, Tucson, Arizona
| | - Nathan Sherman
- Department of Orthopaedic Surgery, The University of Arizona College of Medicine-Tucson, Tucson, Arizona
| | - Megan Tatusko
- Department of Orthopaedic Surgery, The University of Arizona College of Medicine-Tucson, Tucson, Arizona
| | - Gregory DeSilva
- Department of Orthopaedic Surgery, The University of Arizona College of Medicine-Tucson, Tucson, Arizona
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Sharma RK, Landeen KC, Ortiz A, Belcher RH, Phillips JD, Stephan SJ, Yang SF, Patel PN. National Trends of Otolaryngology Involvement in Cleft Surgical Management over 10-Years. Laryngoscope 2024; 134:671-677. [PMID: 37314217 DOI: 10.1002/lary.30812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/19/2023] [Accepted: 05/28/2023] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Surgical management of cleft lip/palate and cleft rhinoplasty have historically been performed by plastic surgeons. No study has addressed temporal trends in cleft-associated surgeries. This study assesses trends in cleft surgical management and complications in a national database. METHODS Cross-sectional analysis of the National Surgical Quality Improvement Program Pediatric database from 2012 to 2021. Patients receiving cleft lip and/or palate repair were isolated using CPT codes. A subset receiving cleft rhinoplasty was also analyzed. The yearly proportion of otolaryngologists compared to general plastic surgeons performing surgeries was noted. Regression analysis was used to identify trends and predictors of management by OHNS. RESULTS We identified 46,618 cases of cleft repair, of which 15.6% (N = 7,255) underwent repair with otolaryngology. On univariate Pearson correlation analysis, neither cleft rhinoplasties performed by OHNS over time (R = 0.371, 95% CI -0.337 to 0.811, p = 0.2907) nor all cases (R = -0.26, -0.76 to 0.44, p = 0.465) exhibited a significant change. On multivariable regression, the operative year was not associated with being treated by otolaryngology (p = 0.826) for all cleft cases but was associated with such in cleft rhinoplasties (OR 1.04, 1.01-1.08, p = 0.024). On multivariable analysis, the operative year was correlated with a higher rate of complications overall (OR 1.04, 1.01-1.07, p = 0.002). Surgeon specialty was not associated with complication rates. CONCLUSIONS In the last 10 years, no change in the proportion of cleft lip/palate repair performed by OHNS was observed. Otolaryngologists are performing more cleft rhinoplasty but at a marginal rate. Otolaryngologists also manage more complex patients with multiple comorbidities compared to their colleagues. Complication rates have increased overall regardless of surgeon specialty, warranting further investigation. LEVEL OF EVIDENCE 3 Laryngoscope, 134:671-677, 2024.
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Affiliation(s)
- Rahul K Sharma
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A
| | - Kelly C Landeen
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A
| | - Alexandra Ortiz
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A
| | - Ryan H Belcher
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A
| | - James D Phillips
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A
| | - Scott J Stephan
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A
| | - Shiayin F Yang
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A
| | - Priyesh N Patel
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A
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McCrary HC, Meeker M, Farlow JL, Seim NB, Old MO, Ozer E, Agrawal A, Rocco JW, Kang SY, Bradford CR, Haring CT. Demographic and Academic Productivity Trends Among American Head & Neck Society Fellows Over a 20-Year Period. JAMA Otolaryngol Head Neck Surg 2023; 149:987-992. [PMID: 37561525 PMCID: PMC10416085 DOI: 10.1001/jamaoto.2023.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/08/2023] [Indexed: 08/11/2023]
Abstract
Importance Historical data reveal that, compared with women, men are more likely to pursue a head and neck surgical oncology fellowship, but little is known about possible gender differences in academic productivity. Objective To assess demographic trends and academic productivity among American Head & Neck Society (AHNS) fellowship graduates. Design, Setting, and Participants This cross-sectional study used electronically published data from the AHNS on fellowship graduates in the US and Canada from July 1, 1997, to June 30, 2022. Scopus was used to extract h-indices for each graduate. Exposure Scholarly activity. Main Outcomes and Measures Main outcomes were changes in demographic characteristics and academic productivity among AHNS graduates over time. Data analysis included effect size, η2, and 95% CIs. Results A total of 691 AHNS fellowship graduates (525 men [76%] and 166 women [24%]) were included. Over the study period, there was an increase in the number of programs offering a fellowship (η2, 0.84; 95% CI, 0.68-0.89) and an increase in the absolute number of women who completed training (η2, 0.66; 95% CI, 0.38-0.78). Among early-career graduates pursuing an academic career, there was a small difference in the median h-index scores between men and women (median difference, 1.0; 95% CI, -1.1 to 3.1); however, among midcareer and late-career graduates, there was a large difference in the median h-index scores (midcareer graduates: median difference, 4.0; 95% CI, 1.2-6.8; late-career graduates: median difference, 6.0; 95% CI, 1.0-10.9). A higher percentage of women pursued academic positions compared with men (106 of 162 [65.4%] vs 293 of 525 [55.8%]; difference, 9.6%; 95% CI, -5.3% to 12.3%). Conclusions and Relevance This cross-sectional study suggests that women in head and neck surgery begin their careers with high levels of academic productivity. However, over time, a divergence in academic productivity between men and women begins to develop. These data argue for research to identify possible reasons for this observed divergence in academic productivity and, where possible, develop enhanced early faculty development opportunities for women to promote their academic productivity, promotion, and advancement into leadership positions.
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Affiliation(s)
- Hilary C. McCrary
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus
| | - Molly Meeker
- The Ohio State University College of Medicine, Columbus
| | - Janice L. Farlow
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus
| | - Nolan B. Seim
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus
| | - Matthew O. Old
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus
| | - Enver Ozer
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus
| | - Amit Agrawal
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus
| | - James W. Rocco
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus
| | - Stephen Y. Kang
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus
| | - Carol R. Bradford
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus
- The Ohio State University College of Medicine, Columbus
| | - Catherine T. Haring
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus
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Choe E, Hakimi AA, Hoa M. Predictors of Career Placement Among American Neurotology Society Fellowship Graduates. Otol Neurotol 2023; 44:775-779. [PMID: 37504976 DOI: 10.1097/mao.0000000000003965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
ABSTRACT AND OBJECTIVE To identify predictors of practice type and location after neurotology fellowship based on demographics and educational history. STUDY DESIGN Cross-sectional analysis. SETTING Conference programs from the American Neurotology Society Spring Meeting from 2016 to 2022. MAIN OUTCOME MEASURE Percentage of neurotologists who pursued academic careers. RESULTS A total of 114 neurotology fellows were identified. Of the 98 individuals included in final analysis, 64 (65%) pursued academic careers. Fellows most likely to enter academic practice trained at a residency program ranked in the top 50% based on Doximity residency rankings by reputation (74 versus 45%, p < 0.01) or graduated from a residency program with a neurotology fellowship (82 versus 56%, p < 0.01). Graduates from fellowship programs in the Northeast were most likely to enter academic careers (83%). Fifty percent of neurotologists practiced in the same region as their residency training, and 48% practiced the same region as their fellowship. The region with the highest number of practicing neurotology graduates was the South (47%). CONCLUSION Residency program ranking and residency institutions with neurotology fellowships were the leading predictors of academic career placement in the field of neurotology. Many neurotologists tend to stay in a similar geographical location to where they underwent medical training.
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Affiliation(s)
- Erica Choe
- Georgetown University School of Medicine, Washington, DC
| | - Amir A Hakimi
- Department of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC
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Yi G, Payandeh J, Mavedatnia D, Neocleous P, Davidson J, Siu J, Zirkle M, Strychowsky JE, Graham ME, Chan Y. Gender representation in leadership & research: a 13-year review of the Annual Canadian Society of Otolaryngology Meetings. J Otolaryngol Head Neck Surg 2023; 52:38. [PMID: 37170245 PMCID: PMC10173511 DOI: 10.1186/s40463-023-00635-8] [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: 03/04/2022] [Accepted: 03/01/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND The gender disparity in surgical disciplines, specifically in speakers across North American medical and surgical specialty conferences, has been highlighted in recent literature. Improving gender diversity at society meetings and panels may provide many benefits. Our aim was to determine the state of gender diversity amongst presenters and speakers at the annual Canadian Society of Otolaryngology-Head and Neck Surgery (CSO) meetings. METHODS Scientific programs for the CSO annual meetings from 2008 to 2020 were obtained from the national society website. Participant name, role, gender, location, and subspecialty topic were recorded for all roles other than poster presenter. Gender (male or female) was determined using an online search. The total number of opportunity spots and proportion of women was then calculated. Gender differences were analyzed using chi-square test and logistic regression with odds ratios. Four categories were analyzed: Society Leadership, Invited Speaker Opportunities, Workshop Composition (male-only panels or "manels", female-only panels, or with at least one female speaker), and Oral Paper Presenters (first authors). RESULTS There were 1874 leadership opportunity spots from 2008 to 2020, of which 18.6% were filled by women. Among elected leadership positions in the society, only 92 unique women filled 738 leadership opportunity spots. 13.2% of workshop chairs, 20.8% of panelists and 22.7% of paper session chairs were female. There was an overall increase in the proportion of leadership positions held by women, from 13.9% of leadership spots in 2008 to 30.1% in 2020. Of the 368 workshops, 61.1% were led by men only, 36.4% by at least 1 female surgeon, and 2.5% by women only. "Manels" have comprised at least 37.5% of workshops each year. CONCLUSIONS The proportion of women in speaking roles at the annual CSO meetings has generally increased over time, particularly among panelists, leading to fewer male-only speaking panels. However, there has been a slower rate of growth in the proportion of unique women in speaker roles. There remains an opportunity to increase gender/sex diversity at the major Canadian otolaryngology meeting.
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Affiliation(s)
- Grace Yi
- Department of Otolaryngology-Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, St. Michael's Hospital, 30 Bond Street, Unit 8CC-121, Toronto, ON, M5B 1W8, Canada
| | | | | | - Penelope Neocleous
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Jacob Davidson
- Division of Pediatric Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Jennifer Siu
- Department of Otolaryngology-Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, St. Michael's Hospital, 30 Bond Street, Unit 8CC-121, Toronto, ON, M5B 1W8, Canada
| | - Molly Zirkle
- Department of Otolaryngology-Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, St. Michael's Hospital, 30 Bond Street, Unit 8CC-121, Toronto, ON, M5B 1W8, Canada
| | - Julie E Strychowsky
- Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - M Elise Graham
- Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Yvonne Chan
- Department of Otolaryngology-Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, St. Michael's Hospital, 30 Bond Street, Unit 8CC-121, Toronto, ON, M5B 1W8, Canada.
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Friedman AD, Gengler I, Altaye M, Tabangin ME. Early-Stage Glottic Carcinoma in the United States: Demographics and Treatment Choice. Laryngoscope 2023; 133:901-907. [PMID: 35852500 DOI: 10.1002/lary.30305] [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: 03/09/2022] [Revised: 06/10/2022] [Accepted: 07/03/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Limited investigation of factors potentially contributing to treatment choice in early-stage glottic carcinoma (EGC) has been performed with large-scale data. The National Cancer Database (NCDB) represents >72% of all new cancer cases in the United States. We hypothesized that NCDB variables may lend insight into treatment decisions between surgery and radiation for EGC. METHODS The NCDB was queried for all cases of T1-2 N0 M0 glottic carcinoma from 2004 to 2016. We used multivariable logistic regression analysis to examine factors associated with first-line treatment modality: radiation therapy (RT) versus surgery. All reported odds ratios (OR) were adjusted for age, gender, race, insurance, residence in a metropolitan area, region, and facility volume. RESULTS 34,991 EGC patients received treatment: 6,687 (19%) surgery; 20,289 (58%) RT; and 8,015 (23%) surgery and RT. OR for receiving RT (vs. surgery alone) were >2 for: more advanced T stage cancers (OR 2.5 [95%CI: 2.3, 2.7]), treatment at non-academic facilities (OR 2.8, [95%CI: 2.6, 3.0]), and shorter travel distances to treatment centers (OR 2.2, [95%CI: 2.0, 2.4]). Surgery was more likely with treatment in the western US, higher income, private insurance, living in a metropolitan (vs. non-metropolitan) area, female gender, older age, and low facility volume. Hispanic ethnicity, education level, and race were not associated with treatment type in the multivariable model. CONCLUSION Most patients in the NCDB receive first-line treatment with radiation for EGC, and this decision is associated with various tumor, patient, and treatment facility characteristics. LEVEL OF EVIDENCE 4 Laryngoscope, 133:901-907, 2023.
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Affiliation(s)
- Aaron D Friedman
- Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati Medical Center, Cincinnati, Ohio, U.S.A
| | - Isabelle Gengler
- Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati Medical Center, Cincinnati, Ohio, U.S.A
| | - Mekibib Altaye
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Meredith E Tabangin
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
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Sajjadi A, Rahbar R, Preciado D, Roby BB. Pediatric Otolaryngology fellowship virtual interview sentiments. Int J Pediatr Otorhinolaryngol 2023; 164:111398. [PMID: 36455431 DOI: 10.1016/j.ijporl.2022.111398] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/31/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Interviews for Pediatric Otolaryngology fellowship rapidly transitioned to virtual interviews mid-cycle in March 2020 due to the COVID-19 pandemic. OBJECTIVE This study aims to describe perspectives on virtual versus in-person interviews for both applicants and program directors. METHODS Cross-sectional study. Surveys were conducted of all Pediatric Otolaryngology fellowship applicants participating in the San Francisco Match and program directors in 2020 and 2021. RESULTS Out of 32 U.S. trained fellowship applicants, 24 completed the survey in 2020 and 18 in 2021. While 70% of applicants felt they did not get the same experience with virtual interviews, 75% did not feel it changed how they ranked programs. Applicant perception of virtual interviews improved in 2021, with the majority (56%) preferring virtual interviews if provided an option. Twenty out of 36 fellowship directors completed the survey in 2020, and eighteen in 2021. While fellowship directors continued to prefer in-person in 2021, an increased number (10% in 2020, 30% in 2021) felt continuing with virtual interviews may increase the number of applicants in the future. CONCLUSION Based on the survey, both applicants and fellowship directors had a less favorable perception of virtual interviews compared to in-person interviews initially; however, applicant perception favored virtual interviews in 2021, while Program Directors continued to prefer in-person.
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Affiliation(s)
- Autefeh Sajjadi
- University of Minnesota, Department of Otolaryngology, Minneapolis, MN, PGY-2 Resident, United States
| | - Reza Rahbar
- Boston Children's Hospital, Boston, MA, United States
| | - Diego Preciado
- Children's National Hospital, Washington, D.C, United States
| | - Brianne Barnett Roby
- University of Minnesota, Department of Otolaryngology, Minneapolis, MN, United States; Children's Minnesota ENT and Facial Plastic Surgery, Minneapolis, MN, United States.
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15
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Shum JW, Dierks EJ. Fellowship Training in Oral and Maxillofacial Surgery: Opportunities and Outcomes. Oral Maxillofac Surg Clin North Am 2022; 34:545-554. [PMID: 36224071 DOI: 10.1016/j.coms.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The pursuit of fellowship training stems from one's desire to master a focused area of surgery. Successful applicants tend to have published articles and participated in other scholarly activities. They commonly have a mentor within the subspecialty of their interest. Selection of the program is generally based on the breadth of experience available followed by faculty reputation and location. Advantages to the successful fellowship graduate include the experience and confidence to provide specialized and efficient care to patients. Enhancements to an academic department with a fellowship program include mentorship for residents and guidance toward fellowship, as well as an increased level of scholarly activity.
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Affiliation(s)
- Jonathan W Shum
- Oral, Head and Neck Oncologic and Reconstructive Surgery Fellowship, Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, 6560 Fannin Street Suite 1900#, Houston, TX 77054, USA.
| | - Eric J Dierks
- Department of Oral and Maxillofacial Surgery, Oregon and Health Sciences University, Head and Neck Surgical Associates, 1849 NW Kearney, Suite 300, Portland, OR 97209, USA
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Suresh NV, Xu MJ, Harris J, Balar E, Barrette LX, Chorath KT, Moreira AG, Rajasekaran K. Characterizing critical predictors of an academic career following head and neck fellowship in otolaryngology. Head Neck 2022; 44:2708-2716. [PMID: 36073185 DOI: 10.1002/hed.27187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/04/2022] [Accepted: 08/18/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Historically, graduating head and neck (HN) fellows outpace available academic HN positions, resulting in a highly competitive job market. We identified factors that associate with full-time academic HN positions post-HN fellowship. METHODS Graduates of American Head and Neck Society (AHNS)-accredited fellowships from 2005 to 2017 (n = 356) were extracted from the AHNS website. RESULTS From 2015 to 2017, the supply-demand mismatch for academic HN jobs improved. Of the 57.3% (n = 204) of graduating HN fellows who entered academia, 64% (n = 130) trained at just 10 fellowship institutions, 47% (n = 94) attended OHNS residency at an NIH top 40 funded institution, and 54% (n = 111) attended OHNS residency at an AHNS-accredited institution offering HN fellowship. After multivariate regression, number of manuscripts (OR = 1.14; p = 0.01) was significantly associated with initial academic job post-fellowship. CONCLUSION The recent improvement in supply-demand mismatch for academic jobs is promising for future HN fellows interested in academia.
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Affiliation(s)
- Neeraj V Suresh
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mary Jue Xu
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jacob Harris
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Eesha Balar
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Louis-Xavier Barrette
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kevin T Chorath
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alvaro G Moreira
- Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Karthik Rajasekaran
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Tamaki A, Cabrera CI, Cooley CR, Fowler NM, Scarola DE, Li S, Thuener JE, Quereshy H, Garneau JC, Lavertu P, Teknos TN, Rezaee RP. Job market in head and neck surgery: A survey and analysis of recent fellowship graduates. Am J Otolaryngol 2022; 43:103591. [PMID: 35988362 DOI: 10.1016/j.amjoto.2022.103591] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/07/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Recent years have seen increase in individuals pursuing postgraduate fellowships in head and neck (HN) surgery. This has presented concerns about insufficient jobs where graduates can apply their scope of specialized training. METHODS Data was collected in two manners- a survey and a manual online search of American Head and Neck Society (AHNS) fellowship graduates. A 25-question survey was sent in 2021 to approximately 400 HN fellows who graduated between 2010 and 2020. The AHNS list of graduates from the same years were searched online to collect information including gender, graduation year, fellowship training, and current job practice. RESULTS Of the 78 survey responses, 64.1 % were male and 34.6 % female. 96.2 % reported ablative, 84.6 % microvascular, and 82.1 % TORS training. Mean number of interviews was 4 with most interviewing during the 3rd quarter (January to March). Majority reported being in academic and university-based practices (79.6 %). Online search was done on 393 graduates. Since 2010 the number of graduates almost doubled. There was a statistically significant increase in females by year (p = 0.022). There was a significant decrease (p = 0.022) in graduates with additional fellowship training from that of their AHNS fellowship. There was also a statistically significant increase in graduates being in academic practices (p = 0.022). CONCLUSION Despite growing numbers, there appears to be more graduates entering an academic practice, although the definition of an academic HN practice may be evolving. These results provide guidance on how to approach the job search in a select market. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Akina Tamaki
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Claudia I Cabrera
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Nicole M Fowler
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Danielle E Scarola
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Shawn Li
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jason E Thuener
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Humzah Quereshy
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Pierre Lavertu
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Theodoros N Teknos
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Rod P Rezaee
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Talwar A, Gordon AJ, Bewley AF, Fancy T, Lydiatt WM, Weed D, Moore MG, Givi B. Distribution of the head and neck surgical oncology workforce in the United States. Head Neck 2022; 44:2537-2544. [PMID: 35942943 DOI: 10.1002/hed.27157] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The recent trends in education and geographic distribution of the head and neck surgery workforce have not been studied extensively. METHODS We reviewed publicly available sources to locate all fellowship-trained head and neck surgeons and recent graduates. The number of surgeons in each state was compared against head and neck cancer incidence data from the Centers for Disease Control. RESULTS The number of graduates increased annually by 1 per 100 000 000 people from 2011-2020. The average number of fellowship-trained surgeons per state was 10 (SD: 12). The average number of new head and neck cancer cases per surgeon was 247 (SD: 135). Ten states (20%) had cases >1 SD above the national average/surgeon, while 3 (6%) had cases >1 SD below the national average. CONCLUSION Head and neck surgeons are located in most states, but not uniformly. Most states have approximately average density of surgeons; however, several states are outliers.
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Affiliation(s)
- Abhinav Talwar
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Alex J Gordon
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Arnaud F Bewley
- Department of Otolaryngology, University of California Davis School of Medicine, Sacramento, California, USA
| | - Tanya Fancy
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - William M Lydiatt
- Head and Neck Surgical Oncology, Methodist Estabrook Cancer Center, Nebraska Methodist Hospital, Omaha, Nebraska, USA
| | - Donald Weed
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Michael G Moore
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Babak Givi
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
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Tucker J, Patel S, Benyo S, Wilson MN, Goyal N, McGinn J. Descriptive Analysis of Otolaryngology Program Directors with a Focus on Gender Disparity. EAR, NOSE & THROAT JOURNAL 2022:1455613221107149. [PMID: 35658588 DOI: 10.1177/01455613221107149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To describe and analyze the demographics and academic backgrounds of United States otolaryngology program directors (PD) and assess gender disparity in the field. METHODS This was a cross-sectional study in which an online search using publicly available sources was performed to gather information on PDs for 125 United States otolaryngology programs from May 14, 2021, to May 30, 2021. Data collected included PD appointment year, age, gender, resident gender breakdown, degree, as well as training location and graduation year. RESULTS There were 69.6% programs with a male PD and 30.4% with a female PD. Ninety percent of PDs have an MD degree and 9.6% have a DO degree. The current average age of PDs was 49.9 years old (range 35-79). Males were older than females PD (51.0 vs 47.1 years, P = 0.045) and have served a longer time as PD (7.1 vs 4.8 years, P = 0.019). There was no significant difference in other variables collected. There were 27.3% of program directors that held the position of professor, 44.5% associate professor, and 28.2% assistant professor. The most common subspecialty practiced by otolaryngology PDs was head and neck oncology. CONCLUSION Disparity in women's representation in otolaryngology still exists, but the program director leadership position demonstrates better parity. There is an equal percent representation when examining female PDs and female otolaryngologists in academic medicine. Continued efforts to encourage women to enter and become leaders in otolaryngology are necessary moving forward.
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Affiliation(s)
- Jacqueline Tucker
- College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Shivam Patel
- College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Sarah Benyo
- College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Meghan N Wilson
- College of Medicine, The Pennsylvania State University, Hershey, PA, USA
- Department of Otolaryngology - Head and Neck Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Neerav Goyal
- College of Medicine, The Pennsylvania State University, Hershey, PA, USA
- Department of Otolaryngology - Head and Neck Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Johnathan McGinn
- College of Medicine, The Pennsylvania State University, Hershey, PA, USA
- Department of Otolaryngology - Head and Neck Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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20
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Miller RH, Gurgel RK, McCrary HC. Graduating Otolaryngology Residents' Ideal Practice Expectations: A Longitudinal Analysis. Otolaryngol Head Neck Surg 2022; 167:472-478. [PMID: 34982583 DOI: 10.1177/01945998211069505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Prior literature has indicated that the number of trained otolaryngologists required to meet the need of our growing population may be insufficient. Therefore, identifying trends in the subspecialty composition of future otolaryngology practices will elucidate workforce needs. STUDY DESIGN One-page anonymous questionnaire. SETTING The survey was completed by examinees at the conclusion of their American Board of Otolaryngology-Head and Neck Surgery oral examination from 2011 to 2019. METHODS Data included age, gender, fellowship, practice type, and ideal future practice components. RESULTS A total of 2286 examinees were included: 58.1% were male and 57.2% completed a fellowship. Ideal practice specialties included general otolaryngology (19%), rhinology (15%), head and neck (13%), and pediatrics (11%). General and pediatric otolaryngology had a negative correlation over time (r = -0.81, P = .01, and r = -0.75, P = .03, respectively). An overall 45% of graduates reported 1 ideal practice area (r = 0.61, P = .10), with a statistically significant decline in the number of ideal practice areas over time (r = -0.79, P = .018). Men more commonly reported allergy, head and neck, otology, rhinology, and sleep medicine as part of their ideal practice (P < .05), while women more commonly reported pediatric otolaryngology (P < .05). There was a higher mean number of ideal practice areas among men than women (2.58 vs 2.1, P < .001). CONCLUSION There is a growing trend for more specialized otolaryngology practices. The data demonstrate a decline in considering general and pediatrics otolaryngology as part of practices, which portends a gap in access to comprehensive otolaryngology in the future.
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Affiliation(s)
- Robert H Miller
- Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Richard K Gurgel
- Division of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Hilary C McCrary
- Division of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Utah, Salt Lake City, UT, USA
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Casazza GC, Kesser BW, Strumpf AM, Gurgel RK, Hashisaki GT. Otology-Neurotology 2020 US Workforce Distribution. OTOLOGY & NEUROTOLOGY OPEN 2021; 1:e007. [PMID: 38550357 PMCID: PMC10969502 DOI: 10.1097/ono.0000000000000007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/05/2021] [Indexed: 04/05/2024]
Abstract
Objective Determine the geographic and per capita distribution of otology-neurotology physician-surgeons within the United States. Study Design National database review. Setting United States. Methods The American Neurotology Society and ENThealth.org membership databases were queried to identify otology-neurotology physician-surgeons within the United States. Physician-surgeons were divided by regional national census areas, state, and by largest population statistical area based on 2019 US Census population estimates. The number of otology-neurotology physician-surgeons per 1 million persons was calculated for each population designation. Results Four-hundred eighty-two physician-surgeons were identified, representing 49 states and the District of Columbia. The New England division (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island) was the most concentrated region (1.89), whereas the West-South-Central (Texas, Oklahoma, Arkansas, Louisiana) was the least concentrated region (1.23) per million persons. The highest concentration of physician-surgeons by state is within the District of Columbia (4.25), Vermont (3.21), North Dakota (2.62), Massachusetts (2.61), and New York (2.21) (per million), whereas Mississippi (0.67), Georgia (0.66), Idaho (0.56), New Mexico (0.48), and Wyoming (0.0) were the least concentrated per million persons. Increasing number of physician-surgeons was significantly correlated by state (r2 = 0.9; P < 0.0001), largest statistical area (r2 = 0.88; P < 0.0001), and census region (r2 = 0.95; P < 0.0005). Conclusions Otology-neurotology physician-surgeons are evenly distributed across the United States; however, certain areas are likely underrepresented. Variability in clinical practice may account for under or overrepresentation not captured in this analysis.
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Affiliation(s)
- Geoffrey C. Casazza
- Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center, Omaha, NE
| | - Bradley W. Kesser
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, VA
| | - Andrew M. Strumpf
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, VA
| | - Richard K. Gurgel
- Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT
| | - George T. Hashisaki
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, VA
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22
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Finding the Right Job: Locum Tenens and Private Practice. Otolaryngol Clin North Am 2021; 55:23-31. [PMID: 34823718 DOI: 10.1016/j.otc.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
When choosing a career path in otolaryngology, one might consider locum tenens as an opportunity to sample a practice or locale before deciding where to settle down. It may also be an excellent way to garner some new perspective and experience while between jobs or while unable to commit to a long-term position. Before deciding to pursue locum tenens otolaryngology, it is important to consider logistical and lifestyle factors. When deciding on an assignment, one must consider the proposed work schedule, call obligation, patient acuity, and reimbursement.
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23
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Hesham HT, Grundfast K, Sarber K. Making a Major Change: Changing Your Practice Setting, Retirement, and Locums. Otolaryngol Clin North Am 2021; 55:33-41. [PMID: 34823719 DOI: 10.1016/j.otc.2021.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The goal of this article is to discuss factors associated with career change and give data and recommendations of how to prepare for a career change in regards to early, mid, and late career.
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Affiliation(s)
- Hosai Todd Hesham
- Adjunct Faculty, Department of Surgery, Division of Otolaryngology, George Washington University, Washington, DC, USA; Maryland ENT Associates, Privia, Private Practice, Silver Spring, MD, USA.
| | | | - Kathleen Sarber
- Department of Surgery, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; Department of Otolaryngology-Head and Neck Surgery, Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA
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24
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Grose E, Chen T, Siu J, Campisi P, Witterick IJ, Chan Y. National Trends in Gender Diversity Among Trainees and Practicing Physicians in Otolaryngology-Head and Neck Surgery in Canada. JAMA Otolaryngol Head Neck Surg 2021; 148:13-19. [PMID: 34792563 DOI: 10.1001/jamaoto.2021.1431] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Importance Monitoring the evolution of gender diversity within medicine is essential to understanding the medical workforce and anticipating its future. Objective To evaluate gender distribution and trends among trainees and practicing physicians in the field of otolaryngology-head and neck surgery (OHNS) across Canada. Design, Setting, and Participants This cross-sectional study collected demographic data on the Canadian population, medical students, resident physicians, fellows, practicing physicians, and full-time professors from the following publicly available databases: the Canadian Post-MD Education Registry, the Canadian Medical Education Statistics from the Association of Faculties of Medicine of Canada, the Canadian Medical Association Masterfile, the Canadian Resident Matching Service archives, and the Canadian Institute for Health Information from 2000 to 2019. Information about the gender distribution in leadership positions and fellowships was obtained through publicly available websites where gender was either listed or assigned by authors. Main Outcomes and Measures The primary outcomes were the proportion of women in OHNS and the evolution of gender diversity over time. Results In 2019, 65 of 155 of OHNS trainees were female (41.9%), whereas female representation among all surgical trainees combined was 1225 of 2496 (49.1%). Female OHNS trainees and practicing physicians are underrepresented despite a 13.3% increase in female trainees and a 14.3% increase in female staff physicians from 2000 to 2019. Proportionally fewer female graduates pursued a fellowship during a 10-year period compared with their male counterparts, with otology and neurotology having the lowest female representation (6 of 27 [22.2%]). A minimal increase occurred in the number of women holding academic leadership positions (eg, 4 of 13 residency training programs had a previous or current female director). Conclusions and Relevance Despite the overall increase in the representation of women in the field of OHNS in Canada, these findings suggest that persistent gender gaps remain with respect to academic leadership positions and fellowship training. Continuous monitoring of the surgical workforce is important to highlight and address gender disparities within OHNS.
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Affiliation(s)
- Elysia Grose
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Tanya Chen
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Siu
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Paolo Campisi
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ian J Witterick
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Yvonne Chan
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, St Michael's Hospital, Toronto, Ontario, Canada
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25
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Choby G, Rabinowitz MR, Patel ZM, McKinney KA, Del Signore AG, Ebert CS, Thorp BD, Wang EW. Emerging concepts in endoscopic skull base surgery training. Int Forum Allergy Rhinol 2021; 11:1611-1616. [PMID: 34569168 DOI: 10.1002/alr.22895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 12/21/2022]
Affiliation(s)
- Garret Choby
- Division of Rhinology and Skull Base Surgery, Department of Otolaryngology - Head & Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Mindy R Rabinowitz
- Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Zara M Patel
- Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology - Head & Neck Surgery, Stanford University, Palo Alto, California, USA
| | - Kibwei A McKinney
- Department of Otolaryngology - Head & Neck Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Anthony G Del Signore
- Department of Otolaryngology - Head & Neck Surgery, Mount Sinai School of Medicine, New York, New York, USA
| | - Charles S Ebert
- Division of Rhinology, Allergy and Skull Base Surgery, Department of Otolaryngology - Head & Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brian D Thorp
- Division of Rhinology, Allergy and Skull Base Surgery, Department of Otolaryngology - Head & Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Eric W Wang
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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26
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Panth N, Torabi SJ, Kasle DA, Savoca EL, Zogg CK, O'Brien EK, Manes RP. Characterizing Medicare Reimbursements and Clinical Activity Among Female Otolaryngologists. Ann Otol Rhinol Laryngol 2021; 131:749-759. [PMID: 34467771 DOI: 10.1177/00034894211042445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate geographic and temporal trends in Medicare fee-for-service (FFS) billing and reimbursements across female otolaryngologists (ORL). METHODS We performed a cross-sectional, retrospective analysis of the 2017 Medicare Physician and Other Suppliers Aggregate File. We analyzed differences in the number of services, patients, reimbursements, unique Current Procedural Terminology (CPT) codes used, and services billed per patient among female ORLs. RESULTS Female ORLs accounted for 15.2% of the 8453 Medicare-reimbursed ORLs. Female ORLs who graduated between 2000 and 2010 were reimbursed a median of $58 031.9 (IQR: $32 286.5-$91 512.2) and performed a median of 702 (IQR: 359.5-1221.5) services, significantly less than those who graduated between 1990 and 1999 (median: $67 508.9; IQR: 37 018.0-110 471.5; P < .001; median: 1055.5; IQR: 497.3-1944; P < .001). Female ORLs who graduated between 2000 and 2010 saw a median of 232 patients (IQR: 130.5-368), significantly less than those who graduated between 1990 and 1999 (median: 308; IQR: 168.3-496; P < .001) patients, significantly more than those. Female ORLs in urban settings performed a median of 795 (IQR: 364-1494.3) services and billed for a median of 42 (IQR: 28-58) unique codes, significantly fewer than their counterparts in rural settings (median: 1096; IQR: 600-2192.5; P = .002; median: 54; IQR: 31.5-64.5; P = .001). CONCLUSIONS Medicare reimbursements and billing patterns across female ORLs varied by graduation decade and geography. Female ORLs further along in their careers may be reimbursed more with greater clinical volume and productivity. Those practicing in urban settings may have practices with decreased procedural diversity and lower clinical volume compared to their counterparts in rural areas.
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Affiliation(s)
- Neelima Panth
- Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, CT, USA
| | - Sina J Torabi
- Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, CT, USA.,Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, CA, USA
| | - David A Kasle
- Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, CT, USA
| | - Emily L Savoca
- Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, CT, USA
| | - Cheryl K Zogg
- Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, CT, USA
| | - Erin K O'Brien
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
| | - R Peter Manes
- Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, CT, USA
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