Just fun or a prejudice? - physician stereotypes in common jokes and their attribution to medical specialties by undergraduate medical students

How neurologists are viewed by their colleagues: exploring stereotypes and social representations of neurologists

INTRODUCTION

The choice of medical specialization is influenced by various factors, including personal, educational, and interpersonal aspects. However, stereotypes and social representations (SRs) can also play a significant role in biasing the choice of a particular medical specialty. The aim of this study is to describe and understand the social representation (SR) of French Neurologist among medical peers, and factors explaining stereotypes about neurology.

METHODS

A nationwide web-based survey was sent to the French medical community (students, residents, and graduated physicians) to collect sociodemographic and professional data, status, experience, and acquaintance in Neurology as well as qualitative hierarchical evocation question to assess the SR of French Neurologists.

RESULTS

Overall, 367 people participated in the survey, including 112 medical students, 170 residents, and 85 graduated physicians. Only 14.3% of students listed neurology among their top 5 specialty choices, and 63.8% disagreed with the statement "I could have chosen (or I will choose) neurology after the validation of my 6th year of medical studies." Qualitative analysis revealed that the most frequently occurring words used to describe neurologists were "stroke", "complicated", "no treatment," "clinical", and "brain" and five themes corresponded to SRs of neurologist: his/her personal and professional traits (36.4% of the corpus), his/her daily practice (18.1%), the negative aspects of the neurological practice (15.3%), and the neurological pathology and daily skills (30.2%).

CONCLUSION

The perception of neurologists by other physicians is nuanced. Neurologists are described as rigorous specialists, maybe excessively so but the cliché of a contemplative specialty with no effective treatment remains. The specialty and neurological patients suffer also from a reputation of complexity. Further interventions among medical students and better information are required to increase the attractiveness of our specialty.

Medical students' perspectives on and understanding of anesthesiology: a Canadian cross-sectional survey

PURPOSE

In Canada, three out of 17 medical schools do not mandate an anesthesia rotation in their clerkship curriculum. Understanding the effects of a mandatory anesthesiology rotation is important in determining its value to the specialty and guiding decision-making for medical educators. We sought to determine whether a mandatory anesthesia rotation affected students' understanding of anesthesiology, as well as their perspectives on anesthesia.

METHODS

We conducted an anonymous cross-sectional survey of Canadian medical students graduating in 2021. Our survey consisted of 46 questions related to student's perspectives of anesthesiology, understanding of anesthesia, their interest in the specialty, and participant's demographics. This included 16 Likert-scale questions, 19 quiz-style questions, four free-text response questions, and seven demographics questions. The survey was hosted by SurveyMonkey® (SurveyMonkey Inc., San Mateo, CA, USA) and distributed to the participants by each individual institution.

RESULTS

We collected a total of 331 responses across 13 different Canadian medical schools, representing a 17.3% response rate of students surveyed and 11.7% of all graduating medical Canadian students in 2021. A mandatory rotation in anesthesiology was associated with a more positive perspective (P = 0.01) but not understanding (P = 0.07) of the specialty. A mandatory rotation was not related to students' application to anesthesiology at a statistically significant level (P = 0.06).

CONCLUSIONS

The results of this national survey study show the benefits of including a mandatory clerkship rotation in anesthesiology, namely on increasing positive perceptions of the specialty, while also revealing avenues for future research and insights on how to further optimize a mandatory anesthesiology rotation in clerkship.

The Ideal Orthopaedic Surgeon: Comparing Patient Preferences of Surgeon Attributes to Notions Held by Orthopaedic Postgraduates

Introduction

Stereotypes have been a barrier to providing patients a diverse orthopaedic workforce. Our goal was to identify stereotypes and disparities among doctors and their patients regarding the attributes that should determine a competent orthopaedic surgeon.

Materials and Methods

A cross-sectional descriptive multicenter study was conducted in India. Tailored questionnaires were administered to patients and orthopaedic postgraduates to determine the attributes they believe patients prefer in their orthopaedic surgeon. Likert data and data on preferred sex of the surgeon were analyzed as categorical data sets using frequency statistics. Participants were asked to rank surgeon attributes and analysis was based on frequency of an item among top 5 surgeon attributes.

Results

304 patients and 91 orthopaedic postgraduates participated in the study. 70.4% and 73% of patients and 27.5% and 29.6% of postgraduates preferred an orthopaedic surgeon with greater physical strength as an outpatient consultant or operating surgeon respectively. 81% of patients had no preference of the sex of their doctor. 56% of postgraduates felt patients would prefer a male operating surgeon, none felt their patient would prefer female orthopaedic surgeon. 92.3% of the female postgraduates felt patients would prefer a male orthopaedic surgeon. Patients most often ranked years of experience, surgical outcomes, time spent with patients, reputation, and physical strength in their top 5 surgeon attributes and sex, religion, and community were given least importance.

Conclusion

Diversity among the orthopaedic workforce is necessary to optimize patient care. It is our collective responsibility to educate our patients and trainees and redress the misconceptions and stereotypes that plague our profession.

Supplementary Information

The online version contains supplementary material available at 10.1007/s43465-023-00988-2.

Learning machines or the key to care: a qualitative study exploring the impact of the hidden curriculum on medical students' longitudinal experiences in primary care

OBJECTIVE

Longitudinal learning often faces implementation challenges within UK medical schools. Some have suggested that the hidden curriculum may be implicated, but there is little evidence regarding how the hidden curriculum influences student experiences of, and engagement with longitudinal learning. Given this, our objective was to explore the impact of the hidden curriculum on student experiences of a longitudinal curriculum based in primary care at a research-intensive medical school.

DESIGN

We conducted a longitudinal qualitative study. Students participated in three serial, in-depth semistructured interviews. We conducted a longitudinal thematic analysis.

SETTING

One research-intensive medical school based in the UK. Data collection occurred in 2021-2022.

PARTICIPANTS

12 penultimate year medical students taking part in a longitudinal primary care placement for 1 day a week over the course of one academic year.

RESULTS

We constructed four themes capturing insights on how hidden curricula influenced students' experiences: (1) A culture which stresses assessment influences student engagement with longitudinal learning; (2) Longitudinal relationships can challenge the hidden curriculum; (3) Support and continuity within primary care improves skills and can influence belonging and (4) Logistical issues influence engagement with longitudinal learning.

CONCLUSIONS

The hidden curriculum, particularly related to assessment, plays a large role in student perceptions of educational value and subsequent engagement with curricula. In a research-intensive institution, longitudinal learning, particularly within primary care, was perceived as at odds with what was important for assessments. Where longitudinal relationships were successfully established, students became more aware of the benefits of person-centred practice. For primary care longitudinal education to succeed in more research-intensive institutions, there must first be advocacy for greater representation of primary care and person-centred values within organisational structures to ensure meaningful curricular alignment.

Comparison of Sense of Humor and Burnout in Surgeons and Internal Medicine Physicians

OBJECTIVES

We aimed to evaluate humor styles in surgeons and internists and investigate the association between humor and burnout.

METHODS

A cross-sectional survey of physicians in surgical and medicine departments was conducted, assessing sense of humor and burnout using the Humor Styles Questionnaire and the Emotional Exhaustion subscale of the Maslach Burnout Inventory-Human Services Survey for Medical Personnel.

RESULTS

For 131 surgeons and 72 internists, no differences in humor styles were found. A sense of personal accomplishment was more common among surgeons (P = 0.03) and rates of burnout were lower for surgeons (P = 0.02). Physicians with a higher-than-average score in affiliative and self-enhancing humor were less likely to suffer from burnout (P < 0.0001 and P = 0.03, respectively).

CONCLUSIONS

Surgeons and internists have similar styles of humor. Surgeons suffer less from burnout. Affiliative and self-enhancing humor styles are associated with reduced burnout.

Surgical Residents' Perception of Multi-Specialty Learning

OBJECTIVE

Perceptions are important and can affect efficacy of trainer-trainee interactions. Inherent bias toward other specialties may influence the perceived benefit of a multi-specialty learning environment. The aim of this work was to determine surgical resident perceptions regarding the utility of learning from faculty and with learners from other surgical specialties.

DESIGN

We measured surgical residents' perceptions before and after a multi-specialty robotic simulation event. Pre- and post-activity surveys were administered electronically to all residents determining previous experience with robotic surgery, perceptions of learning from faculty in different surgical sub-specialties, and of learning from and with residents in other surgical specialties.

SETTING

Robotic simulation laboratory.

PARTICIPANTS

General surgery (GS), Obstetrics and gynecology (OBG), and Urology (URO) residents in one academic healthcare program.

RESULTS

Prior to the simulation, OBG and URO residents perceived highest utility in learning from faculty within their own specialty. While OBG residents reported high pre-activity agreement that learning from other faculty was useful, more than 50% of GS and URO residents were neutral or disagreed that learning from OBG faculty was useful. Pre-activity, all specialties perceived highest value in learning from and about residents of their own specialty. Following the educational event, all specialties reported increased agreement that learning from faculty of different specialties had utility. Following the simulation, the cohort reported the multi-specialty learning environment improved their knowledge and confidence in robotic surgery.

CONCLUSIONS

Participation in a multi-specialty educational event can improve perceptions of surgical residents regarding the utility of being taught by faculty in different specialties. Resident opinion of the benefits of learning with and about learners from other specialties can also be improved. Multi-specialty learning environments are important in developing communities of practice to allow socialization and promotion of positive identity development in our surgical residents, which may ultimately benefit efficacy of learning and patient care.

Trainee doctors' perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study

BACKGROUND

The demography of the medical profession is changing as more women join the workforce. Traditional assumptions about the personal qualities required to be a successful surgeon may change as more women join the specialty. While exploring the attitudes and beliefs of doctors in their second 'Foundation' year of post-graduate training (FY2) about their choice of specialty, evidence emerged about how the stereotype of the surgeon influences professional identification and beliefs about person-specialty fit.

METHODS

Qualitative telephone interviews with 24 FY2 doctors, 17 women and 7 men, in South-West England.

RESULTS

Many participants reported exposure to stereotypes about the personal qualities desirable in a surgeon. Senior doctors and other trainees were the primary source of these stereotypical views. Experience on surgical placements could either reinforce stereotypes or challenge them, the latter particularly where senior surgeons provided positive role models. As more women enter the surgical specialties, they are increasingly challenging the traditional stereotype and sub-culture.

CONCLUSION

Gendered stereotypes about surgical roles persist, and for some this can hinder professional identification with the role. Positive role models and mentoring can encourage and support women who are interested a surgical career to identify with the role, but there is a need for a broader debate encompassing job redesign and surgical identities.

How to attract our future? - Perception of plastic surgery among medical students

BACKGROUND

There is a mounting body of evidence that underscores the worldwide and US national need for increased plastic surgery recruitment of trainees. Thus, plastic surgery must attract more applicants while maintaining the high-level qualifications of residency candidates.

METHODS

A total of 250 (w = 197) medical students rated the prototypical plastic surgeon (PS), general practitioner (GP), and craniomaxillofacial surgeon (CMF) with respect to traits derived from a literature review on the general perception of surgery, favorability, and their intention to pursue a respective career.

RESULTS

Factor analysis yielded two overarching dimensions of prototype perception in addition to femininity and resilience, one reflecting a coldhearted, narcissistic, competitive character (status primacy; SP), and one reflecting role-model-like traits (hard-working, healthy, admired, and empathetic). Prototypical PSs scored significantly higher on SP than GPs (t(249) = 18.72, p < 0.001, d = 1.26) and CMFs (t(249) = 5.73, p < 0.001, d = 0.36), while receiving significantly less positive evaluations (GP: t(249) = -9.93, p < 0.001, d = -0.63; CMF: t(249) = -3.52, p < 0.001, d = -0.22). The higher participants rated PSs on SP, the more likely a career in plastic surgery was excluded (OR = 0.71, p = 0.03). An opposite relationship with femininity approached significance (OR = 1.32, p = 0.06).

CONCLUSIONS

Given the growing need for PSs, worldwide and US national task fields have to overcome the outdated traits and highlight the field's pro-bono engagement. Furthermore, plastic surgery should further expand its leading role in promoting female trainees.

Personality in anaesthesiologists, a systematic review of the literature

BACKGROUND

As a central part of their job, anaesthesiologists often have to perform demanding tasks under high-stakes conditions. Yet, some anaesthesiologists seem better able to deal with the demands of the profession than others.

OBJECTIVES

This review aims to answer the following questions. What are the necessary or desirable qualities of an anaesthesiologist? Which personality traits or characteristics have been found in anaesthesiologists? How does personality relate to job performance and work stress among anaesthesiologists?

DESIGN

Systematic review of studies that examined anaesthesiologists' personality or personality characteristics. We performed our synthesis in terms of the five-factor model of personality.

DATA SOURCES

The search was conducted in the PubMed, EMBASE and Web of Science databases. Literature was included until December 2020.

ELIGIBILITY CRITERIA

We included qualitative and quantitative studies that examined anaesthesiologists' personality; also, we included studies that focused on anaesthesiologists' stress, performance or mental health but only if these topics were examined from the perspective of personality.

RESULTS

We included 6 qualitative and 25 quantitative articles. Synthesis of the qualitative articles revealed two classes of desirable technical and nontechnical personality characteristics. Synthesis of the quantitative articles suggested that anaesthesiologists do not essentially differ from other medical specialists. Moreover, our synthesis revealed several personality traits that predict good performance, low stress and good mental health among anaesthesiologists: lower Neuroticism, higher Extraversion, higher Openness and higher Conscientiousness.

CONCLUSION

Those personality traits that predict performance, stress or mental health in anaesthesiologists, also predict performance, stress or mental health in other high demand/high stakes environments (both medical and nonmedical). The ideal anaesthesiologist would be lower on Neuroticism, higher on Extraversion and higher on Conscientiousness.

Professional stereotypes among specialties and fields of work within the veterinary community

BACKGROUND

Medical specialties hold varying degrees of prestige, stemming from the existence of stereotypes among them. These have been shown to lead to prejudice against specific specialists, which not only influences career choices but also affects the perception of equality among specialties.

METHOD

The aim of the research was to determine the presence of stereotypes in the UK veterinary community. Using an online questionnaire, participants were asked to provide an adjective that best characterises 15 specialties, in addition to their perceptions on prestige and gender association. Word cloud analysis coupled with sentiment analysis in Python using the language processing software Natural Language Toolkit (NLTK) was used to assess sentiments with respect to the adjectives.

RESULTS

There were 665 questionnaire respondents, and there was evidence of their construction of specialty-specific stereotypes. Some specialties were perceived more negatively than others, including equine general practitioners, surgeons, pathologists, dermatologists and public health veterinarians/epidemiologists. Gender bias was identified within this study, most prominently within production animal and behavioural medicine veterinarians. The most prestigious specialties were neurology, surgery and cardiology.

CONCLUSION

Specialty-specific stereotypes exist within the veterinary community. Acknowledging their existence is a first step to recognising the influence they have on career choices.

From bench to bar side: Evaluating the red wine storage lesion

Vitally essential red fluids like packed cells and red wine are seriously influenced in quality when stored over prolonged periods. In the case of red cell concentrates, the resulting storage lesion has particular significance in perioperative medicine. We hypothesized that, in contrast, aging rather improves the properties of red wine in several ways. A translational approach, including (I) in vitro experiments, (II) a randomized, blinded crossover trial of acute clinical effects, and (III) a standardized red wine blind tasting was used. Three monovarietal wines (Cabernet Sauvignon, Chianti, Shiraz) in three different vintages (range 2004-2016), each 5 years different, were assessed. Assessments were performed at a German university hospital (I, II) and on a garden terrace during a mild summer evening (III). Young wines induced cell stress and damage while significantly reducing cytoprotective proteins in HepG2 hepatoma cells. Sympathetic activity and multitasking skills were altered depending on wines' ages. Hangovers tended to be aggravated by young red wine. Aged variants performed better in terms of aroma and overall quality but worse in optical appearance. We found no evidence for a red wine storage lesion. However, we plead for consensus-based guidelines for proper storage, as it is common in clinical medicine.

Competency-based undergraduate curriculum implementation in anesthesiology-A survey-based comparison of two models of training

Background and Aim:

Imparting the knowledge and skills of Anesthesiology to undergraduates can be challenging. Competency Based Undergraduate (CBUG) Curriculum for the Undergraduate medical students introduced by the Medical Council of India (MCI) aims to improve the quality of the Indian Medical Graduate (IMG). The Department of Anesthesiology and Critical Care of our college redrafted the training program and brought it in-line with the CBUG Curriculum beginning February 2019. A questionnaire based survey was conducted to assess the efficacy, satisfaction levels and the perception of the students towards the new competency based curriculum. The aim was to assess the students perception of the competency based curriculum and to evaluate two slightly different approaches to the implementation of the curriculum.

Material and Methods:

Two groups of undergraduate medical students belonging to the 6^th and 8^th term, underwent two different models of teaching. The 8^th term students had already completed their theory classes based on the older curriculum a year ago when they were in 6^th term. However, their clinics and tutorials were modelled as per the new CBUG Curriculum. The current 6^th term students had their first exposure to Anesthesiology and their theory, tutorials and clinics were scheduled in the same term, simulation based training was added, the operation theatre rotation was held in the mornings at 0730hrs and the intensive care unit rounds were held in the evenings. There was no difference in the theory classes taken for the two batches, however the clinics were different. After both the batches finished their rotation, they were given the survey questionnaire to assess their perception of the model of CBUG Curriculum that they were exposed to.

Results:

The results of the survey revealed that about 80% of the students in both groups preferred that theory classes and practical training should be conducted in parallel in 6^th term. About 60% students in both groups felt that early morning clinics 0800hrs were better than mid-morning clinics at 1100hrs as they get to see and do more procedures. 66%-82% students in both groups felt that the practical training in the OT, ICU and skills lab were very helpful or extremely helpful. The most important aspect of Anesthesiology rotation was “learning basic life saving skills and simulation based learning“ according to 85% students in both groups. Nearly 80% students in both groups felt that the training in Anesthesiology should be allotted more time and more weightage in undergraduate training. 72% students in 6^th term and 63% students in 8^th term felt more confident of handling emergencies after their Anesthesiology rotation.

Conclusion:

The new curriculum was extremely well received by the students of both groups. The model used for 6^th term students comprising of teaching theory and practical in the same term and having early morning clinics, was found to be superior as compared to the model used to teach 8^th term students where there was a gap of one year between theory and practical teaching and the clinics were held midmorning.

Motivations, barriers, and social media: a qualitative study of uptake of women into neurosurgery

OBJECTIVE

To explore how social media could be utilised to influence an individual's motivation to pursue a neurosurgical career, an emerging topic area. The focus of this study was on women interested in neurosurgery.

SUMMARY BACKGROUND DATA

Women are significantly under-represented in neurosurgery. 18% of all neurosurgeons - including 8% of consultants - are women. Most previous studies have used quantitative methods that are not best suited to gaining an in-depth understanding of the barriers that women face in pursuing a career in neurosurgery, or what would enable more women to go into the speciality.

METHODS

In this qualitative study, individual semi-structured interviews were conducted until data saturation was achieved. Participants were women pre-neurosurgical trainees. The interview data was examined through a thematic analysis involving open and axial coding.

RESULTS

Thirty women participated in the study. Four overarching themes were identified: (1) mentorship, (2) testimony from other women doing neurosurgery, (3) social media as a means of increasing interest in neurosurgery as a career choice, and (4) real-life exposure to the speciality.

CONCLUSION

There is scope to further improve uptake of women into neurosurgical training in the UK. Motivations and barriers to women pursuing neurosurgery should be addressed openly through early experience, role models and mentorship. Social media can help facilitate these opportunities, disseminate information and inspiration, and has the potential to undo societal biases.

The surgical personality: does it matter?

Responding to recently published research Into surgeons’ personalities, Rebecca Grossman argues that the notion of a ‘surgical personality’ may be illusory, and counterproductive for recruitment.