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Mossanen JC, Schmidt M, Brücken A, Thommes M, Marx G, Sopka S. Short-time mentoring - enhancing female medical students' intentions toward surgical careers. MEDICAL EDUCATION ONLINE 2024; 29:2347767. [PMID: 38696113 PMCID: PMC11067559 DOI: 10.1080/10872981.2024.2347767] [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: 02/29/2024] [Accepted: 04/22/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Women pursuing a career in surgery or related disciplines are still in the minority, despite the fact that women compose at least half of the medical student population in most Western countries. Thus, recruiting and retaining female surgeons remains an important challenge to meet the need for surgeons and increase the quality of care. The participations were female medical students between their third and fifth academic year. In this study, we applied the well-established psychological theory of planned behavior (TPB) which suggests that the intention to perform a behavior (e.g. pursuing a career in surgery) is the most critical and immediate predictor of performing the behavior. We investigated whether a two-part short-mentoring seminar significantly increases students' intention to pursue a career in a surgical or related specialty after graduation. METHOD The mentoring and role-model seminar was conducted at 2 days for 90 minutes by six inspiring female role models with a remarkable career in surgical or related disciplines. Participants (N = 57) filled in an online survey before (T0) and after the seminar (T1). A pre-post comparison of central TPB concept attitude towards the behavior, 2) occupational self-efficacy and 3) social norm) was conducted using a paired sampled t-test. A follow-up survey was administered 12 months later (T2). RESULTS The mentoring seminar positively impacted female students' attitude towards a career in a surgical specialty. Female students reported a significantly increased positive attitude (p < .001) and significantly higher self-efficacy expectations (p < .001) towards a surgical career after participating in the mentoring seminar. Regarding their career intention after the seminar, female students declared a significantly higher intention to pursue a career in a surgical specialty after graduating (p < .001) and this effect seems to be sustainable after 1 year. CONCLUSION For the first time we could show that short-mentoring and demonstrating role models in a seminar surrounding has a significant impact on female medical student decision´s to pursue a career in a surgery speciality. This concept may be a practical and efficient concept to refine the gender disparity in surgery and related disciplines.
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Affiliation(s)
- J. C. Mossanen
- Department of Intensive and Intermediate Care, University Hospital RWTH Aachen, Aachen, Germany
| | - M. Schmidt
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
- AIXTRA – Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - A. Brücken
- Department of Intensive and Intermediate Care, University Hospital RWTH Aachen, Aachen, Germany
| | - M. Thommes
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
- AIXTRA – Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - G. Marx
- Department of Intensive and Intermediate Care, University Hospital RWTH Aachen, Aachen, Germany
| | - S. Sopka
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
- AIXTRA – Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany
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Alansari AN, Alhussaini NW, Elshaikh U, Al-Zoubi RM. The journey of female surgeons in the arab region: A scoping review. Surgeon 2024:S1479-666X(24)00080-5. [PMID: 39107173 DOI: 10.1016/j.surge.2024.07.009] [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: 05/11/2024] [Accepted: 07/22/2024] [Indexed: 08/09/2024]
Abstract
BACKGROUND In the Arab region, there's a dearth of research on female surgeons' experiences and challenges. To address this gap, a scoping review aims to map existing literature. It seeks to understand the hurdles faced by female surgeons in Arab countries and examine any gender biases in public preferences for surgeons. No previous reviews were conducted on female surgeons in the Arab region. By identifying systemic barriers, the review aims to promote inclusivity and support for female surgeons in the Arab medical community. METHODS A scoping review was performed and reported using the PRISMA extension for scoping reviews. Five databases were searched which include PubMed, Web of Science, Scopus, Embase, and ProQuest. The search strategy included three main strings that are "Women" AND "Surgeons" AND "Arab Country". A priori-identified spreadsheet was used for data extraction. RESULTS A total number of 23 studies were included in this review. The findings were categorized under several headings, such as the general public's preferred gender of surgeon and well-being, challenges, and experiences of female surgeons as well as career perspectives, choices, and satisfaction. CONCLUSIONS This scoping review explores experiences and challenges faced by female surgeons in the Arab region, emphasizing the need to address systemic barriers and promote inclusivity.
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Affiliation(s)
- Amani N Alansari
- Department of Pediatric Surgery, Hamad Medical Corporation, Doha, 3050, Qatar.
| | - Nour W Alhussaini
- College of Health Sciences, QU-Health, Qatar University, Doha, 2713, Qatar.
| | - Usra Elshaikh
- College of Health Sciences, QU-Health, Qatar University, Doha, 2713, Qatar; WISH Institute, Qatar Foundation, Doha, Qatar.
| | - Raed M Al-Zoubi
- Department of Biomedical Sciences, QU-Health, College of Health Sciences, Qatar University, Doha, 2713, Qatar; Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar; Department of Chemistry, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan.
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Chawla S, Faheem S, Moreton ML, Sekhon A, Amornteerasawas OM, Ding J, Khosa F. Analysis of Additional Degrees in Academic Plastic Surgery Faculty. Plast Surg (Oakv) 2024; 32:508-514. [PMID: 39104923 PMCID: PMC11298144 DOI: 10.1177/22925503221144039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/23/2022] [Accepted: 11/06/2022] [Indexed: 08/07/2024] Open
Abstract
Background: As plastic surgery continues to evolve, an increasing number of surgeons are attaining additional degrees (ADs). Prior studies illustrate this trend of increased AD attainment among plastic surgery faculty within the United States. Yet, no such study has documented AD attainment variability and influence within Canadian plastic surgery faculty. Objectives: Our objective was to investigate the relationship between AD attainment and gender, alongside research productivity, and academic rank of Canadian plastic surgery faculty members. Methods: All Canadian academic plastic surgery faculty members were identified and information regarding gender, academic rank, research productivity, timing of AD attainment was recorded. AD was defined as any degree beyond a medical degree or equivalent. Results: A total of 299 faculty members were identified. Of these, 33% (N = 99) attained an AD. A higher percentage of females (40%) obtained ADs compared to males (30%) (P = .0402). When controlling for number of years in practice, there was a significantly larger proportion of females than males with ADs as assistant and associate professor (P = .033). Faculty with ADs were associated with higher research productivity and higher academic rank than those with MDs (P < .05). ADs were commonly obtained post-residency (38%) and most common ADs were MSc (51%) and PhDs (21%). It was found that the Canadian plastic surgeons were less likely to pursue MBAs than US plastic surgeons (P = .002). Conclusion: One-third of Canadian academic plastic surgeons had ADs. Those with ADs present with higher research productivity and academic rank. When segmented by gender, there were significant differences among AD holders. The results of this study will lend support to ongoing endeavors voicing the need for gender equity in academic plastic surgery.
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Affiliation(s)
- Sahil Chawla
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sarim Faheem
- Faculty of Science, University of British Columbia, Kelowna, BC, Canada
| | - Michael L. Moreton
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Amardeep Sekhon
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Jeffrey Ding
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Faisal Khosa
- Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada
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Seizilles de Mazancourt E, Cotte J, Pinar U, Goujon A, Taha F, Seguier D, An Nguyen T, Lannes F, Deleuze C, Bardet F, Plassais C, Kaulanjan K. Barriers for pregnancy and perceptions of gender discrimination of urologists in training in France: Results of a national survey. THE FRENCH JOURNAL OF UROLOGY 2024; 34:102671. [PMID: 38909782 DOI: 10.1016/j.fjurol.2024.102671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/29/2024] [Accepted: 06/19/2024] [Indexed: 06/25/2024]
Abstract
INTRODUCTION Gender discrimination seems more prevalent in surgery than other medical specialties. In addition, female urologists are more likely to have obstetric complications and to be discouraged from starting a family during training. The objective of this study was to determine the prevalence of perceived gender discrimination and barriers for pregnancy during fellowship, among French urology residents and fellows. MATERIAL AND METHODS The French Association of Urologists in Training performed a national online survey between August and September 2022. Participants were assured that their participation was anonymous. Respondents were questioned on demographics, gender discrimination and on pregnancy barriers during fellowship. RESULTS In total, 153 members answered the questionnaire out of the 427 members of the association (36%), among which 75 women (49%). Thirty nine percent of the female respondents found that their gender was a barrier in their career advancement, versus 1% of the male (P<0.0001). Forty female respondents (53%) perceived that female urologists earned less respect than their male counterparts versus 22% of the male (P<0.0001). Among the female respondents, 19 (25%) have felt that it would not be possible to become pregnant at the time they would have wanted it and 7 (9%) reported having already been threatened to lose a fellowship position in case of a pregnancy. CONCLUSION This survey found a high prevalence of gender discrimination among French urologists in training, perceived in majority by women. Female urologists perceived obstacles and received threats when wanting to become pregnant during their training.
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Affiliation(s)
| | - Juliette Cotte
- Pitié Salpêtrière Hospital, Sorbonne university, Paris, France
| | - Ugo Pinar
- Pitié Salpêtrière Hospital, Sorbonne university, Paris, France
| | - Anna Goujon
- Department of urology, Rennes Hospital, Rennes, France
| | - Fayek Taha
- Department of urology, Reims Hospital, Reims, France
| | - Denis Seguier
- Department of urology, Lille Hospital, Lille, France
| | | | | | - Claire Deleuze
- Department of urology, Pointe-à-Pitre Hospital, Guadeloupe, France
| | | | | | - Kevin Kaulanjan
- Department of urology, Pointe-à-Pitre Hospital, Guadeloupe, France
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Homberg A, Narciß E, Obertacke U, Schüttpelz-Brauns K. Surgical experiences of final-year undergraduates and the impact on their career aspiration stratified by sex/gender. GMS JOURNAL FOR MEDICAL EDUCATION 2024; 41:Doc28. [PMID: 39131898 PMCID: PMC11310790 DOI: 10.3205/zma001683] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/07/2024] [Accepted: 04/30/2024] [Indexed: 08/13/2024]
Abstract
Objectives Surgical undergraduate training takes place in a male-dominated work environment that struggles with recruitment problems. Experiences of cultural and sex/gender-specific barriers of women in surgery have been reported worldwide. Overall, the experiences that students have in coping with the emotional impact of surgery as a profession are thought to be crucial to their subsequent career choices. We investigated whether students' self-reported experiences differed by sex/gender in terms of frequency and content, and whether they were related to their career aspirations. Methods In Germany, the final year represents the last part of the undergraduate medical study program. At the Mannheim Medical Faculty, a 12-week surgical training is mandatory. After completing their surgical training, the students were asked about their experiences and their later career aspirations. These experiences were analysed using quantitative content analysis. The relationship between the quality of experience and career aspirations as well as sex/gender differences were statistically measured. Results In the 475 questionnaires analysed (response rate 52%), the number of positive and negative mentions does not differ by sex/gender. However, male students feel more actively involved and female students feel poorly briefed and think that supervisors are less interested in their training. A significant influence on career aspirations was found in the performance category for female and male students, and in the supervision category for female students. Conclusion The positive experiences that students gain while performing surgical activities have an impact on their subsequent career choices. In particular, a good settling-in period and encouragement to actively participate could help to attract more women to surgery.
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Affiliation(s)
- Angelika Homberg
- Medical Faculty Mannheim, Heidelberg University, Division for Study and Teaching Development, Department of Medical Education Research, Mannheim, Germany
| | - Elisabeth Narciß
- Medical Faculty Mannheim, Heidelberg University, Division for Study and Teaching Development, Competence Center for final-year education, Mannheim, Germany
| | - Udo Obertacke
- Medical Faculty Mannheim, Heidelberg University, Division for Study and Teaching Development, Competence Center for final-year education, Mannheim, Germany
- University Medical Center Mannheim, Centre for Orthopaedics and Trauma Surgery, Mannheim, Germany
| | - Katrin Schüttpelz-Brauns
- Medical Faculty Mannheim, Heidelberg University, Division for Study and Teaching Development, Department of Medical Education Research, Mannheim, Germany
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Corbisiero MF, Acker SN, Bothwell S, Christian N. Transforming Perceptions: The Impact of a Formal Parental Leave Policy on Surgical Trainees. JOURNAL OF SURGICAL EDUCATION 2024; 81:816-822. [PMID: 38677898 PMCID: PMC11088490 DOI: 10.1016/j.jsurg.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/13/2024] [Accepted: 03/03/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE Surgical trainees who welcome a new child during residency often face challenges related to appropriate parental leave. To address this, we instituted a comprehensive family medical leave policy within our training program and assessed resident perceptions before and after the policy's introduction. We hypothesized that this new formal policy would enhance feelings of support amongst all (not just childbearing) trainees. DESIGN A web-based survey to gauge resident perceptions on parental leave was distributed to all residents at a single academic general surgery residency at 2 intervals: prior to policy implementation and 1 year after policy implementation. SETTING The study was conducted at a single institution, academic general surgery residency program. PARTICIPANTS All general surgery residents at the institution were included (n = 95). RESULTS About 40 out of 95 (42%) residents participated in the initial survey and 25 of 95 (26%) completed the subsequent survey. There was a significant improvement in resident reported satisfaction with the policy from pre to post: 15% pre to 68% post, p < 0.001, report the policy frequently supported trainees' needs, 20% pre to 88% post, p < 0.001, perceived the policy as fair. Most residents (90.0% pre and 80.0% post) perceived pregnancy as a risk during surgical training. There were no differences in perception of the new policy between residents who were parents and residents who were not parents. CONCLUSIONS The introduction of a comprehensive family medical leave policy improved all surgical trainees' (including nonparents) perception of policy effectiveness and policy fairness. This is counter to the published perception that parental leave creates a burden on fellow trainees. However, pregnancy remains a stressor for the individual new parent. Surgical programs can develop supportive formal family medical leave policies; it is important to address the inherent systemic and cultural barriers surrounding childrearing during surgical training.
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Affiliation(s)
| | - Shannon N Acker
- Division of Pediatric Surgery, Department of Surgery, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado
| | - Samantha Bothwell
- Center for Children's Surgery, Research Outcomes in Children's Surgery, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - Nicole Christian
- Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado.
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Sido V, Schröter F, Rashvand J, Ostovar R, Chopsonidou S, Albes JM. Female Surgeons in Cardiac Surgery: Does the Surgeon's Gender Affect the Outcome of Routine Coronary Artery Bypass Graft and Isolated Aortic Valve Surgery? Thorac Cardiovasc Surg 2024. [PMID: 38729166 DOI: 10.1055/s-0044-1786182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
BACKGROUND The increasing presence of female doctors in the field of cardiac surgery has raised questions about their surgical quality compared to their male colleagues. Despite their success, female surgeons are still underrepresented in leadership positions, and biases and concerns regarding their performance persist. This study aims to examine whether female surgeons perform worse, equally well, or better than their male counterparts in commonly performed procedures that have a significant number of female patients. METHOD A retrospective cohort of patients from 2011 to 2020 who underwent isolated coronary artery bypass graft (CABG) and aortic valve surgery was studied. To compare the surgical quality of men and women, a 1:1 propensity score matching (two groups of 680 patients operated by men and women, respectively, factors: age, logarithm of EuroSCORE (ES), elective, urgent or emergent surgery, isolated aortic valve, or isolated CABG) was performed. Procedure time, bypass time, x-clamp time, hospital stay, and early mortality were compared. RESULTS After propensity score matching between surgeons of both sexes, patients operated by males (PoM) did not differ from patients operated by females (PoF) in mean age (PoM: 66.72 ± 9.33, PoF: 67.24 ± 9.19 years, p = 0.346), log. ES (PoM: 5.58 ± 7.35, PoF: 5.53 ± 7.26, p = 0.507), or urgency of operation (PoM: 43.09% elective, 48.97% urgent, 7.94% emergency, PoF: 40.88% elective, 55.29% urgent, 3.83% emergency, p = 0.556). This was also the case for male and female patients separately. Female surgeons had higher procedure time (PoM: 224.35 ± 110.54 min; PoF: 265.41 ± 53.60 min), bypass time (PoM: 107.46 ± 45.09 min, PoF: 122.42 ± 36.18 min), and x-clamp time (PoM: 61.45 ± 24.77 min; PoF: 72.76 ± 24.43 min). Hospitalization time (PoM: 15.96 ± 8.12, PoF: 15.98 ± 6.91 days, p = 0,172) as well as early mortality (PoM: 2.21%, PoF: 3.09%, p = 0.328) did not differ significantly. This was also the case for male and female patients separately. CONCLUSION Our study reveals that in routine heart surgery, the gender of the surgeon does not impact the success of the operation or the early outcome of patients. Despite taking more time to perform procedures, female surgeons demonstrated comparable surgical outcomes to their male counterparts. It is possible that women's inclination for thoroughness contributes to the longer duration of procedures, while male surgeons may prioritize efficiency. Nevertheless, this difference in duration did not translate into significant differences in primary outcomes following routine cardiac surgery. These findings highlight the importance of recognizing the equal competence of female surgeons and dispelling biases regarding their surgical performance.
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Affiliation(s)
- Viyan Sido
- Department of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, Faculty of Health Sciences Brandenburg, Bernau, Germany
- Paracelsus Medical University, Master Programme Public Health, Center for Public Health and Healthcare Research, Salzburg, Austria
| | - Filip Schröter
- Department of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, Faculty of Health Sciences Brandenburg, Bernau, Germany
| | - Jacqueline Rashvand
- Department of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, Faculty of Health Sciences Brandenburg, Bernau, Germany
| | - Roya Ostovar
- Department of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, Faculty of Health Sciences Brandenburg, Bernau, Germany
| | - Sofia Chopsonidou
- Department of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, Faculty of Health Sciences Brandenburg, Bernau, Germany
| | - Johannes M Albes
- Department of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, Faculty of Health Sciences Brandenburg, Bernau, Germany
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Sikakulya FK, Muhumuza J, Vivalya BMN, Mambo SB, Kamabu LK, Muteke JK, Lussy JP, Ilumbulumbu MK, Emmanuel T, Kiyaka SM, Kavuyiro A, Mukandirwa C, Lekuya HM, Vahwere BM, Francis Okedi X, Masumbuko CK. Psychosocial impact of surgical complications and the coping mechanisms among surgeons in Uganda and Eastern Democratic Republic of the Congo. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003180. [PMID: 38683841 PMCID: PMC11057973 DOI: 10.1371/journal.pgph.0003180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 04/10/2024] [Indexed: 05/02/2024]
Abstract
We aimed to assess the psychosocial impact from postoperative complications on the surgical workforce and the coping mechanisms they use following these complications in Uganda and Eastern Democratic Republic of the Congo (DRC). This was a cross-sectional multi-center study conducted from first February 2022 to 31st March 2022 in the preselected main teaching hospitals of Uganda and Eastern DRC. We surveyed the surgical workforce (practicing surgeons, Obstetrician-Gynecologists, and residents in surgery/ Obstetrics-Gynecology) who had experienced postoperative complications in their career. Data was analysed using SPSS version 23. One hundred ninety-eight participants responded to the questionnaire. Worry about patient and reputation were the commonest psychological impacts in 54.0% and 45.5% of the participants respectively. Majority of the participants (55.1%) used positive coping mechanisms with a positive impact on their practice (94.4%). Being a female doctor (AOR = 2.637, CI 1.065-6.533, P = 0.036), worrying about reputation (AOR = 3.057, CI = 1.573-5.939, P = 0.001) and guilt after a complication (AOR = 4.417, CI = 2.253-8.659, P = <0.001) were predictors of a negative coping mechanism. Postoperative surgical complications continue to cause a huge psychological impact on the operating doctors in Uganda and the Eastern DRC. Female doctors, those that worry about the reputation and those that feel guilty following a complication should be given more support and guidance by peers when surgical complications occur to their patients.
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Affiliation(s)
- Franck Katembo Sikakulya
- Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
- Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo
| | - Joshua Muhumuza
- Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
| | - Bives Mutume Nzanzu Vivalya
- Faculty of Clinical Medicine and Dentistry, Department of Psychiatry and Mental Health, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
| | - Simon Binezero Mambo
- Youth Alliance for Reproductive Health, Goma, Democratic Republic of the Congo
- Allied Health Sciences Department, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
| | - Larrey Kasereka Kamabu
- Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo
- Department of Surgery, Division of Neurosurgery, Makerere University CHS, Kampala, Uganda
| | | | - Justin Paluku Lussy
- Faculty of Medicine, Université de Goma, Goma, Democratic Republic of the Congo
| | | | - Tapem Emmanuel
- Department of Surgery, Makerere University, Kampala, Uganda
| | - Sonye Magugu Kiyaka
- Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
| | - Alpha Kavuyiro
- Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo
| | - Claude Mukandirwa
- Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo
| | - Hervé Monka Lekuya
- Department of Surgery, Division of Neurosurgery, Makerere University CHS, Kampala, Uganda
- Faculty of Medicine, Ghent University, Ghent, Belgium
| | - Bienfait Mumbere Vahwere
- Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
| | - Xaviour Francis Okedi
- Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
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Etherington C, Boet S, Chen I, Duffy M, Mamas MA, Bader Eddeen A, Bateman BT, Sun LY. Association Between Surgeon/Anesthesiologist Sex Discordance and 1-year Mortality Among Adults Undergoing Noncardiac Surgery: A Population-based Retrospective Cohort Study. Ann Surg 2024; 279:563-568. [PMID: 37791498 DOI: 10.1097/sla.0000000000006111] [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: 10/05/2023]
Abstract
OBJECTIVE To investigate the association between surgeon-anesthesiologist sex discordance and patient mortality after noncardiac surgery. BACKGROUND Evidence suggests different practice patterns exist among female and male physicians. However, the influence of physician sex on team-based practices in the operating room and subsequent patient outcomes remains unclear in the context of noncardiac surgery. METHODS We conducted a population-based, retrospective cohort study of adult Ontario residents who underwent index, inpatient noncardiac surgery between January 2007 and December 2017. The primary exposure was physician sex discordance (ie, the surgeon and anesthesiologist were of the opposite sex). The primary outcome was 1-year mortality. The association between physician sex discordance and patient outcomes was modeled using multivariable Cox proportional hazard regression with adjustment for relevant physician, patient, and hospital characteristics. RESULTS Of 541,209 patients, 158,084 (29.2%) were treated by sex-discordant physician teams. Physician sex discordance was associated with a lower rate of mortality at 1 year [5.2% vs. 5.7%; adjusted HR: 0.95 (0.91-0.99)]. Patients treated by teams composed of female surgeons and male anesthesiologists were more likely to be alive at 1 year than those treated by all-male physician teams [adjusted HR: 0.90 (0.81-0.99)]. CONCLUSIONS Noncardiac surgery patients had a lower likelihood of 1-year mortality when treated by sex-discordant surgeon-anesthesiologist teams. The likelihood of mortality was further reduced if the surgeon was female. Further research is needed to explore the underlying mechanisms of these observations and design strategies to diversify operating room teams to optimize performance and patient outcomes.
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Affiliation(s)
- Cole Etherington
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Sylvain Boet
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Innie Chen
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Melissa Duffy
- Department of Educational Studies, University of South Carolina, Columbia, SC
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, Staffordshire, UK
| | | | - Brian T Bateman
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA
| | - Louise Y Sun
- Institute for Clinical Evaluative Sciences, ON, Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA
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Saadé S, Delafontaine A, Cattan J, Celanie D, Saiydoun G. Attractiveness and gender dynamics in surgical specialties: a comparative analysis of French medical graduates (2017-2022). BMC MEDICAL EDUCATION 2024; 24:197. [PMID: 38413964 PMCID: PMC10900538 DOI: 10.1186/s12909-024-05174-y] [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: 10/02/2023] [Accepted: 02/13/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND French medical graduates undertake a national examination at the end of their studies with a subsequent national ranking. Specialty is then chosen by each candidate according to their ranking. This study aims to describe the attractiveness of surgical specialties and the evolution of the male-female distribution among French medical graduates (FMG) from 2017 to 2022. METHODS Our database included the candidates' ranking, sex and choice of specialty from 2017 to 2022. It included all French medical graduates from 2017 to 2022 and all French medical schools. A linear regression was performed to predict future trends. Dependent variables were mean rankings and the percentage of women. The independent variable was year of application. A Pearson correlation was performed to examine any relationship with mean workweek. RESULTS A total number of 5270 residents chose a surgical programme between 2017 and 2022. The number of residents who were assigned their desired surgical programme held stable at 878 surgical residents per year. Plastic and reconstructive surgery remained the most frequently chosen surgical programme. Thoracic and cardiovascular surgery was the least frequently chosen surgical programme between 2017 and 2022. The mean ranking for a candidate choosing a surgical programme rose significantly by 9% from 2017 to 2022 (p < 0.01). Neurosurgery exhibited the greatest fall as a surgical specialty as its rankings decreased by 163.6% (p < 0.01). Maxillo-facial surgery was the only specialty with a statistically significant increase in its rankings by 35.9% (p < 0.05). The overall proportion of women was 51.1%. Obstetrics-and-gynecology was the highest represented specialty among female candidates, with a mean of 83.9% of women. Orthopedic surgery was the lowest represented, being composed of a mean of 28.6% of women. The number of female surgical residents increased significantly over the six-year period, by 7.6% (p < 0.01). CONCLUSIONS More and more medical school graduates decide not to choose surgery for their residency programme. Some specialties continue to be attractive while many are losing their appeal. While there does appear to be progress towards gender equity, further investigation is necessary to assess its actual implementation.
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Affiliation(s)
- Saadé Saadé
- Department of Cardiac Surgery, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, 67000, Strasbourg, France.
| | - Arnaud Delafontaine
- Université Libre de Bruxelles, Faculté de Médecine, Route de Lennik, Bruxelles, 1070, Belgium
| | - Johann Cattan
- Department of Cardiac Surgery, CHU de Bordeaux, Place Amélie Raba Léon, Bordeaux, 33000, France
| | - Doris Celanie
- Université des Antilles, 97100, Pointe-à-Pitre, Guadeloupe, France
| | - Gabriel Saiydoun
- Department of cardiac surgery, Pitié-Salpêtrière, Bld Vincent Auriol, 75013, Paris, France
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Vervoort D, Elfaki LA, Servito M, Herrera-Morales KY, Kanyepi K. Redefining global cardiac surgery through an intersectionality lens. MEDICAL HUMANITIES 2024; 50:109-115. [PMID: 38388185 DOI: 10.1136/medhum-2023-012801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 02/24/2024]
Abstract
Although cardiovascular diseases are the leading cause of morbidity and mortality worldwide, six billion people lack access to safe, timely and affordable cardiac surgical care when needed. The burden of cardiovascular disease and disparities in access to care vary widely based on sociodemographic characteristics, including but not limited to geography, sex, gender, race, ethnicity, indigeneity, socioeconomic status and age. To date, the majority of cardiovascular, global health and global surgical research has lacked intersectionality lenses and methodologies to better understand access to care at the intersection of multiple identities and traditions. As such, global (cardiac) surgical definitions and health system interventions have been rooted in reductionism, focusing, at most, on singular sociodemographic characteristics. In this article, we evaluate barriers in global access to cardiac surgery based on existing intersectionality themes and literature. We further examine intersectionality methodologies to study access to cardiovascular care and cardiac surgery and seek to redefine the definition of 'global cardiac surgery' through an intersectionality lens.
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Affiliation(s)
- Dominique Vervoort
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Lina A Elfaki
- University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
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12
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Janz C, Hadelsberg UP, Broekman M, Cavallo C, Engel D, Hatipoglu Majernik G, Hoellig A, Ilic T, Jeltema HR, Mielke D, Rodríguez-Hernández A, Ryang YM, Fozia S, Syrmos N, Vanchaze K, Vayssiere P, Hernandez-Duran S. Parenthood and neurosurgery in Europe, a white paper from the European association of neurosurgical societies' diversity in neurosurgery committee, part II - practice with children. BRAIN & SPINE 2023; 4:102717. [PMID: 38510633 PMCID: PMC10951702 DOI: 10.1016/j.bas.2023.102717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 11/17/2023] [Accepted: 11/25/2023] [Indexed: 03/22/2024]
Abstract
Introduction In the first part of this White Paper, the European Association of Neurosurgical Societies (EANS) Diversity in Neurosurgery Committee (DC) addressed the obstacles faced by neurosurgeons when planning to have a family and practice during pregnancy, attempting to enumerate potential, easily implementable solutions for departments to be more family-friendly and retain as well as foster talent of parent-neurosurgeons, regardless of their gender identity and/or sexual orientation. Attrition avoidance amongst parent-neurosurgeons is at the heart of these papers. Research question In this second part, we address the obstacles posed by practice with children and measures to mitigate attrition rates among parent-neurosurgeons. For the methodology employed to compose this White Paper, please refer to Supplementary Electronic Materials (SEM) 1. Materials and methods For composing these white papers, the European Association of Neurosurgical Societies (EANS)'s Diversity Committee (DC) recruited neurosurgeon volunteers from all member countries, including parents, aspiring parents, and individuals without any desire to have a family to create a diverse and representative working group (WG). Results In spite of the prevailing heterogeneity in policies across the continent, common difficulties can be identified for both mothers and fathers considering the utilization of parental leave. Discussion and conclusion Reconciliation of family and a neurosurgical career is challenging, especially for single parents. However, institutional support in form of childcare facilities and/or providers, guaranteed lactation breaks and rooms, flexible schedule models including telemedicine, and clear communication of policies can improve working conditions for parent-neurosurgeons, avoid their attrition, and foster family-friendly work environments.
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Affiliation(s)
- Claudia Janz
- Städtisches Klinikum Solingen, Neurochirurgische Klinik, Gotenstrasse 1,
42563, Solingen, Germany
| | | | - Marike Broekman
- Dept of Neurosurgery, Haaglanden Medical Center, The Hague and Dept of
Neurosurgery, Leiden University Medical Centre, Leiden, the
Netherlands
| | - Claudio Cavallo
- Department of Neurosurgery, Neurocenter of Southern Switzerland,
Switzerland
- Regional Hospital of Lugano, Lugano, Switzerland
| | - Doortje Engel
- Department of Neurosurgery, Canton Hospital, St. Gall,
Switzerland
| | - Gökce Hatipoglu Majernik
- Department of Clinical Neurological Sciences, Schulich School of Medicine
and Dentistry, Western University, London, Ontario, Canada
| | - Anke Hoellig
- Department of Neurosurgery, University Hospital RWTH Aachen,
Germany
| | - Tijana Ilic
- National Department of Neurosurgery, Centre Hospitalier de Luxembourg,
the Netherlands
| | - Hanne-Rinck Jeltema
- Department of Neurosurgery, University Medical Center Groningen,
Groningen, the Netherlands
| | - Dorothee Mielke
- Department of Neurosurgery, University Hospital Göttingen, Göttingen,
Germany
| | - Ana Rodríguez-Hernández
- Dept. of Neurological Surgery, Germans Trias i Pujol University Hospital,
Universidad Autónoma, Barcelona, Spain
| | - Yu-Mi Ryang
- Dept. of Neurosurgery &Center for Spinetherapy, Helios Klinikum
Berlin-Buch, Germany
| | - Saeed Fozia
- Department of Neurosurgery at Leeds General Infirmary, Leeds, United
Kingdom
| | | | | | - Pia Vayssiere
- Department of Neurosurgery, Hôpitaux Universitaires de Genève (HUG),
Geneva, Switzerland
- Faculty of Medicine, Université de Genève (UNIGE), Geneva,
Switzerland
| | - Silvia Hernandez-Duran
- Klinik für Neurochirurgie, Universitätsmedizin Göttingen,
Robert-Koch-Straße 40, 37075, Göttingen, Germany
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Siech C, Knipper S, Bellut L, Herlemann A, Müller K, Pompe R, Walach TM, Wiemer L, Welte MN, Weinberger S, Greiser EM, Schönburg S. [Factors influencing job satisfaction of female urologists-results of a survey by the German Society of Urology (DGU)]. UROLOGIE (HEIDELBERG, GERMANY) 2023; 62:1302-1308. [PMID: 37589741 DOI: 10.1007/s00120-023-02164-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION Job satisfaction is a valuable good. However, literature on job satisfaction of female and male physicians, especially in the field of urology, is scarce. Therefore, the aim of this study was to evaluate job satisfaction among female members of the German Society of Urology (DGU). MATERIALS AND METHODS An online questionnaire was sent to 1343 female members of the DGU in Germany, Austria, and Switzerland. The responses of 521 female physicians were statistically analyzed regarding baseline characteristics and in relation to job satisfaction and satisfaction with the choice of specialty. RESULTS The median age of the participants was 37 (IQR 33; 45) years. While 91% of the respondents were rather or very satisfied with their choice of specialty-urology-only about 54% of the female urologists were satisfied with their job situation. Of the female urologists satisfied (vs. not satisfied) with their professional situation, 95% (vs. 87%) were also satisfied with their choice of urology as their specialty. Satisfaction with the working time model (odds ratio [OR] 9.61) and feeling unequal treatment (OR: 0.18) were independent predictors of satisfaction with the professional situation. CONCLUSION Considering the increasing proportion of women in the health sector, it is important to identify factors influencing decisions on career and choice of specialty as well as career progression. Achieving career goals, increasing satisfaction with the working time model, and reducing unequal treatment or discrimination are central arguments for sustainably increasing the job satisfaction of female urologists.
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Affiliation(s)
- Carolin Siech
- Klinik für Urologie, Universitätsklinikum, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
| | - Sophie Knipper
- Martini-Klinik Prostatakarzinom Zentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Laura Bellut
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - Annika Herlemann
- Klinik für Urologie, Campus Großhadern, LMU München, München, Deutschland
| | - Karina Müller
- Klinik für Urologie, Klinikum Bremen Mitte, Bremen, Deutschland
| | - Raisa Pompe
- Klinik für Urologie, Klinikum Herford, Herford, Deutschland
| | - Teresa Margarete Walach
- Klinik für Urologie und Urochirurgie, Universitätsmedizin Mannheim (UMM), Mannheim, Deutschland
| | - Laura Wiemer
- Pro Uro Berlin, Berlin, Deutschland
- Klinik für Urologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Maria-Noemi Welte
- Klinik für Urologie, Universitätsklinikum, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland
| | - Sarah Weinberger
- Klinik für Urologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Eva Maria Greiser
- Klinik für Urologie, Klinikum Rheine Mathias-Spital, Rheine, Deutschland
| | - Sandra Schönburg
- Klinik und Poliklinik für Urologie und Nierentransplantation, Martin-Luther-Universität, Halle (Saale), Deutschland
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de Almeida NRC, Bentes LGDB, Aranha MFDAC, Lemos RS, dos Santos DR, Yasojima EY. Women in surgery: do surgical specialties keep up with the feminization of medicine in Brazil? Rev Col Bras Cir 2023; 50:e20233614. [PMID: 37991063 PMCID: PMC10644865 DOI: 10.1590/0100-6991e-20233614-en] [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: 07/06/2023] [Accepted: 10/04/2023] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION historically, surgical medical specialties are mostly male, a scenario which, in recent years, has undergone changes. In this sense, despite the relevance of the growth of female participation in the medical career, little is discussed about the distribution between genders of the main surgical medical specialties in the country. OBJECTIVE discuss the process of feminization in surgical specialties in Brazil over the last few years, tracing a distribution profile of these specialties. METHODS this is a retrospective and cross-sectional study with secondary data from the Censuses of Medical Demography in Brazil in the years 2011, 2013, 2015, 2018, 2020 and 2023, including the surgical specialties: Urology, Orthopedics and Traumatology, Thoracic Surgery, Neurosurgery, Digestive System Surgery, Cardiovascular Surgery, Hand Surgery, General Surgery, Head and Neck Surgery, Vascular Surgery, Plastic Surgery, Ophthalmology, Coloproctology, Otorhinolaryngology, Pediatric Surgery, and Gynecology and Obstetrics. RESULTS males prevails in numbers, among the surgical specialties, however, with a lower growth rate compared to females. Specialties such as urology, orthopedics and traumatology and neurosurgery are mostly male, while gynecology and obstetrics are female. CONCLUSION it is evident that female participation in the surgical medical field has increased significantly over the last few years.
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Affiliation(s)
| | | | | | - Rafael Silva Lemos
- - Universidade do Estado do Pará, Laboratório de Cirurgia Experimental - Belém - PA - Brasil
| | - Deivid Ramos dos Santos
- - Universidade do Estado do Pará, Laboratório de Cirurgia Experimental - Belém - PA - Brasil
| | - Edson Yuzur Yasojima
- - Universidade do Estado do Pará, Laboratório de Cirurgia Experimental - Belém - PA - Brasil
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15
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Norton EL, Castro-Varela A, Figueredo J, Do-Nguyen CC, Russell JL, Qiu J, Luc JGY, Hirji S, Miter SL. Academic Rank and Productivity Among United States Cardiothoracic Surgeons. Ann Thorac Surg 2023; 116:1091-1097. [PMID: 37270085 DOI: 10.1016/j.athoracsur.2023.04.040] [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: 08/17/2022] [Revised: 04/03/2023] [Accepted: 04/24/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Despite a significant growth of women trainees in cardiothoracic surgery recently, women remain a minority of cardiothoracic surgeons and hold a minority of leadership positions. This study evaluates differences in cardiothoracic surgeon subspecialty choices, academic rank, and academic productivity between men and women. METHODS The Accreditation Council for Graduate Medical Education database was used to identify 78 cardiothoracic surgery academic programs in the United States, including integrated, 4+3, and traditional fellowships, as of June 2020. A total of 1179 faculty members were identified within these programs, 585 adult cardiac surgeons (50%), 386 thoracic surgeons (33%), and 168 congenital surgeons (14%), and other, 40 (3%). Data were collected using institutional websites, ctsnet.org, doximity.com, linkedin.com, and Scopus. RESULTS Of the 1179 surgeons, only 9.6% were women. Overall, women composed 6.7% of adult cardiac, 15% of thoracic, and 7.7% of congenital surgeons. Among subspecialties, women represent 4.5% (17 of 376) of full professors and 5% (11 of 195) of division chiefs in cardiothoracic surgery in the United States, have shorter career durations, and lower h-indices compared with men. However, women had similar m-indices, which factors in career length, compared with men in adult cardiac (0.63 vs 0.73), thoracic (0.77 vs 0.90), and congenital (0.67 vs 0.78) surgeons. CONCLUSIONS Career duration, including cumulative research productivity, appears to be the most important factors predicting full professor rank, potentially contributing to persistent sex-based disparities in academic cardiothoracic surgery.
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Affiliation(s)
- Elizabeth L Norton
- Division of Cardiothoracic Surgery, Department of Surgery, Emory University, Atlanta, Georgia
| | | | - Jessica Figueredo
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas
| | - Chi Chi Do-Nguyen
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan
| | | | - Julie Qiu
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Jessica G Y Luc
- Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sameer Hirji
- Division of Thoracic and Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sarah L Miter
- Department of Surgery, Inova Fairfax Hospital, Falls Church, Virginia.
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16
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Shah NR, Maselli KM, Lotakis DM, Henry MC, Newman EA, Gadepalli SK, Perrone EE. Beyond Parity: Gender Diversity of National and International Pediatric Surgery Societal Leadership. J Pediatr Surg 2023; 58:2181-2186. [PMID: 37286414 DOI: 10.1016/j.jpedsurg.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/18/2023] [Accepted: 05/01/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE Despite trends toward equal gender representation among medical school graduates, surgical trainees and fellows, diversity in higher levels of pediatric surgery is largely unstudied. This study aims to quantify gender diversity among leadership of pediatric surgical associations and societies across the globe. METHODS National and international pediatric surgical organizations were identified from the websites of the American Pediatric Surgical Association (APSA) and World Federation of Associations of Pediatric Surgery (WOFAPS). Compositional gender data of current and past organizational leadership was collected by examining publicly available archives of executive membership rosters. If roster pictures were not available, member names were input into social media sites and other search engines to ensure accurate gender denotation. Univariate analyses of organizational metrics and aggregate data of 5-year time intervals were performed via Fischer's Exact Test with significance of p < 0.05. RESULTS Nineteen pediatric surgical organizations were included for study analysis. Of 189 current organizational leaders, 50 (26.4%) are women. Eight organizations (42.1%) have less than 20% of leadership positions filled by women members, while two executive boards have no women members. Four organizations (22.2%) have a current woman seated as president/chairperson. Historical gender distribution stratified by organization demonstrates a range of 0-7.8% (p = 0.99), with one organization having yet to elect a woman president/chairperson. Longitudinally, women presidential representation remained consistently low (5-11%) across all time intervals from 1993 to 2022 (p = 0.35). CONCLUSIONS Despite advances in diversity in medical school graduates, surgical training, and workforce recruitment, there are still significant disparities in gender representation within pediatric surgery societal leadership. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Nikhil R Shah
- University of Michigan, Michigan Medicine, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, 1540 E. Hospital Dr, Ann Arbor, MI, 48109-4211, USA
| | - Kathryn M Maselli
- University of Michigan, Michigan Medicine, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, 1540 E. Hospital Dr, Ann Arbor, MI, 48109-4211, USA
| | - Dimitra M Lotakis
- University of Michigan, Michigan Medicine, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, 1540 E. Hospital Dr, Ann Arbor, MI, 48109-4211, USA
| | - Marion C Henry
- University of Chicago, Department of Surgery, Section of Pediatric Surgery, Comer Children's Hospital, Chicago, IL, 60637, USA
| | - Erika A Newman
- University of Michigan, Michigan Medicine, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, 1540 E. Hospital Dr, Ann Arbor, MI, 48109-4211, USA
| | - Samir K Gadepalli
- University of Michigan, Michigan Medicine, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, 1540 E. Hospital Dr, Ann Arbor, MI, 48109-4211, USA
| | - Erin E Perrone
- University of Michigan, Michigan Medicine, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, 1540 E. Hospital Dr, Ann Arbor, MI, 48109-4211, USA.
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17
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Blohm M, Sandblom G, Enochsson L, Österberg J. Differences in Cholecystectomy Outcomes and Operating Time Between Male and Female Surgeons in Sweden. JAMA Surg 2023; 158:1168-1175. [PMID: 37647076 PMCID: PMC10469280 DOI: 10.1001/jamasurg.2023.3736] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 05/27/2023] [Indexed: 09/01/2023]
Abstract
Importance Female surgeons are still in the minority worldwide, and highlighting gender differences in surgery is important in understanding and reducing inequities within the surgical specialty. Studies on different surgical procedures indicate equal results, or safer outcomes, for female surgeons, but it is still unclear whether surgical outcomes of gallstone surgery differ between female and male surgeons. Objective To examine the association of the surgeon's gender with surgical outcomes and operating time in elective and acute care cholecystectomies. Design, Setting, and Participants A population-based cohort study based on data from the Swedish Registry of Gallstone Surgery was performed from January 1, 2006, to December 31, 2019. The sample included all registered patients undergoing cholecystectomy in Sweden during the study period. The follow-up time was 30 days. Data analysis was performed from September 1 to September 7, 2022, and updated March 24, 2023. Exposure The surgeon's gender. Main Outcome(s) and Measure(s) The association between the surgeon's gender and surgical outcomes for elective and acute care cholecystectomies was calculated with generalized estimating equations. Differences in operating time were calculated with mixed linear model analysis. Results A total of 150 509 patients, with 97 755 (64.9%) undergoing elective cholecystectomies and 52 754 (35.1%) undergoing acute care cholecystectomies, were operated on by 2553 surgeons, including 849 (33.3%) female surgeons and 1704 (67.7%) male surgeons. Female surgeons performed fewer cholecystectomies per year and were somewhat better represented at universities and private clinics. Patients operated on by male surgeons had more surgical complications (odds ratio [OR], 1.29; 95% CI, 1.19-1.40) and total complications (OR, 1.12; 95% CI, 1.06-1.19). Male surgeons had more bile duct injuries in elective surgery (OR, 1.69; 95% CI, 1.22-2.34), but no significant difference was apparent in acute care operations. Female surgeons had significantly longer operation times. Male surgeons converted to open surgery more often than female surgeons in acute care surgery (OR, 1.22; 95% CI, 1.04-1.43), and their patients had longer hospital stays (OR, 1.21; 95% CI, 1.11-1.31). No significant difference in 30-day mortality could be demonstrated. Conclusions and Relevance The results of this cohort study indicate that female surgeons have more favorable outcomes and operate more slowly than male surgeons in elective and acute care cholecystectomies. These findings may contribute to an increased understanding of gender differences within this surgical specialty.
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Affiliation(s)
- My Blohm
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Mora Hospital, Mora, Sweden
- Center for Clinical Research, Uppsala University, Falun, Sweden
| | - Gabriel Sandblom
- Department of Clinical Science and Education, South General Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Lars Enochsson
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
- Department of Surgery, Sunderby Hospital, Luleå, Sweden
| | - Johanna Österberg
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Mora Hospital, Mora, Sweden
- Center for Clinical Research, Uppsala University, Falun, Sweden
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He ZW, Wang C, Li Y, Danzeng A, Liu FB, Zhu Y, Shi JY, Ciren P, Yuan XY, Wu CX, Lan RH, Zhang BH. The state of female hepato-pancreato-biliary (HPB) surgeons in China: see us in operation theater with great prospects. HPB (Oxford) 2023; 25:1402-1410. [PMID: 37543474 DOI: 10.1016/j.hpb.2023.07.884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/02/2023] [Accepted: 07/12/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVE This study aims to investigate the proportion and distribution of female HPB surgeons in China, describe their current status, and analyze the possible barriers and challenges in their careers. METHOD Tertiary hospitals with the division of HPB in mainland China in 2021 were enrolled and surgeon demographic information was collected through the review of official websites and/or telephone interviews. RESULTS The majority of female HPB surgeons (72.92%) were located in the first or second-tier cities in mainland China, with an increasing number of new female HPB surgeons entering the field annually, particularly after 2005 (from 27 to 52 per 5 years). Despite no significant difference in academic backgrounds, female HPB surgeons initiated their careers at an earlier age and took a longer time to obtain chief titles (P < 0.05). Interestingly, female HPB surgeons performed laparoscopic complex HPB cases at a similar rate (95.42%) to their male counterparts and were more likely to specialize in endoscopic surgery (P = 0.021), with a similar ratio of obtaining administrative positions. CONCLUSION Minimally invasive surgery may provide females with unprecedented opportunities in the HPB surgery field. However, despite the increasing numbers of female HPB surgeons, the proportion remains low in China.
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Affiliation(s)
- Zheng-Wei He
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Chao Wang
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yong Li
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Awang Danzeng
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Fu-Bin Liu
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Yuan Zhu
- School of Automation, China University of Geosciences, Wuhan, 430074, China
| | - Jia-Yu Shi
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Pingcuo Ciren
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao-Yin Yuan
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Cheng-Xian Wu
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Run-Hu Lan
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Bin-Hao Zhang
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China.
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Hida K, Hirano S, Poudel S, Kurashima Y, Stefanidis D, Hashimoto D, Akiyama H, Eguchi S, Fukui T, Hagiwara M, Izaki T, Kawamoto S, Otomo Y, Nagai E, Takami H, Takeda Y, Toi M, Yamaue H, Yoshida M, Yoshida S, Kodera Y, Saito M. The degree of satisfaction and level of learning in male and female surgical residents: a nationwide questionnaire survey of graduating residents in Japan. Surg Today 2023; 53:1275-1285. [PMID: 37162584 DOI: 10.1007/s00595-023-02683-z] [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: 08/07/2022] [Accepted: 03/14/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE Since 2002, the Japan Surgical Society has established a board certification system for surgeons to be certified for a specialty. Surgery remains a male-dominated field in Japan. This study aimed to clarify if the Japanese surgical residency training system is equally suitable for female and male residents. METHODS The Japan Surgical Society conducted the first questionnaire survey regarding the system of surgical training for the residents in 2016. The questionnaire included the degree of satisfaction with 7 aspects of the training system, including the number and variety of cases experienced and duration and quality of instruction, and the learning level for 31 procedures. The degree of satisfaction and level of learning were compared between female and male residents. RESULTS The degree of satisfaction was similar for all items between female and male residents. Female residents chose breast surgery as their subspecialty more frequently than male residents and were more confident in breast surgery procedures than male residents. Conversely, fewer female residents chose gastrointestinal surgery and were less confident in gastrointestinal surgery procedures than male residents. CONCLUSION Female residents were as satisfied with the current surgical training system as male residents. However, there may be room for improvement in the surgical system, considering that fewer applications for gastrointestinal surgery come from female residents than from males.
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Affiliation(s)
- Koya Hida
- Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Saseem Poudel
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Yo Kurashima
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Dimitrios Stefanidis
- Department of Surgery, School of Medicine, Indiana University, Indianapolis, USA
| | | | - Hirotoshi Akiyama
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University, Kumamoto, Japan
| | - Masaru Hagiwara
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Tomoko Izaki
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shunsuke Kawamoto
- Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yasuhiro Otomo
- Trauma and Acute Critical Care Center, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Eishi Nagai
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hideki Takami
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuko Takeda
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
| | - Masakazu Toi
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Motofumi Yoshida
- Department of Medical Education, Graduate School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Shigetoshi Yoshida
- Department of Thoracic Surgery, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
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Kato N, Kojima T, Ouchi M, Nakamura T, Tokuda Y, Yakushiji T, Ichikawa K. Gender-based differences in the job titles and lifestyles in the cataract and refractive surgery society in Japan. Medicine (Baltimore) 2023; 102:e35216. [PMID: 37800820 PMCID: PMC10553083 DOI: 10.1097/md.0000000000035216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/23/2023] [Indexed: 10/07/2023] Open
Abstract
To investigate sex differences in the titles and lifestyles of Japanese ophthalmologists, we evaluated work places and private lives. Retrospective cross-sectional study. The study included 1721 members (1344 males and 377 females) of the Japanese Society of Cataract and Refractive Surgery. An online, anonymized questionnaire was distributed to the society members. The questionnaire included 40 questions to collect data on profiles, lifestyles, job title, families, spouses, children, household chores, child-rearing, and work satisfaction. In total, 219 members (144 males and 75 females; 53.4 ± 1.0 and 51.3 ± 9.9 years old, respectively) completed the questionnaire. The job title, working time, annual income, marriage rate, and the number of children significantly differed between male and female respondents. Female respondents had greater responsibilities toward house chores, child care, and nursing, whereas several male doctors had spouses who did not work or worked for shorter times, earned a lower income, and contributed greater toward family responsibilities. Female respondents changed their job titles after having children more frequently than male respondents. Both males and females had limited time available for community activities and volunteer work. There were no significant differences in daily sleep duration. Both sexes were equally satisfied with their career choice of ophthalmology; however, fewer females recommended ophthalmology as a career for students and children compared to males. There are significant sex differences among ophthalmologists in Japan in terms of family responsibilities; this topic has received insufficient attention.
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Affiliation(s)
| | | | | | | | | | - Tadayuki Yakushiji
- Department of Cardiology, Showa University Northern Yokohama Hospital, Kanagawa, Japan
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21
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Alshehri M, Bin Helayel H, Vargas JM, Almutlak M, Fairaq R. Preferred surgical techniques for secondary intraocular lens implantation in adults with aphakia. Int Ophthalmol 2023; 43:3539-3547. [PMID: 37356032 DOI: 10.1007/s10792-023-02761-8] [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: 02/21/2023] [Accepted: 05/21/2023] [Indexed: 06/27/2023]
Abstract
AIM To identify the current surgical management of aphakia and the outcomes and complications of each technique. METHODS This cross-sectional study included ophthalmic surgeons with at least one-year experience in surgery for aphakia. A study questionnaire was formulated to collect data in Saudi Arabia and other regional countries. The questionnaire included 22 questions on demographics, preferred surgical techniques, complications and the factors related to surgeon decision and the choice for managing aphakia. RESULTS The study included 145 participants (111; 76.6% were males) with mean age of 46.7 ± 11.5 years. The mean duration of cataract surgery experience was 17.6 ± 11.1 years. Most participants (86.2%) were trained in cataract surgery. Scleral fixation of intraocular lens (SFIOL) was the most commonly preferred technique, followed by iris fixation IOL, and anterior chamber IOL (75.2%, 9%, and 15.9%, respectively). The main determinants for selection of a surgical technique were simplicity (56.6%), surgical instrument availability (48.3%), and training on the technique (47.6%). The most frequent postoperative complications were pupil distortion, high intraocular pressure (IOP), pupillary capture of the IOL, and IOL decentration. CONCLUSIONS SFIOL is the preferred surgical technique for managing aphakia. The decision to choose one technique over another is complex and is based on several factors, including technical difficulty, previous training, anatomical variations, ocular comorbidities, and the potential complications. The most frequent complications after surgical correction of aphakia are pupil distortion, high IOP, pupillary capture of the IOL, and decentered IOLs.
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Affiliation(s)
- Mohammed Alshehri
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia
- Anterior Segment Division, King Faisal Medical City, Abha, Saudi Arabia
| | - Halah Bin Helayel
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia
| | - José Manuel Vargas
- Ophthalmology Division, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Mohammed Almutlak
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia
| | - Rafah Fairaq
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia.
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22
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Graham V, Arora B. Women in surgery: trends in nine surgical specialties. ANZ J Surg 2023; 93:2344-2349. [PMID: 37458242 DOI: 10.1111/ans.18600] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/30/2023] [Accepted: 07/02/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Gender disparity in surgery remains an issue worldwide. We analysed the trends in gender distribution in surgical subspecialties across Australia and New Zealand over the last 8 years. METHODS Workforce reports from the Royal Australasian College of Surgeons were reviewed from 2014 to 2021. Data relating to 4802 applicants, 1554 trainees and 6839 active surgeons across nine surgical subspecialties was analysed. Statistical analysis was performed using a difference of proportions hypothesis test. Predictions regarding time to parity were performed using a linear regression model. RESULTS All nine surgical subspecialties' surgeon numbers saw a steady increase in the representation of women between 2014 and 2021. The most significant rise seen in general surgery from 14% to 21% (P ≤ 0.001). Proportions of women trainees were variable, the only significant rise was seen in orthopaedics from 9% to 19% (P ≤ 0.001). Proportions of women applicants and successful applicants have also been variable. General surgery saw the only consistent increase in women applicants over the last 6 years, from 35% in 2016 to 43% in 2021. Linear regression predictions estimate that paediatric surgery will be the first to reach gender parity in 23 years, and orthopaedics the last, in 186 years. CONCLUSION A steady increase in women has been observed across all surgical subspecialities over the last 8 years. However, estimates based on current trends suggest that gender parity may be out of reach for the next eight generations in subspecialties such as cardiothoracic and orthopaedic surgery.
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Affiliation(s)
- Vaite Graham
- Department of Surgery, Urology Division, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Bharti Arora
- Urology Division, Mater Hospital, Brisbane, Queensland, Australia
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Hakami N, Madkhali A, Hakami F, ALshekh M, Masmali E, Hamithi D, Zogel B. Obstacles Deterring Medical Students From Pursuing a Career in the Field of Surgery in Jazan University, Saudi Arabia. Cureus 2023; 15:e43233. [PMID: 37692738 PMCID: PMC10491465 DOI: 10.7759/cureus.43233] [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: 07/16/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Particularly in Saudi Arabia, there is a dearth of trained specialists in the field of surgery. Understanding the obstacles that discourage medical students and residents from pursuing a surgical career is essential for resolving this shortage. This study intended to investigate the characteristics that influence medical students and trainees at Jazan University, Saudi Arabia, to pursue a career in surgery. METHODOLOGY This observational study employed a descriptive, cross-sectional approach. The intended audience consisted of fourth- to sixth-year medical students and medical residents. The questionnaire gathered information on demographics, academic year, previous surgical experience, perceptions of surgery as a specialty, and variables influencing career selections. RESULTS Out of 413 participants, 74.3% were considering a surgical career, with 24.4% interested in general surgery, followed by cardiac surgery (14.3%) and pediatric surgery (12.4%). Factors influencing career decisions included potential income (82%), the possibility of part-time work (82%), and partial leave (74%). A significant proportion of participants agreed or strongly agreed that the incidence of suicide (62%) and the risk of depression (72%) are higher in surgical specialties. Female participants were more likely to agree that their chance of becoming a spouse could be affected by a surgical career (p=0.002) and that meeting role models could influence their choice of surgical specialty (p=0.015). CONCLUSION Work-life balance, long working hours, and mental health concerns are identified as variables that discourage medical students and residents from pursuing a surgical career in the study. Efforts to encourage work-life balance, minimize workload, and provide support and resources for mental health issues should help surgeons suffer less stress and burnout. Moreover, encouraging an open-minded attitude and de-stigmatizing mental health concerns in the medical field should encourage individuals to seek assistance when necessary and lower the incidence of suicide and depression. Finally, tackling gender discrimination and encouraging diversity and inclusion in surgical specialties could attract more skilled surgeons.
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Affiliation(s)
| | | | | | | | - Enas Masmali
- Faculty of Medicine, Jazan University, Jazan, SAU
| | | | - Basem Zogel
- Faculty of Medicine, Jazan University, Jazan, SAU
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Rauf H, Martins RS, Arif HE, Ahmed A, Nawaz A, Malik MA. Sex-based Disparities Among Surgical Faculty Positions Across Medical Colleges in Pakistan. World J Surg 2023; 47:870-876. [PMID: 36595089 PMCID: PMC9809513 DOI: 10.1007/s00268-022-06880-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Despite women being under-represented in academic surgery, there is no publicly accessible repository describing the distribution of surgeons by sex and specialty in Pakistan. This short report aims to fulfill this gap by describing female representation across surgical faculty positions in medical colleges across Pakistan. METHODS This cross-sectional study was conducted in 2021 across medical universities in Pakistan. A dual mode of data collection was employed, whereby data regarding sex, academic designation, and subspecialty of surgical faculty was retrieved via emails to representative faculty from medical colleges, and from medical colleges' websites. RESULTS A total of 97/114 (85.1%) medical colleges across Pakistan were included, providing us with data of 2070 surgical faculty. Overall, only 10.3% of surgical faculty were women, with women comprising 14.1% of assistant professors, 9.3% of associate professors, and only 5.7% of professors. Most women surgical faculty were assistant professors (63.1%), with only 17.8% being professors. Sindh (14.3%) and Punjab (9.7%) had the greatest percentage of women across surgical faculty overall, while Khyber Pakhtunkhwa had the lowest (6.5%). Apart from breast surgery (100%), pediatric surgery (29.4%), ophthalmology (15.0%) and general surgery (11.6%), women did not represent more than 10% of surgical faculty for any surgical subspecialty. CONCLUSION In Pakistan, there is a blatant lack of female representation across all faculty positions and in most surgical specialties, with imbalances more pronounced in the relatively under-developed Khyber Pakhtunkhwa and Balochistan. These sex disparities may aggravate the surgical disease burden and adversely impact surgical prospects for women across the country.
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Affiliation(s)
- Hareem Rauf
- Medical College, Aga Khan University, Karachi, 74800, Pakistan
| | | | - Hibba Erum Arif
- Medical College, Aga Khan University, Karachi, 74800, Pakistan
| | - Aymen Ahmed
- Medical College, Dow University of Health Sciences, Karachi, 74200, Pakistan
| | - Arisha Nawaz
- Medical College, Dow International Medical College, Dow University of Health Sciences, Karachi, 74200, Pakistan
| | - Mahim A Malik
- Section of Cardiothoracic Surgery, Department of Cardiothoracic Surgery, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan.
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Busa I, Nagraj S. Women as a driver to address gaps in the global surgical workforce. HUMAN RESOURCES FOR HEALTH 2023; 21:22. [PMID: 36927692 PMCID: PMC10021942 DOI: 10.1186/s12960-023-00808-6] [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: 11/19/2022] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Five billion people around the world lack access to safe and affordable surgical, anaesthetic, and obstetric care. There is a link between countries in which women are underrepresented in the surgical workforce and those struggling to meet their surgical need. In this commentary article, the underrepresentation of women in low- and middle-income country's (LMIC) surgical workforce is discussed. It is argued that the issue is self-reinforcing. On one hand, active change requires a sufficient number of female surgeons to initiate it. On the other, women can only start to penetrate the surgical workforce once they are safe, healthy, and motivated enough to do so, in turn depending on the presence of female surgeons to advocate for their female patients and empower future generations of young girls and women.
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Affiliation(s)
- Isabella Busa
- University of Oxford Medical School, Osler House, John Radcliffe Hospital, Oxford, UK.
| | - Shobhana Nagraj
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
- Health Systems Collaborative, Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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26
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Yong V, Kahler D, Schlossberg A, Gilmore K, Zhao H, Philp MM. Controller size matters: User proficiency is affected by endoscopic controller size. Am J Surg 2023; 225:378-382. [PMID: 36182597 DOI: 10.1016/j.amjsurg.2022.09.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/02/2022] [Accepted: 09/22/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Endoscope controllers are traditionally a one-size-fits-all design. However, this design may not fit the modern workforce in endoscopy-related fields. Our study aims to determine if endoscopic controller size, independent of user dexterity, affects user proficiency. METHODS 54 endoscopically naive participants completed a baseline dexterity test, followed by large-controller endoscopic and small-controller bronchoscopic simulation exercises. Participants were stratified by surgical glove size (≥7.5 and < 7.5) and gender. RESULTS Endoscopy time was longer in participants with <7.5 size gloves (p = 0.01) and in females (p < 0.001). However, participants with glove size <7.5 had better dexterity measures (p = 0.04). There was no difference in bronchoscopy time based on glove size (p = 0.61). CONCLUSIONS Participants with larger hands were more proficient with the larger controller despite being less dexterous than their counterparts. This advantage was less pronounced with the smaller controller. Our findings suggest that endoscopic controllers should be modified in design to accommodate all providers.
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Affiliation(s)
- Valeda Yong
- Department of Surgery, Temple University Hospital, 3401 N. Broad Street, Zone C, 4th Floor, Philadelphia, PA, 19140, USA.
| | - Dylan Kahler
- Department of Surgery, Temple University Hospital, 3401 N. Broad Street, Zone C, 4th Floor, Philadelphia, PA, 19140, USA
| | - Axel Schlossberg
- Lewis Katz School of Medicine at Temple University, 3500 N. Broad Street, Philadelphia, PA, 19140, USA
| | - Kimberly Gilmore
- William Maul Measey Institute for Clinical Simulation and Patient Safety, Lewis Katz School of Medicine at Temple University, 3500 N. Broad Street, Philadelphia, PA, 19140, USA
| | - Huaqing Zhao
- Department of Biomedical Education and Data Science, Lewis Katz School of Medicine at Temple University, 3500 N. Broad Street, Philadelphia, PA, 19140, USA
| | - Matthew M Philp
- Division of Colorectal Surgery, Department of Surgery, Temple University Hospital, 3401 N. Broad Street, Zone C, 3rd Floor, Philadelphia, PA, 19140, USA
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Ahmed A, Davidson J, Van Koughnett JA, Bütter A. Gender trends in applicants to general surgery residency programs in Canada. J Pediatr Surg 2023; 58:917-924. [PMID: 36797112 DOI: 10.1016/j.jpedsurg.2023.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND Surgical disciplines lag behind non-surgical disciplines in attracting female trainees. Female representation of Canadian General Surgeons has not been evaluated in recent years in the literature. The objectives of this study were to assess gender trends in applicants to Canadian General Surgery residency programs and practicing general surgeons and subspecialists. METHODS This retrospective cross-sectional study analyzed gender data for residency applicants ranking General Surgery as their first-choice discipline from publicly-available annual Canadian Residency Matching Service (CaRMS) R-1 match reports from 1998 to 2021. Aggregate gender data for practicing female physicians in General Surgery and related subspecialties, including Pediatric Surgery, obtained from annual Canadian Medical Association (CMA) census from 2000 to 2019 was also analysed. RESULTS There was a significant increase in the proportion of female applicants from 34% in 1998 to 67% in 2021 (p < 0.001) and of successfully matched candidates from 39% to 68% (p = 0.002) from 1998 to 2021. Success rates between male and female candidates were significantly different in 1998 (p < 0.001), but not in 2021 (p = 0.29). The proportion of practicing female General Surgeons also significantly increased from 10.1% in 2000 to 27.9% in 2019 (p = 0.0013), with variable trends in subspecialties. CONCLUSION Gender inequality in General Surgery residency matches has normalized since 1998. Despite females representing more than 40% of applicants and successfully matched candidates to General Surgery since 2008, a gender gap still exists amongst practicing General Surgeons and subspecialists. This suggests the need for further cultural and systemic change to mitigate gender disparities. TYPE OF STUDY Original research article, clinical research. LEVEL OF EVIDENCE Level III (Retrospective cross-sectional study).
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Affiliation(s)
- Alveena Ahmed
- Schulich School of Medicine & Dentistry, Western University, Windsor Campus, London, Ontario, Canada
| | - Jacob Davidson
- Division of Pediatric Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Julie Ann Van Koughnett
- Division of General Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Andreana Bütter
- Division of Pediatric Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Division of General Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
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28
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Ruparell K, Barve R, Tas RN, Chen S, Mclaughlin R, Ravendren A, Gupte CM. Motivators and deterrents for early career female doctors applying to surgical training programmes in the UK National Health Service: a mixed-methods study. BMJ Open 2022; 12:e055652. [PMID: 36456020 PMCID: PMC9723904 DOI: 10.1136/bmjopen-2021-055652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To perform a mixed-methods study identifying motivators and deterrents to female doctors interested in core surgical training (CST). To provide tangible implementations based on the findings. DESIGN This study used quantitative (questionnaires) and qualitative (semistructured interviews (SSIs)) analyses. Participants completed online questionnaires on Qualtrics and SSIs were conducted remotely on Microsoft Teams. Questions were derived from previous studies and a novel term, the gender impact rating (GIR), was coined to assess the impact of gender on opportunities available during CST application. SETTING Participants were working in the UK National Health Service and data collected from December 2020 to January 2021. PARTICIPANTS A total of 100 female surgical trainees in the UK ranging from Foundation Year 2 to Core Training Year 2. MAIN OUTCOME MEASURES Participants ranked factors by their influence on their CST application. Of the 100 trainees, 21 were randomly selected for an SSI to explore their questionnaire responses. Statistical analyses were performed using MATLAB and SPSS, alongside a thematic analysis of the interviews. RESULTS A total of 44 out of 100 questionnaire respondents ranked early exposure to surgery as the most influential motivator, while 43% selected work-life balance as the greatest deterrent and 33% suggested mentoring schemes to encourage women to apply to CST. The median GIR was 3 out of 5, indicating a moderate perceived impact of gender on opportunities available during CST application. Qualitative analysis found four overarching themes: institutional factors (including mentorship schemes), organisational culture (including active engagement), social factors and personal factors. CONCLUSION Thematic analysis suggested that seniors involving women in theatre and a supportive work environment would encourage entry of more female surgeons. Therefore, the proposed implementations are the active engagement of women in theatre and destigmatising less than full-time training. Further research into ethnicity and personality on motivations to enter surgery is advised.
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Affiliation(s)
| | - Rajas Barve
- Imperial College London Faculty of Medicine, London, UK
| | - Rukiye N Tas
- King's College London Faculty of Life Sciences and Medicine, London, UK
| | - Sihan Chen
- Imperial College London Faculty of Medicine, London, UK
| | | | | | - Chinmay M Gupte
- Imperial College London Faculty of Medicine, London, UK
- Imperial College Biomedial Research Centre, London, UK
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29
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Surgery is really a team sport. Lancet Glob Health 2022; 10:e1713. [PMID: 36400082 DOI: 10.1016/s2214-109x(22)00472-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/13/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022]
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30
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Sachdeva S, Hartley B, Roberts C. Ladies in the Bone Room? Addressing the Gender Gap in Orthopaedics. Injury 2022; 53:3065-3066. [PMID: 36137730 DOI: 10.1016/j.injury.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Pandrowala S, Patkar S, Nair D, Maheshwari A, Pramesh CS, Puri A. Gender discrimination in surgical oncology: An in-house appraisal. Front Surg 2022; 9:939010. [PMID: 35903261 PMCID: PMC9314771 DOI: 10.3389/fsurg.2022.939010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Gender discrimination (GD) though rarely blatant, may present indirectly within a surgical department in the form of subtle inequities, differing standards, and bias. GD encompasses a wide spectrum including academic development, surgical opportunities and sexual harassment. Methods We conducted an online survey to analyse the perceived incidence of GD in the surgical oncology department at a tertiary care cancer centre in India. The questionnaire consisted of 15 questions and was mailed to the entire department including trainees and faculty. Anonymity was maintained while collecting the data only of the participants' gender and whether they were faculty or trainee. Collated responses were analysed using proportions. Results The questionnaire was sent out to 200 recipients of whom 56% (112/200) responded via an online survey. Respondents included 84% of faculty (42/50) and 46.6% of trainees (70/150). GD was perceived by 28% of female trainees (7/25) as compared to 6.6% of male trainees (3/45), whereas amongst faculty, GD was perceived by 26.6% of female faculty (4/15) compared to 14.8% of male faculty (3/27). Approximately 13% of our trainees and 12% of our faculty mentioned that GD affected their professional performance or mental well-being. GD was experienced in terms of work experience and opportunities by a majority of trainees (13%) and faculty (9.5%). There was a significant lack of awareness about recourse to an institutional grievance committee by trainees (47%) compared to faculty (14%). About 7% of trainees and 12% of faculty acknowledged that they may have been responsible for intentional/unintentional GD. Conclusion Gender discrimination can present in subtle or overt fashion in surgical departments and requires active sustained efforts to allow both genders to feel equally empowered. Establishing a system to objectively evaluate gender equity while avoiding stereotyping for certain roles can help minimize GD.
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Affiliation(s)
- Saneya Pandrowala
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - Shraddha Patkar
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
- Correspondence: Shraddha Patkar
| | - Deepa Nair
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - Amita Maheshwari
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - C. S. Pramesh
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - Ajay Puri
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
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Early Barriers to Career Progression of Women in Surgery and Solutions to Improve Them: A Systematic Scoping Review. Ann Surg 2022; 276:246-255. [PMID: 35797642 DOI: 10.1097/sla.0000000000005510] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aims to summarize the evidence concerning the barriers that exist to the career progression of women in surgery and to provide potential solutions to overcome these obstacles. BACKGROUND Visible and invisible impediments can hinder female doctors' pursuit of a surgical career, from choosing a surgical specialty to training opportunities and all the way through career progression. METHODS Database search of original studies about barriers for female surgeons during choice of surgical career, residency, and career progression. A query including possible solutions such as mentorship and network was included. RESULTS Of 4618 total articles; 4497 were excluded as duplicates, having incorrect study focus, or not being original studies; leaving 120 studies meeting the inclusion criteria. Of the articles included, 22 (18%) focused on factors affecting the pursuit of a surgical career, such as surgical work hours and limited time for outside interests, 55 (46%) analyzed the main barriers that exist during surgical residency and fellowship training, such as discrimination and sexual harassment, 27 (23%) focused on barriers to career advancement, heavy workloads, ineffective mentorship, unclear expectations for advancement, inequality in pay or work-home conflicts. Among studies reporting on possible solutions, 8 (6.5%) articles reported on the role of effective mentorship to support career advancement and to provide moral support and 8 (6.5%) on the emerging role of social media for networking. Our analysis showed how different impediments hinder surgical career progression for women, with notable consequences on burnout and attrition. CONCLUSIONS Identification and recognition of obstacles to career progression is the first step to addressing the gender gap in surgery. Active strategies should be improved to promote a culture of diversity and to create equal opportunity for women in surgery, while implementing structured mentoring programs and investing on an adequate communication on social media to engage the future generations.
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Towards Global Gender Equity in Surgery : Commentary on Factors Influencing the Intention to Pursue Surgery Among Female Pre-medical Students: A Cross-Sectional Study in Pakistan. World J Surg 2022; 46:2073-2074. [PMID: 35752678 DOI: 10.1007/s00268-022-06644-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2022] [Indexed: 10/17/2022]
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Zientara A, Siepe M. Support, mentor and empower: female cardiothoracic surgeons across Europe and the role of the society. Eur J Cardiothorac Surg 2022; 61:1400-1401. [PMID: 35218655 DOI: 10.1093/ejcts/ezac064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Alicja Zientara
- Department of Cardiac Surgery, Royal Brompton Hospital, Guys and St. Thomas' NHS Foundation Trust, London, UK
| | - Matthias Siepe
- Department of Cardiovascular Surgery, Heart Center University Freiburg-Bad Krozingen, Bad Krozingen, Germany
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Women surgeons: How can we shape the future of new leaders? A celebration of the past with a glimpse of the future. Surgery 2022; 172:633-638. [DOI: 10.1016/j.surg.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 02/22/2022] [Accepted: 03/03/2022] [Indexed: 11/22/2022]
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Newman TH, Parry MG, Zakeri R, Pegna V, Nagle A, Bhatti F, Vig S, Green JSA. Gender diversity in UK surgical specialties: a national observational study. BMJ Open 2022; 12:e055516. [PMID: 35314455 PMCID: PMC8968535 DOI: 10.1136/bmjopen-2021-055516] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To compare gender diversity between UK surgical specialties, assess trends over time, and estimate when gender parity might be achieved. DESIGN Observational study. SETTING National Health Service, UK. PARTICIPANTS NHS Hospital & Community Health Service workforce statistics for 2011 to 2020 MAIN OUTCOME MEASURES: Logistic regression was used to compare female representation in 2020 between surgical specialties, and to examine for any significant trends between 2011 and 2020. The method of least squares was used to estimate when female representation of specialty registrars would reach 50% ('gender parity') for specialties with <40% female representation. RESULTS In 2020, female consultant and specialty registrar representation was significantly different between surgical specialties (both p<0.001). Female representation for each specialty were as follows (from highest to lowest): Specialty Registrars-Ophthalmology 49.7%, Otolaryngology 48.2%, Paediatric Surgery 45.5%, Plastic Surgery 42.2%, General Surgery 39.8%, Urology 31.6%, Vascular Surgery 25.0%, Neurosurgery 24.7%, Cardiothoracic Surgery 21.3%, and Trauma and Orthopaedics 20.6%; Consultants-Ophthalmology 32.4%, Paediatric Surgery 31.7%, Plastic Surgery 20.9%, General Surgery 17.5%, Otolaryngology 17%, Vascular Surgery 13.7%, Urology 11.7%, Cardiothoracic Surgery 10.8%, Neurosurgery 8.2%, and Trauma and Orthopaedics 7.3%. There was a significant positive trend in female representation of specialty registrars between 2011 and 2020 for all specialties except for Paediatric Surgery (representation consistently >45%) and Vascular Surgery (representation consistently <30%). General Surgery was estimated to achieve gender parity of their specialty registrars by 2028, Urology by 2033, Neurosurgery by 2064, Trauma and Orthopaedics by 2070, and Cardiothoracic Surgery by 2082. CONCLUSIONS Despite improvements over the last decade, gender disparity persists in the UK surgical workforce and there are significant differences between surgical specialties. Further work is necessary to establish the reasons for these observed differences with a specific focus on Vascular Surgery, Cardiothoracic Surgery, Neurosurgery, and Trauma and Orthopaedics.
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Affiliation(s)
| | - Matthew G Parry
- London School of Hygiene and Tropical Medicine Department of Health Services Research and Policy, London, London, UK
| | - Roxanna Zakeri
- Whittington Hospital, London, London, UK
- UCL Division of Medicine, London, London, UK
| | - Victoria Pegna
- Kent Surrey and Sussex Deanery, Crawley, West Sussex, UK
- Royal College of Surgeons of England, London, London, UK
| | - Amy Nagle
- Urological Department, Barts Health NHS Trust, London, London, UK
| | - Farah Bhatti
- Royal College of Surgeons of England, London, London, UK
- Cardiothoracic surgery, Morriston Hospital, Swansea, Wales, UK
| | - Stella Vig
- Royal College of Surgeons of England, London, London, UK
- Department of Vascular and General Surgery, Croydon Health Services NHS Trust, Croydon, Greater London, UK
| | - James Stephen Arthur Green
- Urology, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
- Health Service and Population Research Department, Center for Implementation Science, King's College London, London, UK
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Abstract
BACKGROUND Over the past twenty years explicit gender bias towards women in surgery has been replaced by more subtle barriers, which represent indirect forms of discrimination and prevents equality. OBJECTIVE The aim of our scoping review is to summarize the different forms of discrimination towards women in surgery. METHODS The database search consisted of original studies regarding discrimination towards female surgeons. RESULTS Of 3,615 studies meeting research criteria, 63 were included. Of these articles, 11 (18%) were focused on gender-based discrimination, 14 (22%) on discrimination in authorship, research productivity and research funding, 21 (33%) on discrimination in academic surgery, 7 (11%) on discrimination in surgical leadership positions and 10 (16%) on discrimination during conferences and in surgical societies. The majority (n = 53, 84%) of the included studies were conducted in the U.S.A. According to our analysis, female surgeons experience discrimination from male colleagues, healthcare workers, but also from patients and trainees. Possible solutions may include acknowledgement of the problem, increased education of diversity and integration for the younger generations, mentorship, coaching and more active engagement by male and female partners to support women in the surgical field. CONCLUSIONS Gender-based discrimination toward women in the field of surgery has evolved over the past twenty years, from an explicit to a more subtle attitude. A work-environment where diversity and flexibility are valued would allow female surgeons to better realize their full potential.
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Munabi NCO, Auslander A, Xepoleas MD, Bunker LD, Vangsness KL, Koualla S, Magee KS, Magee WP, Yao CA. The influence of an all-female healthcare environment on mentorship and empowerment of female healthcare professionals. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000081. [PMID: 36962245 PMCID: PMC10021414 DOI: 10.1371/journal.pgph.0000081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 01/09/2022] [Indexed: 11/19/2022]
Abstract
Low- and middle-income countries (LMICs) have the greatest need for additional healthcare providers, and women outside the workforce help address the need. Women in healthcare need more mentorship and leadership training to advance their careers due to systemic barriers. This study evaluates how women working together on a medical team influences mentorship, leadership and empowerment. A single all-female volunteer team participating in a cleft surgery mission in Oujda, Morocco were surveyed before and after the mission. Statistical analysis with student's t-test or chi-squared were performed. 95 female volunteers from 23 countries participated on this team and 85% completed surveys. Volunteers from high-income countries (32%) and LMICs (68%) had similar mission roles (p = 0.58). Experience as a mission volunteer (p = 0.47), team leader (p = 0.28), and educator (p = 0.18) were equivalent between cohorts. 73% of women had previously received mentorship but 98% wanted more. 75% had previously mentored others, but 97% wanted to be mentors. 73% of volunteers who had no prior mentorship found their first mentor during the mission. All participants found a long-term peer relationship and felt motivated to mentor women at home. 95% were inspired to pursue leadership positions, advance professionally, and continue working with other women. This population of female healthcare professionals overwhelmingly desired more mentorship than is felt to be available. An all-female healthcare environment appears to provide opportunities for mentorship and create lasting motivation to teach, lead, and advance professionally. Findings raise the potential that increasing visibility of female professionals may effectively empower women in healthcare.
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Affiliation(s)
- Naikhoba C. O. Munabi
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, CA, United States of America
- Operation Smile Inc, Virginia Beach, VA, United States of America
| | - Allyn Auslander
- Operation Smile Inc, Virginia Beach, VA, United States of America
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA, United States of America
| | | | - Libby D. Bunker
- Operation Smile Inc, Virginia Beach, VA, United States of America
| | - Kella L. Vangsness
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA, United States of America
| | - Sara Koualla
- Faculté de Médecine et de Pharmacie d’Oujda, Oujda, Morocco
| | - Kathy S. Magee
- Operation Smile Inc, Virginia Beach, VA, United States of America
| | - William P. Magee
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, CA, United States of America
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA, United States of America
- Department of Plastic Surgery, Shriners Hospital for Children, Los Angeles, CA, United States of America
| | - Caroline A. Yao
- Operation Smile Inc, Virginia Beach, VA, United States of America
- Department of Plastic Surgery, Shriners Hospital for Children, Los Angeles, CA, United States of America
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Viana SW, Campos LN, DO-Nascimento MEDEFM, Ribeiro LS, Morais VMDAF, Haddad JOD, Ferreira RV, Lage F, Ferreira JL. Women Representation in Surgical Specialties: Reflections about Gender Equity after the 34th Brazilian Surgical Conference. Rev Col Bras Cir 2022; 49:e20223204EDIT01. [PMID: 35239856 PMCID: PMC10578858 DOI: 10.1590/0100-6991e-20223204edit01] [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: 10/10/2021] [Accepted: 10/20/2021] [Indexed: 11/21/2022] Open
Abstract
In September 2021, the 34th Brazilian Surgical Conference hosted the "Panel: Women in Surgery" - the only session in the event solely composed of female speakers. Although gender inequities in surgery are well recognized in the international literature, the panel portrayed how distant we are from the desired equity in our country. In addition, the session emphasized the need to broaden the debate and identify the mechanisms for greater inclusion and maintenance of women in the surgical career. In this editorial, we provide a historical overview of gender disparities in the Brazilian surgical ecosystem, highlight the contributing factors to a reduced number of female surgeons, and how the structure of medical societies may influence the rise of women to leadership positions. Accordingly, we discuss the benefits of gender diversity for surgeons, patients, and institutions. Furthermore, we analyze the representation of women in the Brazilian College of Surgeons since its foundation and in the scientific sessions at the conference, demonstrating that more initiatives are required to encourage female representation in the college. Finally, we propose a series of recommendations to foster engagement and contribute to the prosperity of women surgeons in Brazil.
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Affiliation(s)
- Sofia Wagemaker Viana
- - International Student Surgical Network of Brazil - Brasil
- - Kursk State Medical University, Faculdade de Medicina - Kursk - Kursk Oblast - Rússia
| | - Letícia Nunes Campos
- - International Student Surgical Network of Brazil - Brasil
- - Universidade de Pernambuco, Faculdade de Ciências Médicas - Recife - PE - Brasil
| | - Maria Eduarda DE Freitas Mesquita DO-Nascimento
- - International Student Surgical Network of Brazil - Brasil
- - Universidade de Pernambuco, Faculdade de Ciências Médicas - Recife - PE - Brasil
- - Gender Equity Initiative in Global Surgery - Brasil
| | - Lívia Sousa Ribeiro
- - International Student Surgical Network of Brazil - Brasil
- - Universidade Federal do Recôncavo da Bahia, Faculdade de Medicina - Santo Antônio de Jesus - BA - Brasil
| | - Vitória Marques DA Fonseca Morais
- - Gender Equity Initiative in Global Surgery - Brasil
- - Universidade Estadual de Feira de Santana, Faculdade de Medicina - Feira de Santana - BA - Brasil
| | - Júlia Oliveira Dabien Haddad
- - Gender Equity Initiative in Global Surgery - Brasil
- - Universidade de Itaúna, Faculdade de Medicina - Itaúna - MG - Brasil
| | - Rodrigo Vaz Ferreira
- - Universidade do Estado do Amazonas, Disciplina de Cirurgia - Manaus - AM - Brasil
| | - Fernanda Lage
- - Universidade Federal do Acre, Faculdade de Medicina - Rio Branco - AC - Brasil
- - Comissão de Mulheres Cirurgiãs do Colégio Brasileiro de Cirurgiões, TCBC, FACS - Brasil
| | - Júlia Loyola Ferreira
- - Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children 's Hospital, McGill University Health Center - Canada
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Marincola Smith P, Nordness MF, Polcz ME. The American Board of Surgery Should Reconsider Its Parental Leave Policy. JAMA Surg 2021; 157:7-8. [PMID: 34705043 DOI: 10.1001/jamasurg.2021.4895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Paula Marincola Smith
- Section of Surgical Sciences, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mina F Nordness
- Section of Surgical Sciences, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Monica E Polcz
- Section of Surgical Sciences, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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My thoughts: Unspoken truths about gender inequality in surgery across different cultures and income levels. Am J Surg 2021; 222:288-289. [DOI: 10.1016/j.amjsurg.2020.12.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 11/18/2022]
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Myers SP, Tzeng E, Downs-Canner SM. Addressing the Challenges Faced by Female Surgical Trainees Who Have Children During Protected Academic Periods. JAMA Surg 2021; 156:2778637. [PMID: 33852007 DOI: 10.1001/jamasurg.2021.0583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Sara P Myers
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Edith Tzeng
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Stephanie M Downs-Canner
- Department of Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
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