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Pershad AR, Kidwai MS, Lugo CA, Lee E, Tummala N, Thakkar P. Factors Influencing Underrepresented Medical Students' Career Choice in Surgical Subspecialties. Laryngoscope 2024; 134:1498-1506. [PMID: 37787431 DOI: 10.1002/lary.31094] [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] [Revised: 08/29/2023] [Accepted: 09/22/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVES Surgical subspecialties rank among the least racially and gender diverse of the medical specialties. The purpose of this systematic review is to evaluate the current factors that influence female, gender and sexual minority (GSM), and underrepresented in medicine (URiM)-identifying medical students' decision to pursue a career in a surgical subspecialty. DATA SOURCES A structured literature search of PubMed, Scopus, Web of Science, and Medline was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Criteria for eligibility included surveys and interviews assessing factors and barriers influencing underrepresented medical students' career choices. REVIEW METHODS Two independent researchers screened the articles' titles and abstracts for relevance; three performed full-text reviews. RESULTS Of 343 studies identified, 17 met the inclusion criteria. Fourteen (82%) were survey-based studies; three (18%) were qualitative interviews. Represented minorities included females (14), URiM (13), and GSM (4). Female medical students were most influenced by (1) exposure to surgery, (2) mentorship, and (3) surgical lifestyle. URiM medical students were most influenced by (1) mentorship, (2) culture and diversity, (3) research opportunities, and (4) personality fit. GSM medical students were most influenced by identity acceptance and instances of discrimination and bias. CONCLUSIONS Our review provides granular data on positive and negative factors influencing career choice among underrepresented medical students to facilitate the development of a more diverse surgical workforce. Female medical students were more positively influenced by increased exposure to surgical subspecialties, whereas URiM medical students were more positively influenced by race-concordant mentorship. Laryngoscope, 134:1498-1506, 2024.
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Affiliation(s)
- Alisha R Pershad
- Department of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Mohammad S Kidwai
- Department of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Ciara A Lugo
- Department of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Esther Lee
- Department of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Neelima Tummala
- Department of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Punam Thakkar
- Department of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Mason A, George Z, Khatskevich K, Gao X, Zwygart K, Gulick D. Matching Against Men: 5 Years of Residency Match Data Show Disparities Still Exist. South Med J 2024; 117:187-192. [PMID: 38569605 DOI: 10.14423/smj.0000000000001673] [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: 04/05/2024]
Abstract
OBJECTIVES Despite progress toward equal representation by sex in medical practice, women remain underrepresented in many specialties. This study sought to examine the current state of gender equality among recently graduated doctors in multiple specialties. METHODS Deidentified demographics, standardized examination scores, and Match results were gathered for 829 graduates. Participants were selected from an allopathic medical school between 2016 and 2020. Nineteen students (2.29%) were excluded from the study. Descriptive statistics were calculated, and χ2 tests for independence were used to compare proportions between reported sex and specialty and program Match results. One-way analysis of variance was then performed to test for differences in US Medical Licensing Examination Step 1 and Step 2 scores between sexes. P < 0.05 was considered statistically significant. RESULTS Of the 829 individuals studied, 44.6% were women. A significantly smaller proportion of women matched into the most competitive specialties, despite no significant difference in US Medical Licensing Examination Step 1 scores between sexes. Furthermore, there was an overall significant trend of women matching into more competitive programs for any given specialty. CONCLUSIONS In this study, we found that men matched into more highly competitive specialties, whereas women matched into more competitive residency program locations. Further research is needed to determine why women matched into specific specialties at lower rates than their male peers and seek to understand how sex affects the narrative of specialty choice.
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Affiliation(s)
- Ashley Mason
- From the University of South Florida Morsani College of Medicine, Tampa
| | - Zeegan George
- From the University of South Florida Morsani College of Medicine, Tampa
| | - Katsiaryna Khatskevich
- Department of Pathology and Laboratory Sciences, Medical University of South Carolina, Charleston
| | - Xiaoxiao Gao
- From the University of South Florida Morsani College of Medicine, Tampa
| | - Kira Zwygart
- Department of Family Medicine, University of South Florida Morsani College of Medicine, Tampa
| | - Danielle Gulick
- Department of Molecular Medicine, University of South Florida Morsani College of Medicine, Tampa
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Marr M, Bruinsma TJ, Spigner ST, Rojo J, Keyes T. Student-Led Webinar to Support LGBTQ+ Students Applying to Medical School During the COVID-19 Pandemic. JOURNAL OF HOMOSEXUALITY 2024; 71:1057-1070. [PMID: 36625541 PMCID: PMC10330930 DOI: 10.1080/00918369.2022.2160942] [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] [Indexed: 06/17/2023]
Abstract
Lesbian, gay, bisexual, transgender, queer, intersex, asexual, non-binary, two-spirit, and other (LGBTQ+) students are a diverse group with unique and frequently overlooked needs in medical training. The present study was designed to understand the concerns of LGBTQ+ applicants to medical school and examine the effectiveness of a webinar in alleviating concerns. Sixty participants joined webinars discussing the medical school application process with particular attention to concerns pertinent to the LGBTQ+ population. Pre and post surveys were administered to examine webinar effectiveness and participant concerns. Results were analyzed using quantitative and qualitative methods. Pre-medical students reported that the webinar format was helpful for their application process. Specifically, pre- and post-test analyses revealed that the webinar increased both students' preparedness as well as their confidence in disclosing their LGBTQ+ identity or being "out" when applying to medical school. Student-led, online webinars increase LGBTQ+ students' confidence and help address SGM students' concerns about applying to medical school.
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Affiliation(s)
- Mollie Marr
- Medical Scientist Training Program, Oregon Health & Science University, Portland, OR, USA
| | - T. J. Bruinsma
- Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - S. T. Spigner
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - J. Rojo
- School of Medicine, Saint Louis University, St. Louis, MO, USA
| | - T. Keyes
- Medical Scientist Training Program, Stanford University School of Medicine, Stanford, CA, USA
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Danckers M, Nusynowitz J, Jamneshan L, Shalmiyev R, Diaz R, Radix AE. The sexual and gender minority (LGBTQ+) medical trainee: the journey through medical education. BMC MEDICAL EDUCATION 2024; 24:67. [PMID: 38233849 PMCID: PMC10795322 DOI: 10.1186/s12909-024-05047-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024]
Abstract
In this literature overview, we share with the reader challenges faced by LGBTQ + individuals pursuing medical education, from undergraduate to postgraduate training. The LGBTQ + acronym has evolved to encompass the diverse spectrum of sexual orientation and gender identities. Recently, the term "Sexual and Gender Minority" (SGM) has emerged as an umbrella term to provide consistency in research advancing SGM health. The unique obstacles LGBTQ + trainees encounter are highlighted throughout this article, including external factors influencing career decisions, a lack of LGBTQ + healthcare curricula, discriminatory social interactions, limited mentorship opportunities, and a higher mental health burden. These challenges have the capacity to affect educational experiences, personal well-being, and professional growth. Additionally, we examine the impact of inclusive institutional climates on LGBTQ + trainees' selection of medical schools and residency programs, as they may prioritize inclusiveness and diversity when making their choice. In postgraduate training, LGBTQ + trainees continue to face challenges, exemplified by disparities in placement rates and discriminatory experiences based on sexual orientation and gender identity. We describe the gap in current research and its long-term impact of these challenges on career paths. Hostile environments persist in certain specialties, and the lack of LGBTQ + mentorship and support can hinder academic pursuits. We shed light on the unique and pervasive challenges faced by LGBTQ + trainees throughout their medical education journey, while emphasizing the need for inclusive policies, support systems, and research to address these challenges. With increasing research and studies, we hope to create a medical workforce and community that better represents the diverse communities it serves.
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Affiliation(s)
- Mauricio Danckers
- Division of Pulmonary and Critical Care Medicine, HCA Florida Aventura Hospital, Aventura, FL, USA.
| | - Jake Nusynowitz
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Lily Jamneshan
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Richard Shalmiyev
- Division of Pulmonary and Critical Care Medicine, HCA Florida Aventura Hospital, Aventura, FL, USA
| | - Raiko Diaz
- Division of Pulmonary and Critical Care Medicine, HCA Florida Aventura Hospital, Aventura, FL, USA
| | - Asa E Radix
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York City, New York, USA
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Macedo A, Aurindo M, Febra C. Effectiveness of undergraduate medical students training on LGBTQIA + people health: a systematic review and meta-analysis. BMC MEDICAL EDUCATION 2024; 24:63. [PMID: 38229060 DOI: 10.1186/s12909-024-05041-w] [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: 05/21/2023] [Accepted: 01/06/2024] [Indexed: 01/18/2024]
Abstract
BACKGROUND Adequacy of learning models and their ability to engage students and match session's objectives are critical factors in achieving the desired outcome. In this systematic review and meta-analysis, we assess the methodological approach, content, and effectiveness of training initiatives addressing medical students' knowledge, attitudes, confidence and discrimination perception towards LGBTQIA + people. METHOD PubMed, Web of Science, Medline and Scopus were searched to identify published studies, from 2013 to 2023, on effectiveness of training initiatives addressing medical students' knowledge, attitudes, confidence and discrimination perception towards LGBTQIA + people. The risk of bias of the selected studies was assessed by the Medical Education Research Study Quality Instrument. Overall effect sizes were calculated using a Mantel-Haenszel method, fixed effect meta-analyses. RESULTS A total of 22 studies were included, representing 2,164 medical students. The interventions were highly diverse and included seminars, lectures, videos, real-case discussions, roleplay, and group discussions with people from the LGBTQIA + community. After the interventions, there was a significant improvement in self-confidence and comfort interacting with patients and in the understanding of the unique and specific health concerns experienced by LGBTQIA + patients. CONCLUSION Our findings indicated that the outcomes of interventions training actions for medical students that promote knowledge and equity regarding LGBTQIA + people, regardless of their scope, methodology and duration, result in a considerable increase in students' self-confidence and comfort interacting with LGBTQIA + patients, highlight the need for more actions and programs in this area promoting a more inclusive society and greater equity.
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Affiliation(s)
- Ana Macedo
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, Edifício 2 - Ala Norte Campus de Gambelas, Faro, 8005-139, Portugal.
- ABC Clinical Reseach Center, Algarve Biomedical Center (ABC), Edifício 2 - Ala Norte Campus de Gambelas, Faro, 8005-139, Portugal.
| | - Maria Aurindo
- National Statistical institute of Portugal, Lisboa, Portugal
| | - Cláudia Febra
- Faculty of Medicine, University of Porto, Porto, Portugal
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Sorgini A, Istl AC, Downie ML, Kirpalani A. Pride & prejudice: A scoping review of LGBTQ + medical trainee experiences. MEDICAL TEACHER 2024; 46:73-81. [PMID: 37418565 DOI: 10.1080/0142159x.2023.2229503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
PURPOSE LGBTQ + medical trainees experience significant discrimination. These individuals are stigmatized within a hetero- and cis-normative system, resulting in poorer outcomes in mental health and increased stress regarding career trajectory compared with their hetero- and cis-identifying counterparts. However, literature on the barriers experienced during medical training in this marginalized group is limited to small heterogeneous studies. This scoping review collates and explores prominent themes in existing literature on the personal and professional outcomes of LGBTQ + medical trainees. METHODS We searched five library databases (SCOPUS, Ovid-Medline, ERIC, PsycINFO and EMBASE) for studies that investigated LGBTQ + medical trainees' academic, personal, or professional outcomes. Screening and full text review were performed in duplicate, and all authors participated in thematic analysis to determine emerging themes, which were iteratively reviewed to consensus. RESULTS From 1809 records, 45 met inclusion criteria (κ = 0.57). Major themes that emerged in the literature included the prevalence of discrimination and mistreatment faced by LGBTQ + medical trainees from colleagues and superiors, concerns regarding disclosure of sexual and/or gender minority identity, and overall negative impacts on mental health including higher rates of depression, substance use, and suicidal ideation. There was a noted lack of inclusivity in medical education and having an LGBTQ + identity had a large impact on career trajectory. Community with peers and mentors was an important determinant of success and belonging. There was a noteworthy lack of research on intersectionality or positive interventions that improved outcomes for this population. CONCLUSION This scoping review highlighted important barriers facing LGBTQ + medical trainees, identifying substantial gaps in the existing literature. Research on supportive interventions and predictors of training success is lacking and will be important to foster an inclusive education system. These findings provide critical insights for education leaders and researchers to help create and evaluate inclusive and empowering environments for trainees.
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Affiliation(s)
- Alana Sorgini
- Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Alexandra C Istl
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mallory L Downie
- Department of Renal Medicine, University College London, London, UK
- Department of Nephrology, Great Ormond Street Hospital NHS Trust, London, UK
| | - Amrit Kirpalani
- Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Division of Nephrology, Children's Hospital, London Health Sciences Centre, London, ON, Canada
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Stevens N. Thinking of Learning Communities? Here Are Some of the Ways They May Benefit Your Medical Students. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205231223303. [PMID: 38204975 PMCID: PMC10775716 DOI: 10.1177/23821205231223303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/07/2023] [Indexed: 01/12/2024]
Abstract
Learning communities are designed to bring together students, faculty, and potentially other healthcare professionals, to learn with and from each other formally in teaching activities but also in the social domain. In recent years, learning communities have gained some recognition as an effective educational strategy but their use is still not widely seen in all medical schools. Numerous benefits of learning communities have been reported and these include improved academic performance, enhanced critical thinking and problem-solving abilities, increased student confidence, and improved communication skills. Learning communities also provide opportunities for personal growth, mentorship, and self-reflection, all of which contribute to a students' professional development.
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Affiliation(s)
- Niall Stevens
- Department of Clinical Microbiology, RCSI Education & Research Centre, Beaumont Hospital, Dublin, Ireland
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Chugh PV, Pernar LI, Hess DT. Our Efforts to Create a Welcoming Surgical Residency for LGBTQ Trainees. JOURNAL OF SURGICAL EDUCATION 2023; 80:1614-1617. [PMID: 37455192 DOI: 10.1016/j.jsurg.2023.06.019] [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: 02/23/2023] [Revised: 05/14/2023] [Accepted: 06/17/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To provide a more welcoming environment for LGBTQ residents. DESIGN This paper is based upon the authors experience creating a training program welcoming to LGBTQ residents. SETTING University General Surgery Training Program. PARTICIPANTS Surgical Residents and Surgical Faculty. RESULTS Over a 9 year period, our residency has made intentional efforts to welcome LGBTQ applicants and support LGBTQ residents. We now have a residency in which over 25% of our residents identify as LGBTQ. CONCLUSIONS We see opportunities for other residencies to signal to applicants and trainees that they are welcome and celebrated for who they are.
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Affiliation(s)
- Priyanka V Chugh
- Boston University Chobanian & Avedesian School of Medicine, Department of Surgery, Boston, Massachusetts; Boston Medical Center, Department of Surgery, Boston, Massachusetts
| | - Luise I Pernar
- Boston University Chobanian & Avedesian School of Medicine, Department of Surgery, Boston, Massachusetts; Boston Medical Center, Department of Surgery, Boston, Massachusetts
| | - Donald T Hess
- Boston University Chobanian & Avedesian School of Medicine, Department of Surgery, Boston, Massachusetts; Boston Medical Center, Department of Surgery, Boston, Massachusetts.
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Torres Acosta MA, Chandra S, Li S, Yoon E, Selgrade D, Quinn J, Ardehali H. The impact of underrepresented minority or marginalized identity status on training outcomes of MD-PhD students. BMC MEDICAL EDUCATION 2023; 23:428. [PMID: 37291579 PMCID: PMC10251672 DOI: 10.1186/s12909-023-04399-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/25/2023] [Indexed: 06/10/2023]
Abstract
Dual-degree MD-PhD programs have historically lacked diversity of race, ethnicity, gender, sexual orientation, and other facets of identity. Like MD- and PhD-granting programs, MD-PhD program training environments are also marked by structural barriers that negatively impact measurable academic outcomes of underrepresented and/or marginalized students in academic medicine (racial and ethnic minority groups considered underrepresented by the National Institute of Health, sexual and gender minorities, individuals with disabilities, and individuals of low socioeconomic status). In this article, we review the existing literature on MD-PhD program disparities affecting students from these groups and provide recommendations grounded on the reviewed evidence. Our literature review identified four generalizable barriers that can impact the training outcomes of students from these marginalized and/or underrepresented groups: 1) discrimination and bias, 2) impostor syndrome and stereotype threat, 3) lack of identity-similar mentors, and 4) suboptimal institutional policies and procedures. We propose goal-oriented interventions that may begin to ameliorate the disparities present in MD-PhD program training environments that affect students from marginalized and/or underrepresented groups in academic medicine.
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Affiliation(s)
- Manuel A Torres Acosta
- Northwestern University's Medical Scientist Training Program, Northwestern University Feinberg School of Medicine, SQBRC 8-521, 303 E Superior Ave, Chicago, IL, 60611, USA.
- Northwestern University's Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
| | - Sidhanth Chandra
- Northwestern University's Medical Scientist Training Program, Northwestern University Feinberg School of Medicine, SQBRC 8-521, 303 E Superior Ave, Chicago, IL, 60611, USA
- The Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Sophia Li
- Northwestern University's Medical Scientist Training Program, Northwestern University Feinberg School of Medicine, SQBRC 8-521, 303 E Superior Ave, Chicago, IL, 60611, USA
- Northwestern University's Department of Biomedical Engineering, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Esther Yoon
- Northwestern University's Medical Scientist Training Program, Northwestern University Feinberg School of Medicine, SQBRC 8-521, 303 E Superior Ave, Chicago, IL, 60611, USA
- The Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Daniel Selgrade
- Northwestern University's Medical Scientist Training Program, Northwestern University Feinberg School of Medicine, SQBRC 8-521, 303 E Superior Ave, Chicago, IL, 60611, USA
- Northwestern University's Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Jeanne Quinn
- Northwestern University's Medical Scientist Training Program, Northwestern University Feinberg School of Medicine, SQBRC 8-521, 303 E Superior Ave, Chicago, IL, 60611, USA
- Northwestern University's Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Hossein Ardehali
- Northwestern University's Medical Scientist Training Program, Northwestern University Feinberg School of Medicine, SQBRC 8-521, 303 E Superior Ave, Chicago, IL, 60611, USA.
- The Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
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Rosecrance K, Archibald A, Victor R, Lasso ET, Nore C, Barrios C. Medical Student Perspectives on Sexual and Gender Minority Acceptance in Surgical Specialties and Sexual and Gender Minority Education. J Surg Res 2023; 289:121-128. [PMID: 37099822 DOI: 10.1016/j.jss.2023.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/15/2023] [Accepted: 03/19/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND The topics of healthcare for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) patients and inclusion of LGBTQ+ health providers remain overlooked. Some specialties may be perceived as less inclusive to LGBTQ+ trainees. This study aimed to describe the perspectives of current medical students regarding LGBTQ+ education and the acceptance of LGBTQ+ trainees among different specialties. MATERIALS AND METHODS A cross-sectional voluntary and anonymous online survey was distributed through REDCap to all medical students (n = 495) at a state medical school. Medical students' sexuality and gender identity were queried. A descriptive statistical analysis was performed, and the responses were classified into two groups: LGBTQ+ and non-LGBTQ+. RESULTS A total of 212 responses were queried. Of the respondents who agreed that certain specialties are less welcoming to LGBTQ+ trainees (n = 69, 39%), orthopedic surgery, general surgery and neurosurgery were identified most frequently (84%, 76%, and 55%, respectively). After analyzing sexual orientation as an influence on choosing a future specialty for residency, only 1% of non-LGBTQ+ students indicated that their sexual orientation influences their specialty of choice in comparison with 30% of LGBTQ+ students (P < 0.001). Finally, more non-LGBTQ+ students indicated that they believe they are receiving appropriate education on caring for LGBTQ+ patients as compared to LGBTQ+ students (71% and 55%, respectively, P < 0.05). CONCLUSIONS LGBTQ+ students are still hesitant to pursue careers in General Surgery as compared to their non-LGBTQ+ peers. The perception that surgical specialties are the least welcoming to LGBTQ+ students continues to be a concern for all students. Further strategies of inclusivity and their effectiveness need to be studied.
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Affiliation(s)
| | - Abigail Archibald
- School of Medicine, University of California, Irvine, Irvine, California
| | - Robert Victor
- School of Medicine, University of California, Irvine, Irvine, California
| | - Erika Tay Lasso
- Department of Surgery, University of California, Irvine, Irvine, California
| | - Caroline Nore
- School of Medicine, University of California, Irvine, Irvine, California
| | - Cristobal Barrios
- School of Medicine, University of California, Irvine, Irvine, California; Department of Surgery, University of California, Irvine, Irvine, California
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Tjoeng YL, Myers C, Irving SY, Esangbedo I, Wheeler D, Musa N. The Current State of Workforce Diversity and Inclusion in Pediatric Critical Care. Crit Care Clin 2023; 39:327-340. [PMID: 36898777 DOI: 10.1016/j.ccc.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Literature suggests the pediatric critical care (PCC) workforce includes limited providers from groups underrepresented in medicine (URiM; African American/Black, Hispanic/Latinx, American Indian/Alaska Native, Native Hawaiian/Pacific Islander). Additionally, women and providers URiM hold fewer leadership positions regardless of health-care discipline or specialty. Data on sexual and gender minority representation and persons with different physical abilities within the PCC workforce are incomplete or unknown. More data are needed to understand the true landscape of the PCC workforce across disciplines. Efforts to increase representation, promote mentorship/sponsorship, and cultivate inclusivity must be prioritized to foster diversity and inclusion in PCC.
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Affiliation(s)
- Yuen Lie Tjoeng
- Division of Pediatric Critical Care, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way Northeast M/S RC.2.820, Seattle, WA 98105, USA.
| | - Carlie Myers
- Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati, 3333 Burnet Avenue, Location G, Cincinnati, OH 45229, USA
| | - Sharon Y Irving
- Department of Family and Community Health, Children's Hospital of Philadelphia, University of Pennsylvania School of Nursing, 418 Curie Boulevard, Office 415, Philadelphia, PA 19104, USA; Department of Nursing and Clinical Services, Critical Care, Philadelphia, PA, USA
| | - Ivie Esangbedo
- Division of Pediatric Critical Care, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way Northeast M/S RC.2.820, Seattle, WA 98105, USA
| | - Derek Wheeler
- Division of Critical Care, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box 1, Chicago, IL 60611, USA
| | - Ndidiamaka Musa
- Division of Pediatric Critical Care, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way Northeast M/S RC.2.820, Seattle, WA 98105, USA
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Reece-Nguyen TL, Tollinche L, Van Rooyen C, Roque RA. Current challenges faced by transgender and gender-diverse patients and providers in anesthesiology. Int Anesthesiol Clin 2023; 61:26-33. [PMID: 36480647 DOI: 10.1097/aia.0000000000000384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Travis L Reece-Nguyen
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, California
| | - Luis Tollinche
- Department of Anesthesiology, MetroHealth Medical Center of Case Western Reserve University, Cleveland, Ohio
| | - Christian Van Rooyen
- Department. of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington
| | - Remigio A Roque
- Department. of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington
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13
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Qu R, Ding N, Li H, Song X, Cong Z, Cai R, Zhu Y, Wen D. The mediating role of general academic emotions in burnout and procrastination among Chinese medical undergraduates during the COVID-19 pandemic: A cross-sectional study. Front Public Health 2022; 10:1011801. [PMID: 36544803 PMCID: PMC9760956 DOI: 10.3389/fpubh.2022.1011801] [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: 08/04/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022] Open
Abstract
Background Academic procrastination has become more prevalent during the COVID-19 pandemic due to teaching/learning changes. This phenomenon induces academic burnout, which is already serious among medical students. However, the academic emotion, which is the factor most vulnerable to changes in the academic environment, is still unknown. Therefore, the current study aimed to investigate the mediating role of general academic emotions in procrastination and burnout among Chinese medical students during the COVID-19 pandemic. Methods This cross-sectional study enrolled 995 medical students from China Medical University. We applied the Chinese version of the Maslach Burnout Inventory Student Survey (MBI-SS), the Aitken Procrastination Inventory (API) and the General Academic Emotion Questionnaire for College Students (GAEQ) to evaluate the variables of interest. We examined the mediation effects of GAEs by hierarchical linear regression analysis. Results Correlation analyses showed a significant positive correlation between procrastination and burnout. Procrastination and burnout positively and negatively correlated with negative academic emotions, respectively. Hierarchical linear regression analyses showed that procrastination had positive associations with negative academic emotions, while it had negative associations with positive academic emotions. The contributions (as mediators) of GAEs to burnout and procrastination were 21.16% (NAEs), 29.75% (PAEs), 54.25% (NDEs) and 23.69% (PDEs). Conclusions The results indicate that academic emotions had mediating effects on procrastination and burnout. Medical students' worries about the uncertainty of the learning environment may have exacerbated academic burnout. Targeted improvements in the teaching environment to communicate encouragement and reduce anxiety and helplessness among medical undergraduates for implementing medical education while preventing and controlling the infection.
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Affiliation(s)
- Ruoyi Qu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Ning Ding
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Xinzhi Song
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Zhangzhao Cong
- Department of Teaching Affairs, China Medical University, Shenyang, China
| | - Ruoxin Cai
- The First Clinical Department, China Medical University, Shenyang, China
| | - Yaxin Zhu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China,*Correspondence: Deliang Wen
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14
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Maru JA, Carvajal ND, de Alba Campomanes AG, Parikh N, Ashraf DC, Kersten RC, Winn BJ, Vagefi MR, Grob SR. Perceived Barriers to Increasing Diversity within Oculofacial Plastic Surgery. JOURNAL OF ACADEMIC OPHTHALMOLOGY 2022. [DOI: 10.1055/s-0042-1758561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Abstract
Purpose Physician diversity is limited in ophthalmology and oculofacial plastic surgery. Determination of barriers within the application process for oculofacial plastic surgery may help target efforts to improve the recruitment of underrepresented groups. This study aimed to illuminate perceived barriers to increasing diversity in oculofacial plastic surgery trainees, according to the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) fellows and fellowship program directors (FPDs).
Methods During the month of February 2021, we sent surveys out to 54 current oculofacial plastic surgery fellows and 56 FPDs at 56 oculofacial plastic surgery programs recognized by the ASOPRS nationwide using a 15-question Qualtrics survey.
Results Sixty-three individuals (57%) responded to the survey: 34 fellows (63%) and 29 FPDs (52%). Eighty-eight percent of fellows and 68% of FPDs identified as non-underrepresented in medicine (UiM). Forty-four percent of fellows and 25% of FPDs identified as men. FPDs most commonly noted, “Not enough minorities applying to our program” and “The objective data (Ophthalmic Knowledge Assessment Program score, United States Medical Licensing Examination Step scores, clinical honors, Alpha Omega Alpha status, letter of recommendation) for minority applicants often do not meet the threshold required to offer an interview or to be ranked to match” as barriers. Among fellows, the lowest-rated considerations when applying to oculofacial plastic surgery were “Racially/ethnically diverse faculty” and “Perceptions of minority candidates by fellowship programs,” whereas “Likelihood of matching in program of choice” was ranked highest in considerations. Fellows identifying as men indicated greater concern for “Financial factors related to fellowship (e.g., loans, salary, cost of living, or cost of interviewing)” compared to fellows identifying as women who noted greater concern for “Program or preceptor acceptance of starting or having a family during fellowship.”
Conclusion Responses from FPDs suggest that efforts focused on recruiting and supporting diverse students to medicine and ophthalmology, mentoring applicants interested in oculofacial plastic surgery, and restructuring the application process to decrease bias, may improve diversity within the subspecialty. The lack of UiM representation in this study, 6% fellows and 7.4% FPDs identified as UiM, shows both the stark underrepresentation and the need for further research into this topic.
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Affiliation(s)
- Johsias A. Maru
- School of Medicine, University of California, San Francisco, San Francisco, California
| | - Nicole D. Carvajal
- School of Medicine, University of California, San Francisco, San Francisco, California
| | | | - Neeti Parikh
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Davin C. Ashraf
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Robert C. Kersten
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Bryan J. Winn
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
- Ophthalmology Section, Surgical Service, San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - M. Reza Vagefi
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Seanna R. Grob
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
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15
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Esparza CJ, Simon M, Bath E, Ko M. Doing the Work—or Not: The Promise and Limitations of Diversity, Equity, and Inclusion in US Medical Schools and Academic Medical Centers. Front Public Health 2022; 10:900283. [PMID: 35812485 PMCID: PMC9256912 DOI: 10.3389/fpubh.2022.900283] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/26/2022] [Indexed: 12/26/2022] Open
Abstract
While the number of positions, committees, and projects described as “Diversity, Equity, and Inclusion (DEI)” work has grown rapidly in recent years, there has been little attention to the theory, praxis, or lived experience of this work. In this perspective, we briefly summarize the research and concepts put forth by DEI leaders in higher education more broadly, followed by an analysis of the literature's application to academic medicine. We then discuss the ways in which language obscures the nature of DEI and the necessity of scholarship to evaluate the extensive range of practices, policies, statements, and programs the label is given to.
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Affiliation(s)
- Caitlin Jade Esparza
- School of Medicine, University of California, Davis, Sacramento, CA, United States
- *Correspondence: Caitlin Jade Esparza
| | - Mark Simon
- Storywalkers Consulting, Davis, CA, United States
| | - Eraka Bath
- The Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, United States
| | - Michelle Ko
- Division of Health Policy and Management, Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
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16
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Pernar LI, Hess DT. Creating a Welcoming Surgery Residency Training Program for LGBTQ Trainees. Am Surg 2022; 88:2796-2801. [PMID: 35538707 DOI: 10.1177/00031348221101582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
General Surgery residencies have been perceived as unwelcoming to lesbian, gay, bisexual, transgender, and queer (LGBTQ) applicants. Historically, applicants have been reluctant to reveal their LGBTQ status when interviewing for residency positions and LGBTQ surgery residents are more likely to consider leaving their residency. Despite the increased acceptance in society and calls for diversity by governing bodies, there is a perception that the field of surgery is lagging behind. In this article, we summarize the recent literature concerning LGBTQ status in surgery residencies and the impact it has on students and trainees. We then review the recent calls to action to remedy the identified shortcomings. We then share what has been done by our surgery residency, which has been successful in recruiting LGBTQ-identifying residents and summarize recommendation for moving forward.
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Affiliation(s)
- Luise I Pernar
- 1846Boston University School of Medicine, Boston, MA, USA.,Department of Surgery, Boston Medical Center, Boston, MA, USA
| | - Donald T Hess
- 1846Boston University School of Medicine, Boston, MA, USA.,Department of Surgery, Boston Medical Center, Boston, MA, USA
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17
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Ryus CR, Samuels EA, Wong AH, Hill KA, Huot S, Boatright D. Burnout and Perception of Medical School Learning Environments Among Gay, Lesbian, and Bisexual Medical Students. JAMA Netw Open 2022; 5:e229596. [PMID: 35486396 PMCID: PMC9055452 DOI: 10.1001/jamanetworkopen.2022.9596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE The perspectives of gay, lesbian, bisexual (sexual minority [SM]) students about their medical school learning environment and how they relate to burnout is poorly understood. OBJECTIVE To understand SM medical students' perceptions of the medical school learning environment and how this is associated with reported burnout. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included medical students graduating from Association of American Medical Colleges (AAMC)-accredited allopathic US medical schools in 2016 and 2017 and responding to the AAMC Graduation Questionnaire. Data analysis was conducted from June 2021 to March 2022. EXPOSURES Sexual orientation, based on self-identification, and categorized as bisexual, gay or lesbian, or heterosexual or straight. MAIN OUTCOMES AND MEASURES Primary outcomes included burnout as measured by Oldenburg Burnout Inventory for Medical Students (OLBI-MS; two 24-point scales [range, 0-48], with higher scores indicating greater burnout) and student perceptions of the medical school learning environment (0-5-point scales for emotional climate [range, 0-20] and student-faculty interactions [range, 0-15], with higher scores indicating more positive perceptions). Logistic regression was used to model the association between burnout, SM status, and learning environment while controlling for demographic characteristics. RESULTS A total of 25 757 respondents (12 527 [48.6%] women; 5347 [20.8%] Asian; 2255 [8.8%] underrepresented in medicine; 15 651 [60.8%] White; 10 726 [41.6%] aged ≤26 years) were included in the analysis: 568 (2.2%) self-identified as bisexual, 854 (3.3%) as gay or lesbian, and 24 335 (94.5%) as heterosexual or straight. Both bisexual students and gay or lesbian students reported less favorable perceptions of their learning environments than heterosexual students (mean [SD] emotional climate score, bisexual students: 8.56 [3.29]; gay or lesbian students: 9.22 [3.33]; heterosexual or straight students: 9.71 [3.20]; P < .001; mean [SD] faculty-student interaction score, bisexual students: 13.46 [3.69]; gay or lesbian students: 14.07 [3.45]; heterosexual or straight students: 14.32 [3.37]; P < .001). Bisexual and gay or lesbian students were more likely to be in the top quartile for burnout scores (bisexual: odds ratio [OR], 1.71; 95% CI, 1.42-2.07; P < .001; gay or lesbian: OR, 1.53; 95% CI, 1.31-1.79; P < .001). This association was attenuated when accounting for student perceptions of the learning environment (bisexual: OR, 1.37; 95% CI, 1.11-1.67; P < .001; gay or lesbian: OR, 1.42; 95% CI, 1.19-1.68; P < .001), with poorer perceptions of the medical school learning environment associated with higher burnout symptoms. CONCLUSIONS AND RELEVANCE In this cross-sectional study, SM students had less favorable perceptions of the medical school learning environment compared with heterosexual students. Results suggest the medical school environment may be associated with higher rates of burnout in SM students. Future research should explore interventions to improve the learning environment for SM students.
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Affiliation(s)
- Caitlin R. Ryus
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Elizabeth A. Samuels
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Ambrose H. Wong
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | | | - Stephen Huot
- Office of Graduate Medical Education, Yale School of Medicine, New Haven, Connecticut
| | - Dowin Boatright
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
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Campbell-Montalvo R, Malaykhan M, Smith CAS, Hughes Miller M, Puccia E, Mayberry M, Skvoretz J, Wao H. Sexual and gender minority undergraduates' relationships and strategies for managing fit in STEM. PLoS One 2022; 17:e0263561. [PMID: 35298464 PMCID: PMC8929613 DOI: 10.1371/journal.pone.0263561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 01/22/2022] [Indexed: 11/19/2022] Open
Abstract
Undergraduates with sexual and/or gender minority (SGM) identities, including lesbian, gay, bisexual, transgender, queer/questioning, pansexual, intersexual, asexual, or additional positionalities, often face an unwelcoming STEM microclimate. The STEM microclimate includes the places students experience, such as classrooms or labs, and the people, such as peers or professors, with whom they discuss their STEM program. While previous work offers a framework of microaggressions faced by SGM people, and the behavioral, cognitive, and emotional strategies they use to react to them, little is known about the strategies SGM students use to persist in the STEM microclimate. We analyze interviews with 29 SGM STEM undergraduates to uncover how they fit in STEM, their experiences that affect fit, how social capital in the form of influential others affects fit, and the strategies used to deal with microaggressions and cultivate a supportive network. Using thematic analysis, we find that students vary in their feelings of fit, with students with gender minority identities experiencing more frequent and more severe microaggressions than students with sexual minority identities (which are often less visible). We likewise find that students with racial minority identities report compounding issues related to identity. SGM students with social capital, or a network of people to whom they can turn in order to access advice and resources, believe they fit in better than those without such capital. To support their feelings of fit, students use defenses against discrimination, including micro-defenses, wherein they change how they present their self to avoid microaggressions and/or surround themselves with accepting people. This research highlights the role of microaggressions and social capital in affecting fit as well as the micro-defenses students use to defend against discrimination. Our introduction of the concept of micro-defenses provides a way to theorize about micro-interactional dynamics and the site at which students defend against microaggressions so they feel more welcome in STEM. Implications provide insight into how SGM students can be supported in STEM as well as the institutional changes STEM departments and campuses can make in order to better support and include SGM students.
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Affiliation(s)
- Rebecca Campbell-Montalvo
- Department of Curriculum and Instruction, Neag School of Education, University of Connecticut, Storrs, Connecticut, United States of America
| | - Mya Malaykhan
- Department of Curriculum and Instruction, Neag School of Education, University of Connecticut, Storrs, Connecticut, United States of America
| | - Chrystal A. S. Smith
- Department of Anthropology, University of Connecticut, Storrs, Connecticut, United States of America
| | - Michelle Hughes Miller
- Department of Women and Gender Studies, University of South Florida, Tampa, Florida, United States of America
| | - Ellen Puccia
- Beta Research Associates, Inc., Palmetto, Florida, United States of America
| | - Maralee Mayberry
- Department of Sociology, University of South Florida, Tampa, Florida, United States of America
| | - John Skvoretz
- Department of Sociology, University of South Florida, Tampa, Florida, United States of America
| | - Hesborn Wao
- Department of Curriculum and Instruction, Neag School of Education, University of Connecticut, Storrs, Connecticut, United States of America
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