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Walter S, Murrell DF. Gender equity in academic dermatology: Problems aplenty, yet paths ahead. J Eur Acad Dermatol Venereol 2024; 38:1504-1513. [PMID: 38606617 DOI: 10.1111/jdv.20027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/13/2024] [Indexed: 04/13/2024]
Abstract
Efforts to achieve gender equity of health professionals should be a priority in all fields of medicine, including academic dermatology. This review aimed, first, to summarize available evidence about the status of gender equity in various domains of academic dermatology-headship positions, salary, editor and editorial board appointments, publications, conference presentations, receipt of research grants and academic prizes-second, to identify challenges to achieving gender equity and, third, to articulate the components of a multifaceted strategy for gender parity. A variety of databases were searched. Manual searching of reference lists and searching of grey literature were also undertaken. It was found that, despite improvements in some domains, the gender inequity persists in all of the above-mentioned areas of academic dermatology. Challenges to achieve gender parity include time in pregnancy, disproportionate participation in childrearing and domestic tasks compared with men, suboptimal legislation in many jurisdictions for parenting and childcare leave, and unconscious biases about women. Elements of a multipronged approach include strengthening women's dermatology societies that advocate for women in academia; celebrating the careers of distinguished female academic dermatologists; mentoring; promoting leadership courses; striving for a greater representation of women among editors-in-chief, authors, and conference presenters, among others; seeking better pay, leave conditions and other work entitlements; conducting high-quality research about gender inequity in academic dermatology; imposing sanctions for violations of gender equity; supporting dermatologists' health; and learning from the experience of other fields of academic medicine.
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Affiliation(s)
- Sophie Walter
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia
| | - Dedee F Murrell
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia
- The George Institute of Global Health, Sydney, New South Wales, Australia
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Li C, Veinot P, Mylopoulos M, Leung FH, Law M. The new mentee: Exploring Gen Z women medical students' mentorship needs and experiences. CLINICAL TEACHER 2024; 21:e13697. [PMID: 38050710 DOI: 10.1111/tct.13697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 10/16/2023] [Indexed: 12/06/2023]
Abstract
PURPOSE The incoming Canadian cohort of medical students is comprised mainly of individuals from Generation Z (Gen Z; born between 1997 and 2012), with greater than 50% of applicants identifying as female. A gap remains in our understanding of Gen Z women learners in their challenges in navigating medical education, their expectations for their medical careers and the influences that have impacted their worldview. This study explored the needs, values, and experiences of Gen Z women medical students and the impact of these factors on mentorship expectations among this population that will soon be entering the workforce. METHODS Upon receiving ethics approval from the University of Toronto Research Ethics Board, semi-structured interviews were conducted (February-May 2021) with 15 Gen Z women students from 14 English-speaking Canadian medical schools who had given written consent to participate. An iterative constant comparative team approach was utilised in which the interview guide and sampling were adjusted as the data evolved. Transcripts were line by line coded into categories, then grouped into themes using descriptive analysis. RESULTS These socially aware learners described how society had afforded them greater opportunities for expression, which gave them a sense of feeling advantaged over older generations. However, participants paradoxically expressed feelings of powerlessness and commented on tensions they experienced when interacting with older generation physician mentors, especially during conversations on social justice issues. They also highlighted instances of biased mentorship specific to their gender. Participants emphasised a desire for inclusive mentorship that considered the mentee's identity and intersectionality. CONCLUSIONS The growing number of women learners in Canadian medical schools necessitates a re-evaluation of mentorship delivery. Mentors must adapt by integrating Gen Z ideals to overcome mentorship challenges.
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Affiliation(s)
- Calandra Li
- Postgraduate Medical Education, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | | | - Maria Mylopoulos
- MD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- The Wilson Centre, University of Toronto, Toronto, Canada
| | - Fok-Han Leung
- MD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Marcus Law
- MD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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Gulati K, Davies J, Gonzalez de la Fuente A, Singh AR. Striving for equity: exploring gender-inclusive medical leadership in India. BMJ LEADER 2024:leader-2023-000970. [PMID: 38443152 DOI: 10.1136/leader-2023-000970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 02/22/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION There is a notable gap in studies examining the impact of gender within sociocultural norms in non-western professional settings, especially concerning the well-being of women physicians. METHODS Using purposive sampling and thematic data analysis, we recorded interviews with 30 physicians in India during May-July 2023. Participants were aged 34 to 65 years, with experience ranging from five to 35 years, in various clinical (37%), surgical (30%), paraclinical (23%) and hospital administration (10%) roles, 97% were postgraduates and 53% were women. The research questions explored how leadership roles happened, managing key challenges, barriers and enablers, and practical interventions to support women into medical leadership positions. RESULTS Findings revealed that the majority of interviewees believed gender-related barriers were obstructing women's progress and success in medical leadership roles in India. These barriers were identified within three overarching domains: (1) specialty, (2) organisational and (3) sociocultural. Interviewees commonly acknowledged the male-dominated landscape of medical leadership although some women stated that they did not perceive any barriers for women's advancement into leadership roles. Interestingly, some men surgeons held the perception that women might not be as effective in certain surgical disciplines, such as orthopaedics and neurosurgery. Some men physicians, however, considered women physicians in India to be highly effective multitaskers. CONCLUSION We recommend structural reforms in medical education, leadership development, workplace systems and cultures, and improved implementation of equality, diversity and inclusion policies in the Indian context.
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Affiliation(s)
- Kamal Gulati
- Centralized Core Research Facility, All India Institute of Medical Sciences, New Delhi, India
| | - Julie Davies
- Global Business School for Health, University College London, London, UK
| | | | - Angel Rajan Singh
- Hospital Administration, All India Institute of Medical Sciences, New Delhi, India
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Sanghavi RM, Nurko S, Silver JK, Rosen R. Award Recipients for Pediatric Gastroenterology: A Descriptive Analysis of Gender Distribution. J Pediatr Gastroenterol Nutr 2023; 77:e99-e103. [PMID: 37319106 DOI: 10.1097/mpg.0000000000003863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Society awards are an important component of recognition in medicine and for career advancement such as promotion. Multiple studies conducted in pediatrics and gastroenterology have shown underrepresentation of women awardees even in fields with a higher proportion of women than men. To our knowledge, no such studies have been conducted in pediatric gastroenterology. We hypothesized that among all recipients, women would be underrepresented when compared to men and that women were more likely to be given teaching awards compared to other career achievement awards. We collected data on recipients of major recognition award presented by The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition from 1987 to 2022. We found that 80.90% of the awards had been given to men and that most nominators were men. This study highlights inequities in women recipients for major awards and presents an opportunity for a call for action to examine and address the factors contributing to this gender inequity.
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Affiliation(s)
- Rinarani M Sanghavi
- From the Department of Pediatrics, Division of Pediatric Gastroenterology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Samuel Nurko
- the Division of Gastroenterology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Julie K Silver
- the Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
- the Massachusetts General Hospital, Boston, MA
- the Brigham and Women's Hospital, Boston, MA
- Spaulding Rehabilitation Hospital, Boston, MA
| | - Rachel Rosen
- the Division of Gastroenterology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
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Cohen A, Alter R, Meyer R, Guigue PA, Levin G. Gender leadership in gynecologic oncology professional societies worldwide. Int J Gynaecol Obstet 2023; 163:154-157. [PMID: 37218436 DOI: 10.1002/ijgo.14890] [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: 11/22/2022] [Revised: 04/22/2023] [Accepted: 05/09/2023] [Indexed: 05/24/2023]
Abstract
OBJECTIVE We aim to study gender representation among the different national gynecologic oncology (GO) societies' presidents over the past decade. METHODS A cross-sectional study examining the period 2013-2022. The leadership positions in 11 GO societies in the USA (SGO), internationally (IGCS), Europe (ESGO), Australia (ASGO), Israel (ISGO), Japan (JSGO), Asia-Oceania (AOGIN), India (INSGO), Latin America (SLAGO), South Africa (SASGO), and Turkey (TRSGO) was studied. The proportion of leadership positions held by women was calculated and trends were evaluated. RESULTS Overall, the average rate of women's representation during the study period was 26.4%, and for the different organizations was: SASGO 70.0%, SGO 50.0%, ESGO 40.0%, ASGO 30.0%, INSGO 30.0%, and IGCS, ISGO, and SLAGO 20.0% each, TRSGO 10%, and no representation of women in JSGO and AOGIN. There was a significant decrease from 2013 to 2016 (63.6% to 9.1%) (P = 0.009) in women's representation as presidents of societies. From 2017 to 2022, there was no difference in women's representation (ranging from 9.1% to 36.4%) (P = 0.13). CONCLUSIONS This study demonstrates that women are significantly under-represented in leadership positions in GO professional societies; however, in South Africa and the USA their representation in the last decade was close to equality.
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Affiliation(s)
- Adiel Cohen
- Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Roie Alter
- Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Raanan Meyer
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat-Gan, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | | | - Gabriel Levin
- Department of Gynecologic Oncology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Lady Davis Institute for Cancer Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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Yin C, McAuliffe PB, Liao CD, Marquez JE, Monroig KG, Hanson OL, Shroyer ALW, Huston TL, Khan SU. Has the Increase of Women in Surgical Training Programs Led to a Concomitant Increase in Female Leadership Positions? A 10-Year Analysis. Ann Plast Surg 2023; 90:376-379. [PMID: 37093772 DOI: 10.1097/sap.0000000000002807] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Women represent greater than 50% of medical students in America and are becoming increasingly well represented in surgical fields. However, parity at the trainee level has yet to be accomplished, and surgical leadership positions have remained disproportionately biased toward men. To date, there have been no comparisons on the progress within plastic surgery and other surgical specialties. This investigates the gender disparity in resident and leadership representation over the past 10 years within surgical specialties and how these disparities compare to plastic surgery. METHODS Counts of female and male residents and surgical society leaders were collected from 2008 to 2018. Surgical fields included plastic, vascular, urologic, neurologic, orthopedic, cardiothoracic, and general surgery. Leadership positions were defined as board seats on executive committees of major surgical societies or board associations. Data were acquired from publicly available sources or provided directly from the organizations. Resident data were obtained from the Accreditation Council of Graduate Medical Education residents' reports. Individuals holding more than 1 leadership position within a year were counted only once. RESULTS In our aggregated analysis, the proportion of women in surgical leadership lags behind women in surgical residency training across all specialties (13.2% vs 27.3%, P < 0.01). General surgery had the highest proportion of female residents and leaders (35% and 18.8%, P < 0.01), followed by plastic (32.2% and 17.3%, P < 0.01), vascular (28.2% and 11.3%, P < 0.01), urologic (24.3% and 5.1%), and cardiothoracic surgery (20.5% and 7.8%, P < 0.01). Women in surgical leadership, however, increased at a faster rate than women in surgical training (11% vs 7%, P < 0.05). Plastic surgery showed the greatest rate of increase in both residents and leaders (17% and 19%, P < 0.05) followed by cardiothoracic surgery (16% and 9%, P < 0.05) and general surgery (8% and 14%, P < 0.05). For neurologic and orthopedic surgery, neither the difference in proportions between residents and leaders nor the yearly growth of these groups were significant. CONCLUSIONS Between 2008 and 2018, women in plastic surgery training and leadership positions have shown the most significant growth compared with other surgical subspecialties, demonstrating a strong concerted effort toward gender equality among surgical professions.
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Affiliation(s)
- Christine Yin
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY
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Lee A, Kuczmarska-Haas A, Dalwadi SM, Gillespie EF, Ludwig MS, Holliday EB, Chino F. Family Planning, Fertility, and Career Decisions Among Female Oncologists. JAMA Netw Open 2022; 5:e2237558. [PMID: 36315148 PMCID: PMC9623435 DOI: 10.1001/jamanetworkopen.2022.37558] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
IMPORTANCE Female oncologists often spend their childbearing years in training and establishing careers, with many later experiencing fertility issues when starting a family. Physician fertility and family planning are rarely discussed during training. Attitudes among female oncologists regarding family planning are unknown. OBJECTIVES To understand barriers to family planning as well as the association of fertility treatment with career decisions and to assess experiences of pregnancy-based discrimination among female oncologists. DESIGN, SETTING, AND PARTICIPANTS In this survey study, a novel 39-item questionnaire was distributed to US female oncologists from May 7 to June 30, 2020, via email and social media channels. Questions regarding factors associated with family planning, maternity leave, and discrimination were included. MAIN OUTCOMES AND MEASURES The distribution of survey responses was compared by oncology subspecialty. Multivariable logistic regression was performed to determine independent variables for discrimination experienced during maternity leave. RESULTS Responses were collected from 1004 female oncologists. Most respondents (847 [84.4%]) were married, and 713 (71.0%) were currently working full-time. A total of 351 oncologists (35.0%) worked in radiation oncology, 344 (34.3%) in medical oncology, 186 (18.4%) in surgical oncology, and 91 (9.1%) in pediatric oncology. A total of 768 respondents (76.5%) had children, and of these, 415 (41.3%) first gave birth during postgraduate training, and 275 (27.4%) gave birth in years 1 to 5 as an attending physician. Almost all respondents (951 [94.7%]) stated that their career plans were at least somewhat associated with the timing of when to start a family. Having a supportive partner was the most commonly cited positive association with family planning (802 [79.9%]), while long work hours and heavy workload (669 [66.6%]) were the most common negative factors. One-third (318 [31.7%]) had miscarried, and 315 (31.4%) reported difficulty with infertility that required fertility counseling and/or treatment; 660 (65.7%) thought fertility preservation should be discussed with women during medical school and/or residency. One-third (312 [31.1%]) reported experiencing discrimination during pregnancy, and 332 (33.1%) stated they experienced discrimination for taking maternity leave. On multivariable logistic regression, having more than 1 child was associated with increased likelihood of experiencing discrimination during maternity leave (2 children: odds ratio, 1.62 [95% CI, 1.10-2.39]; P = .02; ≥3 children: odds ratio, 1.84 [95% CI, 1.14-2.95; P = .01). CONCLUSIONS AND RELEVANCE In this survey study of female oncologists, 1 in 3 reported experiencing infertility and 1 in 3 stated they experienced discrimination during pregnancy and/or for taking maternity leave. Systemic changes are necessary to ensure women are supported and able to advance equitably in the field.
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Affiliation(s)
- Anna Lee
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston
| | | | - Shraddha M. Dalwadi
- Department of Radiation Oncology, University of Texas Health Science Center, MD Anderson Mays Cancer Center, San Antonio
| | - Erin F. Gillespie
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michelle S. Ludwig
- Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas
| | - Emma B. Holliday
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - Fumiko Chino
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
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Hitti E, Hadid D, Khoury SJ, Tamim H, Makki M, Karam CM. Domestic tethers: Gender differences in career paths and domestic responsibilities of top-research medical school graduates. PLoS One 2022; 17:e0267288. [PMID: 35442989 PMCID: PMC9020711 DOI: 10.1371/journal.pone.0267288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/05/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Gendered differences in career paths of medical graduates persist globally. We aim to explore the impact of domestic tethers on the career paths of physicians by studying gendered differences in domestic burdens of physicians as well as differences in perceptions around the impact of domestic work on professional advancement. Methods A web-based survey including 38 questions was sent to all 3866 physician alumni of the top academic medical school in Lebanon. Data was collected between November 2018 and January 2019, with up to three invite reminders. Overall, 382 were included in the final analysis, 124 women (32%), 258 men (68%). Results The study had a response rate of 10.4%. Findings show that a greater percentage of men were married and had children (77.5% vs 62.1%, p = 0.004, 77.9% vs 51.6%, <0.001, respectively). Majority of both women and men held full-time positions (82.1% and 87.1%), having children however reduced the odds significantly [OR = 0.2, 95% CI: (0.1–0.6), p = 0.01]for women, while only older age reduced it for men (OR = 0.1,95% CI: (0.04–0.2), p<0.001]. Among full-time physicians, men and women spent similar time on professional activities (60.2hrs/wk vs 58.3hrs/wk, p = 0.32). Women spent more time on parenting and household work (23.5hrs/wk vs 10.4hrs/wk, <0.001; 8.9hrs/wk vs 6.0hrs/wk, p = 0.001, respectively). Women physicians’ spouses contributed to 14.5 hours/week of total time on domestic activities whereas men physicians’ spouses spent two folds more time on domestic activities (35.0 hours/week, P<0.001). Of physicians with children, a higher percentage of women than men reported that children prevented their career advancement or their participation in development opportunities (43.8% vs 15.9%, p<0.001; 50.0% vs 19.4%, p<0.001, respectively). A greater percentage of women than men scaled back their career after first child (31.3% vs 3.5%, <0.001). Of married/partnered physicians, fewer women than men reported their career took priority over their partner’s when conflicts arose, (52.0% vs 86.0%, p<0.001). Conclusion These findings highlight the heavier impact of domestic tethers on the career paths of women physicians than men physicians. Men are more likely than women to hold full-time positions in the early advancement defining phases of their careers. Full-time women shoulder more domestic work than men and experience more professional advancement concessions. Closing persistent gender gaps in medicine requires addressing inequities in domestic burdens through strategies that include mentorship on domestic tethers, support of on-site child-care and advocacy for parental leave policies that encourage shared care-work.
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Affiliation(s)
- Eveline Hitti
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- * E-mail:
| | - Dima Hadid
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Samia J. Khoury
- Abu Haidar Neuroscience Institute, American University of Beirut, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Maha Makki
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Charlotte M. Karam
- Telfer School of Management, University of Ottawa and Olayan School of Business, American University of Beirut, Beirut, Lebanon
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Chilakala A, Camacho-Rivera M, Frye V. Experiences of race- and gender-based discrimination among Black female physicians. J Natl Med Assoc 2022; 114:104-113. [PMID: 35058066 DOI: 10.1016/j.jnma.2021.12.008] [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: 07/06/2021] [Revised: 09/24/2021] [Accepted: 12/29/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Recently, in the United States, there has been a strong effort to increase representation of members of social groups underrepresented in medicine (URiM). Experiences of discrimination among URiM group members, including women and people of color, have negative effects on their health and well-being and drive further underrepresentation. Here we report results of a qualitative research study designed to characterize Black female physicians' experiences of discrimination related to their identities both as women and people of color, in medical education and the practice of medicine. METHODS A trained interviewer conducted semi-structured qualitative, in-depth interviews with twenty Black, cis-gender, female physicians working in various fields of medicine. Broadly framed within intersectionality theory and analyzed using a pragmatic analytic approach, all interviews were transcribed, read, coded, and analyzed identifying key emergent themes. RESULTS Two broad and overlapping themes emerged: (1) experiencing and managing micro/macroaggressions and biases in the workplace; and (2) strategies to overcome experiences of intersectional discrimination. Each theme contained several subthemes, such as "presumed incompetence", "isolation and exclusion", "managing burdensome expectations", "building support systems", "speaking up", and "resilience". Participants described both intersectional and independent forms of discrimination and a range of sources of discrimination, including patients, peers, and colleagues, in their careers as trainees and professionals. Most described minimal and largely ineffective efforts to prevent or mitigate the impact of discrimination at any level of their educational and professional contexts. DISCUSSION Black female physicians report experiencing damaging discrimination with few effective intervention efforts in tAheir medical training and workplaces. There is need for more research and evaluation of interventions to reduce discrimination at all levels of education and training.
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Affiliation(s)
- Akhila Chilakala
- Sophie Davis School of Biomedical Education, CUNY School of Medicine, Townsend Harris Hall, Room 313, 160 Convent Avenue, New York, NY 10031, United States; Department of Community Health Sciences, SUNY Downstate Health Sciences University, United States; Department of Community Health and Social Medicine, CUNY School of Medicine, United States
| | - Marlene Camacho-Rivera
- Sophie Davis School of Biomedical Education, CUNY School of Medicine, Townsend Harris Hall, Room 313, 160 Convent Avenue, New York, NY 10031, United States; Department of Community Health Sciences, SUNY Downstate Health Sciences University, United States; Department of Community Health and Social Medicine, CUNY School of Medicine, United States
| | - Victoria Frye
- Sophie Davis School of Biomedical Education, CUNY School of Medicine, Townsend Harris Hall, Room 313, 160 Convent Avenue, New York, NY 10031, United States; Department of Community Health Sciences, SUNY Downstate Health Sciences University, United States; Department of Community Health and Social Medicine, CUNY School of Medicine, United States.
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Gender Disparity in Academic Gastroenterology: Beginning of the End of the Underrepresentation of Women? Dig Dis Sci 2022; 67:380-387. [PMID: 33141389 DOI: 10.1007/s10620-020-06692-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 10/22/2020] [Indexed: 12/09/2022]
Abstract
BACKGROUND Though there are an increasing number of female medical graduates, women remain underrepresented in academic medicine. There have been several reasons to explain this gender disparity, including marital status, number of children, number of hours worked, job flexibility, perceptions of women as inferior leaders, gender bias, sexual harassment, and unsupportive academic climates. AIMS This study aimed to investigate the relationship between scholarly productivity and the representation of female gastroenterologists in academia. Specifically, scholarly productivity measured by the h-index and academic rank were explored to determine if there were gender disparities in academic productivity and rank in gastroenterology. METHODS Gastroenterology departmental listings were obtained from the Fellowship and Residency Interactive Database of the American Medical Association. The Scopus database was used to record each physician's h-index. Statistical analyses were conducted with Wilcoxon rank-sum test, which compared matched samples by academic rank, and ANOVA tests, which compared multiple academic ranks. RESULTS Out of 1703 academic gastroenterologists, women account for 25% of academic physicians. Women have statistically lower h-indices at the level of Assistant Professor (p = 0.0012), and at the level of Chair (p = 0.01). There was no difference in h-indices between male and female at the rank of Associate Professor and Professor. CONCLUSIONS While these results mirror patterns appreciated in other fields of medicine, the results at the rank of Chair may suggest that despite the lower h-index compared to their male counterparts, females are perceived as having strong inherent leadership skills outside of academic productivity that are also conducive to leading a department and may be contributing to their rise to Chair.
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D'Souza RS, Langford B, Moeschler S. Gender Representation in Fellowship Program Director Positions in ACGME-Accredited Chronic Pain and Acute Pain Fellowship Programs. PAIN MEDICINE 2021; 22:1360-1366. [PMID: 33880559 DOI: 10.1093/pm/pnab041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE We quantified the representation of female program directors (PDs) and assessed their respective demographics, academic metrics, and program-related characteristics in chronic pain and acute pain medicine fellowship programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). METHODS We identified chronic and acute pain PDs on the ACGME website on November 15, 2020. We abstracted data from public databases and performed comparisons of demographics, academic metrics, and program-related characteristics between female and male PDs. RESULTS We identified 111 chronic pain programs and 35 acute pain programs. Overall, there were 35 (31.5%) chronic pain programs with a female PD and 76 (68.5%) chronic pain programs with a male PD. Female chronic pain PDs published fewer peer-reviewed articles (4.0 publications, interquartile range [IQR] = 2.0-12.0) compared with male chronic pain PDs (9.0 publications, IQR = 4.0-27.0; P = 0.050), although there was no difference in the H-index score (3.0 vs 4.0 publications, respectively; P = 0.062) or senior academic rank status (57.1% vs 50.0%, respectively; P = 0.543). There were 10 (28.6%) acute pain programs with a female PD and 25 (71.4%) acute pain programs with a male PD. Similar to the chronic pain cohort, there was no difference in senior academic rank status based on gender in acute pain PDs (50.0% vs 24.0%, respectively; P = 0.227). CONCLUSION Our study highlights gender differences in the PD role in ACGME-accredited chronic and acute pain fellowships. Female PDs remain underrepresented and have fewer peer-reviewed publications. Senior academic rank status was similar across genders, contradicting the current evidence in academic medicine.
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Affiliation(s)
- Ryan S D'Souza
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Brendan Langford
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Susan Moeschler
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
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Madden C, O'Malley R, O'Connor P, O'Dowd E, Byrne D, Lydon S. Gender in authorship and editorship in medical education journals: A bibliometric review. MEDICAL EDUCATION 2021; 55:678-688. [PMID: 33258140 DOI: 10.1111/medu.14427] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 05/13/2023]
Abstract
CONTEXT Gender bias has been observed in the authorship and editorship of academic literature in varied medical specialties. This is important as peer-reviewed publications, and participation on editorial boards, are closely related to academic productivity and advancement. The aim of this paper was to examine whether gender-based disparities in authorship and editorship exist in leading medical education journals. METHODS A retrospective bibliometric review was conducted of articles published at eight different time-points across a 49-year time period (specifically: 1970, 1980, 1990, 2000, 2005, 2010, 2015 and 2019) in four leading medical education journals (Academic Medicine, BMC Medical Education, Medical Education and Medical Teacher). First and last (as a proxy for senior) author gender was determined for each article, along with the gender of the 2019 editorial board members of each journal. Chi-square tests for trend were conducted to examine variations in author gender distributions over time, and binomial tests of proportions were conducted to examine gender distributions in authorship and editorship in 2019. Logistic regression analyses were carried out to determine factors that predicted the odds of authorship by women. RESULTS A total of 5749 articles were included. A significant trend of increased women as first and last authors was observed across all journals. The percentage of women first authors increased from 6.6% in 1970 to 53.7% in 2019 (P < .001), and women last authors increased from 9.5% in 1970 to 46% in 2019 (P < .001). Overall, the distributions of women first authors, last authors and editorial board members in 2019 indicated greater gender parity than many other fields of medicine. CONCLUSIONS Positive progress towards gender parity has been made in medical education scholarship. However, future research and efforts are needed to ensure the continued participation, and highlighting, of women in medical education scholarship and to address other factors which may hinder academic advancement for women in this field.
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Affiliation(s)
- Caoimhe Madden
- Department of General Practice, National University of Ireland, Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
| | - Róisín O'Malley
- Department of General Practice, National University of Ireland, Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
| | - Paul O'Connor
- Department of General Practice, National University of Ireland, Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
| | - Emily O'Dowd
- Department of General Practice, National University of Ireland, Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
| | - Dara Byrne
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
| | - Sinéad Lydon
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Ireland
- School of Medicine, National University of Ireland, Galway, Ireland
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Abstract
IMPORTANCE Gender disparity exists among authors of the oncology literature. OBJECTIVE To quantify trends in authorship by gender within a comprehensive data set of Medline-indexed oncology articles in medical journals with high impact factors. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used Medline citations to examine archives of research journals from 3 disciplines in the oncology literature. Authors from all oncology-related articles with Medical Subject Headings terms assigned from 2002 to 2018 from 13 general oncology/medicine, radiation oncology, and surgical journals were included for analysis, encompassing clinical trials, observational studies (excluding case reports), reviews, systematic reviews, meta-analyses, and all other published articles. Data were analyzed between April and May 2020. EXPOSURES Authors were assigned genders based on societal naming norms via third-party gender identification service Gender-API.com. This assignment was internally validated based on manually obtained publicly available data on the internet. MAIN OUTCOMES AND MEASURES Trend in female authorship over time while considering journal type, authorship position, and article type. RESULTS A total of 420 526 authors from 58 368 articles were found, of which 400 945 were assigned a gender based on their name. In total, 29.5% (95% CI, 29.4%-29.6%) of authors were identified as female, rising from 25.5% (95% CI, 24.7%-26.3%) in 2002 to 31.7% (95% CI, 31.2%-32.3%) in 2018. Each subgroup of primary article type by journal type saw a rise in female authorship over the studied period. For primary articles, last authors were less likely to be women than first authors, regardless of journal type, year, and primary article type (eg, general oncology: odds ratio [OR], 0.60; 95% CI, 0.52-0.69). For general oncology articles, women were less likely to be authors of clinical trials at each authorship position than authors at that respective position for observational studies (first, second, and last authors: OR, 0.58; 95% CI, 0.49-0.67; other authors: OR, 0.84; 95% CI, 0.79-0.89). This difference was not seen for radiation oncology or surgical oncology journals. CONCLUSIONS AND RELEVANCE This cross-sectional study found that female authorship in oncology research literature has increased. However, there remains a dearth of female senior authors, and the overall rise in female authorship has not kept up with the rise in female oncology faculty.
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Affiliation(s)
| | - Emily S. Zhang
- Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor
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Ngaage LM, Harris C, Landford W, Knighton BJ, Stewart T, Ge S, Silverman RP, Slezak S, Rasko YM. Follow the money: Investigating gender disparity in industry payments among senior academics and leaders in plastic surgery. PLoS One 2020; 15:e0235058. [PMID: 33370290 PMCID: PMC7769471 DOI: 10.1371/journal.pone.0235058] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 06/07/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Differences in academic qualifications are cited as the reason behind the documented gender gap in industry sponsorship to academic plastic surgeons. Gendered imbalances in academic metrics narrow among senior academic plastic surgeons. However, it is unknown whether this gender parity translates to industry payments. Methods We conducted a cross-sectional analysis of industry payments disbursed to plastic surgeons in 2018. Inclusion criteria encompassed (i) faculty with the rank of professor or a departmental leadership position. Exclusion criteria included faculty (i) who belonged to a speciality besides plastic surgery; (ii) whose gender could not be determined; or (iii) whose name could not be located on the Open Payment Database. Faculty and title were identified using departmental listings of ACGME plastic surgery residency programs. We extracted industry payment data through the Open Payment Database. We also collected details on H-index and time in practice. Statistical analysis included odds ratios (OR) and Pearson’s correlation coefficient (R). Results We identified 316 senior academic plastic surgeons. The cohort was predominately male (88%) and 91% held a leadership role. Among departmental leaders, women were more likely to be an assistant professor (OR 3.9, p = 0.0003) and heads of subdivision (OR 2.1, p = 0.0382) than men. Industry payments were distributed equally to male and female senior plastic surgeons except for speakerships where women received smaller amounts compared to their male counterparts (median payments of $3,675 vs $7,134 for women and men respectively, p<0.0001). Career length and H-index were positively associated with dollar value of total industry payments (R = 0.17, p = 0.0291, and R = 0.14, p = 0.0405, respectively). Conclusion Disparity in industry funding narrows at senior levels in academic plastic surgery. At higher academic levels, industry sponsorship may preferentially fund individuals based on academic productivity and career length. Increased transparency in selection criteria for speakerships is warranted.
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Affiliation(s)
- Ledibabari M. Ngaage
- Division of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland, United States of America
| | - Chelsea Harris
- Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland, United States of America
| | - Wilmina Landford
- Department of Plastic & Reconstructive Surgery, John Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Brooks J. Knighton
- Division of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland, United States of America
| | - Talia Stewart
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America
| | - Shealinna Ge
- Division of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland, United States of America
| | - Ronald P. Silverman
- Division of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland, United States of America
- Acelity Corporation, San Antonio, TX, United States of America
| | - Sheri Slezak
- Division of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland, United States of America
| | - Yvonne M. Rasko
- Division of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland, United States of America
- * E-mail:
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Dugani SB, Geyer HL, Maniaci MJ, Burton MC. Perception of barriers to research among internal medicine physician hospitalists by career stage. Hosp Pract (1995) 2020; 48:206-212. [PMID: 32510254 DOI: 10.1080/21548331.2020.1779537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Physician hospitalists may participate in research and generate knowledge for evidence-based hospital practice. Despite this, physician hospitalists are primarily involved in patient care, and there is sparse information on barriers for their participation in research and if these barriers differ by career stage. METHODS We conducted a survey of physician hospitalists at Mayo Clinic sites based in four states (Arizona, Florida, Minnesota, and Wisconsin). We surveyed physician hospitalists on demographics, academic rank, current research skills, barriers for participation in research, and research skills they aspire to acquire. Responses were summarized using descriptive statistics and categorized by early-career (<10 years), mid-career (10-20 years), and later-career (≥20 years) stages at Mayo Clinic. The survey was conducted from March to April 2019. RESULTS Of 188 physician hospitalists, there was a 52% response rate with 71% in early career, 21% mid-career, and 7% late career, with 39% female. Physician hospitalists at early-career (90%), mid-career (76%), and later-career (71%) stages were interested in participating in research. Among physician hospitalists with ≤3 peer-reviewed publications, barriers for participation in research included lack of mentorship, time, research skills, and funding. Among physician hospitalists with ≥4 peer-reviewed publications, factors for research success included mentorship (89% early-career, 38% mid-career, 75% later-career; p = 0.002) and membership in a research team. Compared to mid- and later-career physician hospitalists, a higher proportion of early-career hospitalists was interested in acquiring skills to both critically review the literature (70% early-career, 43% mid-career, 0% later-career; p = 0.006) and write manuscripts (86% early-career, 57% mid-career, 50% later-career; p = 0.02); there was generally similar interest across career stages to acquire skills to conduct literature searches and write grants. CONCLUSION The generally similar responses from physician hospitalists across career stages highlight system-level opportunities to increase research mentorship, promote the acquisition of research skills, and reduce barriers for participation in research.
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Affiliation(s)
- Sagar B Dugani
- Division of Hospital Internal Medicine, Mayo Clinic , Rochester, MN, USA
| | - Holly L Geyer
- Division of Hospital Internal Medicine, Mayo Clinic , Scottsdale, AZ, USA
| | - Michael J Maniaci
- Division of Hospital Internal Medicine, Mayo Clinic , Jacksonville, FL, USA
| | - M Caroline Burton
- Division of Hospital Internal Medicine, Mayo Clinic , Rochester, MN, USA
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Gender Disparity in Industry Relationships With Academic Interventional Radiology Physicians. AJR Am J Roentgenol 2020; 215:494-501. [PMID: 32348184 DOI: 10.2214/ajr.19.22176] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. Industry relationships drive technologic innovation in interventional radiology and offer opportunities for professional growth. Women are underrepresented in interventional radiology despite the growing recognition of the importance of diversity. This study characterized gender disparities in financial relationships between industry and academic interventional radiologists. MATERIALS AND METHODS. In this retrospective cross-sectional study, U.S. academic interventional radiology physicians and their academic ranks were identified by searching websites of practices with accredited interventional radiology fellowship programs. Publicly available databases were queried to collect each physician's gender, years since medical school graduation, h-index, academic rank, and industry payments in 2018. Wilcoxon and chi-square tests compared payments between genders. A general linear model assessed the impact of academic rank, years since graduation, gender, and h-index on payments. RESULTS. Of 842 academic interventional radiology physicians, 108 (13%) were women. A total $14,206,599.41 was received by 686 doctors (81%); only $147,975.28 (1%) was received by women. A lower percentage of women (74%) than men (83%) received payments (p = 0.04); median total payments were lower for women ($535) than men ($792) (p = 0.01). Academic rank, h-index, years since graduation, and male gender were independent predictors of higher payments. Industry payments supporting technologic advancement were made exclusively to men. CONCLUSION. Female interventional radiology physicians received fewer and lower industry payments, earning 1% of total payments despite constituting 13% of physicians. Gender independently predicted industry payments, regardless of h-index, academic rank, or years since graduation. Gender disparity in interventional radiology physician-industry relationships warrants further investigation and correction.
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Verran D, Dwyer K, Hardstaff R, Lawton P, Schultz H. Gender Parity Remains To Be Achieved for the Range of Editorial Roles Associated with Current Australasian Medical Journals. Cureus 2020; 12:e7879. [PMID: 32489733 PMCID: PMC7255541 DOI: 10.7759/cureus.7879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/28/2020] [Indexed: 11/25/2022] Open
Abstract
With gender parity of medical school graduates having been achieved for well over two decades, it is timely to assess whether this has translated into gender parity for all of the editorial type roles of Australasian medical journals, reflecting a move toward gender equity. Data analysis was undertaken of the gender ratios of the current editorial roles of Australasian medical journals as compared to available Australian Health Workforce data. This reveals some variation in the gender ratios for all of the current range of editorial type positions and, hence, an absence of parity. There are no women holding formal editorial positions at all for 27.7% of these journals, whilst 77.7% of the chief editors' roles are occupied by men. For five out of 18 (27.7%) of the journals, gender parity has been or is close to having been achieved for these particular roles. These gender ratios do not mirror the gender ratios of the wider community of practice for at least 50% of the journals. Hence, it can be seen that gender parity is yet to be achieved for the range of editorial roles of Australasian medical journals, which carries implications for gender equity initiatives.
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Affiliation(s)
- Deborah Verran
- Surgery, Ramsey Healthcare, Sydney, AUS
- Medicolegal Services, Avant Mutual Group, Sydney, AUS
| | | | | | - Paul Lawton
- Nephrology, Menzies School of Health Research, Darwin, AUS
- Renal Services, Top End Health Services, Darwin, AUS
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Grinnell M, Higgins S, Yost K, Ochuba O, Lobl M, Grimes P, Wysong A. The proportion of male and female editors in women's health journals: A critical analysis and review of the sex gap . Int J Womens Dermatol 2020; 6:7-12. [PMID: 32025554 PMCID: PMC6997826 DOI: 10.1016/j.ijwd.2019.11.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/17/2019] [Accepted: 11/17/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Historically, women have been underrepresented in leadership positions in medicine. The reasons for this are multifactorial. In recent years, women's representation in medicine has improved. However, inequities in the proportion of men and women in medical leadership remain, especially with regard to editorial journal boards. OBJECTIVE This study aimed to explore current trends of women in leadership positions on journal editorial boards. METHODS A comprehensive search for women's health journals was performed in collaboration with university librarians in February 2019 using EMBASE, Scopus, SciFinder, and MEDLINE records for journals with relevance to women's health. Each journal was e-mailed to verify the accuracy of the journal editorial boards listed on their respective webpages. Five categories, as well as the totals for each journal, were analyzed for the proportion of women versus men: editor-in-chief, associate editor, deputy editor, and section editor, and other. RESULTS Women comprised the minority of positions on women's health editorial boards. Of the total 1440 board members included, 602 members (42%) were women and 838 members (58%) were men. Women occupied 54 of 132 editor-in-chief positions (41%), 257 of 596 associate editor positions (43%), 13 of 42 deputy editor positions (30%), 46 of 120 section editor positions (38%), and 232 of 549 other editor positions (42%). CONCLUSION Although the sex gap in leadership in medicine is improving, it is still present. Our findings suggest that women are underrepresented as editors at most levels in women's health journals centered on topics such as reproductive health, obstetrics and gynecology, perinatology, gynecological oncology, and breastfeeding. With sponsorship/mentorship for women, flexible scheduling, and considerate thought in leadership appointment, this sex gap will continue to improve.
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Affiliation(s)
- Madison Grinnell
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Shauna Higgins
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Kelli Yost
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Olivia Ochuba
- Creighton University School of Medicine, Omaha, Nebraska
| | - Marissa Lobl
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Pearl Grimes
- Vitiligo & Pigmentation Institute, Los Angeles, California
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
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Grimes PE. Physician burnout or joy: Rediscovering the rewards of a life in medicine . Int J Womens Dermatol 2020; 6:34-36. [PMID: 32042882 PMCID: PMC6997840 DOI: 10.1016/j.ijwd.2019.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 12/05/2022] Open
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Hasan TF, Turnbull MT, Vatz KA, Robinson MT, Mauricio EA, Freeman WD. Burnout and attrition: Expanding the gender gap in neurology? Neurology 2019; 93:1002-1008. [PMID: 31690682 DOI: 10.1212/wnl.0000000000008583] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 08/23/2019] [Indexed: 11/15/2022] Open
Abstract
Neurology faces an increasing shortage of neurologists in the United States due to a growing demand for neurologic services. A 7% increase in the supply of neurologists is predicted from 2012 to 2025, whereas the demand will rise by 16%. An increase in the neurology workforce is critical to meet the demands, and a significant gender gap remains within the workforce that must be addressed to further ease the discrepancy between supply and demand. Individual, institutional, and societal factors contribute to this gender discrepancy and potentially result in the burnout or soft attrition of women from neurology. These factors, including earning disparity between male and female neurologists, one of the largest gaps in pay for any medical specialty, and the lack of representation at higher academic levels with only 12% (14 of 113) of neurology department chairs at academic medical centers being women, could lead to increased attrition of women from neurology. Identifying and mitigating these factors may help narrow the gender gap and increase the supply of neurologists to better meet future demand.
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Affiliation(s)
- Tasneem F Hasan
- From the Department of Neurology (T.F.H.), Ochsner Louisiana State University Health Sciences Center, Shreveport; Departments of Neurology (M.T.T., M.T.R., E.A.M., W.D.F.) and Neurologic Surgery (W.D.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (K.A.V.), CommunityHealth, Chicago, IL
| | - Marion T Turnbull
- From the Department of Neurology (T.F.H.), Ochsner Louisiana State University Health Sciences Center, Shreveport; Departments of Neurology (M.T.T., M.T.R., E.A.M., W.D.F.) and Neurologic Surgery (W.D.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (K.A.V.), CommunityHealth, Chicago, IL
| | - Kenneth A Vatz
- From the Department of Neurology (T.F.H.), Ochsner Louisiana State University Health Sciences Center, Shreveport; Departments of Neurology (M.T.T., M.T.R., E.A.M., W.D.F.) and Neurologic Surgery (W.D.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (K.A.V.), CommunityHealth, Chicago, IL
| | - Maisha T Robinson
- From the Department of Neurology (T.F.H.), Ochsner Louisiana State University Health Sciences Center, Shreveport; Departments of Neurology (M.T.T., M.T.R., E.A.M., W.D.F.) and Neurologic Surgery (W.D.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (K.A.V.), CommunityHealth, Chicago, IL
| | - Elizabeth A Mauricio
- From the Department of Neurology (T.F.H.), Ochsner Louisiana State University Health Sciences Center, Shreveport; Departments of Neurology (M.T.T., M.T.R., E.A.M., W.D.F.) and Neurologic Surgery (W.D.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (K.A.V.), CommunityHealth, Chicago, IL
| | - William D Freeman
- From the Department of Neurology (T.F.H.), Ochsner Louisiana State University Health Sciences Center, Shreveport; Departments of Neurology (M.T.T., M.T.R., E.A.M., W.D.F.) and Neurologic Surgery (W.D.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (K.A.V.), CommunityHealth, Chicago, IL.
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Abstract
BACKGROUND Participation in scientific meetings yields multiple benefits, yet participation opportunities may not be equally afforded to men and women. The authors' primary goal was to evaluate the representation of men and women at five major academic plastic surgery meetings in 2017. Secondarily, the authors used bibliometric data to compare academic productivity between male and female physician invited speakers or moderators. METHODS The authors compiled information regarding male and female invited speakers from meeting programs. Bibliometric data (h-index, m-value) and metrics of academic productivity (numbers of career publications, publications in 2015 to 2016, career peer-reviewed publications, first and senior author publications) for invited speakers were extracted from Scopus and analyzed. RESULTS There were 282 academic physician invited speakers at the five 2017 meetings. Women constituted 14.5 percent. Univariate analysis showed no differences in h-index, m-value, or numbers of total career publications or first and last author publications at the assistant and associate professor ranks, but higher values for men at the professor level. A model of academic rank based on bibliometric and demographic variables showed male gender significantly associated with increased probability of holding a professor title, even when controlling for academic achievement markers (OR, 2.17; 95 percent CI, 1.61 to 2.92). CONCLUSIONS Although the impact of women's published work was no different than that of men among junior and midcareer faculty, women constitute a minority of invited speakers at academic plastic surgery meetings. Sponsorship is imperative for achieving gender balance within plastic surgery and to ultimately create more diverse and effective teams to improve patient care.
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Killelea BK, Modestino AS, Gass J, Kuerer HM, Margenthaler J, Boolbol SK, Dietz JR, Manahan ER. The 2018 Compensation Survey of the American Society of Breast Surgeons. Ann Surg Oncol 2019; 26:3052-3062. [DOI: 10.1245/s10434-019-07546-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Indexed: 11/18/2022]
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Raffi J, Trivedi MK, White L, Murase JE. Work-life balance among female dermatologists. Int J Womens Dermatol 2019; 6:13-19. [PMID: 32025555 PMCID: PMC6997827 DOI: 10.1016/j.ijwd.2019.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 05/22/2019] [Accepted: 07/01/2019] [Indexed: 10/26/2022] Open
Abstract
Background Female dermatologists often face the challenges of balancing a rewarding medical career with duties of home life and childrearing. Excessive responsibility at home or work can introduce barriers to balance and prove detrimental to the health and wellness of the physician. Objective We aim to perform a needs assessment through a series of survey questions with regard to home and work responsibilities and impacts on mental health. Methods Survey participants were selected from the Women's Dermatologic Society through an e-mail invitation with a link to an anonymous survey tool and a paper questionnaire at the Women's Dermatologic Society Forum in February 2019 in Dallas, Texas. The survey included 20 questions with regard to household responsibilities, child care, clinical responsibilities, specialty education, and impacts on personal time, sleep, and overall sense of well-being. There were a total of 127 respondents. Results Eighty-five percent of physicians in our cohort are currently married. A large percent of respondents utilized hired household help in the form of nannies to perform chores. Spousal contribution was emphasized in this cohort and often highlighted as an important factor in maintaining home life duties. Conclusion The professional women in our cohort may be balancing work and life at the expense of personal physical and mental health with little time to exercise and fewer hours of sleep per night.
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Affiliation(s)
- Jodie Raffi
- Department of Dermatology, University of California San Francisco, San Francisco, California.,University of California, Irvine, School of Medicine, Irvine, California
| | | | - Lucile White
- Laser Surgery DermSurgery Laser Center, Houston, Texas
| | - Jenny E Murase
- Department of Dermatology, University of California San Francisco, San Francisco, California.,Department of Dermatology, Palo Alto Medical Foundation, Palo Alto, California
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Pinto da Costa M, Giurgiuca A, Andreou E, Baessler F, Banjac V, Biskup E, Dragasek J, El-Higaya E, Feffer K, Frydecka D, Kaaja J, Kanellopoulos A, Kilic O, Marinova P, Mitkovic-Voncina M, Molina-Ruiz R, Palumbo C, Pantovic-Stefanovic M, Rakos I, Stoyanova M, Tomori S, De Picker L. Women, Partners, and Mothers-Migratory Tendencies of Psychiatric Trainees Across Europe. Front Public Health 2019; 7:143. [PMID: 31281806 PMCID: PMC6596323 DOI: 10.3389/fpubh.2019.00143] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 05/20/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction: Combining a successful career with family planning has become increasingly important in recent years. However, maintaining a relationship, deciding upon the optimal time for pregnancy and other family planning decisions can still be quite challenging, especially for junior doctors whose training is long and demanding. Currently, women form an important part of the medical workforce, and there is noticeable feminization in migration. However, little is known about the personal characteristics of junior doctors in Europe and how these play a role in their decision to migrate. Methods: Survey of psychiatric trainees in 33 European countries, exploring how personal characteristics, such as gender, relationship status and parenthood, impact their attitudes toward migration. Results: 2,281 psychiatric trainees in Europe took part in the study. In this sample, the majority of psychiatric trainees were in a relationship, but only one quarter had children, although there were variations across Europe. Both men and women indicated personal reasons as their top reason to stay. However, women ranked personal reasons as the top reason to leave, and men financial reasons. Single woman were the most likely of all subgroups to choose academic reasons as their top reason to leave. Interestingly, when women were in a relationship or had children, their attitudes toward migration changed. Conclusions: In this study, a low number of psychiatric trainees in Europe had children, with differences across Europe. These findings raise awareness as to the role of parental conditions, which may be favoring or discouraging parenthood in junior doctors in different countries.
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Affiliation(s)
- Mariana Pinto da Costa
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.,Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, United Kingdom.,Hospital de Magalhães Lemos, Porto, Portugal
| | - Ana Giurgiuca
- The "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Franziska Baessler
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Visnja Banjac
- Clinic of Psychiatry, University Clinical Center of the Republic of Srpska, Banjaluka, Bosnia and Herzegovina
| | - Ewelina Biskup
- Shanghai University of Medicine and Health Sciences Basic Medical College, Shanghai, China.,Division of Internal Medicine, University of Basel, Basel, Switzerland
| | - Jozef Dragasek
- 1st Department of Psychiatry, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
| | - Emam El-Higaya
- Galway Acute Child and Adolescent Psychiatry Inpatient Unit, Merlin Park University Hospital, Galway, Ireland
| | - Kfir Feffer
- Lev-Hasharon Mental Health Center Tzur-Moshe, Israel and Tel-Aviv University, Tel-Aviv, Israel
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | | | - Athanasios Kanellopoulos
- First Department of Pediatrics, Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ozge Kilic
- Department of Psychiatry, Koç University Hospital, Istanbul, Turkey
| | | | | | | | - Claudia Palumbo
- Department of Psychiatry, Hospital Papa Giovanni XXIII-Bergamo (BG), Bergamo, Italy
| | | | - Iva Rakos
- Department of Psychiatry, Referral Center for the Stress-Related Disorders, University Hospital Dubrava, Zagreb, Croatia
| | - Maria Stoyanova
- Mental Health Center "Prof. N. Shipkovenski", Sofia, Bulgaria
| | - Sonila Tomori
- Department of Pediatrics, University Hospital Center Mother Teresa, Tirana, Albania
| | - Livia De Picker
- Faculty of Medicine, Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium
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Chauvin S, Mulsant BH, Sockalingam S, Stergiopoulos V, Taylor VH, Vigod SN. Gender Differences in Research Productivity among Academic Psychiatrists in Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:415-422. [PMID: 30616409 PMCID: PMC6591752 DOI: 10.1177/0706743718802798] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Gender inequity in academic medicine persists despite increases in the number of women physicians. We sought to explore gender differences in research productivity for academic psychiatrists in Canada. METHODS In a cross-sectional study of the 3379 psychiatrists in all 17 university departments of psychiatry in Canada, research productivity, as measured by the h-index and number of publications, was compared between women and men using a negative log binomial regression model to generate relative rates (RRs), adjusted for career duration (aRR). Findings were stratified by academic rank, institution region, and institution size. A subanalysis of those with 10 or more publications was conducted as a proxy for identifying physicians on a research track. RESULTS Women (43% of the sample) had a lower mean (standard deviation) h-index than men (2.87 [6.49] vs. 5.31 [11.1]; aRR, 0.62; 95% confidence interval [CI], 0.54 to 0.72). Differences were significant only for junior faculty and not for associate and full professors. Comparison by number of publications followed a similar pattern (aRR, 0.46; 95% CI, 0.39 to 0.55). Among those with 10 or more publications (n = 721), differences between men and women were smaller than in the overall cohort for both the h-index (aRR, 0.77; 95% CI, 0.68 to 0.87) and number of publications (aRR, 0.62; 95% CI, 0.53 to 0.72). CONCLUSIONS Gender differences in research productivity at the national level in academic psychiatry in Canada support a call to adopt a more systematic approach to promoting equitable opportunities for women in research, especially in early career, to improve diversity and enhance future psychiatric research and discovery.
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Affiliation(s)
- Sarah Chauvin
- 1 Undergraduate Medical Education Program, University of Toronto, Toronto, Ontario
| | - Benoit H Mulsant
- 2 Department of Psychiatry, University of Toronto, Toronto, Ontario.,3 Centre for Addiction and Mental Health, Toronto, Ontario
| | - Sanjeev Sockalingam
- 2 Department of Psychiatry, University of Toronto, Toronto, Ontario.,3 Centre for Addiction and Mental Health, Toronto, Ontario
| | - Vicky Stergiopoulos
- 2 Department of Psychiatry, University of Toronto, Toronto, Ontario.,3 Centre for Addiction and Mental Health, Toronto, Ontario
| | - Valerie H Taylor
- 2 Department of Psychiatry, University of Toronto, Toronto, Ontario.,4 Women's College Research Institute, Women's College Hospital, Toronto, Ontario
| | - Simone N Vigod
- 2 Department of Psychiatry, University of Toronto, Toronto, Ontario.,4 Women's College Research Institute, Women's College Hospital, Toronto, Ontario
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Templeton K, Bernstein CA, Sukhera J, Nora LM, Newman C, Burstin H, Guille C, Lynn L, Schwarze ML, Sen S, Busis N. Gender-Based Differences in Burnout: Issues Faced by Women Physicians. NAM Perspect 2019. [DOI: 10.31478/201905a] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Larese Filon F, Paniz E, Prodi A. The gender gap in Italian academic medicine from 2005 to 2015: still a glass ceiling. LA MEDICINA DEL LAVORO 2019; 110:29-36. [PMID: 30794246 PMCID: PMC7810006 DOI: 10.23749/mdl.v110i1.7617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/23/2019] [Indexed: 11/04/2022]
Abstract
Background: Although women make up half of the population of medical students and residents, they are still under-represented in prominent leadership positions in academia. The disparity is greatest at the highest levels and represents a loss of talent for academic health centers, showing that women must choose between career advancement and personal life. Objectives: The aim of this study was to analyze gender distribution in Italian medical academia in all hierarchical roles (researchers in tenure track positions, associate and full professors) in different disciplinary scientific fields (SSD) in 2015 compared to 2005. Methods: Medical faculties were considered at 31/12/2005 and 30/09/2015, and analyzed using Excel data sheet (Office for Windows 2007). Database was analyzed using STATA software (Texas, Inc. 2014). Results: Women are under-represented in all careers: in 2005 they made up 36.2% of researchers, 21.7% of associate professors and only 9.4% of full professors. The percentage of women researchers increased significantly (p<0.0001) in 2015 to 41.9%, but the percentages of female associate professors (25.3%) and full professors (14.2%) were still extremely low. Discussion: Our study shows that women are under-represented in Italian academia, with only a slight increase in presence in 2015 compared to ten years before. More action is needed to create a supportive environment, increase awareness and monitor potential discrimination.
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Al Sabah S, AlHamdan F, Qadhi I, Shuaibi S, Younes S, Al Haddad E. Female Physicians Leading Health Care in the Arab World. Med Princ Pract 2019; 28:315-323. [PMID: 30870857 PMCID: PMC6639578 DOI: 10.1159/000499592] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 03/14/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES A global trend in female leadership roles in the medical profession is on the rise, and females have been taking up leadership roles in varying and increasing levels. This study aims to identify changes in trends in the medical field in terms of gender in the last decade in Kuwait. METHODS A case study was conducted, in which data on leadership positions in Kuwait's government hospitals were obtained from hospital registries. Demographic data about female to male physicians were collected from statistics published by the Department of Manpower, Statistics and Planning of Kuwait's Ministry of Health. In addition, statistics on medical graduates were obtained from the Faculty of Medicine (FOM), Kuwait University (KU). RESULTS In general, every government hospital in Kuwait has experienced an increase in leadership roles among females; in 2008, among all leadership positions in Kuwait's general hospitals, males occupied a majority of positions (60%); whereas in 2016, the male to female ratio was 1:1. The most change in gender trends was witnessed at Mubarak Al-Kabeer Hospital, where female leaders went from 38% in 2008 to 73% in 2016. The specialties that have the highest number of females in leadership positions across all hospitals from 2008 to 2016 were nuclear medicine, radiology, and laboratory medicine. In KU's FOM, female graduates outweighed male graduates, except in 2005-2006, where females reached a minimum of 48%. The number of female physicians has also increased from its lowest of 31% of the total number of physicians in 2004-2006, to 37% in 2015. CONCLUSION While women make up more than half of medical graduates in Kuwait at present, significant barriers had restricted their entry into formal medical leadership roles in the past. However, it is now seen that females currently occupy more leadership positions in government hospitals in Kuwait.
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Affiliation(s)
- Salman Al Sabah
- Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait,
| | - Fajer AlHamdan
- Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Iman Qadhi
- Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Sameera Shuaibi
- Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Shaden Younes
- Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Eliana Al Haddad
- Department of Surgery, Faculty of Medicine, Al Amiri Hospital, Kuwait City, Kuwait
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Abstract
PURPOSE Women continue to be disproportionately represented in top leadership positions. Leadership development programs typically focus on skills attainment. The purpose of this paper is to explore the perceptions and experiences of academic leaders in order to inform how leadership development programs may more effectively address the gender gap in leadership. DESIGN/METHODOLOGY/APPROACH A sequential mixed methods study design was used. Participants completed the Leadership Practice Inventory ®(LPI) survey followed by individual interviews of a subset of participants. The survey results were analyzed and compared by gender using the t-test. Thematic analysis was used to compare themes across and between genders. Quantitative and qualitative findings were integrated in the final analysis. FINDINGS In total, 65 leaders (38 women; 27 men) (37.7 percent response rate) participated in the survey. There were no significant demographic or statistical differences between women and men on any of the LPI® components. Five women and five men were interviewed. Thematic analysis revealed common leadership aspirations and values. Gender differences were noted in leadership attainment, mentorship and the influence of gender on leadership. While the male narratives reflected cognitive awareness of gender inequities, the female narratives also included lived experiences. Male participants focused on the importance of meritocracy whereas the female participants emphasized the gendered social and structural influences on leadership attainment. PRACTICAL IMPLICATIONS Leadership development programs need go beyond generic "skills-building" in order to conceptualize leadership within a gendered social context. This framework will enable critical awareness and tools for developing both women and men's fullest leadership potential. ORIGINALITY/VALUE This study was conducted in order to better understand how academic health leaders experience the intersection of gender and leadership. The findings contribute to the current literature by providing insight into perceptual gaps that exist at the level of practice between women and men leaders. In doing so, the authors discuss how leadership development programs may play a more effective role in addressing gender equity in leadership.
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Affiliation(s)
- Anne Wong
- Department of Anesthesia, McMaster University Faculty of Health Sciences , McMaster University, Hamilton, Canada
| | - Colleen McKey
- School of Nursing, Faculty of Health Sciences, McMaster University , Hamilton, Canada
| | - Pamela Baxter
- School of Nursing, Faculty of Health Sciences, McMaster University , Hamilton, Canada
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Affiliation(s)
- Mayte Figueroa
- Division of Cardiology and Critical Care, Department of Pediatrics, Washington University School of Medicine , St. Louis, MO , USA
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Kaatz A, Dattalo M, Regner C, Filut A, Carnes M. Patterns of Feedback on the Bridge to Independence: A Qualitative Thematic Analysis of NIH Mentored Career Development Award Application Critiques. J Womens Health (Larchmt) 2015; 25:78-90. [PMID: 26418619 DOI: 10.1089/jwh.2015.5254] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND NIH Mentored Career Development (K) Awards bridge investigators from mentored to independent research. A smaller proportion of women than men succeed in this transition. The aim of this qualitative study was to analyze reviewers' narrative critiques of K award applications and explore thematic content of feedback provided to male and female applicants. METHOD We collected 88 critiques, 34 from 9 unfunded and 54 from 18 funded applications, from 70% (n = 26) of investigators at the University of Wisconsin-Madison with K awards funded between 2005 and 2009 on the first submission or after revision. We qualitatively analyzed text in the 5 critique sections: candidate, career development plan, research plan, mentors, and environment and institutional commitment. We explored thematic content within these sections for male and female applicants and for applicants who had received a subsequent independent research award by 2014. RESULTS Themes revealed consistent areas of criticism for unfunded applications and praise for funded applications. Subtle variations in thematic content appeared for male and female applicants: For male applicants criticism was often followed by advice but for female applicants it was followed by questions about ability; praise recurrently characterized male but not female applicants' research as highly significant with optimism for future independence. Female K awardees that obtained subsequent independent awards stood out as having track records described as "outstanding." CONCLUSION This exploratory study suggests that K award reviewer feedback, particularly for female applicants, should be investigated as a potential contributor to research persistence and success in crossing the bridge to independence.
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Affiliation(s)
- Anna Kaatz
- 1 Center for Women's Health Research, University of Wisconsin-Madison , Madison, Wisconsin
| | - Melissa Dattalo
- 2 William S. Middleton Memorial Veterans Hospital Geriatric Research Education and Clinical Center , Madison, Wisconsin
| | - Caitlin Regner
- 3 School of Medicine and Public Health, University of Wisconsin-Madison , Madison, Wisconsin
| | - Amarette Filut
- 1 Center for Women's Health Research, University of Wisconsin-Madison , Madison, Wisconsin
| | - Molly Carnes
- 4 School of Medicine and Public Health, Departments of Medicine and Psychiatry; College of Engineering Department of Industrial & Systems Engineering, University of Wisconsin-Madison , Wisconsin
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