The 2020 Evidence-Based Promotion Ladder of Academic Plastic Surgery

Background

Metrics were evaluated between academic plastic surgeons from different tiered training programs to determine promotion predictors within tiers and between tiers for those seeking promotion from assistant professor, associate professor, to full professors.

Methodology

We performed a retrospective, cross-sectional study by collecting 61 variables from full-time plastic surgery faculty affiliated with United States residency training programs during the 2020-2021 academic year. Surgeons were stratified into nine cohorts for comparison by professorship (assistant, associate, professor) and Doximity-ranked institution program tiers (Tier 1 = T1, Tier 2 = T2, Tier 3 = T3). Univariate followed by multivariate regressions with reciprocal transformation were performed to determine predictors more likely associated with promotion or lateral movement.

Results

A total of 98 programs listed 851 surgeons. T1/T2/T3 surgeon promotion predictors included more years in practice (p = 0.002; p < 0.001; p < 0.001) and greater number of last-author publications (p < 0.001; p < 0.001; p = 0.007). T1/T3 surgeon promotion predictors included higher h-indexes (p = 0.001; p = 0.002). T1 surgeon promotion predictors included being on journal editorial board (p = 0.040). T2 surgeon promotion predictors from assistant to associate included non-white race (p = 0.010). T3 surgeon promotion predictors included residency director (p = 0.009) and greater number of citations (p = 0.026). Promotion predictors from assistant, associate, and professors for T3/T2/T1 programs included greater number of last-author publications (p = 0.007; p = 0.002; p < 0.001). Movement from assistant and associate between T3/T2/T1 programs included plastic surgery department (p = 0.002; p < 0.001). Movement from assistant between programs included attending Top 10 US News medical schools (p = 0.012), attending more favorable Doximity-ranked research programs (p < 0.001), greater number of first-author publications (p = 0.017), and greater number of citations (p = 0.023). Movement from associate between programs included attending more favorable Doximity-ranked reputation programs (p = 0.017) and higher h-indexes (p = 0.017). Movement from professor between programs included receiving any American Association of Plastic Surgeons (AAPS) award (p = 0.039) and greater number of AAPS awards (p = 0.012).

Conclusions

Promotion predictors provided evidence to synthesize the Doximity-tiered Promotion Ladder of Academic Plastic Surgery.

Women in radiology: why is the pipeline still leaking and how can we plug it?

Today, >50% of medical students are women. This proportion, however, dramatically decreases throughout the higher levels of academia, a phenomenon described as the "leaky pipeline." This gender disparity is particularly pronounced in academic radiology, mirrored by a significant lack of women in editorial board positions, key authorship positions, and conference keynote lectures. The scientific invisibility is not only a key hurdle facing women in radiology, the lack of female role models and mentors in this context might also negatively affect career choices of young female radiologists thereby further widen the existing gender gap. In this article, the origins of the "leaky pipeline," the reasons for women's choice or rejection of careers in academic medicine, as well as solutions as to how the continued loss of a large part of the talent pool can be prevented, are discussed. Active monitoring and intervention are needed to identify problems, plan targeted actions, and evaluate their efficacy. Among those are measures that address a lack of support in the workplace, specific mentoring needs of women, flexible working hours and opportunities to align work and family, financial constraints, and support for returners after career breaks. Cooperative steps of politics and universities need to be taken that ensure a sustainable way forward to enable many talented women in radiology to achieve their full potential.

Influences for Gender Disparity in Academic Family Medicine in North American Medical Schools

Background

Women physicians continue to comprise the minority of leadership roles in Academic Family Medicine (AFM) faculty across North American medical schools. Our study quantified the current state of gender disparity by analyzing academic position, leadership ranking, and research productivity.

Methods

We generated a database for 6,746 AFM faculty members. Gender and academic profiles were obtained for 2,892 academic ranks and 1,706 leadership roles by searching faculty listings enlisted in Fellowship and Residency Electronic Interactive Database (FREIDA) and Canadian Resident Matching Service (CaRMS). To measure research productivity, we obtained bibliometric data: h-index, citations, and tenure from 2,383 faculty members using Elsevier’s SCOPUS archives. Data analysis and h-index were formulated using Stata version 14.2 (StataCorp LP, College Station, TX).

Results

Our results indicated that women hold 46.11% (3,110/6,746) of faculty positions. The proportional composition decreased with increasing academic ranking (49.84% assistant, 46.78% associate, and 41.5% full professor). The same decreasing trend was demonstrated with leadership rank (57.14% minor leadership, 47.65% second-in-command, and 36.61 first-in-command). Compared to their gender counterparts, women in AFM demonstrated lower publication productivity as measured by citation number (p=0.04) and years of study (p=0.008). The final prediction equation model after multivariable analyses included gender, publications, citations, country of graduation, and years of active research (p<0.05).

Conclusions

The composition of academic family medicine faculty members included in this study demonstrated gender disparity. Inclusivity initiatives and policies to tackle the issue of female retention, promotion, and recruitment need to be further explored.