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Mossanen JC, Schmidt M, Brücken A, Thommes M, Marx G, Sopka S. Short-time mentoring - enhancing female medical students' intentions toward surgical careers. MEDICAL EDUCATION ONLINE 2024; 29:2347767. [PMID: 38696113 PMCID: PMC11067559 DOI: 10.1080/10872981.2024.2347767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/22/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Women pursuing a career in surgery or related disciplines are still in the minority, despite the fact that women compose at least half of the medical student population in most Western countries. Thus, recruiting and retaining female surgeons remains an important challenge to meet the need for surgeons and increase the quality of care. The participations were female medical students between their third and fifth academic year. In this study, we applied the well-established psychological theory of planned behavior (TPB) which suggests that the intention to perform a behavior (e.g. pursuing a career in surgery) is the most critical and immediate predictor of performing the behavior. We investigated whether a two-part short-mentoring seminar significantly increases students' intention to pursue a career in a surgical or related specialty after graduation. METHOD The mentoring and role-model seminar was conducted at 2 days for 90 minutes by six inspiring female role models with a remarkable career in surgical or related disciplines. Participants (N = 57) filled in an online survey before (T0) and after the seminar (T1). A pre-post comparison of central TPB concept attitude towards the behavior, 2) occupational self-efficacy and 3) social norm) was conducted using a paired sampled t-test. A follow-up survey was administered 12 months later (T2). RESULTS The mentoring seminar positively impacted female students' attitude towards a career in a surgical specialty. Female students reported a significantly increased positive attitude (p < .001) and significantly higher self-efficacy expectations (p < .001) towards a surgical career after participating in the mentoring seminar. Regarding their career intention after the seminar, female students declared a significantly higher intention to pursue a career in a surgical specialty after graduating (p < .001) and this effect seems to be sustainable after 1 year. CONCLUSION For the first time we could show that short-mentoring and demonstrating role models in a seminar surrounding has a significant impact on female medical student decision´s to pursue a career in a surgery speciality. This concept may be a practical and efficient concept to refine the gender disparity in surgery and related disciplines.
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Affiliation(s)
- J. C. Mossanen
- Department of Intensive and Intermediate Care, University Hospital RWTH Aachen, Aachen, Germany
| | - M. Schmidt
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
- AIXTRA – Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - A. Brücken
- Department of Intensive and Intermediate Care, University Hospital RWTH Aachen, Aachen, Germany
| | - M. Thommes
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
- AIXTRA – Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - G. Marx
- Department of Intensive and Intermediate Care, University Hospital RWTH Aachen, Aachen, Germany
| | - S. Sopka
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
- AIXTRA – Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany
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He ZW, Wang C, Li Y, Danzeng A, Liu FB, Zhu Y, Shi JY, Ciren P, Yuan XY, Wu CX, Lan RH, Zhang BH. The state of female hepato-pancreato-biliary (HPB) surgeons in China: see us in operation theater with great prospects. HPB (Oxford) 2023; 25:1402-1410. [PMID: 37543474 DOI: 10.1016/j.hpb.2023.07.884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/02/2023] [Accepted: 07/12/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVE This study aims to investigate the proportion and distribution of female HPB surgeons in China, describe their current status, and analyze the possible barriers and challenges in their careers. METHOD Tertiary hospitals with the division of HPB in mainland China in 2021 were enrolled and surgeon demographic information was collected through the review of official websites and/or telephone interviews. RESULTS The majority of female HPB surgeons (72.92%) were located in the first or second-tier cities in mainland China, with an increasing number of new female HPB surgeons entering the field annually, particularly after 2005 (from 27 to 52 per 5 years). Despite no significant difference in academic backgrounds, female HPB surgeons initiated their careers at an earlier age and took a longer time to obtain chief titles (P < 0.05). Interestingly, female HPB surgeons performed laparoscopic complex HPB cases at a similar rate (95.42%) to their male counterparts and were more likely to specialize in endoscopic surgery (P = 0.021), with a similar ratio of obtaining administrative positions. CONCLUSION Minimally invasive surgery may provide females with unprecedented opportunities in the HPB surgery field. However, despite the increasing numbers of female HPB surgeons, the proportion remains low in China.
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Affiliation(s)
- Zheng-Wei He
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Chao Wang
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yong Li
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Awang Danzeng
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Fu-Bin Liu
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Yuan Zhu
- School of Automation, China University of Geosciences, Wuhan, 430074, China
| | - Jia-Yu Shi
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Pingcuo Ciren
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao-Yin Yuan
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Cheng-Xian Wu
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Run-Hu Lan
- Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Bin-Hao Zhang
- Hepatic Surgery Center, Institute of Hepato-pancreato-biliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Division of Hepato-pancreato-biliary Surgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China.
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Kueppers J, Heuer LD, Szavay PO, Zundel S. Is There Gender (In)Equality in Pediatric Surgery? An Online Survey on Gender-Related Career Opportunities. Eur J Pediatr Surg 2023; 33:152-157. [PMID: 35830860 DOI: 10.1055/s-0042-1749434] [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: 11/04/2022]
Abstract
INTRODUCTION The highest percentage of female surgeons is found in pediatric surgery but most departments are led by men. The aim of this study is to evaluate gender-related career goals, perceived career opportunities, and reasons for differences. MATERIALS AND METHODS An online questionnaire was created and distributed to pediatric surgeons in Germany, Switzerland, and Austria between July and September 2020. Participants were asked to state current position, career goals, and perceived career opportunities in comparison to a colleague of the opposite gender. Reasons for gender-related differences were asked for as free-text comments. RESULTS A total of 182 questionnaires were analyzed. The overall gender ratio was balanced but junior positions were predominantly held by women, while there were more men in leading positions. Most women pursued a position as a consultant, while the majority of men aimed for a leading position. Men mostly regard both genders to have the same career opportunities, whereas most women believe the chances of men to be better. From the free-text answers, three following categories for gender-related differences in career chances were derived: (1) absences due to maternity, (2) differing support and bias arising from gender-related stereotypes, and (3) assumed personality traits. CONCLUSION There are gender-related differences in career opportunities in pediatric surgery. Gender equality is needed not only to overcome injustice but also to maximize team efficiency and collaboration. Career support needs to be gender-independent and (unconscious) bias needs to be recognized and eradicated.
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Affiliation(s)
- Julia Kueppers
- Department of Pediatric Surgery, Dr. von Haunersches Kinderspital Kinderklinik und Kinderpoliklinik der Ludwig Maximilian Universitat Munchen, Munchen, Germany
- Department of Pediatric Surgery, Luzerner Kantonsspital Kinderspital Luzern, Luzern, Switzerland
| | - Luisa D Heuer
- Department of Pediatric Surgery, Luzerner Kantonsspital Kinderspital Luzern, Luzern, Switzerland
| | - Philipp O Szavay
- Department of Pediatric Surgery, Luzerner Kantonsspital Kinderspital Luzern, Luzern, Switzerland
| | - Sabine Zundel
- Department of Pediatric Surgery, Luzerner Kantonsspital Kinderspital Luzern, Luzern, Switzerland
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Abstract
OBJECTIVE The objective of this study is to systematically synthesize the existing literature on the experiences of motherhood in female surgeons both during surgical training and as staff physicians, to identify knowledge gaps, and to provide recommendations for institutional changes to better support pregnant female surgeons. BACKGROUND There are disproportionately fewer medical students pursuing surgical specialties, as surgery is often seen as incompatible with childbearing and pregnancy. However, no review has summarized the published literature on the collective experiences of female surgeons in navigating motherhood. METHODS Four databases were searched and 1106 abstracts were identified. Forty-two studies were included and a thematic analysis was performed. RESULTS Four themes were identified: path toward motherhood (n=18), realities of motherhood (n=25), medical culture and its impact on career and family life (n=24), and institutional reproductive wellness policies (n=21). Female surgeons are more likely to delay motherhood until after training and have high rates of assisted reproductive technology use. Pregnancy during surgical training is associated with negative perception from peers, pregnancy complications, and scheduling challenges. Maternity leave policies and breastfeeding and childcare facilities are variable and often inadequate. Many female surgeons would agree that greater institutional support would help support women in both their roles as mothers and as surgeons. CONCLUSIONS Both female residents and staff surgeons experience significant and unique barriers before, during, and after motherhood that impact their personal and professional lives. Understanding the unique challenges that mothers face when pursuing surgical specialties is critical to achieving gender equity.
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Pandrowala S, Patkar S, Nair D, Maheshwari A, Pramesh CS, Puri A. Gender discrimination in surgical oncology: An in-house appraisal. Front Surg 2022; 9:939010. [PMID: 35903261 PMCID: PMC9314771 DOI: 10.3389/fsurg.2022.939010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Gender discrimination (GD) though rarely blatant, may present indirectly within a surgical department in the form of subtle inequities, differing standards, and bias. GD encompasses a wide spectrum including academic development, surgical opportunities and sexual harassment. Methods We conducted an online survey to analyse the perceived incidence of GD in the surgical oncology department at a tertiary care cancer centre in India. The questionnaire consisted of 15 questions and was mailed to the entire department including trainees and faculty. Anonymity was maintained while collecting the data only of the participants' gender and whether they were faculty or trainee. Collated responses were analysed using proportions. Results The questionnaire was sent out to 200 recipients of whom 56% (112/200) responded via an online survey. Respondents included 84% of faculty (42/50) and 46.6% of trainees (70/150). GD was perceived by 28% of female trainees (7/25) as compared to 6.6% of male trainees (3/45), whereas amongst faculty, GD was perceived by 26.6% of female faculty (4/15) compared to 14.8% of male faculty (3/27). Approximately 13% of our trainees and 12% of our faculty mentioned that GD affected their professional performance or mental well-being. GD was experienced in terms of work experience and opportunities by a majority of trainees (13%) and faculty (9.5%). There was a significant lack of awareness about recourse to an institutional grievance committee by trainees (47%) compared to faculty (14%). About 7% of trainees and 12% of faculty acknowledged that they may have been responsible for intentional/unintentional GD. Conclusion Gender discrimination can present in subtle or overt fashion in surgical departments and requires active sustained efforts to allow both genders to feel equally empowered. Establishing a system to objectively evaluate gender equity while avoiding stereotyping for certain roles can help minimize GD.
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Affiliation(s)
- Saneya Pandrowala
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - Shraddha Patkar
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
- Correspondence: Shraddha Patkar
| | - Deepa Nair
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - Amita Maheshwari
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - C. S. Pramesh
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - Ajay Puri
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
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Equity, Inclusion and Diversity in Surgical Training. Indian J Surg 2022. [DOI: 10.1007/s12262-021-03068-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Shen MR, Tzioumis E, Andersen E, Wouk K, McCall R, Li W, Girdler S, Malloy E. Impact of Mentoring on Academic Career Success for Women in Medicine: A Systematic Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:444-458. [PMID: 34907962 DOI: 10.1097/acm.0000000000004563] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE Research has shown that barriers to career success in academic medicine disproportionately affect women. These barriers include inadequate mentoring, which may perpetuate the underrepresentation of women in senior leadership positions. The purpose of this review was to summarize the qualitative and quantitative evidence of the impact of mentoring on women's career outcomes and to inform future interventions to support the promotion and retention of women in academic medicine. METHOD The authors conducted a systematic review of original research published in English-language, peer-reviewed journals through March 20, 2020. Search terms related to mentorship, women, and academic medicine. The authors searched MEDLINE, Embase, Scopus, Current Contents Connect via Web of Science, Cochrane Library, and PsycINFO. They excluded studies not specifically addressing women and those without gender-stratified outcomes. They extracted and analyzed the following data: study design, population, sample size, response rate, participant age, percentage of women, mentoring prevalence, and outcomes. RESULTS Of 2,439 citations identified, 91 studies met the inclusion criteria, including 65 quantitative and 26 qualitative studies. Mentoring was associated with objective and subjective measures of career success. Women perceived mentorship to be more valuable to their career development yet were more likely to report having no mentor. Additionally, women were more likely to report lower levels of research productivity, less career satisfaction, and greater barriers to promotion. Qualitative results indicated that women had less access to informal mentoring and family responsibilities had a greater effect on their career outcomes. Professional networking, female mentors, and relational aspects of mentoring were common themes. CONCLUSIONS This review examined gender disparities in mentoring and the impact on research productivity, promotion success, and career satisfaction for women in academic medicine. Institution-supported mentoring programs are needed to facilitate identification of appropriate mentors and promotion of a more equitable academic career environment for women.
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Affiliation(s)
- Mary R Shen
- M.R. Shen is a resident, Department of Surgery, University of Michigan, Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0002-8923-4174
| | - Emma Tzioumis
- E. Tzioumis is assistant professor, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Elizabeth Andersen
- E. Andersen is assistant professor, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathryn Wouk
- K. Wouk is a postdoctoral research fellow, Carolina Global Breastfeeding Institute, and adjunct associate professor, Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Rebecca McCall
- R. McCall is clinical librarian, Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Winston Li
- W. Li is assistant professor, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Susan Girdler
- S. Girdler is professor, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Erin Malloy
- E. Malloy is professor, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Schizas D, Papapanou M, Routsi E, Mastoraki A, Lidoriki I, Zavras N, Avgerinos DV, Lazaris AM, Tsaroucha A. Career barriers for women in surgery. Surgeon 2022; 20:275-283. [PMID: 34996719 DOI: 10.1016/j.surge.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 11/09/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Despite the increasing numbers of female medical students, surgery remains male-dominated. PURPOSE To highlight the principal career obstacles experienced by aspiring female surgeons. METHODS A narrative review of literature on the position and career barriers of female surgeons has been conducted, using the MEDLINE and EMBASE databases. MAIN FINDINGS Implicit and even explicit biases against female surgeons remain prevalent, negatively impacting their training performance and overall professional trajectory. Female surgeons are globally underrepresented in leadership positions and senior academic rankings, especially that of a full professor. They feel hampered by lack of effective mentorship, whose value for a successful career has been acknowledged by all medical students, surgeons and surgical leaders. Their work-life imbalance is sometimes expressed as lower likelihood than their male contemporaries of getting married or having children and may be attributed to their conventional association with the role of caretaker, their personal desire to accommodate occupational and family duties and the inadequate implementation of parental leave and childcare policies. Female surgeons' "infertility" may be further explained by direct and indirect pregnancy-related difficulties. Female surgeons are also financially undercompensated compared to their male contemporaries. Finally, specialty-specific challenges should not be overlooked. CONCLUSIONS While encouraging steps have been made, women in surgery feel still hindered by various obstacles. The qualitative, interview-based nature of current literature requires more meticulous studies on these barriers with a more quantitative and objective approach. Attenuation of gender imbalance in surgical specialties requires further changes in mentality and more targeted modifications in relevant policies.
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Affiliation(s)
- Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Michail Papapanou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.
| | - Eleni Routsi
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Aikaterini Mastoraki
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Irene Lidoriki
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Nikolaos Zavras
- Department of Pediatric Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Dimitrios V Avgerinos
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, NewYork Presbyterian, New York, NY, United States
| | - Andreas M Lazaris
- Department of Vascular Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Alexandra Tsaroucha
- Second Department of Surgery and Laboratory of Experimental Surgery, Democritus University of Thrace, Alexandroupolis, Greece
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Methangkool E, Brodt J, Kolarczyk L, Ivascu NS, Hicks MH, Herrera E, Oakes D. Perceptions of Gender Disparities Among Women in Cardiothoracic Anesthesiology. J Cardiothorac Vasc Anesth 2021; 36:1859-1866. [PMID: 34903458 DOI: 10.1053/j.jvca.2021.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/05/2021] [Accepted: 11/07/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In this study of women in cardiothoracic anesthesiology, the authors aimed to characterize demographics, roles in leadership, and perceived professional challenges. DESIGN A prospective cross-sectional survey of female cardiothoracic anesthesiologists in the United States. SETTING An internet-based survey of 43 questions was sent to women in cardiothoracic anesthesiology. The survey included questions on demographics, leadership, and perceptions of professional challenges including career advancement, compensation, promotion, harassment, and intimidation. PARTICIPANTS A database of women in cardiothoracic anesthesiology was created via personal contacts and snowball sampling. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS A total of 153 responses were analyzed, for a response rate of 65.1%. Most respondents were at the Clinical Instructor or Assistant Professor rank. Many women perceived that compensation, promotion, authorship, and career advancement were affected by gender. Furthermore, 67% of respondents identified having children as having a negative impact on career advancement. Many women reported experiencing derogatory comments (55.6%), intimidation (57.8%), microaggression (69.6%), sexual harassment (25.2%), verbal harassment (45.2%), and unwanted physical or sexual advances (24.4%). These behaviors were most often from a surgical attending, anesthesia attending, or patient. CONCLUSION This survey study of women in cardiothoracic anesthesiology found that many women perceived inequities in financial compensation, authorship opportunities, and promotion; in addition, many felt that their career advancement was impacted negatively by having children. A striking finding was that the majority of women have experienced intimidation, derogatory comments, and microaggressions in the workplace.
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Affiliation(s)
- Emily Methangkool
- Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, Los Angeles, CA.
| | - Jessica Brodt
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA
| | - Lavinia Kolarczyk
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC
| | - Natalia S Ivascu
- Department of Anesthesiology, Weill Cornell Medical College, New York, NY
| | - Megan H Hicks
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Elizabeth Herrera
- Department of Anesthesiology, Houston Methodist Hospital, Houston, TX
| | - Daryl Oakes
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA
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Au S, Bellato V, Carvas JM, Córdoba CD, Daudu D, Dziakova J, Eltarhoni K, El Feituri N, Fung ACH, Fysaraki C, Gallo G, Gultekin FA, Harbjerg JL, Hatem F, Ioannidis A, Jakobsen L, Clinch D, Kristensen HØ, Kuiper SZ, Kwok AMF, Kwok W, Millan M, Milto KM, Ng HJ, Pellino G, Picciariello A, Pronin S, van Ramshorst GH, Ramser M, Jiménez-Rodríguez RM, Sainz Hernandez JC, Samadov E, Sohrabi S, Uchiyama M, Wang JHS, Younis MU, Fleming S, Alhomoud S, Mayol J, Moeslein G, Smart NJ, Soreide K, Teh C, Verran D, Maeda Y. Global parental leave in surgical careers: differences according to gender, geographical regions and surgical career stages. Br J Surg 2021; 108:1315-1322. [PMID: 34467970 DOI: 10.1093/bjs/znab275] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/24/2021] [Accepted: 07/01/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND There is a lack of information regarding the provision of parental leave for surgical careers. This survey study aims to evaluate the experience of maternity/paternity leave and views on work-life balance globally. METHODS A 55-item online survey in 24 languages was distributed via social media as per CHERRIES guideline from February to March 2020. It explored parental leave entitlements, attitude towards leave taking, financial impact, time spent with children and compatibility of parenthood with surgical career. RESULTS Of the 1393 (male : female, 514 : 829) respondents from 65 countries, there were 479 medical students, 349 surgical trainees and 513 consultants. Consultants had less than the recommended duration of maternity leave (43.8 versus 29.1 per cent), no paid maternity (8.3 versus 3.2 per cent) or paternity leave (19.3 versus 11.0 per cent) compared with trainees. Females were less likely to have children than males (36.8 versus 45.6 per cent, P = 0.010) and were more often told surgery is incompatible with parenthood (80.2 versus 59.5 per cent, P < 0.001). Males spent less than 20 per cent of their salary on childcare and fewer than 30 hours/week with their children. More than half (59.2 per cent) of medical students did not believe a surgical career allowed work-life balance. CONCLUSION Surgeons across the globe had inadequate parental leave. Significant gender disparity was seen in multiple aspects.
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Affiliation(s)
- S Au
- NHS Education for Scotland, Edinburgh, UK
| | | | | | - C D Córdoba
- University of Lausanne, Lausanne, Switzerland
| | - D Daudu
- Faculty of Health and Medical Sciences, University of Western Australia, Australia
| | - J Dziakova
- Hospital Clinico San Carlos, IDISSC, Madrid, Spain
| | | | | | - A C H Fung
- Department of Surgery, The University of Hong Kong, Hong Kong SAR, China
| | - C Fysaraki
- Urology Department, Mid Yorkshire Hospitals NHS Trust, UK
| | - G Gallo
- Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy
| | - F Ayca Gultekin
- General Surgery Department, Zonguldak Bulent, Ecevit University School of Medicine, Zonguldak, Turkey
| | - J L Harbjerg
- Department of Surgery, Research Unit C119, Aarhus University Hospital, Palle Juul-Jensens, Aarhus N, Denmark
| | - F Hatem
- Glasgow Royal Infirmary, Glasgow, UK
| | | | - L Jakobsen
- UiT, The Arctic University of Norway, University Hospital of North Norway, Tromso, Norway
| | - D Clinch
- Department of General Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - H Ø Kristensen
- Department of Surgery, Research Unit C119, Aarhus University Hospital, Palle Juul-Jensens, Aarhus N, Denmark
| | - S Z Kuiper
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands
| | | | - W Kwok
- Royal Infirmary of Edinburgh, Edinburgh, UK
| | - M Millan
- Coloproctology Unit, Department of Surgery, La Fe University Hospital, Valencia, Spain
| | - K M Milto
- NHS Education for Scotland, Edinburgh, UK
| | - H J Ng
- Royal Alexandra Hospital, NHS Greater Glasgow and Clyde, UK
| | - G Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - A Picciariello
- Department of Emergency and Organ Transplantation, University 'Aldo Moro' of Bari, Italy
| | - S Pronin
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | | | - M Ramser
- Department of Surgery, Solothurner Spitäler SoH, Bürgerspital Solothurn, Solothurn, Switzerland
| | | | - J C Sainz Hernandez
- Instituto Nacional de Ciencias Médicas y Nutrición 'Salvador Zubirán', Mexico City, Mexico
| | - E Samadov
- Surgical Department, LEYLA Medical Centre, Baku, Azerbaijan
| | | | - M Uchiyama
- Showa University School of Medicine, Tokyo, Japan
| | - J H-S Wang
- Australasian Students' Surgical Association, New Zealand
| | - M U Younis
- Mediclinic City Hospital, Dubai, United Arab Emirates
| | - S Fleming
- Barts and the London School of Medicine and Dentistry, London, UK
| | - S Alhomoud
- King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - J Mayol
- Hospital Clinico San Carlos, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense, Madrid, Spain
| | - G Moeslein
- Ev. Bethesda Khs Duisburg, University of Witten, Herdecke, Germany
| | - N J Smart
- Royal Devon & Exeter Hospital & University of Exeter Medical School, Exeter, UK
| | - K Soreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
| | - C Teh
- Department of Surgery, Makati Medical Centre, Makati, Philippines.,Department of General Surgery, National Kidney & Transplant Institute, Quezon City, Philippines
| | - D Verran
- Ramsey Health Care, Sydney, Australia
| | - Y Maeda
- Department of Colorectal Surgery, Western General Hospital and University of Edinburgh, Edinburgh, UK
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11
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Parini S, Lucidi D, Azzolina D, Verdi D, Frigerio I, Gumbs AA, Spolverato G. Women in Surgery Italia: National Survey Assessing Gender-Related Challenges. J Am Coll Surg 2021; 233:583-592.e2. [PMID: 34438082 DOI: 10.1016/j.jamcollsurg.2021.08.675] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND In 2019, women accounted for 46% of surgical residents. Despite the international debate on gender disparities, no literature regarding the experience in Italy is available. The aim of this survey study was to assess satisfaction among female surgeons in Italy, and determine whether they encounter gender-based discrimination. STUDY DESIGN An anonymous, 83-item web-based survey was distributed among female surgeons working in Italy, from November 18 to December 31, 2020. Gender equity, satisfaction, and factors associated with higher satisfaction and work-life balance were explored. RESULTS There were 3,242 volunteer respondents, 1,833 of whom completed at least 50% of the specific questions and were included in the study. Approximately 54% of female Italian surgeons reported being satisfied with their job, but only 34% with their work-life balance. Among residents, 67% thought they were not adequately trained. The majority of respondents were responsible for most of the housekeeping (60%) and childcare duties (53%), regardless of their partner's workload, and 62% reported that gender affects the way they are treated at work, with most of them experiencing microaggressions. Sexual harassment was common (59%), but only 10% of women reported it. CONCLUSIONS Most Italian female surgeons are satisfied with their professional choice. However, they face gender discrimination, including incidents of sexual harassment and microaggression. Due to the fact that half of surgeons working in Italian hospitals will be females in the next few years, actions are urgently required to build a culture that supports a gender-neutral environment.
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Affiliation(s)
- Sara Parini
- Division of Thoracic Surgery, Ospedale Maggiore della Carità di Novara, Novara, Italy; University of Turin, Turin, Italy.
| | - Daniela Lucidi
- Department of Otolaryngology - Head and Neck Surgery, University Hospital of Modena, University of Modena and Reggio Emilia, Italy
| | - Danila Azzolina
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Daunia Verdi
- Department of Surgery, Mirano Hospital, Mirano, Italy
| | - Isabella Frigerio
- Pancreatic Surgical Unit, Pederzoli Hospital, Peschiera del Garda, Verona, Italy
| | - Andrew A Gumbs
- Department of Digestive Surgery, Centre Hospitalier Intercommunal de Poissy/Saint-Germain-en-Laye, Poissy, France
| | - Gaya Spolverato
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padua, Italy
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12
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Marks IH, Diaz A, Keem M, Ladi-Seyedian SS, Philipo GS, Munir H, Pomerani TI, Sughayer HM, Peter N, Lavy C, Chang DC. Barriers to Women Entering Surgical Careers: A Global Study into Medical Student Perceptions. World J Surg 2020; 44:37-44. [PMID: 31616970 DOI: 10.1007/s00268-019-05199-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Barriers to female surgeons entering the field are well documented in Australia, the USA and the UK, but how generalizable these problems are to other regions remains unknown. METHODS A cross-sectional survey was developed by the International Federation of Medical Students' Associations (IFMSA)'s Global Surgery Working Group assessing medical students' desire to pursue a surgical career at different stages of their medical degree. The questionnaire also included questions on students' perceptions of their education, resources and professional life. The survey was distributed via IFMSA mailing lists, conferences and social media. Univariate analysis was performed, and statistically significant exposures were added to a multivariate model. This model was then tested in male and female medical students, before a further subset analysis by country World Bank income strata. RESULTS 639 medical students from 75 countries completed the survey. Mentorship [OR 3.42 (CI 2.29-5.12) p = 0.00], the acute element of the surgical specialties [OR 2.22 (CI 1.49-3.29) p = 0.00], academic competitiveness [OR 1.61 (CI 1.07-2.42) p = 0.02] and being from a high or upper-middle-income country (HIC and UMIC) [OR 1.56 (CI 1.021-2.369) p = 0.04] all increased likelihood to be considering a surgical career, whereas perceived access to postgraduate training [OR 0.63 (CI 0.417-0.943) p = 0.03], increased year of study [OR 0.68 (CI 0.57-0.81) p = 0.00] and perceived heavy workload [OR 0.47 (CI 0.31-0.73) p = 0.00] all decreased likelihood to consider a surgical career. Perceived quality of surgical teaching and quality of surgical services in country overall did not affect students' decision to pursue surgery. On subset analysis, perceived poor access to postgraduate training made women 60% less likely to consider a surgical career [OR 0.381 (CI 0.217-0.671) p = 0.00], whilst not showing an effect in the men [OR 1.13 (CI 0.61-2.12) p = 0.70. Concerns about high cost of training halve the likelihood of students from low and low-middle-income countries (LICs and LMICs) considering a surgical career [OR 0.45 (CI 0.25-0.82) p = 0.00] whilst not demonstrating a significant relationship in HIC or UMIC countries. Women from LICs and LMICs were 40% less likely to consider surgical careers than men, when controlling for other factors [OR 0.59 CI (0.342-1.01 p = 0.053]. CONCLUSION Perceived poor access to postgraduate training and heavy workload dissuade students worldwide from considering surgical careers. Postgraduate training in particular appears to be most significant for women and cost of training an additional factor in both women and men from LMICs and LICs. Mentorship remains an important and modifiable factor in influencing student's decision to pursue surgery. Quality of surgical education showed no effect on student decision-making.
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Affiliation(s)
- I H Marks
- Department of Primary Care and Public Health, Imperial College, London, UK.
| | - A Diaz
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - M Keem
- Royal Melbourne Hospital, Melbourne, Australia
| | | | - G S Philipo
- School of International Education, Southern Medical University, Guangzhou, China
| | - H Munir
- Jinnah Hospital, Lahore, Pakistan
| | - T I Pomerani
- Medicine and Surgery, School of Human Health Sciences, University of Florence, Florence, Italy
| | - H M Sughayer
- Faculty of Medicine, Al-Quds University, East Jerusalem, Palestine
| | - N Peter
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - C Lavy
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - D C Chang
- Department of Surgery, Massachusetts General Hospital, Boston, USA
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13
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Xepoleas MD, Munabi NCO, Auslander A, Magee WP, Yao CA. The experiences of female surgeons around the world: a scoping review. HUMAN RESOURCES FOR HEALTH 2020; 18:80. [PMID: 33115509 PMCID: PMC7594298 DOI: 10.1186/s12960-020-00526-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/15/2020] [Indexed: 05/25/2023]
Abstract
INTRODUCTION The Lancet Commission for Global Surgery identified an adequate surgical workforce as one indicator of surgical care accessibility. Many countries where women in surgery are underrepresented struggle to meet the recommended 20 surgeons per 100,000 population. We evaluated female surgeons' experiences globally to identify strategies to increase surgical capacity through women. METHODS Three database searches identified original studies examining female surgeon experiences. Countries were grouped using the World Bank income level and Global Gender Gap Index (GGGI). RESULTS Of 12,914 studies meeting search criteria, 139 studies were included and examined populations from 26 countries. Of the accepted studies, 132 (95%) included populations from high-income countries (HICs) and 125 (90%) exclusively examined populations from the upper 50% of GGGI ranked countries. Country income and GGGI ranking did not independently predict gender equity in surgery. Female surgeons in low GGGI HIC (Japan) were limited by familial support, while those in low income, but high GGGI countries (Rwanda) were constrained by cultural attitudes about female education. Across all populations, lack of mentorship was seen as a career barrier. HIC studies demonstrate that establishing a critical mass of women in surgery encourages female students to enter surgery. In HICs, trainee abilities are reported as equal between genders. Yet, HIC women experience discrimination from male co-workers, strain from pregnancy and childcare commitments, and may suffer more negative health consequences. Female surgeon abilities were seen as inferior in lower income countries, but more child rearing support led to fewer women delaying childbearing during training compared to North Americans and Europeans. CONCLUSION The relationship between country income and GGGI is complex and neither independently predict gender equity. Cultural norms between geographic regions influence the variability of female surgeons' experiences. More research is needed in lower income and low GGGI ranked countries to understand female surgeons' experiences and promote gender equity in increasing the number of surgical providers.
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Affiliation(s)
- Meredith D. Xepoleas
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA USA
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
| | - Naikhoba C. O. Munabi
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, 1510 San Pablo St, Suite 415, Los Angeles, CA USA
| | - Allyn Auslander
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA USA
| | - William P. Magee
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA USA
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, 1510 San Pablo St, Suite 415, Los Angeles, CA USA
- Division of Plastic Surgery, Shriners Hospital for Children, Los Angeles, CA USA
| | - Caroline A. Yao
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, 1510 San Pablo St, Suite 415, Los Angeles, CA USA
- Division of Plastic Surgery, Shriners Hospital for Children, Los Angeles, CA USA
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14
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Marks IH, Diaz A, Keem M, Ladi-Seyedian SS, Philipo GS, Munir H, Pomerani TI, Sughayer HM, Peter N, Lavy C, Chang DC. Barriers to Women Entering Surgical Careers: A Global Study into Medical Student Perceptions. World J Surg 2019. [PMID: 31616970 DOI: 10.1007/s00268-019-05199-1.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Barriers to female surgeons entering the field are well documented in Australia, the USA and the UK, but how generalizable these problems are to other regions remains unknown. METHODS A cross-sectional survey was developed by the International Federation of Medical Students' Associations (IFMSA)'s Global Surgery Working Group assessing medical students' desire to pursue a surgical career at different stages of their medical degree. The questionnaire also included questions on students' perceptions of their education, resources and professional life. The survey was distributed via IFMSA mailing lists, conferences and social media. Univariate analysis was performed, and statistically significant exposures were added to a multivariate model. This model was then tested in male and female medical students, before a further subset analysis by country World Bank income strata. RESULTS 639 medical students from 75 countries completed the survey. Mentorship [OR 3.42 (CI 2.29-5.12) p = 0.00], the acute element of the surgical specialties [OR 2.22 (CI 1.49-3.29) p = 0.00], academic competitiveness [OR 1.61 (CI 1.07-2.42) p = 0.02] and being from a high or upper-middle-income country (HIC and UMIC) [OR 1.56 (CI 1.021-2.369) p = 0.04] all increased likelihood to be considering a surgical career, whereas perceived access to postgraduate training [OR 0.63 (CI 0.417-0.943) p = 0.03], increased year of study [OR 0.68 (CI 0.57-0.81) p = 0.00] and perceived heavy workload [OR 0.47 (CI 0.31-0.73) p = 0.00] all decreased likelihood to consider a surgical career. Perceived quality of surgical teaching and quality of surgical services in country overall did not affect students' decision to pursue surgery. On subset analysis, perceived poor access to postgraduate training made women 60% less likely to consider a surgical career [OR 0.381 (CI 0.217-0.671) p = 0.00], whilst not showing an effect in the men [OR 1.13 (CI 0.61-2.12) p = 0.70. Concerns about high cost of training halve the likelihood of students from low and low-middle-income countries (LICs and LMICs) considering a surgical career [OR 0.45 (CI 0.25-0.82) p = 0.00] whilst not demonstrating a significant relationship in HIC or UMIC countries. Women from LICs and LMICs were 40% less likely to consider surgical careers than men, when controlling for other factors [OR 0.59 CI (0.342-1.01 p = 0.053]. CONCLUSION Perceived poor access to postgraduate training and heavy workload dissuade students worldwide from considering surgical careers. Postgraduate training in particular appears to be most significant for women and cost of training an additional factor in both women and men from LMICs and LICs. Mentorship remains an important and modifiable factor in influencing student's decision to pursue surgery. Quality of surgical education showed no effect on student decision-making.
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Affiliation(s)
- I H Marks
- Department of Primary Care and Public Health, Imperial College, London, UK.
| | - A Diaz
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - M Keem
- Royal Melbourne Hospital, Melbourne, Australia
| | | | - G S Philipo
- School of International Education, Southern Medical University, Guangzhou, China
| | - H Munir
- Jinnah Hospital, Lahore, Pakistan
| | - T I Pomerani
- Medicine and Surgery, School of Human Health Sciences, University of Florence, Florence, Italy
| | - H M Sughayer
- Faculty of Medicine, Al-Quds University, East Jerusalem, Palestine
| | - N Peter
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - C Lavy
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - D C Chang
- Department of Surgery, Massachusetts General Hospital, Boston, USA
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Kawase K, Nomura K, Tominaga R, Iwase H, Ogawa T, Shibasaki I, Shimada M, Taguchi T, Takeshita E, Tomizawa Y, Nomura S, Hanazaki K, Hanashi T, Yamashita H, Kokudo N, Maeda K. Analysis of gender-based differences among surgeons in Japan: results of a survey conducted by the Japan Surgical Society. Part 1: Working style. Surg Today 2017. [PMID: 28634729 DOI: 10.1007/s00595-017-1556-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess the working styles of men and women working as surgeons in Japan. METHODS In July, 2014, the Japan Surgical Society invited all their members (n = 29,861), through an internet campaign, to participate in a nationwide survey of surgeons. The items investigated in this descriptive study included demographic information and working styles, based on a questionnaire. RESULTS In total, 6211 surgeons participated (response rate 20.8%, 5586 men and 625 women). The largest age stratum was 40-49 years for men and 30-39 years for women. Overall, respondents identified their labor contract, including salary and work hours, as the highest priority for improvement. Women with children were more likely to be part-time employees, work fewer hours, and take fewer house calls/on-calls than their male counterparts. Moreover, women of all ages earned a lower annual income than men, irrespective of whether they had children. Perception scores for discrimination related to work and promotion were significantly higher among women than men (p < 0.01 and p = 0.011, respectively). CONCLUSIONS A significant difference in working style was observed between men and women working as surgeons in Japan.
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Affiliation(s)
- Kazumi Kawase
- Department of Surgery, The Jikei University School of Medicine Katsushika Medical Center, 6-41-2 Aoto, Katsushika-ku, Tokyo, 125-8506, Japan.
| | - Kyoko Nomura
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi, Tokyo, 173-8606, Japan
| | - Ryuji Tominaga
- Fukuoka Wajiro Hospital, 2-2-75 Wajirogaoka, Higashi-ku, Fukuoka, 811-0213, Japan
| | - Hirotaka Iwase
- Department of Breast and Endocrine Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Tomoko Ogawa
- Department of Breast Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Ikuko Shibasaki
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Mitsuo Shimada
- Department of Surgery, Tokushima University, Kuramoto 3-18-15, Tokushima, Tokushima, 770-8503, Japan
| | - Tomoaki Taguchi
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, 812-8582, Japan
| | - Emiko Takeshita
- Department of Surgery, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8585, Japan
| | - Yasuko Tomizawa
- Department of Cardiovascular Surgery, Tokyo Women's Medical University, 8-1 Kawada, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Sachiyo Nomura
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kazuhiro Hanazaki
- Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku, Kochi, 783-8505, Japan
| | - Tomoko Hanashi
- Department of Surgery, Tokai University Tokyo Hospital, 1-2-5 Yoyogi, Shibuya-ku, Tokyo, 151-0053, Japan
| | - Hiroko Yamashita
- Breast Surgery, Hokkaido University Hospital, Kita 14 Nishi 5, Kita-ku, Sapporo, 060-8648, Japan
| | - Norihiro Kokudo
- Hepatobiliary Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kotaro Maeda
- Department of Surgery, Fujita Health University, 1-98 Denngakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
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16
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Harries RL, Gokani VJ, Smitham P, Fitzgerald JEF. Less than full-time training in surgery: a cross-sectional study evaluating the accessibility and experiences of flexible training in the surgical trainee workforce. BMJ Open 2016; 6:e010136. [PMID: 27091819 PMCID: PMC4838701 DOI: 10.1136/bmjopen-2015-010136] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Generational changes in lifestyle expectations, working environments and the feminisation of the medical workforce have seen an increased demand in postgraduate less than full-time training (LTFT). Despite this, concerns remain regarding access to, and information about, flexible training for surgeons. This study aimed to assess the opinions and experiences of LTFT for surgical trainees. DESIGN Prospective, questionnaire-based cross-sectional study. SETTING/PARTICIPANTS An electronic, self-administered questionnaire was distributed in the UK and Republic of Ireland through mailing lists via the Association of Surgeons in Training and British Orthopedic Trainee Association. RESULTS Overall, 876 completed responses were received, representing all grades of trainee across all 10 surgical specialties. Median age was 33 years and 63.4% were female. Of those who had undertaken LTFT, 92.5% (148/160) were female. Most worked 60% of a full-time post (86/160, 53.8%). The reasons for either choosing or considering LTFT were childrearing (82.7%), caring for a dependent (12.6%) and sporting commitments (6.8%). Males were less likely to list childrearing than females (64.9% vs 87.6%; p<0.0001). Only 38% (60/160) found the application process easy and 53.8% (86/160) experienced undermining behaviour from workplace staff as a result of undertaking LTFT. Of all respondents, an additional 53.7% (385/716) would consider LTFT in future; 27.5% of which were male (106/385). Overall, only 9.9% of all respondents rated current LTFT information as adequate. Common sources of information were other trainees (47.3%), educational supervisors (20.6%) and local postgraduate school website (19.5%). CONCLUSIONS Over half of surgical trainees working LTFT have experienced undermining behaviour as a result of their LTFT. Despite a reported need for LTFT in both genders, this remains difficult to organise, access to useful information is poor and negative attitudes among staff remain. Recommendations are made to provide improved support and information for those wishing to pursue LTFT.
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Affiliation(s)
- Rhiannon L Harries
- Association of Surgeons in Training Council, Association of Surgeons in Training, London, UK
| | - Vimal J Gokani
- Association of Surgeons in Training Council, Association of Surgeons in Training, London, UK
| | - Peter Smitham
- The British Orthopaedic Trainees Association, British Orthopaedic Association Offices, London, UK
| | - J Edward F Fitzgerald
- Association of Surgeons in Training Council, Association of Surgeons in Training, London, UK
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17
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Harries RL, McGoldrick C, Mohan H, Fitzgerald JEF, Gokani VJ. Less Than Full-time Training in surgical specialities: Consensus recommendations for flexible training by the Association of Surgeons in Training. Int J Surg 2015; 23 Suppl 1:S10-4. [DOI: 10.1016/j.ijsu.2015.09.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Baschera D, O’Donnell Taylor E, Masilonyane-Jones T, Isenegger P, Zellweger R. Are Medical Students Who Want to Become Surgeons Different? An International Cross-Sectional Study. World J Surg 2015; 39:2908-18. [DOI: 10.1007/s00268-015-3195-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Aspalter M, Linni K, Metzger P, Hölzenbein T. Female choice for surgical specialties: development in Germany, Austria, and Switzerland over the past decade. Eur Surg 2014. [DOI: 10.1007/s10353-014-0284-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Seelandt JC, Kaderli RM, Tschan F, Businger AP. The surgeon's perspective: promoting and discouraging factors for choosing a career in surgery as perceived by surgeons. PLoS One 2014; 9:e102756. [PMID: 25025428 PMCID: PMC4099181 DOI: 10.1371/journal.pone.0102756] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 06/22/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The aim of this study was to identify the factors perceived by surgeons that promote surgery as an attractive or unattractive career choice for today's graduates. In addition, it examined whether the perspectives of surgeons in different professional situations converges. The content of work, contextual work conditions, and calling to this job are discussed in the context of choosing surgery as a career. METHODS Eight hundred sixty-nine surgeons were asked to answer open-ended questions regarding the factors that promote surgery as an attractive or unattractive career choice for today's graduates. Four hundred ninety-two surgeons participated, and 1,525 statements were analyzed using Mayring's content-analyses method. Chi-square tests were used to analyze the differences among hierarchical positions. RESULTS With respect to the factors that promote surgery as a profession, 40.8% (209/492) of the surgeons stated that surgery is a calling, 29.1% (149/492) of the surgeons provided at least one argument related to the positive task characteristics, and 12.9% (66/492) of the surgeons provided statements related to the positive contextual factors. With respect to the factors that discourage surgery as a profession, 45.7% (234/492) of the surgeons provided at least one argument related to the discouraging work characteristics, and 67.6% (346/492) of the surgeons provided problematic contextual characteristics. CONCLUSION This study emphasizes the importance of the calling to surgery as an important factor for choosing surgery as a career. However, the extensive workload, training, and poor work-family balance have been identified as factors that discourage graduates from choosing surgery as a career. The identified positive factors could be used to attract and maintain graduates in surgical disciplines.
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Affiliation(s)
- Julia C. Seelandt
- Institute of Work Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Reto M. Kaderli
- Department of Visceral Surgery and Medicine, Inselspital University Hospital Bern, Bern, Switzerland
| | - Franziska Tschan
- Institute of Work Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Adrian P. Businger
- Military Medical Service, Swiss Armed Forces, Ittigen-Bern, Switzerland
- Private University in the Principality of Liechtenstein, Triesen, Liechtenstein
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21
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Fitzgerald JEF, Tang SW, Ravindra P, Maxwell-Armstrong CA. Gender-related perceptions of careers in surgery among new medical graduates: results of a cross-sectional study. Am J Surg 2012; 206:112-9. [PMID: 22902099 DOI: 10.1016/j.amjsurg.2012.04.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 04/01/2012] [Accepted: 04/01/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite promotional measures at a national level, female surgeons account for only 10% of the consultant workforce in the United Kingdom. With rising proportions of female medical graduates, it is important that surgery continues to recruit the most able candidates regardless of sex. This study investigates the differing perceptions of surgical careers among recent medical school graduates and identifies factors discouraging female doctors from pursuing a career in surgery. METHODS Newly qualified graduates from the University of Nottingham Medical School, Nottingham, UK, were invited to complete a nonmandatory questionnaire investigating career intentions and factors influencing this. RESULTS Two hundred and eight questionnaires were returned (a 66% response rate). Male respondents were significantly more likely to rate surgery as an attractive or very attractive career (P = .0116). Overall, only 33 (25%) female doctors expressed interest in a surgical career as opposed to 33 (42%) male doctors (P = .010). Frequently cited reasons included no interest in surgery itself (21%) and negative attitudes toward women in surgery among the surgical teams (18%). Irrespective of career interests, 59% of male and 68% of female respondents believed surgery was not a career welcoming women (P = .186). Reasons included difficulty maintaining family life, limited flexible training, and lack of role models. CONCLUSIONS This study identifies significant sex differences in the perception of surgical careers. The majority believes surgery does not welcome female trainees. Future strategies to promote surgery must address attitudes and behaviors in both sexes while taking active steps to support female surgeons during their training and in the workplace.
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Affiliation(s)
- J Edward F Fitzgerald
- Department of Gastrointestinal Surgery, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom NG7 2UH.
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22
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Chong VH. Gender preference and implications for screening colonoscopy: Impact of endoscopy nurses. World J Gastroenterol 2012; 18:3590-4. [PMID: 22826625 PMCID: PMC3400862 DOI: 10.3748/wjg.v18.i27.3590] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Revised: 03/27/2012] [Accepted: 03/29/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the gender preferences, specifically the gender of the nursing staff (endoscopy assistants) and the impact on acceptance for screening colonoscopy (SC).
METHODS: Patients or relatives attending the clinics or health care workers working in a tertiary center were invited to participate in this questionnaire study. The questionnaire enquired on the general demographics (1) age, gender, ethnicity, education level, and employment status, previous history of colonoscopy, family or personal history of colonic pathologies, personal and family history of any cancers; (2) subjects were asked if they would go for an SC if they had appropriate indications (age over 50 years, family history of colorectal cancer (CRC), fecal occult blood positive, anemia especially iron deficiency anemia, bleeding per rectum with or without loss of appetite, weight loss and abdominal pain) with and without symptoms attributable to CRC; and (3) preferences for the gender of the endoscopists and assistants and whether they would still undergo SC even if their preferences were not met.
RESULTS: Eighty-four point seven percent (470/550) completed questionnaire were analysed. More female subjects expressed gender preferences for the endoscopists [overall 70%; female (67.7%) and male (2.3%)] compared to male subjects [overall 62.8%; male (56%) and female (6.8%), P = 0.102]. Similarly, more female subjects expressed gender preferences for the assistants [overall 74.5%; female (73.4%) and male (1.1%)] compared to male subjects [overall 58%, male (49.3%) and female (8.7%), P < 0.001]. Overall, a third would decline an SC, despite having appropriate indications, if their preferences were not met. On univariate analysis, male gender, non-Malay ethnicity (Chinese and others) and previous colonoscopy experience were more likely to undergo an SC, even if their preferences were not met (all P < 0.05). Gender and previous experience [odds ratio (OR) 1.68, 95% confidence interval (CI) 1.00-2.82, P < 0.05] with colonoscopy (OR 4.70, 95% CI 1.41-15.66, P < 0.05) remained significant on multivariate analysis.
CONCLUSION: Genders preference for the endoscopy nurses/assistants is more common than for the endoscopist among women and has implications for the success of a screening colonoscopy program.
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