1
|
Kim JL, Forster CS, Allan JM, Schondelmeyer A, Ruch-Ross H, Barone L, Fromme HB. Gender and work-life balance: Results of a national survey of pediatric hospitalists. J Hosp Med 2024. [PMID: 38800852 DOI: 10.1002/jhm.13413] [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: 02/19/2024] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024]
Abstract
In medicine, difficulty integrating work and home can lead to decreased job satisfaction, diminished well-being, and increased turnover. Understanding the experience of pediatric hospitalists can provide insights into building a stable, long-term workforce. We aim to examine gender differences in work-life balance and parental leave for physicians practicing Pediatric Hospital Medicine. METHODS This was a cross-sectional survey study of 1096 pediatric hospitalists. Responses were collected via an online survey platform and summarized using descriptive statistics, including frequency distributions and measures of central tendency. A multivariable logistic regression was used to examine associated variables and work-life balance satisfaction. We analyzed free responses on parental leave to provide nuance to quantitative survey data. RESULTS Five hundred and sixty-five respondents (52% response rate) completed the survey with 71% women. 343 (62%) prioritize work-life balance in career decision-making. Women report taking on more household responsibilities than their partners (41.4% vs. 8.4%; p < .001) including a larger percentage of caregiving and domestic tasks. Female gender and performing <50% caregiving were associated with decreased work-life balance satisfaction; performing <50% domestic tasks increased satisfaction. Median parental leaves were 4 weeks, with men taking significantly shorter leaves (3.5 vs. 6 weeks; p < .001) and more "paid back" time off. CONCLUSION Work-life balance is an important factor in career decisions for men and women. Women perceive carrying a larger load at home. Qualitative results suggest that parental leave may be inadequate in length and salary support for men and women. This study adds insights into work-life integration in PHM.
Collapse
Affiliation(s)
- Juliann L Kim
- Department of Pediatrics, Pediatric Hospital Medicine, Palo Alto Medical Foundation, Palo Alto, California, USA
| | - Catherine S Forster
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jessica M Allan
- Department of Pediatrics, Pediatric Hospital Medicine, Palo Alto Medical Foundation, Palo Alto, California, USA
| | - Amanda Schondelmeyer
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Holly Ruch-Ross
- Department of Primary Care and Subspecialty Pediatrics, American Academy of Pediatrics, Itasca, Illinois, USA
| | - Lauren Barone
- Department of Primary Care and Subspecialty Pediatrics, American Academy of Pediatrics, Itasca, Illinois, USA
| | - H Barrett Fromme
- Department of Pediatrics, The University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
2
|
Hoang Roberts LN, Zwaans BMM, Vollstedt A, Sharrak A, Han E, Fischer M, Sirls L, Padmanabhan P. Maternity Leave Satisfaction Among Physicians Compared with Nonphysician Professionals. J Womens Health (Larchmt) 2024; 33:33-38. [PMID: 37639698 DOI: 10.1089/jwh.2023.0054] [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] [Indexed: 08/31/2023] Open
Abstract
Objective: The objective of this study was to compare maternity leave satisfaction between physicians and nonphysicians. Currently, paid maternal leave is not guaranteed in the United States, resulting in palpable dissatisfaction among parents. Previous studies have shown associations between length of paid leave and career satisfaction and maternal happiness. Materials and Methods: A Qualtrics® electronic survey was distributed to female professionals through email and social media from April 2019 to March 2020. Inclusion criterion was ≥1 child by birth or adoption, or active pregnancy. Continuous and categorical data were analyzed using two-sample t-test and chi-square, respectively. Results: Of 808 respondents, 77% were physicians. Mean age at birth/adoption of first child was higher in physicians versus nonphysicians (32.1 years vs. 29.7 years; p < 0.001). Physicians took shorter maternity leave than nonphysicians (10.9 weeks vs. 12.0 weeks, p = 0.017) with half of that time paid by employers (5.4 weeks vs. 5.9 weeks, p = 0.2). Dissatisfaction was high among physicians (85.1%) and nonphysicians (92.4%) that correlates with maternity leave compensation dissatisfaction (49% vs. 71.3%, p < 0.001). Thirty-four percent of physicians versus 41% of nonphysicians stated that their health was negatively impacted by maternity leave length. Physicians and nonphysicians reported similar incidences of depression, and breastfeeding, delivery, and other postpartum complications. When queried, 38.8% of physicians and 57% of nonphysicians said they would desire >16 weeks of paid maternity leave (p < 0.001). Conclusions: In conclusion, dissatisfaction among professional women on maternity leave duration and compensation is high in the United States. Given health implications for both mother and child, this should invite further discussion and changes.
Collapse
Affiliation(s)
| | - Bernadette M M Zwaans
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
- William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Annah Vollstedt
- Department of Urology, University of Iowa, Iowa City, Iowa, USA
| | | | - Esther Han
- Orlando Health Medical Group, Orlando, Florida, USA
| | - Melissa Fischer
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
- William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Larry Sirls
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
| | - Priya Padmanabhan
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
- William Beaumont School of Medicine, Rochester, Michigan, USA
| |
Collapse
|
3
|
Clark CT, Payne JL. Gender Diversity in the Psychiatric Workforce: It's Still a (White) Man's World in Psychiatry. Child Adolesc Psychiatr Clin N Am 2024; 33:45-52. [PMID: 37981335 DOI: 10.1016/j.chc.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Academic psychiatry has slightly higher rates of women in the upper ranks and leadership positions than academic medicine as a whole but women continue to be seriously underrepresented. Psychiatry departments should take specific steps to address barriers for women in psychiatry including harassment and discrimination, Imposter Syndrome, lack of mentorship and sponsorship, work-life integration issues, and overinvolvement in nonpromotion generating activities. Addressing these barriers within academic psychiatry will improve the environment for all minorities.
Collapse
Affiliation(s)
- Crystal T Clark
- Department of Psychiatry, University of Toronto, Women's College Hospital, 76 Grenville Street, Toronto, ON M5S 1B2, Canada; Department of Obstetrics and Gynecology.
| | - Jennifer L Payne
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, PO Box 800548, Charlottesville, VA 22908, USA.
| |
Collapse
|
4
|
King Z, Zhang Q, Liang JW, Levy MS, Plowden TC, Jeelani R, Marshall AL, Barnett R, Caban-Martinez AJ, Brown A, Mueller CM, Brown-Johnson C, Salles A. Barriers to Family Building Among Physicians and Medical Students. JAMA Netw Open 2023; 6:e2349937. [PMID: 38153730 PMCID: PMC10755597 DOI: 10.1001/jamanetworkopen.2023.49937] [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] [Received: 07/12/2023] [Accepted: 11/14/2023] [Indexed: 12/29/2023] Open
Abstract
Importance Physicians and medical students who desire to build families face significant barriers due to the structure and culture of medicine. Objective To understand the barriers and facilitators to family building for all people in medicine-not only individuals who can become pregnant-through an open-ended, qualitative analysis of survey responses. Design, Setting, and Participants This qualitative study used a survey conducted in April and May 2021 with a broad sample of physicians and medical students. Participants were recruited through social media, targeting physician and medical student communities. Physicians (residents, fellows, and physicians in independent practice) and medical students of all gender identities and sexual orientations were included. Informed by a postpositivist approach, coding reliability thematic analysis was performed on 3 open-ended survey questions on family-building experiences (what they would do differently, what advice they have for others, and anything else they wished to share). Main Outcomes and Measures Identified themes were mapped to the social-ecological model, a model used in public health to examine how a spectrum of factors is associated with health outcomes. Results A total of 2025 people (1860 [92%] women; 299 [15%] Asian, 151 [8%] Black, and 1303 [64%] White; 1730 [85%] heterosexual; and 1200 [59%] physicians who had completed training) responded to at least 1 of 3 open-ended questions. Themes mapped to social-ecological model levels included: (1) cultural, eg, medical training being at odds with family building; (2) organizational, eg, lack of institutional support for the range of family-building routes; (3) interpersonal, eg, impact of social support on family building; and (4) individual, eg, socioeconomic status and other individual factors that facilitate or inhibit family building. Recommendations to improve family-building experiences include implementing family-building curricula at medical schools, providing adequate parental leave for all physicians and medical students who become parents, and providing insurance coverage for all family-building routes. Conclusions and Relevance In this qualitative study of physicians and medical students, self-reported barriers to family building were identified at each level of the social-ecological model. Addressing these barriers is critical to creating a more equitable family-building environment for physicians and medical students.
Collapse
Affiliation(s)
- Zoe King
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Palo Alto, California
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California
| | - Qiang Zhang
- University of California, Los Angeles David Geffen School of Medicine, Los Angeles
| | - Jane W. Liang
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Morgan S. Levy
- University of Miami Miller School of Medicine, Miami, Florida
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Torie C. Plowden
- Department of Gynecologic Surgery and Obstetrics, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Roohi Jeelani
- Department of OB/GYN, Division of Reproductive Endocrinology and Infertility Wayne State University School of Medicine, Detroit, Michigan
- Kindbody Fertility Clinic, Chicago, Illinois
| | - Ariela L. Marshall
- Department of Medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis
| | - Rebecca Barnett
- University of Miami Miller School of Medicine, Miami, Florida
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Alberto J. Caban-Martinez
- University of Miami Miller School of Medicine, Miami, Florida
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Alyssa Brown
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Claudia M. Mueller
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California
| | - Cati Brown-Johnson
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Arghavan Salles
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California
- Clayman Institute for Gender Research, Stanford University School of Medicine, Palo Alto, California
| |
Collapse
|
5
|
Magudia K, Arleo EK, Porter KK, Ng TSC. A Practical Guide for Paid Family and Medical Leave in Radiology, From the AJR Special Series on DEI. AJR Am J Roentgenol 2023; 221:575-581. [PMID: 37195791 DOI: 10.2214/ajr.23.29327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Paid family and medical leave (FML) has significant benefits to organizations, including improvements in employee recruitment and retention, workplace culture, and employee morale and productivity, and is supported by evidence for overall cost savings. Furthermore, paid FML related to childbirth has significant benefits to individuals and families, including but not limited to improved maternal and infant health outcomes and improved breastfeeding initiation and duration. In the case of nonchildbearing parental leave, paid FML is associated with more equitable long-term division of household labor and childcare. Paid FML is increasingly being recognized as an important issue in medicine, as evidenced by the recent passage of policies by national societies and governing bodies, including the American Board of Medical Specialties, American Board of Radiology, Accreditation Council for Graduate Medical Education (ACGME), American College of Radiology, and American Medical Association. Implementation of paid FML requires adherence to federal, state, and local laws as well as institutional requirements. Specific requirements pertain to trainees from national governing bodies, such as the ACGME and medical specialty boards. Flexibility, work coverage, culture, and finances are additional considerations for ensuring an optimal paid FML policy that accounts for concerns of all impacted individuals.
Collapse
Affiliation(s)
- Kirti Magudia
- Department of Radiology, Duke University School of Medicine, 2301 Erwin Rd, Box 3808, Durham, NC 27710
| | - Elizabeth K Arleo
- Department of Radiology, New York-Presbyterian Hospital/Weill Cornell Imaging, New York, NY
| | | | - Thomas S C Ng
- Department of Radiology, Massachusetts General Hospital, Boston, MA
| |
Collapse
|
6
|
Rennels C, Murthy SG, Handley MA, Morris MD, Alldredge BK, Dahiya P, Jagsi R, Kerns JL, Mangurian C. Informal Caregiving Among Faculty at a Large Academic Health Sciences University in the United States: an Opportunity for Policy Changes. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023:10.1007/s40596-023-01885-4. [PMID: 37821717 DOI: 10.1007/s40596-023-01885-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE This article aims to determine the prevalence of caregiving among faculty at a large academic health sciences institution, to examine the effect of gender and other demographic and professional covariates on caregiving status, and to explore caregiver-generated policy recommendations. METHOD A cross-sectional, mixed-methods survey was collected from June through August 2018. Participants were faculty within one of the institution's health professional schools (dentistry, medicine, nursing, or pharmacy) receiving at least 50% salary from the institution. In addition to demographic information, we collected academic series and rank, and assessed association between covariates on caregiving status using logistic regression. We analyzed open-ended responses using thematic analysis to identify themes in caregiver barriers and policy suggestions. RESULTS Among 657 eligible respondents, 11.4% were informal caregivers. Women were more likely to be caregivers than men (aOR 2.53, 95% CI: 1.40, 4.78), as were older faculty. Caregivers identified unsupportive climate or unrealistic work expectations, concern about career advancement, insufficient information about policies, and concern about colleague burden as barriers to support. Suggestions for workplace support included improved leave policies, increased flexibility, caregiver resource support, improved clarity and dissemination of policy information, and financial support. CONCLUSIONS Women faculty are more likely to be informal caregivers, exacerbating disparities within academic medicine for promotion and retention among women faculty. Institutions might include caregiving status in annual burnout surveys to guide the development of structural support and policies for extension of family leave beyond childbearing (or catastrophic leave), flexibility in work hours, and subsidized eldercare services.
Collapse
Affiliation(s)
- Carolyn Rennels
- University of California San Francisco, San Francisco, CA, USA
| | - Snehal G Murthy
- University of California San Francisco, San Francisco, CA, USA
| | | | - Meghan D Morris
- University of California San Francisco, San Francisco, CA, USA
| | | | - Priya Dahiya
- University of California San Francisco, San Francisco, CA, USA
| | | | | | | |
Collapse
|
7
|
Vestal N, Hunt KN, Levy MS, Roytman M, Mossbarger A, Sriprasert I, Winer S. Family Planning, Fertility, and Medical School: A Survey of Students' Plans and Perceptions of Institutional Support. Perm J 2023; 27:37-48. [PMID: 37337673 PMCID: PMC10502386 DOI: 10.7812/tpp/23.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Background Deciding when to pursue parenthood can be difficult for medical trainees and infertility is more common in the physician population. However, few studies have examined the views of very early career trainees. The goal of this study was to assess premedical and medical student plans for family building, knowledge of fertility, and thoughts on assisted reproductive technology, as well as institutional support for parenthood in medical school and fertility curriculum. Methods Web-based cross-sectional survey on Qualtrics distributed through social media and school organization-based networks. Responses were reported as frequency and percent and compared across subgroups of population with χ2 tests. Results The study had a total of 605 premedical and medical students respondents. Most students (78%) do not have children but plan to have children in the future. Almost two-thirds (63%) of students would consider using assisted reproductive technology. More than 80% of respondents have considered or would consider oocyte cryopreservation for themselves or their partners. A majority (95%) of students are worried about balancing parenthood and a career in medicine and about their fertility declining while they complete medical training (84%). The most frequently cited barriers to family planning during medical school and residency were: limited time off during training (84%), demands of training (82%), cost of having a child (59%), and stigma of having a child during training (45%). Less than half of medical students had formal education on infertility. Conclusions Premedical and medical students are worried about fertility declining in training and about balancing parenthood and medical careers, but gaps in knowledge and institutional support exist.
Collapse
Affiliation(s)
- Nicole Vestal
- Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Kelby N Hunt
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Morgan S Levy
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Alissa Mossbarger
- Michigan State University College of Osteopathic Medicine, Detroit, MI, USA
| | - Intira Sriprasert
- Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Sharon Winer
- Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
8
|
Slostad J, Jain S, McKinnon M, Chokkara S, Laiteerapong N. Evaluation of Faculty Parental Leave Policies at Medical Schools Ranked by US News & World Report in 2020. JAMA Netw Open 2023; 6:e2250954. [PMID: 36689228 PMCID: PMC9871796 DOI: 10.1001/jamanetworkopen.2022.50954] [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] [Received: 08/23/2022] [Accepted: 11/15/2022] [Indexed: 01/24/2023] Open
Abstract
Importance Physician parents, particularly women, are more likely to experience burnout, poor family-career balance, adverse maternal and fetal outcomes, and stigmatization compared with nonparent colleagues. Because many physicians delay child-rearing due to the rigorous demands of medical training, favorable parental leave policies for faculty physicians are crucial to prevent physician workforce attrition. Objective To evaluate paid and unpaid parental leave policies at medical schools ranked by US News & World Report in 2020 and identify factors associated with leave policies. Design, Setting, and Participants This cross-sectional national study was performed at US medical schools reviewed from December 1, 2019, through May 31, 2020, and February 1 through March 31, 2021, due to the COVID-19 pandemic. All medical schools ranked by US News & World Report in 2020 were included. Main Outcomes and Measures The primary outcome was the number of weeks of paid and unpaid leave for birth, nonbirth, adoption, and foster care physician parents. Institutional policies for the number of weeks of leave and requirements to use vacation, sick, or disability leave were characterized. Institutional factors were evaluated for association with the duration of paid parental leave using χ2 tests. Results Among the 90 ranked medical schools, 87 had available data. Sixty-three medical schools (72.4%) had some paid leave for birth mothers, but only 13 (14.9%) offered 12 weeks of fully paid leave. While 11 medical schools (12.6%) offered 12 weeks of full paid leave for nonbirth parents, 38 (43.7%) had no paid leave for nonbirth parents. Adoptive and foster parents had no paid leave in 35 (40.2%) and 65 (74.7%) medical schools, respectively. Median paid parental leave was 4 (IQR, 0-8) weeks for birth parents, 4 (IQR, 0-6) weeks for adoptive parents, 3 (IQR, 0-6) weeks for nonbirth parents, and 0 (IQR, 0-1) weeks for foster parents. About one-third of medical schools required birth mothers to use vacation (29 [33.3%]), sick leave (31 [35.6%]), or short-term disability (9 [10.3%]). Among institutional characteristics, higher ranking (top vs bottom quartile: 30.4% vs 4.0%; P = .03) and private designation (private vs public, 23.5% vs 9.4%; P < .001) was associated with a higher rate of 12 weeks of paid leave for birth mothers. Conclusions and Relevance In this cross-sectional national study of medical schools ranked by US News & World Report in 2020, many physician faculty receive no or very limited paid parental leave. The lack of paid parental leave was associated with higher rates of physician burnout and work-life integration dissatisfaction and may further perpetuate sex, racial and ethnic, and socioeconomic disparities in academic medicine.
Collapse
Affiliation(s)
- Jessica Slostad
- Division of Hematology-Oncology, Rush University Medical Center, Chicago, Illinois
| | - Shikha Jain
- Division of Hematology-Oncology, University of Illinois, Chicago
| | - Marie McKinnon
- Department of Medicine, University of Chicago, Chicago, Illinois
- Department of Medicine, Emory University, Atlanta, Georgia
| | - Sukarn Chokkara
- Department of Medicine, University of Chicago, Chicago, Illinois
| | | |
Collapse
|
9
|
Lee LK, Miller KA, Chuersanga G, Melvin P, Zola J, Ward VL. Childbearing and Family Leave Policies for Physicians at US Children's Hospitals. J Pediatr 2022; 255:240-246. [PMID: 36528054 DOI: 10.1016/j.jpeds.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/13/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
The objective of this study was to examine the childbirth and parental leave policies for physicians at children's hospitals. We obtained institutional policies from 15 hospitals in 2021. The median duration of full salaried leave was 8 weeks (range, 2-12 weeks). Leave policies vary widely among US children's hospitals.
Collapse
Affiliation(s)
- Lois K Lee
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA; Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA; Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston, MA.
| | - Kelsey A Miller
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Geeranan Chuersanga
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA
| | - Patrice Melvin
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA; Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston, MA
| | - Judith Zola
- Office of Human Resources, Boston Children's Hospital, Boston, MA
| | - Valerie L Ward
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA; Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston, MA; Department of Radiology, Boston Children's Hospital, Boston, MA; Department of Radiology, Harvard Medical School, Boston, MA
| |
Collapse
|
10
|
Maitra R, McCowan S, Cohen MC. Caring for carers within the psychiatry workforce. PROGRESS IN NEUROLOGY AND PSYCHIATRY 2022. [DOI: 10.1002/pnp.763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Raka Maitra
- Dr Maitra is ST6 Child and Adolescent Mental Health at Tavistock and Portman NHS Foundation Trust
| | - Sue McCowan
- Dr McCowan is Associate Specialist Doctor in Old Age Psychiatry at Dorset Healthcare University Foundation Trust. Previously a GP with MRCGP(merit) Dr McCowan moved into Old Age Psychiatry 20 years ago
| | - Marta C Cohen
- Professor Cohen is Consultant Paediatric Pathologist and Clinical Director of Pharmacy, Diagnostics and Genetics at Sheffield Children's NHS FT, Honorary Professor, Department of Bone and Metabolism, University of Sheffield, all authors are on the Executive Board, Women in Medicine Carers Network
| |
Collapse
|
11
|
Jain S, Neaves S, Royston A, Huang I, Juengst SB. Breastmilk pumping experiences of physician mothers: quantitative and qualitative findings from a nationwide survey study. J Gen Intern Med 2022; 37:3411-3418. [PMID: 35060006 PMCID: PMC9550890 DOI: 10.1007/s11606-021-07388-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/29/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Nearly half of graduating medical students today are women, with many having children early in their careers, necessitating thoughtful consideration of practices and policies. The short duration of maternity leave for physician mothers often means that most who choose to breastfeed must return to work while still breastfeeding their infants. OBJECTIVE To characterize the experience of physician mothers and identify facilitators and barriers related to breastmilk pumping upon return to work. DESIGN Cross-sectional nationwide survey study administered to physician mothers electronically via REDCap™ to broadly characterize their personal experiences with family leave and return to work. PARTICIPANTS Physician mothers in the USA (n=724). APPROACH/MAIN MEASURE Demographic data and survey responses related to experiences during family leave and return to work, including free-text response options when participants indicated "other" experiences not captured by the survey response options and one open-ended question asking, "What do you think are the most important factors contributing to a positive maternity/family leave experience?" For this study, we searched free-text responses across the entire survey for keywords related to breastfeeding and pumping and thematically analyzed them to summarize key features of physician mothers' experiences. KEY RESULTS Lack of time, flexibility, dedicated and hygienic locations for pumping breast milk, disrespect and lack of support from others, and concerns about financial consequences of productivity changes were the most common barriers to pumping breastmilk reported by physician mothers. CONCLUSIONS Flexibility in scheduling, adjusted productivity targets, and clean, private, and well-equipped pumping rooms would likely provide the greatest support to help physician mothers thrive in their careers while simultaneously allowing them to provide the nourishment needed for their developing infants.
Collapse
Affiliation(s)
- Snigdha Jain
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Stephanie Neaves
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9055, USA
| | - Alexa Royston
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9055, USA
| | - Isabel Huang
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9055, USA
| | - Shannon B Juengst
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9055, USA.
- TIRR Memorial Hermann, Brain Injury Research Center, Houston, TX, USA.
| |
Collapse
|
12
|
Defoe MV, Cameron KA, Burden M, Mazurek SR, Updike JA, Keniston A, O'Leary KJ, Best JA. Men and Women Pursue Nonlinear Career Paths, but Impacts Differ: a Cross-Sectional Study of Academic Hospitalists. J Gen Intern Med 2022; 37:3097-3104. [PMID: 35091922 PMCID: PMC8796748 DOI: 10.1007/s11606-022-07402-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 01/05/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nonlinear career paths are increasingly common. Women in academia pursuing nonlinear career paths experience negative impacts on career trajectory. No published studies have examined how pursuit of nonlinear career paths might perpetuate gender inequities within academic hospital medicine. OBJECTIVE (1) Compare the frequency of nonlinear career paths by gender among academic hospitalists; (2) assess the perceived impact of two types of nonlinear career paths-extended leave (EL) and non-traditional work arrangements (NTWA) on hospitalists' personal lives and careers. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional descriptive survey study of adult hospitalist physicians in three academic centers within the USA. INTERVENTION Electronic survey including closed- and open-ended items assessing respondent utilization of and experiences with nonlinear career paths. MAIN OUTCOMES AND MEASURES (1) Associations between EL and demographic variables as well as gender differences in leave length and NTWA strategies using Fisher's exact test; 2) grounded theory qualitative analysis of open-text responses. KEY RESULTS Compared with men, women reported taking EL more often (p = 0.035) and for longer periods (p = 0.002). Men and women reported taking NTWA at similar rates. Women reported negative impacts of EL within domains of personal life, career, well-being, and work-life integration whereas men only reported negative impacts to career. Men and women described positive impacts of NTWA across all domains. CONCLUSIONS Women academic hospitalists reported taking EL more often than men and experienced disproportionately more adverse impacts to personal lives and careers. Surprisingly, men reported taking NTWA to address burnout and childbirth at similar rates to women. Our findings lay the groundwork for additional exploration of cultural and policy interventions, particularly improved paid leave policies.
Collapse
Affiliation(s)
- Maya V Defoe
- Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Kenzie A Cameron
- Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Marisha Burden
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, IL, USA
| | - Sophia R Mazurek
- Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - John A Updike
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, IL, USA
| | - Angela Keniston
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, IL, USA
| | - Kevin J O'Leary
- Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jennifer A Best
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| |
Collapse
|
13
|
Trockel J, Bohman B, Wang H, Cooper W, Welle D, Shanafelt TD. Assessment of the Relationship Between an Adverse Impact of Work on Physicians' Personal Relationships and Unsolicited Patient Complaints. Mayo Clin Proc 2022; 97:1680-1691. [PMID: 36058580 DOI: 10.1016/j.mayocp.2022.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 02/12/2022] [Accepted: 03/04/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the relationship between an adverse impact of work on physicians' personal relationships and unsolicited patient complaints about physician behavior - a well-established indicator of patient care quality. PARTICIPANTS AND METHODS We paired data from a physician wellness survey collected in April and May 2013 with longitudinal unsolicited patient complaint data collected independently from January 1, 2013, to December 31, 2016. Unsolicited patient complaints were used to calculate the Patient Advocacy Reporting System (PARS) score, an established predictor of clinical outcomes and malpractice suits. The primary outcome was PARS score tercile. Ordinal logistic regression mixed effects models were used to assess the association between the impact of work on a physician's personal relationships and PARS scores. RESULTS Of 2384 physicians eligible to participate, 831 (34.9%) returned surveys including 429 (51.6%) who consented for their survey responses to be linked to independent data and had associated PARS scores. In a multivariate model adjusting for gender and specialty category, each 1-point higher impact of work on personal relationships score (0-10 scale; higher score unfavorable) was associated with a 19% greater odds of being in the next higher PARS score tercile of unsolicited patient complaints (odds ratio, 1.19; 95% CI, 1.07-1.33) during the subsequent 4-year study period. CONCLUSION An adverse impact of work on physicians' personal relationships is associated with independently assessed, unsolicited patient complaints. Organizational efforts to mitigate an adverse impact of work on physicians' personal relationships are warranted as part of efforts to improve the quality of patient experience and malpractice risk.
Collapse
Affiliation(s)
| | - Bryan Bohman
- Stanford University School of Medicine, Stanford, CA, USA
| | - Hanhan Wang
- Stanford University School of Medicine, Stanford, CA, USA
| | - William Cooper
- Vanderbilt Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dana Welle
- Tribeca Companies, San Francisco, CA, USA
| | - Tait D Shanafelt
- Stanford University School of Medicine, Stanford, CA, USA. https://twitter.com/StanfordWellMD
| |
Collapse
|
14
|
Affiliation(s)
- Kelsey A Miller
- Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.,Departments of Pediatrics
| | - Lois K Lee
- Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.,Departments of Pediatrics.,Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
15
|
Rao SJ, Douglas PS, Rzeszut A, Hayes SN, Poppas A, Mehta LS, Blumenthal RS, Sharma G. Global Differences in Parental Leave Policies and Satisfaction Among Cardiologists. Curr Probl Cardiol 2022; 47:101299. [PMID: 35753397 DOI: 10.1016/j.cpcardiol.2022.101299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/03/2022]
Abstract
Gender and regional differences in paid parental leave among cardiologists worldwide has not been documented. We investigated differences in paid parental leave policies globally. There are significant regional differences in parental leave among cardiologists, with North America having the shortest duration for both men and women, and highest dissatisfaction. Both genders reported similar levels of dissatisfaction with parental leave policies worldwide. Most cardiologists in the United States were not aware of policy around adjustment of productivity expectations for the paid time off and one in five said that they did not receive an adjustment. This should be addressed by institutions to allow for career flexibility and work life balance.
Collapse
Affiliation(s)
- Shiavax J Rao
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University, School of Medicine, Baltimore, MD; Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD
| | - Pamela S Douglas
- Division of Cardiology, Duke University School of Medicine, Durham, NC
| | | | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Athena Poppas
- Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI
| | - Laxmi S Mehta
- Division of Cardiology, The Ohio State University, Columbus, OH
| | - Roger S Blumenthal
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University, School of Medicine, Baltimore, MD
| | - Garima Sharma
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University, School of Medicine, Baltimore, MD.
| |
Collapse
|
16
|
Roselin D, Lee J, Jagsi R, Blair-Loy M, Ira K, Dahiya P, Williams J, Mangurian C. Medical Student Parental Leave Policies at U.S. Medical Schools. J Womens Health (Larchmt) 2022; 31:1403-1410. [PMID: 35704286 DOI: 10.1089/jwh.2022.0048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: As medical training occurs during prime childbearing years, parental leave policies may affect the career and family choices of medical students. Materials and Methods: This cross-sectional study builds on existing research by quantifying the prevalence of formal policies for parental leave in highly ranked United States Medical Degree granting institutions, and analyzing the characteristics of those policies, with the objective of identifying existing best practices for future policy adopters to consider. Results: Only 14% of the medical schools reviewed had substantive, stand-alone parental leave policies, and the majority of schools had leave of absence policies without mention of parental leave. Discussion: Leveraging the authors' legal and medical expertise, this analysis highlights existing best practices for medical school leadership to consider, as they examine and develop their policies. Best practices utilized by institutions with the most robust parental policies include adopting a formal and public parental policy, providing a parental enrolled academic adjustment option, guaranteeing approval to take and return from leave/academic adjustment, and continuing health care and financial aid benefits. Given the role of childbearing as a factor associated with gender disparities in academic medicine, and potential impact on racial disparities for students of color, medical school leadership should consider implementation of best practice parental policies to promote equity and wellness of their students. In fact, the deficit of robust parental leave policies in most highly ranked schools may contribute to existing gender and racial disparities in violation with antidiscrimination law. Strengthening policies could increase equity in medical education with positive impacts on the patient population.
Collapse
Affiliation(s)
- Danielle Roselin
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), California, USA.,San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Jessica Lee
- Center for WorkLife Law, Hastings College of the Law, University of California, San Francisco, California, USA
| | - Reshma Jagsi
- Department of Radiation Oncology, Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Mary Blair-Loy
- Department of Sociology, Center for Research on Gender in STEMM, University of California, San Diego, San Diego, California, USA
| | - Kim Ira
- Center for WorkLife Law, Hastings College of the Law, University of California, San Francisco, California, USA
| | - Priya Dahiya
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Joan Williams
- Center for WorkLife Law, Hastings College of the Law, University of California, San Francisco, California, USA
| | - Christina Mangurian
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), California, USA.,San Francisco Veterans Affairs Medical Center, San Francisco, California, USA.,Department of Epidemiology and Biostatistics, Center for Vulnerable Populations, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco (UCSF), San Francisco, California, USA
| |
Collapse
|
17
|
Gender Diversity in the Psychiatric Workforce: It's Still a (White) Man's World in Psychiatry. Psychiatr Clin North Am 2022; 45:271-278. [PMID: 35680242 DOI: 10.1016/j.psc.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Academic psychiatry has slightly higher rates of women in the upper ranks and leadership positions than academic medicine as a whole but women continue to be seriously underrepresented. Psychiatry departments should take specific steps to address barriers for women in psychiatry including harassment and discrimination, Imposter Syndrome, lack of mentorship and sponsorship, work-life integration issues, and overinvolvement in nonpromotion generating activities. Addressing these barriers within academic psychiatry will improve the environment for all minorities.
Collapse
|
18
|
Abstract
BACKGROUND Specialty training in cardiovascular diseases is consistently perceived to have adverse job conditions and interfere with family life. There is a dearth of universal workforce support for trainees who become parents during training. OBJECTIVES This study sought to identify parental policies across cardiovascular training programs internationally. METHODS An Internet-based international survey study available from August 2020 to October 2020 was sent via social media. The survey was administered 1 time and anonymously. Participants shared experiences regarding parental benefits/policies and perception of barriers for trainees. Participants were divided into 3 groups: training program directors, trainees pregnant during cardiology fellowship, and trainees not pregnant during training. RESULTS A total of 417 replies were received from physicians, including 47 responses (11.3%) from training program directors, 146 responses (35%) from current or former trainees pregnant during cardiology training, and 224 responses (53.7%) from current or former trainees that were not pregnant during cardiology training. Among trainees, 280 (67.1%) were parents during training. Family benefits and policies were not uniformly available across institutions, and knowledge regarding the existence of such policies was low. Average parental leave ranged from 1 to 2 months in the United States compared with >4 months outside the United States, and in all countries, paternity leave was uncommon (only 11 participants [2.6%]). Coverage during family leave was primarily provided by peers (n = 184 [44.1%]), and 168 (91.3%) were without additional monetary or time compensation. CONCLUSIONS This is the first international survey evaluating and comparing parental benefits and policies among cardiovascular training programs. There is great variability among institutions, highlighting disparities in real-world experiences.
Collapse
|
19
|
Smith KS, Bakkensen JB, Hutchinson AP, Cheung EO, Thomas J, Grote V, Moreno PI, Goldman KN, Jordan N, Feinberg EC. Knowledge of Fertility and Perspectives About Family Planning Among Female Physicians. JAMA Netw Open 2022; 5:e2213337. [PMID: 35583866 PMCID: PMC9118076 DOI: 10.1001/jamanetworkopen.2022.13337] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Pervasive gender disparities exist in medicine regarding promotion, achievement of academic rank, and appointment to leadership positions. Fertility and childbearing concerns may contribute to these disparities. OBJECTIVE To assess fertility knowledge and concerns and evaluate barriers to family building and impact on academic attrition reported by female physicians. DESIGN, SETTING, AND PARTICIPANTS This qualitative study used mixed methods; first, structured 1:1 interviews exploring fertility knowledge and family-building concerns were conducted among 16 female physicians between November 2019 and May 2020. Transcripts were coded in Dedoose and used to develop a survey instrument with subsequent pilot testing conducted among 24 female physicians between April 2020 and September 2020. Data analysis was performed from January 2021 to March 2021. MAIN OUTCOMES AND MEASURES Fertility knowledge, perceptions of peer and institutional support surrounding childbearing, factors contributing to delayed childbearing, and impact of family planning on career decisions. RESULTS Among 16 women who completed qualitative interviews, 4 (25%) were Asian, 1 (6%) was Black, 1 (6%) was multiracial, and 10 (63%) were White; mean (SD) age was 34.9 (4.0) years. Evaluation of fertility knowledge revealed 3 notable themes: (1) inadequate formal fertility education, (2) informal learning through infertility experiences of patients, peers, or personal struggles, and (3) desire to improve medical education through early introduction and transparent discussions about infertility. Exploration of childbearing concerns similarly revealed several salient themes: (1) high incidence of delayed childbearing, (2) perceived lack of peer and administrative support, and (3) impact of family building on career trajectory. These themes were borne out in pilot testing of the survey instrument: of 24 female physicians (7 Asian women [27%], 1 Black woman [4%], 1 Hispanic or Latinx woman [4%], 1 multiracial woman [4%], 15 White women [58%]; mean [SD] age, 36.1 [6.7] years), 17 (71%) had delayed childbearing and 16 (67%) had altered their career for family-building reasons. CONCLUSIONS AND RELEVANCE Qualitative interviews identified fertility and family building concerns among female physicians and were used to develop a tailored survey for women in medicine. These findings suggest that female physicians may delay childbearing and make substantial accommodations in their careers to support family building. A large-scale national survey is needed to better characterize the unique fertility, childbearing, and parenting needs of women in academic medicine to better understand how these concerns may contribute to academic attrition.
Collapse
Affiliation(s)
- Kathryn S. Smith
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jennifer B. Bakkensen
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anne P. Hutchinson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Shady Grove Fertility in Philadelphia, Philadelphia, Pennsylvania
| | | | - Jessica Thomas
- Preventive Medicine at Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Veronika Grote
- Osher Center for Integrative Medicine at Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Patricia I. Moreno
- Department of Public Health Sciences at the University of Miami Miller School of Medicine, Miami, Florida
| | - Kara N. Goldman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Neil Jordan
- Institute for Public Health and Medicine-Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Center of Innovation for Complex Chronic Healthcare at the Edward J. Hines, Jr. VA Hospital, Hines, Illinois
| | - Eve C. Feinberg
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine, Chicago, Illinois
| |
Collapse
|
20
|
Linden JA, Baird J, Madsen TE, Rounds K, Lall MD, Raukar NP, Fang A, Lin M, Sethuraman K, Dobiesz VA. Diversity of leadership in academic emergency medicine: Are we making progress? Am J Emerg Med 2022; 57:6-13. [PMID: 35462120 DOI: 10.1016/j.ajem.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Faculty who identify as women or racial/ethnic groups underrepresented in medicine (URiM) are less likely to occupy senior leadership positions or be promoted. Recent attention has focused on interventions to decrease this gap; thus, we aim to evaluate changes in leadership and academic promotion for these populations over time. METHODS Successive cross-sectional observational study of six years (2015 to 2020) of data from the Academy of Administrators/Association of Academic Chairs of Emergency Medicine- Benchmark Survey. Primary analyses focused on gender/URiM differences in leadership roles and academic rank. Secondary analysis focused on disparities during the first 10 years of practice. Statistical modeling was conducted to address the primary aim of assessing differences in gender/URiM representation in EM leadership roles/rank over time. RESULTS 12,967 responses were included (4589 women, 8378 men). Women had less median years as faculty (7 vs 11). Women and URiM were less likely to hold a leadership role and had lower academic rank with no change over the study period. More women were consistently in the early career cohort (within 10 years or less as faculty) : 2015 =-75.0% [95% CI:± 3.8%] v 61.4% [95% CI:± 3.0%]; 2020 =-75.1% [95% CI: ± 2.9%] v 63.3%, [95% CI:: ± 2.5%]. Men were significantly more likely to have any leadership role compared to women in 2015 and 2020 (2015 = 54.3% [95% CI: ± 3.1%] v 44.8%, [95% CI: ± 4.3%]; 2020 = 43.1% [95% CI:± 2.5%] v 34.8 [95% CI:± 3.1%]). Higher academic rank (associate/professor) was significantly more frequent among early career men than women in 2015 (21.1% [95% CI:± 2.58%] v 12.9%; [95% CI:± 3.0%]) and 2020 (23.1% [95% CI:± 2.2%] v 17.4%; [95% CI:± 2.5%]). CONCLUSIONS Disparities in women and URiM faculty leadership and academic rank persist, with no change over a six-year time span. Men early career faculty are more likely to hold leadership positions and be promoted to higher academic rank, suggesting early career inequities must be a target for future interventions.
Collapse
Affiliation(s)
- Judith A Linden
- Boston University School of Medicine, Boston, MA, United States of America.
| | - Janette Baird
- Warren Alpert School of Medicine at Brown University, Providence, RI, United States of America.
| | - Tracy E Madsen
- Warren Alpert School of Medicine at Brown University, United States of America.
| | - Kirsten Rounds
- Warren Alpert School of Medicine at Brown University, Providence, RI, Colorado Animal Specialty & Emergency, United States of America.
| | - Michelle D Lall
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States of America.
| | - Neha P Raukar
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, United States of America.
| | - Andrea Fang
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States of America.
| | - Michelle Lin
- Departments of Emergency Medicine and Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
| | - Kinjal Sethuraman
- Department of Emergency Medicine, University of Maryland, Baltimore, MD, United States of America.
| | - Valerie A Dobiesz
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
| |
Collapse
|
21
|
Ghosh-Choudhary S, Carleton N, Flynn JL, Kliment CR. Strategies for Achieving Gender Equity and Work-Life Integration in Physician-Scientist Training. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:492-496. [PMID: 34292189 PMCID: PMC8770678 DOI: 10.1097/acm.0000000000004246] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Substantial gender inequities persist across academic medicine. These issues are not new: Recent evidence still points to a chilly climate for women in academic medicine, including those in physician-scientist training. The discussion for how to address gender equity and issues of work-life integration typically centers around faculty and rarely includes trainees. The authors delineate specific strategies to address gender inequity in physician-scientist training by identifying key stakeholders for implementation and proposing areas to integrate these strategies with current training timelines. Strategies discussed include multiple-role mentoring, allyship training for trainees and faculty, early implementation of professional development sessions, incorporation of childcare and family-friendly policies, and additional policies for funding bodies to prioritize gender equity practices. The goal of this article is to equip trainees and the academic community with proactive strategies to create a more equitable environment for future generations of trainees in academic medicine.
Collapse
Affiliation(s)
- Shohini Ghosh-Choudhary
- S. Ghosh-Choudhary is a fourth-year MD-PhD student, Medical Scientist Training Program, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Neil Carleton
- N. Carleton is a fourth-year MD-PhD student, Medical Scientist Training Program, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - JoAnne L Flynn
- J.L. Flynn is professor of microbiology and molecular genetics, University of Pittsburgh, and assistant dean and codirector, Medical Scientist Training Program, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Corrine R Kliment
- C.R. Kliment is assistant professor of medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| |
Collapse
|
22
|
Abstract
Although a dermatology residency is associated with a favorable lifestyle, nearly one in three budding dermatologists meet the criteria for burnout. The competitive nature of dermatology residency selection may confer a predisposition to burnout. Contributing factors during residency include a high-volume clinical experience and frequent use of electronic health records. Women may face particular pressures in managing work-life balance when starting a family during dermatology residency. In addition to preventing burnout before residency, fears of professional repercussions should be alleviated to ensure resident well-being. We have focusedW focus on the causes of burnout among dermatology residents and suggest solutions to promote wellness.
Collapse
|
23
|
De Haan JL, Dexter F, Fleming BM, Pearson AC, Reuter SD. Elements of Pregnancy and Parenthood Policies of Importance to Medical Students and Included in a Sample of Medical Schools' Websites and Student Handbooks. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2021; 2:533-541. [PMID: 34909759 PMCID: PMC8665277 DOI: 10.1089/whr.2021.0105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 11/13/2022]
Abstract
Background: Medical students who are parents or considering parenthood often want information about school policies. An earlier survey of 194 medical students from one U.S. school examined seven "elements that [students thought] should be included in a school policy on pregnancy/maternity leave." For example, students want to know "how much time a student can take off during medical school and still graduate with their class." We performed multivariate and multivariable analyses of the University of South Dakota survey to understand its generalizability and usefulness. Methods: The earlier survey also included 35 demographic variables about individual students. We tested empirically for associations between the demographics and the seven policy items, thereby evaluating generalizability of the survey results to different demographic groups. We then surveyed public websites of a sample of U.S. medical schools to evaluate usefulness of the knowledge of the seven items. For the 33 surveyed schools, we documented if each of the items was present on publicly available webpages and handbooks. Results: The seven items had content validity as a necessary and sufficient set of items. There also were no significant associations of the items with demographic variables. Therefore, there is little chance that differences among medical schools in their average demographic would affect the items needed for their websites and student handbooks. Among the surveyed medical school websites, 1 of 33 had all seven items (upper 95% confidence limit: 14% of schools nationally would be expected to have all seven items shown). Conclusions: These findings show that it is known what information students want to know about in a school policy on pregnancy and parental leave. Adding these items to public websites is a necessary and an easily actionable intervention to help current and future medical students.
Collapse
Affiliation(s)
- Jessica L.R. De Haan
- Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Franklin Dexter
- Department of Anesthesia and Health Management and Policy and University of Iowa, Iowa City, Iowa, USA
| | - Bradley M. Fleming
- Department of Department of Anesthesia, University of Iowa, Iowa City, Iowa, USA
| | - Amy C.S. Pearson
- Department of Department of Anesthesia, University of Iowa, Iowa City, Iowa, USA
| | - Suzanne D. Reuter
- Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA
| |
Collapse
|
24
|
Lanziotti VS, Dewan M, Behrens D, Bulut Y, Miller J, Ong JSM, Kudchadkar S. Gender Equity and Diversity in Pediatric Critical Care Medicine: We Must Do Better. J Pediatr Intensive Care 2021. [DOI: 10.1055/s-0041-1735871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Vanessa Soares Lanziotti
- Maternal and Child Health Postgraduate Program, Institute of Pediatrics, Federal University of Rio De Janeiro, Rio De Janeiro, Brazil
| | - Maya Dewan
- Division of Critical Care Medicine, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, United States
| | - Deanna Behrens
- Pediatric Critical Care Faculty, Children's Hospital, Park Ridge, Illinois, United States
| | - Yonca Bulut
- Department of Pediatrics, Division of Pediatric Critical Care, David Geffen School of Medicine at UCLA, UCLA Mattel Children's Hospital, Los Angeles, California, United States
| | - Jenna Miller
- Department of Pediatrics, Division of Pediatric Critical Care, Department of Pediatrics, University of Missouri, Children's Mercy Hospital, Kansas City, Missouri, United States
| | - Jacqueline S. M. Ong
- Division of Paediatric Critical Care Khoo Teck Puat, National University Children's Medical Institute, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sapna Kudchadkar
- Anesthesiology and Critical Care Medicine, Pediatrics, and Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Charlotte Bloomberg Children's Center, Baltimore, Maryland, United States
| |
Collapse
|
25
|
Cansino C, Khanna K, Johnson Bhembe X, Overholser B, Burstin HR, Spector ND. The Path Forward: Using Metrics to Promote Equitable Work Environments. Pediatrics 2021; 148:e2021051440G. [PMID: 34470882 DOI: 10.1542/peds.2021-051440g] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2021] [Indexed: 01/13/2023] Open
Abstract
Women continue to be underrepresented in medicine, especially in senior leadership positions, and they experience challenges related to gender bias and sexual harassment. Women who are members of multiple groups that experience marginalization, including, for example, women who are American Indian, Alaskan native, indigenous, Black, or Hispanic, face a compounded challenge. In this article, we explore how institutions and professional organizations in medicine can use metrics to better understand the structural disparities that create and promote gender inequity in the work environment and how to employ these metrics to track progress in narrowing these gaps. Examples in health care (clinical medicine, scientific organizations, scientific publishing), business, and law are used to illustrate how impactful metrics can promote accountability when coupled with transparent reporting.
Collapse
Affiliation(s)
- Catherine Cansino
- Department of Obstetrics and Gynecology, School of Medicine, University of California, Davis, Sacramento, California
| | - Kajal Khanna
- Department of Emergency Medicine, School of Medicine, Stanford University, Stanford, California
| | - Xenia Johnson Bhembe
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School affiliate, Cambridge, Massachusetts
| | - Barbara Overholser
- Executive Leadership in Academic Medicine, Department of Pediatrics, Drexel University College of Medicine, Drexel University, Philadelphia, Pennsylvania
| | - Helen R Burstin
- Council of Medical Specialty Societies, District of Columbia
| | - Nancy D Spector
- Executive Leadership in Academic Medicine, Department of Pediatrics, Drexel University College of Medicine, Drexel University, Philadelphia, Pennsylvania
| |
Collapse
|
26
|
Durfey SNM, White J, Adashi EY. Pregnancy and Parenting in Medical School: Highlighting the Need for Data and Support. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:1259-1262. [PMID: 33570853 DOI: 10.1097/acm.0000000000003988] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
More than 7% of medical students graduate from medical school with at least 1 nonspouse dependent, the majority of whom are likely children. However, there are no national studies on medical students who are parents, and very little is known about what medical schools are doing to support them. A growing literature on the experiences of residents and attending physicians who are parents has neglected to include those of medical students who are parents. It is possible that focusing on research and policy change for residents and attending physicians who are parents without considering medical students may bring about improvements that come too late for many. Further data are needed both on the available policies for students who are parents and on the experiences and needs of these students. Leading national organizations in medical education can help guide medical schools by leveraging their national networks to highlight existing best practices and to foster discussions about how best to support medical students who are parents.
Collapse
Affiliation(s)
- Shayla N M Durfey
- S.N.M. Durfey is a first-year resident, Hasbro Children's Hospital, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Jordan White
- J. White is assistant professor of family medicine and medical science, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Eli Y Adashi
- E.Y. Adashi is professor of medical science, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| |
Collapse
|
27
|
Slama EM, Johnson HM, Yu YR, Sumra H, Altieri MS. Paid parental leave for surgeons in the United States. Am J Surg 2021; 223:218-220. [PMID: 34419264 DOI: 10.1016/j.amjsurg.2021.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Eliza M Slama
- Association of Women Surgeons Publication Committee, USA; Department of Surgery, Saint Agnes Hospital, Baltimore, MD, 21227, USA.
| | - Helen M Johnson
- Association of Women Surgeons Publication Committee, USA; Department of Surgery, East Carolina University Brody School of Medicine, Greenville, NC, 27834, USA
| | - Yangyang R Yu
- Association of Women Surgeons Publication Committee, USA; Department of Surgery, University of California, Irvine Medical Center, Orange, CA, 92868, USA
| | - Hibba Sumra
- Association of Women Surgeons Publication Committee, USA; University of Toledo, College of Medicine, Toledo, OH, 43614, USA
| | - Maria S Altieri
- Association of Women Surgeons Publication Committee, USA; Department of Surgery, East Carolina University Brody School of Medicine, Greenville, NC, 27834, USA
| |
Collapse
|
28
|
Marshall AL, Dines V, Wahner Hendrickson A, Warsame R, Thanarajasingam G, Thompson C, Petterson T, Wolanskyj-Spinner A. Parental health in fellowship trainees: Fellows' satisfaction with current policies and interest in innovation. ACTA ACUST UNITED AC 2021; 16:1745506520949417. [PMID: 32990525 PMCID: PMC7534076 DOI: 10.1177/1745506520949417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Parenthood during medical training is common and impacts trainee well-being. However, current graduate medical education parental health policies are often limited in scope. We explored current fellowship trainees' knowledge of/satisfaction with current policies as well as interest in potential changes/additions to existing policies. METHODS Fellowship program directors/coordinators at a three-site academic institution were surveyed and information was collected from 2015 to 2019 regarding fellow demographics and parental health policies. We distributed an electronic survey to fellows containing Likert-type-scale questions rating knowledge/level of satisfaction with current parental health policies and interest in potential additions/modifications to current policies. RESULTS Thirty-five of 47 (74%) fellowship programs responded. An average of 11% of female fellows and 15% of male fellows took parental leave during the study period. Three (9%) of the programs had at least one additional parental health policy beyond institutional graduate medical education policies. In the fellow survey, 175 of 609 fellows responded (28.7%), of which 84 (48.6%) were female. Although 89.1% agreed/strongly agreed that parental health is an important part of health and well-being for fellows, only 32% were satisfied/very satisfied with current policies (no significant sex-related differences). Fellows reported the following potential interventions as important/very important: 79.2% increased (paid) maternity leave (72.7% male, 86.7% female, p = 0.02), 78% increased (paid) paternity leave (76.4% male, 81.9% female, p = 0.37), 72.3% part-time return to work (60.2% male, 84.3% female, p = 0.0005), 63% coverage for workup/management of infertility (52.3% male, 74.7% female, p = 0.002), and 79.9% on-site day care (70.7% male, 89.2% female, p = 0.003). CONCLUSIONS Parental health includes multiple domains, not all of which are covered by current policies. Fellows feel that parental health is an important part of overall health and well-being, but most are not satisfied with current policies. Expanded access to parental leave and new policies (part-time return to work, infertility management, and on-site day care) are opportunities for innovation.
Collapse
Affiliation(s)
- Ariela L Marshall
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.,Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Rahma Warsame
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Gita Thanarajasingam
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Carrie Thompson
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Tanya Petterson
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Alexandra Wolanskyj-Spinner
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
29
|
Moulton KL, Battaglioli N, Sebok-Syer SS. Is Lactating in the Emergency Department a Letdown? Exploring Barriers and Supports to Workplace Lactation in Emergency Medicine. Ann Emerg Med 2021; 78:400-408. [PMID: 34016455 DOI: 10.1016/j.annemergmed.2021.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/01/2021] [Accepted: 03/01/2021] [Indexed: 11/15/2022]
Abstract
STUDY OBJECTIVE To explore the social and environmental conditions in emergency departments that contribute to perceived barriers and supports for workplace lactation among individuals working in emergency medicine. METHODS Constructivist grounded theory was used by our team to understand the social processes and behaviors associated with workplace lactation for health care professionals working in EDs. A total of 24 interviews of individuals in EDs with recent return-to-work experience after childbirth were performed. The interviews yielded 36 unique experiences (from 21 faculty, 12 trainees, and 3 nurses) because some participants had more than 1 child, in which case all lactation experiences were discussed. Interview transcriptions were coded and analyzed iteratively for the development of themes, per constructivist grounded theory. RESULTS Using constant comparative inductive methods, we describe 3 pervasive themes as they relate to workplace lactation that emerged from the analysis of interview data: (1) emergency medicine culture, (2) workplace lactation policies, and (3) supports for workplace lactation. CONCLUSION Although formalized workplace lactation policies and other identifiable supports for workplace lactation aid individuals desiring to lactate after returning to work in EDs, many individuals still experience cultural barriers to their desired lactation habits. Policies and individual support systems may continue to fall short of meeting the needs of lactating individuals in emergency medicine unless broader cultural change occurs. Our work offers initial recommendations for shifting the landscape of lactation practices in emergency medicine.
Collapse
|
30
|
Lu DJ, King B, Sandler HM, Tarbell NJ, Kamrava M, Atkins KM. Paid Parental Leave Policies Among U.S. News & World Report 2020-2021 Best Hospitals and Best Hospitals for Cancer. JAMA Netw Open 2021; 4:e218518. [PMID: 33974058 PMCID: PMC8114142 DOI: 10.1001/jamanetworkopen.2021.8518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
This cross-sectional study examines paid parental leave policies for faculty and staff physicians at leading US hospitals and cancer centers.
Collapse
Affiliation(s)
- Diana J Lu
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Benjamin King
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Howard M Sandler
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Nancy J Tarbell
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Mitchell Kamrava
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Katelyn M Atkins
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| |
Collapse
|
31
|
Crown A, Berry C, Khabele D, Fayanju OM, Cobb A, Backhus L, Smith RN, Sweeting R, Hasson RM, Johnson-Mann C, Oseni T, Newman EA, Turner P, Karpeh M, Pugh C, Jordan AH, Henry-Tillman R, Joseph KA. The Role of Race and Gender in the Career Experiences of Black/African American Academic Surgeons: A Survey of the Society of Black Academic Surgeons and a Call to Action. Ann Surg 2021; 273:827-831. [PMID: 32941287 DOI: 10.1097/sla.0000000000004502] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the role of race and gender in the career experience of Black/AA academic surgeons and to quantify the prevalence of experience with racial and gender bias stratified by gender. SUMMARY OF BACKGROUND DATA Compared to their male counterparts, Black/African American women remain significantly underrepresented among senior surgical faculty and department leadership. The impact of racial and gender bias on the academic and professional trajectory of Black/AA women surgeons has not been well-studied. METHODS A cross-sectional survey regarding demographics, employment, and perceived barriers to career advancement was distributed via email to faculty surgeon members of the Society of Black American Surgeons (SBAS) in September 2019. RESULTS Of 181 faculty members, 53 responded (29%), including 31 women (58%) and 22 men (42%). Academic positions as a first job were common (men 95% vs women 77%, P = 0.06). Men were more likely to attain the rank of full professor (men 41% vs women 7%, P = 0.01). Reports of racial bias in the workplace were similar (women 84% vs men 86%, not significant); however, reports of gender bias (women 97% vs men 27%, P < 0.001) and perception of salary inequities (women 89% vs 63%, P = 0.02) were more common among women. CONCLUSIONS AND RELEVANCE Despite efforts to increase diversity, high rates of racial bias persist in the workplace. Black/AA women also report experiencing a high rate of gender bias and challenges in academic promotion.
Collapse
Affiliation(s)
- Angelena Crown
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Cherisse Berry
- Department of Surgery, New York University Grossman School of Medicine, NYC Health and Hospitals/Bellevue, New York, New York
| | - Dineo Khabele
- Department of Obstetrics and Gynecology, Washington University in St Louis, Missouri
| | | | - Adrienne Cobb
- Department of Surgery, Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois
| | - Leah Backhus
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California
| | - Randi N Smith
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Raeshell Sweeting
- Department of Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Rian M Hasson
- Department of Surgery, Geisel School of Medicine of Dartmouth College, Hanover, New Hampshire
| | - Crystal Johnson-Mann
- Department of Surgery, University of Florida College of Medicine, Gainesville, FL
| | - Tawakalitu Oseni
- MGH Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Erika A Newman
- Department of Surgery, University of Michigan School of Medicine, Ann Arbor, Michigan
| | | | - Martin Karpeh
- Department of Surgery, Northwell Health, Greenlawn, NY
| | - Carla Pugh
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Andrea Hayes Jordan
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Ronda Henry-Tillman
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Kathie-Ann Joseph
- Department of Surgery, New York University Grossman School of Medicine, NYC Health and Hospitals/Bellevue, New York, New York
| |
Collapse
|
32
|
Wang KM, Lee B, Woreta FA, Ramanathan S, Singman EL, Tian J, Srikumaran D. Parental Leave Policy for Ophthalmology Residents: Results of a Nationwide Cross-Sectional Study of Program Directors. JOURNAL OF SURGICAL EDUCATION 2021; 78:785-794. [PMID: 32948506 PMCID: PMC7960573 DOI: 10.1016/j.jsurg.2020.08.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/25/2020] [Accepted: 08/27/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Many residents become parents during residency and the adequacy of parental leave is integrally related to resident wellness. OBJECTIVE To understand current parental leave policies in ophthalmology residency programs and program director perceptions of the impact of parental leave on trainees. DESIGN Cross-sectional study. SETTING Multicenter among all U.S. ophthalmology residency programs. PARTICIPANTS Ophthalmology residency program directors during the 2017 to 2018 academic year. RESULTS Sixty-eight percent (82/120) program directors participated in this study. The majority of programs had written maternity leave policies (89%) and partner leave policies (72%). The typical duration of maternity leave taken ranged from 4 to 6 weeks while typical partner leave duration taken ranged from 1 day to 2 weeks. Residents who take leave may need to extend training at 72% of programs. Program directors perceived that parental leave negatively impacts resident scholarly activities and surgical skills and volume. Male program directors, relative to female program directors, perceived that becoming a childbearing parent negatively impacts resident dedication to patient care. Program directors raised concerns including local support and policy, extension of residency, impact on residents, impact on programs, consistency and fairness, and desire for national policy change. CONCLUSIONS Parental leave practices vary significantly among ophthalmology training programs with residents typically taking less leave than permitted. Program directors are challenged to accommodate parental leave while balancing resident training and wellness for all trainees in their program.
Collapse
Affiliation(s)
- Kendrick M Wang
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Benjamin Lee
- Department of Ophthalmology, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Fasika A Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Saraswathy Ramanathan
- University of California San Francisco, Department of Ophthalmology, San Francisco, California
| | - Eric L Singman
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jing Tian
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Divya Srikumaran
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
| |
Collapse
|
33
|
Reilly G, Tipton C, Liberman P, Berkenstock M. Attitudes toward parental leave and breastfeeding during ophthalmology residency. Can J Ophthalmol 2021; 57:175-187. [PMID: 33789088 DOI: 10.1016/j.jcjo.2021.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/18/2021] [Accepted: 02/27/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION As mandated by the Accreditation Council for Graduate Medical Education (ACGME), residency programs are required to have parental leave policies. A lack of standardized requirements leads to a lack of uniformity among programs. We discuss resident and program director attitudes toward parental leave and examine the range of policies on parental leave and breastfeeding within ophthalmology residency programs. METHODS Two electronic surveys assessing perceptions toward parental leave during residency and breastfeeding on return to clinical duties were created individually for completion by ophthalmology residents or residency program directors, respectively, with responses collected over 4 weeks. RESULTS Of residents who took parental leave, 23 (87%) denied taking time off without pay. The most commonly reported effects on training by residents were missed surgical training and impact on research. Nearly 60% of residents (N = 26) reported receiving negative feedback or actions prior to or after the leave. The majority of residents felt program directors and coresidents were supportive (53.8%, 48.1%, respectively), but parental leave negatively affected their coresidents (46.2%). Twenty-five program directors reported that there are written parental leave policies in place at their institution. Sex disparities were noted, with program directors reporting more negative impacts on surgical training in female residents (p = 0.035). There was no statistically significant difference between program director attitudes on clinical training, well-being, or burnout by resident sex. All program directors were supportive of breastfeeding; half reported an institutional breastfeeding policy. CONCLUSION A national discussion on standardizing parental leave and breastfeeding policies over all ophthalmology residency programs is warranted.
Collapse
Affiliation(s)
- Grace Reilly
- Drexel University College of Medicine, Philadelphia, PA
| | | | - Paulina Liberman
- Departamento de Oftalmología. Escuela de Medicina. Pontificia Universidad Católica de Chile, Santiago, Chile
| | | |
Collapse
|
34
|
Radico J, Oser TK, Fausnight TB, Berg A, Ouyang A, Leong SL. Factors that Influence Work Family Conflict for Women Faculty. MEDEDPUBLISH 2021; 10:63. [PMID: 38486540 PMCID: PMC10939630 DOI: 10.15694/mep.2021.000063.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Purpose: This study examined the interaction between work role overload, work-to-family conflict, and departmental/division culture conducive to women's academic success. Methods: All women assistant and associate professors eligible for promotion from the Departments of Family Medicine, Internal Medicine, and Pediatrics were invited to complete a validated web-based survey that measured work-to-family conflict, work hours, work role overload, and culture conducive to women's academic success ( Westring et al., 2012). Results: With 88 survey respondents, high work role overload was associated with increased levels of work-to-family conflict while those who reported a higher culture conducive to women's academic success reported less work-to-family conflict. Culture conducive to women's academic success did not moderate the impact of work demand on work-to-family conflict. Conclusions: While departmental/division culture was important, it was not sufficient to completely mitigate work-to-family conflict. Work demand appears to impact work-to-family conflict related to strain, in which women report being too stressed by work to focus on their family and their own health and wellness. Employers can greatly impact work culture by reducing the strain of work demands that interfere with women pursuing promotion, increase burnout, and contribute to women faculty deciding to work part-time.
Collapse
Affiliation(s)
- Julie Radico
- Penn State College of Medicine and Penn State Health
| | - Tamara K. Oser
- University of Colorado School of Medicine Anschutz and the Penn State College of Medicine
| | | | | | - Ann Ouyang
- Penn State College of Medicine and Penn State Health
| | | |
Collapse
|
35
|
Borlik MF, Godoy SM, Wadell PM, Petrovic-Dovat L, Cagande CC, Hajirnis A, Bath EP. Women in Academic Psychiatry: Inequities, Barriers, and Promising Solutions. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:110-119. [PMID: 33532916 DOI: 10.1007/s40596-020-01389-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Affiliation(s)
- Marcy Forgey Borlik
- David Geffen School of Medicine at The University of California, Los Angeles, Los Angeles, CA, USA.
| | - Sarah M Godoy
- David Geffen School of Medicine at The University of California, Los Angeles, Los Angeles, CA, USA
| | - Paula M Wadell
- The University of California Davis School of Medicine, Davis, California, USA
| | | | - Consuelo C Cagande
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Aditi Hajirnis
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Eraka P Bath
- David Geffen School of Medicine at The University of California, Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
36
|
Gender Disparity and Potential Strategies for Improvement in Neurology and Clinical Neurophysiology. J Clin Neurophysiol 2020; 37:446-454. [PMID: 32756266 DOI: 10.1097/wnp.0000000000000712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Discrimination in the workplace when documented is illegal but is seen to still exist in some forms whether based on culture, race, or gender. Each of these disparities warrants further discussion and study because of their significant impacts on hiring decisions, career advancement, and compensation. In this article, the authors have focused their attention on gender disparity in the fields of neurology and clinical neurophysiology and shared the data currently available to them. At a time when the field of clinical neurophysiology has seen enormous growth, gender disparity in leadership and compensation remain. Despite the increasing number of women entering the fields of neurology and clinical neurophysiology, women remain underrepresented in national leadership positions. Many women physicians report experiencing gender discrimination despite increasing efforts by universities and medical centers to improve inclusivity and diversity. Equity and inclusivity are not the same and there is a disconnect between the increased numbers of women and their shared experiences in the workplace. Implicit bias undermines the ability of women to advance in their careers. For neurologists, data indicate that the latest gender pay gap is $56,000 (24%), increased from $37,000 in 2015, and is one of the largest pay gaps in any medical specialty. One third of the top 12 medical schools in the United States require that maternity leave be taken through disability coverage and/or sick benefits, and most family leave policies constrain benefits to the discretion of departmental leadership. The authors recommend strategies to improve gender disparity include institutional training to Identify and overcome biases, changes to professional organizations and national scientific meeting structure, transparency in academic hiring, promotion and compensation, and mentorship and sponsorship programs.
Collapse
|
37
|
Matsumoto MM, Schultz O, Jiang T, Navuluri R. Recruitment in Surgery and Interventional Radiology: Factors in Female Trainees' Specialty Decisions. JOURNAL OF SURGICAL EDUCATION 2020; 77:1454-1464. [PMID: 32571694 DOI: 10.1016/j.jsurg.2020.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/28/2020] [Accepted: 06/02/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE This study aims to identify factors influencing female medical students' decision-making about specialties, specifically surgery and interventional radiology (IR), in an effort to inform future recruitment and professional development strategies. DESIGN An electronic survey was created to assess both qualitative and quantitative data. SETTING The survey was sent prior to a symposium for trainees interested in pursuing IR or surgery, held at University of Chicago (Chicago, IL) in February 2019. PARTICIPANTS The 90 female trainees who registered were sent the survey, and 48 (53%) responded voluntarily. RESULTS All respondents were female, 46% planned to pursue surgery or IR. Students pursuing surgery/IR were less concerned about being valued by their colleagues (p = 0.0073), being in charge of patients' lives (p = 0.0017), radiation exposure (p = 0.0171), chemical exposure (p = 0.0223), emotional stress (p = 0.0244), or shift work (p = 0.0045), compared to the nonsurgery/IR students. No differences were found in ranking of motivating factors, personal strengths or weaknesses, deciding factors, areas for seeking mentorship, or gender diversity. Top motivations among all respondents were intellectual rigor of medicine and becoming a mentor, while concerns were personal physical health, managing a career, pay equity, and gender-based biases. Students most often sought mentors and clerkship experience for making specialty decisions. They reported greatest strengths in empathy and resilience, and weaknesses in negotiating and public speaking. CONCLUSIONS Female medical students planning to pursue surgery/IR expressed greater confidence in their contributions to patient care and lower concerns about workplace hazards. Regardless of specialty intent, female students shared scholarship motivations for a career in medicine, valued the role of mentorship, and expressed persistent concerns about gender discrimination, personal health, and skills-based weaknesses. Identifying factors influential in career decision-making is important in order to recruit and retain a more gender-diverse physician workforce.
Collapse
Affiliation(s)
- Monica M Matsumoto
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois; Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Olivia Schultz
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Teresa Jiang
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Rakesh Navuluri
- Department of Radiology, University of Chicago Medicine, Chicago, Illinois
| |
Collapse
|
38
|
Shanafelt T, Stolz S, Springer J, Murphy D, Bohman B, Trockel M. A Blueprint for Organizational Strategies To Promote the Well-being of Health Care Professionals. ACTA ACUST UNITED AC 2020. [DOI: 10.1056/cat.20.0266] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Tait Shanafelt
- Professor of Medicine, Chief Wellness Officer, and Associate Dean, Stanford University School of Medicine, Stanford, California, USA
| | - Sherilyn Stolz
- Executive Administrative Director, Stanford Medicine WellMD Center, Stanford University School of Medicine, Stanford, California, USA
| | - Jill Springer
- Administrative Director, Stanford Medicine WellMD Center, Stanford University School of Medicine, Stanford, California, USA
| | - Daniel Murphy
- Professor of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Bryan Bohman
- Clinical Professor, Anesthesiology, Perioperative and Pain Medicine, Stanford Medicine, Stanford, California, USA
| | - Mickey Trockel
- Associate Professor, Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|
39
|
Lim CT, Kleiner SM, Santopietro JM, Un H, Boyd JW. Physician Mental Health: Where to Intervene? A Framework and a Pilot Survey of Psychiatrists. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2020; 44:646-647. [PMID: 32607790 DOI: 10.1007/s40596-020-01271-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 06/17/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Christopher T Lim
- Cambridge Health Alliance/Harvard Medical School, Cambridge, MA, USA.
| | | | - John M Santopietro
- Hartford HealthCare/University of Connecticut School of Medicine, Hartford, CT, USA
| | | | - J Wesley Boyd
- Cambridge Health Alliance/Harvard Medical School, Cambridge, MA, USA
| |
Collapse
|
40
|
Marshall AL, Dyrbye LN, Shanafelt TD, Sinsky CA, Satele D, Trockel M, Tutty M, West CP. Disparities in Burnout and Satisfaction With Work-Life Integration in U.S. Physicians by Gender and Practice Setting. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:1435-1443. [PMID: 32459677 DOI: 10.1097/acm.0000000000003521] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To explore the interaction between practice setting (academic practice [AP], private practice [PP]) and gender in relation to physician burnout and satisfaction with work-life integration (WLI). METHOD In 2017, the authors administered a cross-sectional survey of U.S. physicians and characterized rates of burnout and satisfaction with WLI using previously validated and/or standardized tools. They conducted multivariable logistic regression to determine the interaction between the included variables. RESULTS Of the 3,603 participants in the final analysis, female physicians reported a higher prevalence of burnout than male physicians in both AP (50.7% vs 38.2%, P < .0001) and PP (48.1% vs 40.7%, P = .001). However, the multivariable analysis found no statistically significant gender-based differences in burnout (odds ratio [OR] 0.94, 95% confidence interval [CI] 0.76-1.17, P = .60). Women and men in AP were less likely to report burnout than men in PP (OR 0.70, 95% CI 0.52-0.94, P = .01 and OR 0.69, 95% CI 0.53-0.90, P < .01, respectively); women in PP did not report different burnout rates from men in PP (OR 0.89, 95% CI 0.68-1.16, P = .38). Women in both AP and PP were less likely to be satisfied with WLI than men in PP (OR 0.62, 95% CI 0.47-0.83, P < .01 and OR 0.75, 95% CI 0.58-0.97, P = .03, respectively); men in AP did not report different satisfaction with WLI than men in PP (OR 1.05, 95% CI 0.82-1.33, P = .71). CONCLUSIONS Gender differences in rates of burnout are related to practice setting and other differences in physicians' personal and professional lives. These results highlight the complex relationships among gender, practice setting, and other personal and professional factors in their influence on burnout and satisfaction with WLI.
Collapse
Affiliation(s)
- Ariela L Marshall
- A.L. Marshall is associate professor of medicine, Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota; ORCID: http://orcid.org/0000-0001-7388-0422
| | - Liselotte N Dyrbye
- L.N. Dyrbye is professor of medicine and medical education, Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Tait D Shanafelt
- T.D. Shanafelt is Jeanie and Stewart Ritchie Professor of Medicine and associate dean, Stanford School of Medicine, Stanford, California
| | - Christine A Sinsky
- C.A. Sinsky is vice president of professional satisfaction, American Medical Association, Chicago, Illinois
| | - Daniel Satele
- D. Satele is a statistician, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Mickey Trockel
- M. Trockel is clinical associate professor, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Michael Tutty
- M. Tutty is group vice president of professional satisfaction and practice sustainability, American Medical Association, Chicago, Illinois
| | - Colin P West
- C.P. West is professor of medicine, medical education, and biostatistics, Division of General Internal Medicine, Department of Internal Medicine, and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0003-1628-5023
| |
Collapse
|
41
|
Farrugia G, Zorn CK, Williams AW, Ledger KK. A Qualitative Analysis of Career Advice Given to Women Leaders in an Academic Medical Center. JAMA Netw Open 2020; 3:e2011292. [PMID: 32697324 PMCID: PMC7376389 DOI: 10.1001/jamanetworkopen.2020.11292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE Women in academic medicine continue to face systemic obstacles on their paths to leadership. In addition to improving recruitment and advancement opportunities, academic medical centers must facilitate a cultural shift that ensures sustained leadership pathways for women. OBJECTIVE To better understand, from the perspective of women leaders, the workplace and cultural changes that need to take place in academic medicine to increase inclusivity and gender equity. DESIGN, SETTING, AND PARTICIPANTS This qualitative study of 40 women physicians and administrators with senior leadership roles at Mayo Clinic, a nonprofit academic medical center and research institution with campuses in Arizona, Florida, and Minnesota, examined participants' responses to a question regarding their paths to leadership. Replies were submitted between November and December 2018. MAIN OUTCOMES AND MEASURES Women were asked to describe career advice (positive or negative) they had received that was the hardest to accept but, in retrospect, turned out to be valuable. RESULTS Of 40 participants, 25 (63%) were physicians and 15 (37%) were administrators at Mayo Clinic; 27 (68%) had achieved the role of chair or the administrative equivalent. Career experience ranged from 6 to 40 years. Of the 40 women leaders queried, 38 (95%) provided written responses, which were separated into the 4 following categories: leadership styles are perceived as having gendered qualities, attaining leadership skills involves a strategic learning process, collisions between personal life and the workplace should not deter individuals from pursuing leadership roles, and leadership pathways for women involved hurdles. These categories represented a roadmap illuminating perceptions about the academic medical workplace. CONCLUSIONS AND RELEVANCE These findings link generalizable principles to help to drive new strategies for gender parity. Shifting the culture of academic medicine begins with fully understanding impediments to women's advancement. The advice women leaders recounted offered a roadmap as well as a glimpse of the extra effort required for women to succeed amid some of the system's limitations and obstacles. A more complete understanding of gender biases may help to shape future programs to expand inclusivity and establish sustained leadership paths for women.
Collapse
|
42
|
Haas MR, Landry A, Joshi N. Breast Practices: Strategies to Support Lactating Emergency Physicians. Ann Emerg Med 2020; 75:681-690. [DOI: 10.1016/j.annemergmed.2020.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/05/2020] [Accepted: 01/06/2020] [Indexed: 11/30/2022]
|
43
|
Scott VCS, Lerner LB, Eilber KS, Anger JT, Ackerman AL. Re-evaluation of birth trends and pregnancy complications among female urologists: Have we made any progress? Neurourol Urodyn 2020; 39:1355-1362. [PMID: 32449995 DOI: 10.1002/nau.24409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/14/2020] [Indexed: 11/10/2022]
Abstract
AIMS Females are becoming surgeons at ever-increasing rates and doing so while many have or wish to have children. This study follows up on a 2007 effort to study the problems and conditions such women faced. We ask here if these challenges are different after a decade that included changes in working rules. METHODS A survey was sent to all female American Board of Urology diplomates. Birth trends, pregnancy complications, infertility service requirements, and satisfaction were evaluated in respondents (n = 183) and compared to the previous survey of female urologists who completed residency before August 2007 as well as Center for Disease Control data. RESULTS Seventy-six physicians completed the survey who were residents before 2007, while 107 replied who experienced residency after. The first group's average age was 50.2 and the second's 38.3. Overall, these women gave birth 6 to 7 years later than the US mean. Complications did not decrease, infertility occurred at similar levels, and both were higher than US norms. Length of maternity leave correlated with respondents' level of overall satisfaction. The most positive responses came from those with more than 8 weeks off (P = .002). CONCLUSIONS Women practicing in urology gave birth later, had greater fertility issues, used assisted reproductive technology (ART) more and reported a higher level of at least one complication during pregnancy than American women overall. Changes in hours and awareness of this issue have not made giving birth a healthier event for these physicians. Further investigation into factors other than work hours is needed.
Collapse
Affiliation(s)
- Victoria C S Scott
- Division of Urology, Cedars Sinai Medical Center, Beverly Hills, California
| | - Lori B Lerner
- Division of Urology, VA Boston Healthcare System, Boston, Massachusetts
| | - Karyn S Eilber
- Division of Urology, Cedars Sinai Medical Center, Beverly Hills, California
| | - Jennifer T Anger
- Division of Urology, Cedars Sinai Medical Center, Beverly Hills, California
| | - A Lenore Ackerman
- Division of Urology, Cedars Sinai Medical Center, Beverly Hills, California
| |
Collapse
|
44
|
Affiliation(s)
- Rebekah Mannix
- Division of Emergency Medicine Boston Children’s Hospital BostonMA
- Departments of Pediatrics and Emergency Medicine Harvard Medical School Boston MA
| | - Lois K. Lee
- Division of Emergency Medicine Boston Children’s Hospital BostonMA
- Departments of Pediatrics and Emergency Medicine Harvard Medical School Boston MA
| |
Collapse
|
45
|
Vance MC, Riano NS, Jagsi R, Guzman MJ, Beeler W, Linos E, Mangurian C. Assessment of Paid Childbearing and Family Leave Policies for Administrative Staff at Top US Medical Schools. JAMA Intern Med 2020; 180:589-592. [PMID: 31961376 PMCID: PMC6990862 DOI: 10.1001/jamainternmed.2019.6653] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This quality improvement study reviews the human resources policies for childbearing and family leave for administrative staff at 12 leading US medical schools.
Collapse
Affiliation(s)
- Mary C Vance
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Nicholas S Riano
- UCSF Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco
| | - Reshma Jagsi
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor.,Department of Radiation Oncology, University of Michigan, Ann Arbor
| | | | - Whitney Beeler
- Department of Radiation Oncology, University of Michigan, Ann Arbor
| | - Eleni Linos
- Department of Dermatology, Stanford University, Stanford, California.,Department of Epidemiology, Stanford University, Stanford, California
| | - Christina Mangurian
- UCSF Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco
| |
Collapse
|
46
|
Ormseth CH, Mangurian C, Jagsi R, Choo EK, Lowenstein DH, Hsia RY. Implementation of Federal Dependent Care Policies for Physician-Scientists at Leading US Medical Schools. JAMA Intern Med 2020; 180:153-157. [PMID: 31609401 PMCID: PMC6802225 DOI: 10.1001/jamainternmed.2019.4611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This survey study explores whether leading US medical schools have policies about dependent care travel costs.
Collapse
Affiliation(s)
- Cora H Ormseth
- School of Medicine, University of California, San Francisco, San Francisco
| | - Christina Mangurian
- Weill Institute for Neurosciences, Center for Vulnerable Populations, Department of Psychiatry, University of California, San Francisco, San Francisco
| | - Reshma Jagsi
- Center for Bioethics and Social Sciences in Medicine, Department of Radiation Oncology, University of Michigan, Ann Arbor
| | - Esther K Choo
- Center for Policy & Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Sciences University, Portland
| | - Daniel H Lowenstein
- Department of Neurology, University of California, San Francisco, San Francisco
| | - Renee Y Hsia
- Department of Emergency Medicine, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco
| |
Collapse
|
47
|
A Questionnaire to Assess the Challenges Faced by Women Who Quit Working as Full-Time Neurosurgeons. World Neurosurg 2020; 133:331-342. [DOI: 10.1016/j.wneu.2019.08.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 12/28/2022]
|
48
|
Ortiz Worthington R, Feld LD, Volerman A. Supporting New Physicians and New Parents: A Call to Create a Standard Parental Leave Policy for Residents. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:1654-1657. [PMID: 31299674 DOI: 10.1097/acm.0000000000002862] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Parents taking leave after the birth of a child is associated with significant benefits for infants, mothers, and fathers. Although nearly 40% of residents have or plan to have children during residency, there is no standard parental leave policy for these trainees. In this Perspective, the authors discuss the benefits of parental leave, synthesize findings about maternity bias and other negative effects of the current variable approaches to parental leave during residency, and explore underlying causes of the lack of a standard parental leave policy for residents. They also call on the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties to work together to address this issue, recommending a standard parental leave policy that ensures a minimum of 8 weeks of paid leave for all residents without requiring them to extend training or making them ineligible to sit for board certification exams. Creating evidence-based and family-friendly guidelines for parental leave is important to the progress of academic medicine in the modern era, as it supports parental and child health, promotes resident wellness, and reduces gender disparities in medicine to the benefit of all.
Collapse
Affiliation(s)
- Rebeca Ortiz Worthington
- R. Ortiz Worthington is a resident, Department of Internal Medicine, University of Chicago Medicine, Chicago, Illinois. L.D. Feld was chief resident, Department of Internal Medicine, University of Chicago Medicine, Chicago, Illinois, at the time this article was written. She is currently a fellow in gastroenterology and hepatology, University of Washington School of Medicine, Seattle, Washington. A. Volerman is assistant professor, Departments of Medicine and Pediatrics, University of Chicago Medicine, Chicago, Illinois
| | | | | |
Collapse
|
49
|
Weaver AN, Willett LL. Is It Safe to Ask the Questions That Matter Most to Me? Observations From a Female Residency Applicant. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:1635-1637. [PMID: 31192805 DOI: 10.1097/acm.0000000000002837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Tens of thousands of senior medical students interview for medical residency positions each year. As the applicant pool shifts to include more women, married individuals, and young parents, the criteria by which interviewees evaluate programs are also changing. Concerns including parental leave policies, lactation facilities, access to childcare, partner recruitment resources, and inclusivity in the work environment are important in selecting an ideal program. However, the National Resident Matching Program Match Communication Code of Conduct prohibits interviewers from addressing gender, marital status, and intent to bear children, so the burden of introducing such topics falls on the interviewees. These topics can be difficult to discuss with potential employers, especially when weighed against the pressure to obtain a competitive position through the Match.In this Invited Commentary, the authors draw on personal experience to examine the questions that residency programs need to answer, encouraging both applicants and programs to improve communication during the residency interview process.
Collapse
Affiliation(s)
- Alice N Weaver
- A.N. Weaver is a first-year resident, Internal Medicine Residency Program, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama. L.L. Willett is professor and program director, Internal Medicine Residency Program, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | | |
Collapse
|
50
|
Stack SW, Jagsi R, Biermann JS, Lundberg GP, Law KL, Milne CK, Williams SG, Burton TC, Larison CL, Best JA. Maternity Leave in Residency: A Multicenter Study of Determinants and Wellness Outcomes. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:1738-1745. [PMID: 31094723 DOI: 10.1097/acm.0000000000002780] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE To characterize determinants of resident maternity leave and the effect of length of leave on maternal well-being. METHOD In 2017, the authors sent a voluntary, anonymous survey to female residents at 78 programs, in 25 unique specialties, at 6 institutions. Survey items included personal, partner, and child demographics, and logistics of leave, including whether leave was paid or vacation or sick leave was used. Outcomes were maternity leave length; duration of breastfeeding; burnout and postpartum depression screens; perceptions of support; and satisfaction with length of leave, breastfeeding, and childbearing during residency. RESULTS Fifty-two percent (804/1,537) of residents responded. Among 16% (126) of respondents who were mothers, 50% (63) had their first child during residency. Seventy-seven maternity leaves were reported (range, 2-40 weeks), with most taking 6 weeks (32% of leaves; 25) and including vacation (81%; 62) or sick leave (64%; 49). Length of leave was associated with institution, use of sick leave or vacation, and amount of paid leave. The most frequently self-reported determinant of leave was the desire not to extend residency training (27%; 59). Training was not extended for 53% (41) of mothers; 9% (7) were unsure. Longer breastfeeding duration and perceptions of logistical support from program administration were associated with longer maternity leaves. Burnout affected approximately 50% (38) of mothers regardless of leave length. CONCLUSIONS This study illustrates variability in administration of resident maternity leaves. Targets for intervention include policy clarification, improving program support, and consideration of parent wellness upon return to work.
Collapse
Affiliation(s)
- Shobha W Stack
- S.W. Stack is assistant professor of medicine, associate director, Medicine Student Programs, and director, Medical Student Scholarship, University of Washington School of Medicine, Seattle, Washington; ORCID: https://orcid.org/0000-0001-6586-9266. R. Jagsi is professor of radiation oncology, program director, Radiation Oncology Residency Program, and director, Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0001-6562-1228. J.S. Biermann is professor of orthopedic surgery and associate dean of graduate medical education at the University of Michigan Medical School, Ann Arbor, Michigan. G.P. Lundberg is associate professor of medicine, Division of Cardiology, Emory University School of Medicine, and clinical director, Emory Women's Heart Center, Atlanta, Georgia. K.L. Law is associate professor of medicine, program director, Internal Medicine Residency Program, and associate vice chair of education, Department of Medicine at the Emory University School of Medicine, Atlanta, Georgia. C.K. Milne is professor of medicine, program director, Internal Medicine Residency Program, and vice chair for education, University of Utah, Salt Lake City, Utah; ORCID: https://orcid.org/0000-0002-4782-1901. S.G. Williams is assistant professor of reproductive medicine, University of California, San Diego School of Medicine, San Diego, California. T.C. Burton is assistant professor of pediatrics, University of South Florida College of Medicine, Tampa, Florida. C.L. Larison is research consultant, Department of Health Services, University of Washington School of Public Health, Seattle, Washington; ORCID: https://orcid.org/0000-0002-1412-5993. J.A. Best is associate professor of medicine, associate program director, Internal Medicine Residency Program, and associate dean of graduate medical education, University of Washington School of Medicine, Seattle, Washington
| | | | | | | | | | | | | | | | | | | |
Collapse
|