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Cardona G, Herrera A. Gender distribution in publishing in five leading optometry journals. Ophthalmic Physiol Opt 2024; 44:634-640. [PMID: 38321803 DOI: 10.1111/opo.13283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 01/13/2024] [Accepted: 01/24/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE To explore gender distribution in authorship and citation parameters of articles published in five optometry journals included in the Ophthalmology category of Journal Citation Reports. METHODS The Scopus database was used to retrieve all citable articles published in 2011 and 2021 in Optometry and Vision Science, Ophthalmic and Physiological Optics, Clinical Experimental Optometry, Contact Lens and Anterior Eye, and Eye and Contact Lens. Gender of the first, last and single authors of all articles, and citation parameters of articles published in 2011 up to May 2023 were determined. Gender of the editor-in-chief and members of the editorial board of these journals was investigated (May 2023). RESULTS Only one journal had a female editor-in-chief and three journals had more males than females in their editorial board. In 2011 and 2021, respectively, 40.1% and 48.0% of articles had female as the first authors (χ 1 , 948 2 = 5.77; p = 0.02), and 32.7% and 39.6% had female as the last authors (χ 1 , 948 2 = 4.61; p = 0.03). Gender parity was observed in one journal for the first author and none for the last author in 2011, and in three journals for the first author and one for the last author in 2021. Regarding combinations of male (M) and female (F) first and last authorship positions, the authors of articles in 2011 were MM (44.5%), FM (22.8%), FF (17.3%) and MF (15.4%), and MM (34.6%), FM (25.8%), FF (22.1%) and MF (17.5%) in 2021. Differences between 2011 and 2021 were statistically significant (χ 3 , 948 2 = 9.80; p = 0.02). The proportion of authorship combinations did not show statistically significant differences among journals in 2011 or in 2021. Neither citation nor self-citation were influenced by gender. CONCLUSIONS Gender disparities persist in optometry journals, with females being under-represented in senior and leadership positions. Increasing the awareness of gender disparity in authorship is a necessary step towards ensuring fairness in science in general, and optometry in particular.
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Affiliation(s)
- Genis Cardona
- Applied Optics and Image Processing Group (GOAPI), School of Optics and Optometry of Terrassa, Universitat Politècnica de Catalunya (UPC), Terrassa, Spain
| | - Aitor Herrera
- School of Optics and Optometry of Terrassa, Universitat Politècnica de Catalunya (UPC), Terrassa, Spain
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Marchetti KA, Ferreri CA, Bethel EC, Lesser-Lee B, Daignault-Newton S, Merrill S, Badalato GM, Brown ET, Guzzo T, Houston Thompson R, Klausner A, Lee R, Parekh DJ, Raman JD, Reese A, Shenot P, Williams DH, Zaslau S, Kraft KH. Gender-based Disparity Exists in the Surgical Experience of Female and Male Urology Residents. Urology 2024; 185:17-23. [PMID: 38336129 DOI: 10.1016/j.urology.2023.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/31/2023] [Accepted: 11/28/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To determine if a discrepancy exists in the number and type of cases logged between female and male urology residents. MATERIALS AND METHODS ACGME case log data from 13 urology residency programs was collected from 2007 to 2020. The number and type of cases for each resident were recorded and correlated with resident gender and year of graduation. The median, 25th and 75th percentiles number of cases were calculated by gender, and then compared between female and male residents using Wilcoxon rank sum test. RESULTS A total of 473 residents were included in the study, 100 (21%) were female. Female residents completed significantly fewer cases, 2174, compared to male residents, 2273 (P = .038). Analysis by case type revealed male residents completed significantly more general urology (526 vs 571, P = .011) and oncology cases (261 vs 280, P = .026). Additionally, female residents had a 1.3-fold increased odds of logging a case in the assistant role than male residents (95% confidence interval: 1.27-1.34, P < .001). CONCLUSION Gender-based disparity exists within the urology training of female and male residents. Male residents logged nearly 100 more cases than female residents over 4years, with significant differences in certain case subtypes and resident roles. The ACGME works to provide an equal training environment for all residents. Addressing this finding within individual training programs is critical.
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Affiliation(s)
- Kathryn A Marchetti
- University of Pittsburgh Medical Center, Department of Urology, Pittsburgh, PA.
| | - Charles A Ferreri
- Vanderbilt University Medical Center, Department of Urology, Nashville, TN
| | - Emma C Bethel
- University of North Carolina School of Medicine, Department of Urology, Chapel Hill, NC
| | | | | | | | | | - Elizabeth T Brown
- MedStar Georgetown University Hospital, Department of Urology, Washington, DC
| | - Thomas Guzzo
- University of Pennsylvania, Department of Urology, Philadelphia, PA
| | | | - Adam Klausner
- Virginia Commonwealth University, Division of Urology, Richmond, VA
| | - Richard Lee
- Weill Cornell Medicine, Department of Urology, New York, NY
| | - Dipen J Parekh
- University of Miami Health System, Department of Urology, Miami, FL
| | - Jay D Raman
- Pennsylvania State University College of Medicine, Department of Urology, Hershey, PA
| | - Adam Reese
- Temple University, Department of Urology, Philadelphia, PA
| | - Patrick Shenot
- Jefferson Health, Department of Urology, Philadelphia, PA
| | | | - Stanley Zaslau
- West Virginia University School of Medicine Urology, Morgantown, WV
| | - Kate H Kraft
- University of Michigan Health System, Department of Urology, Ann Arbor, MI
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Udeh A, Huh D, Young T, Knight O, Woreta F. Disparities in Promotion and Retention Rates Among Underrepresented in Medicine Faculty in U.S. Ophthalmology Departments. Am J Ophthalmol 2024; 258:1-7. [PMID: 37757997 DOI: 10.1016/j.ajo.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE This study examines the rates and trends of faculty promotions within the field of ophthalmology, with comparative emphasis on the rates of promotion among underrepresented in medicine (URiM) faculty. DESIGN A retrospective panel study was conducted using the Association of American Medical Colleges Faculty Roster database. METHODS We used the Association of American Medical Colleges Faculty Roster data to assess trends in academic faculty promotions within U.S. ophthalmology departments. Full-time assistant and associate professors appointed between 2000 and 2010 were included in the analysis, and tracked until November 2021 to determine promotion rates. Pearson χ2 and Fisher exact tests were used to evaluate differences in promotion and retention rates based on gender, race and ethnicity, advanced degree, and tenure status. RESULTS The demographics of 1436 assistant and 680 associate faculty members were obtained for analysis through the Association of American Medical Colleges. Black faculty had lower promotion rates when compared with White faculty (20% vs 37%, P < .001). Faculty with MD and PhD degrees demonstrated higher promotion rates than faculty with MD degrees alone (59% vs 36%, P < .001). In addition, faculty not on tenure track had lower rates of promotion than those on tenure track (35% vs 48%, P < .001). With respect to faculty retention, among assistant and associate professors combined, Black faculty and faculty without tenure track appointments were more likely to leave academic medicine (46% vs 33%, P < .001) and (36% vs 27%, P < .001), respectively. CONCLUSION In this study, promotion rates varied significantly by race/ethnicity. Specifically, Black faculty had lower rates of promotion and retention in academic medicine. These findings underscore the need to explore and implement strategies and policies to address equity in promotion rates and retention of URiM faculty within academic ophthalmology.
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Affiliation(s)
- Adanna Udeh
- From the Department of Ophthalmology (A.U.), New York Langone Medical Center, New York, New York
| | - Dana Huh
- Wilmer Eye Institute (D.H., F.W.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Terri Young
- Department of Ophthalmology and Visual Sciences (T.Y.), University of Wisconsin, Madison, Wisconsin
| | - O'Rese Knight
- Kittner Eye Center (O.K.), University of North Carolina, Chapel Hill, North Carolina, USA
| | - Fasika Woreta
- Wilmer Eye Institute (D.H., F.W.), Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Gottlieb M, Mannix A, Shappell E, Jordan J, Fix M, Cooney R, King A, Krzyzaniak S. Differences in Emergency Medicine Resident Procedural Reporting by Gender in the United States. J Grad Med Educ 2024; 16:70-74. [PMID: 38304598 PMCID: PMC10829910 DOI: 10.4300/jgme-d-23-00238.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/17/2023] [Accepted: 10/17/2023] [Indexed: 02/03/2024] Open
Abstract
Background Studies across specialties have demonstrated gender disparities in feedback, learner assessments, and operative cases. However, data are limited on differences in numbers of procedures among residents. Objective To quantify the association between gender and the number of procedures reported among emergency medicine (EM) residents. Methods We conducted a retrospective review of procedural differences by self-identified gender among graduating EM residents at 8 separate programs over a 10-year period (2013 to 2022). Sites were selected to ensure diversity of program length, program type, and geography. Residents from combined training programs, those who did not complete their full training at that institution, and those who did not have data available were excluded. We calculated the mean, SD, median, and IQR for each procedure by gender. We compared reported procedures by gender using linear regression, controlling for institution, and performed a sensitivity analysis excluding outlier residents with procedure totals >3 SD from the mean. Results We collected data from 914 residents, with 880 (96.3%) meeting inclusion criteria. There were 358 (40.7%) women and 522 (59.3%) men. The most common procedures were point-of-care ultrasound, adult medical resuscitation, adult trauma resuscitation, and intubations. After adjusting for institutions, the number of dislocation reductions, chest tube insertions, and sedations were higher for men. The sensitivity analysis findings were stable except for central lines, which were also more common in men. Conclusions In a national sample of EM programs, there were increased numbers of dislocation reductions, chest tube insertions, and sedations reported by men compared with women.
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Affiliation(s)
- Michael Gottlieb
- Michael Gottlieb, MD, is Vice Chair of Research, Ultrasound Division Director, and Associate Professor, Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Alexandra Mannix
- Alexandra Mannix, MD, is Assistant Residency Program Director and Assistant Professor, Department of Emergency Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida, USA
| | - Eric Shappell
- Eric Shappell, MD, MHPE, is Associate Residency Program Director and Assistant Professor, Department of Emergency Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Jaime Jordan
- Jaime Jordan, MD, MAEd, is Vice Chair Acute Care College, Associate Residency Program Director, and Associate Professor, Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Megan Fix
- Megan Fix, MD, is Vice Chair of Education and Associate Professor, Department of Emergency Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Robert Cooney
- Robert Cooney, MD, MSMedEd, is Associate Dean of Faculty Development and Associate Professor, Department of Emergency Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Andrew King
- Andrew King, MD, is Associate Residency Program Director, Associate Professor, Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA; and
| | - Sara Krzyzaniak
- Sara Krzyzaniak, MD, is Residency Program Director, Associate Vice Chair, and Associate Professor, Department of Emergency Medicine, Stanford University, Stanford, California, USA
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Parvand M, Eslami M, Doughty N, Yeung SN, Kherani F. Closing the Gender Gap Among Canadian Ophthalmology Societies. Semin Ophthalmol 2024; 39:150-157. [PMID: 37731295 DOI: 10.1080/08820538.2023.2253898] [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] [Received: 07/03/2023] [Accepted: 08/16/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE To evaluate gender distribution in Canadian ophthalmology societies' leadership and to determine associations between gender, academic productivity, and institutional rank. METHODS We identified members and assessed their gender composition using publicly available updated webpages. SCOPUS database was used to gather research metrics. RESULTS In this study, data was collected from 12 Canadian ophthalmology societies, which included 277 executive committee members. Of these, 70.5% (196) were male and 29.1% (81) were female (p < .0001). Males were significantly more prevalent in presidential leadership roles (39 males vs. 23 females, p = .02), while females were more represented in other leadership categories (77 females vs. 61 males, p = .03). The Canadian Ophthalmological Society (COS) showed an upward trend in female representation from 19.2% in 2016 to 42.3% in 2021. Research productivity showed a positive correlation with society leadership rank, with a correlation coefficient of 0.732 for the m-index (p < .001) and 0.356 for the h-index (p < .05). Academic rank was also positively correlated with society leadership rank, with a correlation coefficient of 0.536 (p < .001). There was no significant difference in h-index (12.7 ± 1.0 for males vs. 13.8 ± 1.5 for females, p = .85) or number of publications (48.6 ± 5.1 for males vs. 60.0 ± 11.3 for females, p = .83) between male and female executive members, but females had a higher m-index (0.67 ± 0.05) compared to males (0.58 ± 0.03, p < .05). In academic rank, males were more likely to be associate professors (25% vs. 5% for females, p = .0001) or instructors (14.8% vs. 6.3% for females, p = .05), while a higher proportion of females held assistant professor positions (47.5% for females vs. 30.1% for males, p = .006). CONCLUSION In this study, we found that males were more prevalent in executive positions, particularly in presidential roles among Canadian ophthalmology societies. The gender distribution in leadership reflected the gender composition of practicing ophthalmologists in Canada. There was a positive correlation between research productivity and society rank, as well as academic position and society rank. Male and female executive members had similar h-index and number of publications, but females had a higher m-index. These findings highlight the need for continued efforts to address gender disparities in ophthalmology leadership.
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Affiliation(s)
- Mahraz Parvand
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Maryam Eslami
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Natalie Doughty
- Division of Ophthalmology, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Sonia N Yeung
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Femida Kherani
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, BC, Canada
- Division of Ophthalmology, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Rousta N, Hussein IM, Kohly RP. Sex Disparities in Ophthalmology From Training Through Practice: A Systematic Review. JAMA Ophthalmol 2024; 142:146-154. [PMID: 38236584 DOI: 10.1001/jamaophthalmol.2023.6118] [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: 01/19/2024]
Abstract
Importance Sex-based research in medicine has revealed inequities against females on almost every metric at almost every career stage; ophthalmology is no exception. Objective To systematically review the experiences of females in ophthalmology (FiO) from training through practice in high-income countries (HICs). Evidence Review A systematic review of English-language studies, published between January 1990 and May 2022, relating to FiO in HICs was performed. PubMed, MEDLINE, and Embase electronic databases were searched, as well as the Journal of Academic Ophthalmology as it was not indexed in the searched databases. Studies were organized by theme at each career stage, starting in medical school when an interest in ophthalmology is expressed, and extending up to retirement. Findings A total of 91 studies, 87 cross-sectional and 4 cohort, were included. In medical school, mentorship and recruitment of female students into ophthalmology was influenced by sex bias, with fewer females identifying with ophthalmologist mentors and gender stereotypes perpetuated in reference letters written by both male and female referees. In residency, females had unequal learning opportunities, with lower surgical case volumes than male trainees and fewer females pursued fellowships in lucrative subspecialties. In practice, female ophthalmologists had lower incomes, less academic success, and poorer representation in leadership roles. Female ophthalmologists had a greater scholarly impact factor than their male counterparts, but this was only after approximately 30 years of publication experience. Pervasive throughout all stages of training and practice was the experience of greater sexual harassment among females from both patients and colleagues. Despite these disparities, some studies found that females reported equal overall career satisfaction rating with males in ophthalmology, whereas others suggested higher burnout rates. Conclusions and Relevance Ophthalmology is approaching sex parity, however, the increase in the proportion of females in ophthalmology had not translated to an increase in female representation in leadership positions. Sex disparities persisted across many domains including recruitment, training, practice patterns, academic productivity, and income. Interventions may improve sex equity in the field.
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Affiliation(s)
- Nikki Rousta
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Isra M Hussein
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Radha P Kohly
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
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Eruchalu CN, Etheridge JC, Hammaker AC, Kader S, Abelson JS, Harvey J, Farr D, Stopenski SJ, Nahmias JT, Elsaadi A, Campbell SJ, Foote DC, Ivascu FA, Montgomery KB, Zmijewski P, Byrd SE, Kimbrough MK, Smith S, Postlewait LM, Dodwad SJM, Adams SD, Markesbery KC, Meister KM, Woeste MR, Martin RCG, Callahan ZM, Marks JA, Patel P, Anstadt MJ, Nasim BW, Willis RE, Patel JA, Newcomb MR, Stahl CC, Yafi MA, Sutton JM, George BC, Quillin RC, Cho NL, Cortez AR. Racial and Ethnic Disparities in Operative Experience Among General Surgery Residents: A Multi-Institutional Study from the US ROPE Consortium. Ann Surg 2024; 279:172-179. [PMID: 36928294 PMCID: PMC11104265 DOI: 10.1097/sla.0000000000005848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To determine the relationship between race/ethnicity and case volume among graduating surgical residents. BACKGROUND Racial/ethnic minority individuals face barriers to entry and advancement in surgery; however, no large-scale investigations of the operative experience of racial/ethnic minority residents have been performed. METHODS A multi-institutional retrospective analysis of the Accreditation Council for Graduate Medical Education case logs of categorical general surgery residents at 20 programs in the US Resident OPerative Experience Consortium database was performed. All residents graduating between 2010 and 2020 were included. The total, surgeon chief, surgeon junior, and teaching assistant case volumes were compared between racial/ethnic groups. RESULTS The cohort included 1343 residents. There were 211 (15.7%) Asian, 65 (4.8%) Black, 73 (5.4%) Hispanic, 71 (5.3%) "Other" (Native American or Multiple Race), and 923 (68.7%) White residents. On adjusted analysis, Black residents performed 76 fewer total cases (95% CI, -109 to -43, P <0.001) and 69 fewer surgeon junior cases (-98 to -40, P <0.001) than White residents. Comparing adjusted total case volume by graduation year, both Black residents and White residents performed more cases over time; however, there was no difference in the rates of annual increase (10 versus 12 cases per year increase, respectively, P =0.769). Thus, differences in total case volume persisted over the study period. CONCLUSIONS In this multi-institutional study, Black residents graduated with lower case volume than non-minority residents throughout the previous decade. Reduced operative learning opportunities may negatively impact professional advancement. Systemic interventions are needed to promote equitable operative experience and positive culture change.
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Affiliation(s)
- Chukwuma N Eruchalu
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - James C Etheridge
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Ariadne Labs, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, Boston, MA
| | - Austin C Hammaker
- Department of Surgery, Cincinnati Research on Education in Surgical Training (CREST), University of Cincinnati, Cincinnati, OH
| | - Sarah Kader
- Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA
| | - Jonathan S Abelson
- Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA
| | - Jalen Harvey
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Deborah Farr
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Jeffry T Nahmias
- Department of Surgery, University of California Irvine, Orange, CA
| | - Ali Elsaadi
- Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX
| | - Samuel J Campbell
- Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX
| | - Darci C Foote
- Department of Surgery, Beaumont Health, Royal Oak, MI
| | | | | | - Polina Zmijewski
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Samuel E Byrd
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Mary K Kimbrough
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR
| | | | | | | | - Sasha D Adams
- Department of Surgery, McGovern Medical School at UTHealth, Houston, TX
| | | | | | | | | | | | - Joshua A Marks
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Purvi Patel
- Department of Surgery, Loyola University, Maywood, IL
| | | | - Bilal Waqar Nasim
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Ross E Willis
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Jitesh A Patel
- Department of Surgery, University of Kentucky, Lexington, KY
| | | | | | - Motaz Al Yafi
- Department of Surgery, University of Toledo, Toledo, OH
| | - Jeffrey M Sutton
- Department of Surgery, Medical University of South Carolina, Division of Oncologic and Endocrine Surgery, Charleston, SC
| | - Brian C George
- Department of Surgery, Center for Surgical Training and Research (CSTAR), University of Michigan, Ann Arbor, MI
| | - Ralph C Quillin
- Department of Surgery, Cincinnati Research on Education in Surgical Training (CREST), University of Cincinnati, Cincinnati, OH
| | - Nancy L Cho
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Alexander R Cortez
- Department of Surgery, Cincinnati Research on Education in Surgical Training (CREST), University of Cincinnati, Cincinnati, OH
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Kalaw FGP, Tavakoli K, Baxter SL. Evaluation of Publications from the American Academy of Ophthalmology: A 5-Year Analysis of Ophthalmology Literature. OPHTHALMOLOGY SCIENCE 2023; 3:100395. [PMID: 38025157 PMCID: PMC10630667 DOI: 10.1016/j.xops.2023.100395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/21/2023] [Accepted: 09/05/2023] [Indexed: 12/01/2023]
Abstract
Objective To analyze recent publications in Ophthalmology, the journal of the American Academy of Ophthalmology. Design Retrospective review of published articles. Participants No human participants were involved in the study. Methods Articles published in Ophthalmology from January 2018 to December 2022 were reviewed and analyzed. Main Outcome Measures Research and review articles were included and analyzed per the following: total number of published articles based on related subspecialty area, level of evidence using the modified Oxford level of evidence, number of citations, number of listed authors, gender of the corresponding author, country of affiliation of the corresponding and contributing author(s), and involvement of consortium(s), group(s), or committee(s). Results A total of 965 articles were included. The mean (standard deviation) number of authors per article was 8.6 (5.7) and the majority of corresponding authors were male (665, 70.7%). The greatest number of published articles were related to retina (296, 30.7%) followed by glaucoma (172, 17.8%). The greatest number of Preferred Practice Pattern guidelines were also related to retina (7/24, 29.1%), followed by cornea/dry eye syndrome/external disease (6/24, 25%). Retina (77) had the most level 1 evidence, glaucoma (30) for level 2 evidence, and retina for levels 3 (69) and 4 (65). There were 223 articles contributed by consortia/groups/committees, with most from retina (73, 32.7%) followed by glaucoma (40, 17.9%). The mean number of citations per subspecialty article was highest in retina (45.8/article), followed by uveitis (31.7/article). The United States had the greatest number of affiliated corresponding authors (544, 56.4%), followed by the United Kingdom (68, 7.0%). There were 357 (37.0%) articles with coauthors affiliated outside the corresponding author's country of affiliation, although with a downward trend over the most recent 5-year period. There has been an increasing trend in the number of authors and consortia/group/committee involvement in publications. Conclusions Although team science and collaborations have increased recently, ongoing efforts to diversify individuals, groups, and subspecialties may be needed. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Fritz Gerald P. Kalaw
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, California
| | - Kiana Tavakoli
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, California
| | - Sally L. Baxter
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, California
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Maling S, Kaur K, Gurnani B. Should there be global standards in ophthalmology training? Eye (Lond) 2023; 37:3710-3711. [PMID: 37248428 PMCID: PMC10697952 DOI: 10.1038/s41433-023-02582-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/02/2023] [Accepted: 05/11/2023] [Indexed: 05/31/2023] Open
Affiliation(s)
- Sarah Maling
- Buckinghamshire Healthcare Trust, Stoke Mandeville Hospital, Aylesbury, UK.
| | - Kirandeep Kaur
- Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janakikund, Chitrakoot, Madhya Pradesh, 485334, India
| | - Bharat Gurnani
- Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janakikund, Chitrakoot, Madhya Pradesh, 485334, India.
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Barequet IS, Rosenblatt A, Schaap Fogler M, Pedut-Kloizman T, Gaton D, Loewenstein A, Habot-Wilner Z. Gender related trends among Israeli ophthalmologists professional career and personal life performance. Eye (Lond) 2023; 37:3496-3501. [PMID: 37106146 PMCID: PMC10630451 DOI: 10.1038/s41433-023-02543-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/17/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Gender-diversity trends in ophthalmology in Israel have not been studied despite a high proportion of female ophthalmologists. Our purpose was to evaluate gender-related trends in ophthalmology professional career and personal life performance in early and advanced careers in Israel. METHODS A survey based on a nationwide voluntary anonymous web questionnaire was distributed to the members of the Israeli Ophthalmological Society. The questionnaire included questions referring to professional career and personal life performance. Gender differences were analyzed. RESULTS Out of 252 respondents, 116 (46%) were women, with a mean age of 47.97 + -11.3 and 53.18 + -12.4 (P = 0.01) years, respectively. Marital status, post-residency fellowship performance or duration, an additional academic degree, academic appointments, and managerial positions were similar between genders. Fellowship predominance of males was found in cornea/cataract/refractive and of females in strabismus, pediatric ophthalmology, and neuro-ophthalmology (P < 0.01, P = 0.032, respectively). Men had significantly more publications and appointments in peer review journals and work hours (P = 0.04 and P = 0.02, P = 0.027, respectively). Both genders responded similarly regarding work satisfaction, combination between family life and work. More women felt inequity during and post-residency in clinical (P = 0.011, P = 0.001, respectively) and surgical work (P = 0.001, P = 0.035, respectively). More women experienced inappropriate remarks from patients and sexual harassment (P = 0.001, P < 0.001, respectively), and supported the need for affirmative action (P < 0.0001). CONCLUSIONS Several gender disparities were found among ophthalmologists in Israel, including subspecialties distributions, publications, appointments in peer review journals, working hours, work inequity sense, harassment events, and support the need for affirmative action.
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Affiliation(s)
- Irina S Barequet
- Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Amir Rosenblatt
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michal Schaap Fogler
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | | | - Dan Gaton
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | - Anat Loewenstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Zohar Habot-Wilner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Ní Dhubhghaill S, Sanogo M, Lefebvre F, Aclimandos W, Asoklis R, Atilla H, Creuzot-Garcher C, Curtin D, Cvenkel B, Flanagan L, Kivelä TT, Maino A, Martinez Costa R, Priglinger S, Prior Filipe H, Stopa M, Strong B, Sturmer J, Tassignon MJ, Ivekovic R, Bourcier T. Cataract surgical training in Europe: European Board of Ophthalmology survey. J Cataract Refract Surg 2023; 49:1120-1127. [PMID: 37867285 DOI: 10.1097/j.jcrs.0000000000001280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/02/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE To survey recently graduated European ophthalmologists concerning cataract surgery (CS) training opportunities. SETTING Countries affiliated to the European Board of Ophthalmology (EBO). DESIGN Cross-sectional study of anonymous survey results. METHODS A 23-question online survey was emailed to candidates who sat the EBO Diploma Examination as residents between 2018 and 2022. RESULTS 821 ophthalmologists from 30 countries completed the survey. The mean residency duration was 4.73 (SD 0.9) years. The mean reported number of entire CS procedures performed was 80.7 (SD 100.6) at the end of residency, but more than 25% of respondents (n = 210) had received no live CS training during their residency. The self-confidence (scale, 1 to 10) to perform a simple case or challenging case, manage posterior capsular rupture, and realize a corneal stitch were rated 4.1, 3.2, 4.2, 2.4, respectively. We observed extensive variation in clinical exposure to CS and self-reported confidence to perform CS between European trainees. Females reported a mean of 18% fewer entire procedures than their male colleagues and were also less confident in their surgical skills (P < .05). Trainees in residency programs longer than 5 years performed fewer procedures and were less confident than trainees in residences of shorter duration (P < .001). The importance of fellowships to complete surgical education was rated 7.7 out of 10. CONCLUSIONS CS training across European countries lacks harmony. Female ophthalmology trainees continue, as in other specialties, to experience apparent gender bias. European level recommendations seem necessary to raise and harmonize competency-based CS training programs and promote post-residency fellowship training programs.
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Affiliation(s)
- Sorcha Ní Dhubhghaill
- From the Department of Ophthalmology, Antwerp University and University Hospital of Antwerp, Antwerp, Belgium (Ní Dhubhghaill, Tassignon); Department of Ophthalmology, Strasbourg University Hospital, NHC, FMTS, University of Strasbourg, Strasbourg, France (Sanogo, Bourcier); Department of Biostatistics, Strasbourg University Hospital, Civil Hospital, FMTS, University of Strasbourg, Strasbourg, France (Lefebvre); King's College Hospital, London, United Kingdom (Aclimandos); Department of Ophthalmology, Center of Eye Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania (Asoklis); Department of Ophthalmology, Ankara University, School of Medicine, Ankara, Turkey (Atilla); Department of Ophthalmology, Dijon University Hospital, University of Dijon, Dijon, France (Creuzot-Garcher); Consultant Ophthalmologist, Clinical Lecturer, Royal College of Surgeons in Ireland, Dublin, Ireland (Curtin); Department of Ophthalmology, University Medical Centre Ljubljana, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (Cvenkel); EBO Secretariat Office, Agenda Communications and Conference Services, Ltd., Dublin, Ireland (Flanagan, Strong); Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (Kivelä); Manchester Royal Eye Hospital, Manchester, United Kingdom (Maino); Department of Ophthalmology, Hospital Universitario y Politécnico La Fe, University of Valencia, Valencia, Spain (Martinez Costa); Department of Ophthalmology, LMU Munich, Germany (Priglinger); Department of Ophthalmology, West Lisbon Hospitals Center, Hospital Egas Moniz, Portugal (Prior Filipe); Department of Ophthalmology, Poznan University Hospital, Poznan University of Medical Sciences, Poland (Stopa); Department of Ophthalmology, Cantonal Hospital Winterthur, University of Zurich, Switzerland (Sturmer); Department of Ophthalmology, University Medical Centre Sestre Milosrdnice, Zagreb, Croatia (Ivekovic)
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12
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Rivera PA, Atayde A, Wang L, Kombo N. Female Authorship and Ophthalmology Journal Editorial Board Membership Trends Over the Last Decade, 2012-2021. Am J Ophthalmol 2023; 255:107-114. [PMID: 37463630 DOI: 10.1016/j.ajo.2023.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/01/2023] [Accepted: 07/01/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To study the relationship between female authorship and editorial board membership in 3 ophthalmology journals from 2012 to 2021. DESIGN Cross-sectional and trend study. METHODS The prevalence of female first, senior authorship, and editorial board members were examined in Ophthalmology, JAMA Ophthalmology, and American Journal of Ophthalmology. Gender-API assigned gender to authors based on name and country. Editorial board (EB) information was manually extracted and grouped for comparison among leadership positions. Gender data collected on authorship and EB membership were compared. The proportion of women in EB positions was identified: editor-in-chief, mid-level editors, and consulting editors. Relationship between female authorship and editorial board membership was analyzed. RESULTS Women published fewer articles as first (1547/4267) and senior (1165/4267) authors than did men. The proportion of women in senior authorship significantly increased from 2012 to 2021 (23.4% to 30.5%, P = .0046). Across EB, a significant increase in female members (13.9% to 34.6%, P = .0006) was observed. There was a significant correlation (P < .0001) between female EB members and female authors (r = 0.74, 95% CI = 0.51-0.87) for all journals. The odds of female first authorships were 1.89 (95% CI = 1.65-2.17) times higher for articles with female senior authors than for male senior authors (P < .0001). CONCLUSION Female senior authorship significantly increased over the last decade. Journals with a higher representation of female EB members also had a higher representation of female authorship. This study found a positive association between first and senior female authorship; however, the gender gap persists. Continued efforts to reach equity in publications and EB representation are necessary.
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Affiliation(s)
- Paola A Rivera
- From the Department of Ophthalmology and Visual Science, Yale School of Medicine (P.A.R., N.K.), New Haven, Connecticut, USA
| | - Agata Atayde
- Harvard T.H. Chan School of Public Health (A.A.), Boston, Massachusetts, USA
| | - Lei Wang
- Harvey Cushing/John Hay Whitney Medical Library (L.W.), Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ninani Kombo
- From the Department of Ophthalmology and Visual Science, Yale School of Medicine (P.A.R., N.K.), New Haven, Connecticut, USA.
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Alshehri M, Bin Helayel H, Vargas JM, Almutlak M, Fairaq R. Preferred surgical techniques for secondary intraocular lens implantation in adults with aphakia. Int Ophthalmol 2023; 43:3539-3547. [PMID: 37356032 DOI: 10.1007/s10792-023-02761-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/21/2023] [Indexed: 06/27/2023]
Abstract
AIM To identify the current surgical management of aphakia and the outcomes and complications of each technique. METHODS This cross-sectional study included ophthalmic surgeons with at least one-year experience in surgery for aphakia. A study questionnaire was formulated to collect data in Saudi Arabia and other regional countries. The questionnaire included 22 questions on demographics, preferred surgical techniques, complications and the factors related to surgeon decision and the choice for managing aphakia. RESULTS The study included 145 participants (111; 76.6% were males) with mean age of 46.7 ± 11.5 years. The mean duration of cataract surgery experience was 17.6 ± 11.1 years. Most participants (86.2%) were trained in cataract surgery. Scleral fixation of intraocular lens (SFIOL) was the most commonly preferred technique, followed by iris fixation IOL, and anterior chamber IOL (75.2%, 9%, and 15.9%, respectively). The main determinants for selection of a surgical technique were simplicity (56.6%), surgical instrument availability (48.3%), and training on the technique (47.6%). The most frequent postoperative complications were pupil distortion, high intraocular pressure (IOP), pupillary capture of the IOL, and IOL decentration. CONCLUSIONS SFIOL is the preferred surgical technique for managing aphakia. The decision to choose one technique over another is complex and is based on several factors, including technical difficulty, previous training, anatomical variations, ocular comorbidities, and the potential complications. The most frequent complications after surgical correction of aphakia are pupil distortion, high IOP, pupillary capture of the IOL, and decentered IOLs.
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Affiliation(s)
- Mohammed Alshehri
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia
- Anterior Segment Division, King Faisal Medical City, Abha, Saudi Arabia
| | - Halah Bin Helayel
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia
| | - José Manuel Vargas
- Ophthalmology Division, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Mohammed Almutlak
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia
| | - Rafah Fairaq
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia.
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14
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Gedde SJ. Gender Disparities in Residency Education. JAMA Ophthalmol 2023; 141:988-989. [PMID: 37707808 DOI: 10.1001/jamaophthalmol.2023.4212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Affiliation(s)
- Steven J Gedde
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
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15
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Huh DD, Yamazaki K, Holmboe E, Bartley GB, Schnabel SD, Levine RB, Srikumaran D. Gender Bias and Ophthalmology Accreditation Council for Graduate Medical Education Milestones Evaluations. JAMA Ophthalmol 2023; 141:982-988. [PMID: 37707837 PMCID: PMC10502694 DOI: 10.1001/jamaophthalmol.2023.4138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/24/2023] [Indexed: 09/15/2023]
Abstract
Importance Women remain underrepresented in ophthalmology and gender-based disparities exist in salary, grant receipt, publication rates, and surgical volume throughout training and in practice. Although studies in emergency medicine and general surgery showed mixed findings regarding gender differences in Accreditation Council for Graduate Medical Education (ACGME) Milestones ratings, limited data exist examining such differences within ophthalmology. Objective To examine gender differences in ophthalmology ACGME Milestones. Design, Setting, and Participants This was a retrospective cross-sectional study of postgraduate year 4 (PGY-4) residents from 120 ophthalmology programs graduating in 2019. Main Outcomes and Measures PGY-4 midyear and year-end medical knowledge (MK) and patient care (PC) ratings and Written Qualifying Examination (WQE) scaled scores for residents graduating in 2019 were included. Differential prediction techniques using Generalized Estimating Equations models were performed to identify differences by gender. Results Of 452 residents (median [IQR] age, 30.0 [29.0-32.0] years), 275 (61%) identified as men and 177 (39%) as women. There were no differences in PC domain average between women and men for both midyear (-0.07; 95% CI, -0.11 to 0; P =.06) and year-end (-0.04; 95% CI, -0.07 to 0.03; P =.51) assessment periods. For the MK domain average in the midyear assessment period, women (mean [SD], 3.76 [0.50]) were rated lower than men (mean [SD], 3.88 [0.47]; P = .006) with a difference in mean of -0.12 (95% CI, -0.18 to -0.03). For the year-end assessment, however, the average MK ratings were not different for women (mean [SD], 4.10 [0.47]) compared with men (mean [SD], 4.18 [0.47]; P = .20) with a difference in mean of -0.08 (95% CI, -0.13 to 0.03). Conclusions and Relevance Results suggest that ACGME ophthalmology Milestones in 2 general competencies did not demonstrate major gender bias on a national level at the time of graduation. There were, however, differences in MK ratings at the midyear mark, and as low ratings on evaluations and examinations may adversely affect career opportunities for trainees, it is important to continue further work examining other competencies or performance measures for potential biases.
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Affiliation(s)
- Dana D. Huh
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kenji Yamazaki
- Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Eric Holmboe
- Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - George B. Bartley
- American Board of Ophthalmology, Doylestown, Pennsylvania
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | | | - Rachel B. Levine
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Divya Srikumaran
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
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16
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Kim BY, Yoon I, Han SJ, Hong SK, Choi S, Kwon HJ, Kim EK. Specialty impact on residents' perceived quality of life, stress, and job satisfaction: a comparative study. Ann Surg Treat Res 2023; 105:188-197. [PMID: 37908383 PMCID: PMC10613823 DOI: 10.4174/astr.2023.105.4.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/22/2023] [Accepted: 08/22/2023] [Indexed: 11/02/2023] Open
Abstract
Purpose Specialty choice in residency training has a significant impact on an individual's career and satisfaction, as well as the supply-demand imbalance in the healthcare system. The current study aimed to investigate the quality of life (QOL), stress, self-confidence, and job satisfaction of residents, and to explore factors associated with such variables, including postgraduate year, sex, and especially specialty, through a cross-sectional survey. Methods An online survey was administered to residents at 2 affiliated teaching hospitals. The survey had a total of 46 items encompassing overall residency life such as workload, QOL, stress, confidence, relationship, harassment, and satisfaction. Related survey items were then reconstructed into 4 key categories through exploratory factor analysis for comparison according to group classification. Results The weekly work hours of residents in vital and other specialties were similar, but residents in vital specialties had significantly more on-call days per month. Residents in vital specialties had significantly lower scores for QOL and satisfaction. Specifically, vital-surgical residents had significantly lower QOL scores and higher stress scores than the other specialty groups. Satisfaction scores were also lowest among vital-surgical residents, with a marginal difference from vital-medical, and a significant difference from other-surgical residents. Female residents had significantly lower satisfaction scores than their male counterparts. Conclusion Residents in vital specialties, particularly vital-surgical specialties, experience significantly worse working conditions across multiple dimensions. It is necessary to improve not only the quantity but also the quality of the system in terms of resource allocation and prioritization.
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Affiliation(s)
- Bo Young Kim
- Division of Rheumatology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Inah Yoon
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seong John Han
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Suk-Kyung Hong
- Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sehoon Choi
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyo-Jin Kwon
- Department of Medical Education, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Key Kim
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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17
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Steren BJ, Yee P, Rivera PA, Feng S, Pepple K, Kombo N. Gender Distribution and Trends of Ophthalmology Subspecialties, 1992-2020. Am J Ophthalmol 2023; 253:22-28. [PMID: 37142172 DOI: 10.1016/j.ajo.2023.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE To describe the gender trends in ophthalmology primary practice areas using the American Board of Ophthalmology (ABO) diplomates. DESIGN A trend study plus a cross-sectional study of the ABO's database. METHODS The de-identified records of all (N = 12,844) ABO-certified ophthalmologists between 1992 and 2020 were obtained. The year of certification, gender, and self-reported primary practice for each ophthalmologist was recorded. Subspecialty was defined as the self-reported primary practice emphasis. Practice trends of the entire population and the subpopulation of subspecialists were explored based on gender and were then visualized using tables and graphs and analyzed using the χ2 or Fisher exact test. RESULTS A total of 12,844 board-certified ophthalmologists were included. Nearly half (47%) reported a subspecialty as their primary practice area (n = 6042), of whom the majority were male (65%, n = 3940). In the first decade, men outnumbered women reporting subspecialty practices by more than 2:1. Over time, the number of women subspecialists increased whereas the number of men remained stable, such that by 2020 women comprised almost half of new ABO diplomates reporting subspecialty practice. When all subspecialists were compared within gender, there was not a significant difference (P = .15) between the percentage of male (46%) and female (48%) ophthalmologist reporting a subspecialty practice. However, a significantly greater proportion of women than men reported primary practice in pediatrics (20.1% vs 7.9%, P < .001) and glaucoma (21.8% vs 16.0%, P < .0001). Alternatively, a significantly greater proportion of men reported primary practice in vitreoretinal surgery (47.2% vs 22.0%, P < .0001). There was no significant difference between the proportion of men and women reporting cornea (P = .15) or oculoplastics (P = .31). CONCLUSIONS The number of women in ophthalmology subspecialty practice has increased steadily over the past 30 years. Men and women subspecialize at the same rate, but significant differences exist between the types of ophthalmology practiced by each gender.
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Affiliation(s)
- Benjamin J Steren
- From the Department of Ophthalmology and Visual Sciences (B.J.S., P.A.R., N.K.), Yale School of Medicine, New Haven, Connecticut, USA
| | - Philina Yee
- Department of Ophthalmology (P.Y., S.F., K.P.), University of Washington, Seattle, Washington, USA
| | - Paola A Rivera
- From the Department of Ophthalmology and Visual Sciences (B.J.S., P.A.R., N.K.), Yale School of Medicine, New Haven, Connecticut, USA
| | - Shu Feng
- Department of Ophthalmology (P.Y., S.F., K.P.), University of Washington, Seattle, Washington, USA
| | - Kathryn Pepple
- Department of Ophthalmology (P.Y., S.F., K.P.), University of Washington, Seattle, Washington, USA
| | - Ninani Kombo
- From the Department of Ophthalmology and Visual Sciences (B.J.S., P.A.R., N.K.), Yale School of Medicine, New Haven, Connecticut, USA.
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18
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Bin Helayel H, Almazyad EM, Almazyad LM, Qadi R, Almubaiyd A, Al-Shahwan S. Evaluation of Surgical Requirements and Competencies of the Saudi Ophthalmology Training Program in a Tertiary Eye Specialist Hospital- A Cross-Sectional Study. Clin Ophthalmol 2023; 17:2373-2382. [PMID: 37605763 PMCID: PMC10440114 DOI: 10.2147/opth.s411239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/27/2023] [Indexed: 08/23/2023] Open
Abstract
Purpose To evaluate the adequacy of a Saudi ophthalmology training programs in achieving the competencies outlined by the Saudi Commission for Health Specialties (SCFHS) and the Accreditation Council for Graduate Medical Education (ACGME) and to assess resident satisfaction with their training. Methods A cross-sectional survey was sent electronically to all trainees (n=50) enrolled in the King Khaled Eye Specialist Hospital (KKESH) ophthalmology training program by email and messaging app (Whatsapp). The survey was sent between January 20, 2021, and January 30, 2021. It evaluated the level of satisfaction with surgical training and skills. The surgical logbooks of all trainees were extracted, and identifiers were removed. Then they were compared with SCFHS and ACGME curriculums for ophthalmology training. Results Out of 50 invitees, 47 returned the questionnaire. All trainees were confident they could meet surgical requirements by the end of their training. Most trainees were satisfied (n=29, 61.7%) with their performance in core competency requirements. There was no difference between female and male trainees' comfort levels when performing surgical steps in core competency requirements (P=0.2). Senior trainees seem more satisfied with their performance, especially in core competency requirements (P=0.087). All trainees practice at the wet lab and a virtual reality simulator to improve their skills. Obstacles faced during training were highlighted, including low exposure in the operating theater (n=18, 37.50%), competition on cases (n=5, 10.42%), attending surgeons not willing to teach (n=5, 10.42%), COVID-19 pandemic (n=5, 10.42%), and complex cases (n=4, 8.33%). Conclusion The outcomes of the current study indicate that trainees at KKESH were adequately satisfied with their surgical training in general. Also, competencies outlined by both the SCFHS and the ACGME were adequately fulfilled.
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Affiliation(s)
- Halah Bin Helayel
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Enmar Mazyad Almazyad
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Laith Mazyad Almazyad
- Fellowship and Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Ruba Qadi
- Fellowship and Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Ophthalmology Department, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia
| | - Alhanoof Almubaiyd
- Fellowship and Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Ophthalmology Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Sami Al-Shahwan
- Fellowship and Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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19
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ElHawary H, Salimi A, Alam P, Karir A, Mitchell E, Huynh MNQ, Leveille CF, Halyk L, St. Denis-Katz H, Iyer H, Padeanu S, Adibfar A, Valiquette C, Morzycki A, Janis JE, Thibaudeau S. Gender Equality in Plastic Surgery Training: A Canadian Nationwide Cross-sectional Analysis. Plast Surg (Oakv) 2023; 31:300-305. [PMID: 37654539 PMCID: PMC10467441 DOI: 10.1177/22925503211051108] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/30/2021] [Accepted: 09/05/2021] [Indexed: 09/02/2023] Open
Abstract
Introduction: One of the important factors in achieving gender equity is ensuring equitable surgical training for all. Previous studies have shown that females get significantly lower surgical exposure than males in certain surgical specialties. Gender gap in surgical exposure has never been assessed in plastic surgery. To that end, the goal of this study was to assess if there are any differences in plastic surgery training between male and female residents. Methods: A survey was sent to all plastic surgery residency programs in Canada to assess the No. of surgeries residents operated on as a co-surgeon or primary assistant during their training. The survey also assessed career goals, level of interest in the specialty, and subjective perception of gender bias. Results: A total of 89 plastic surgery residents (59.3% participation rate) completed the survey and were included in the study. The average No. of reconstructive cases residents operated on as a co-surgeon or primary assistant was 245 ± 312 cases. There was no difference in either reconstructive or aesthetic surgery case logs between male and female residents (p > .05). However, a significantly larger proportion of females (39%) compared to males (4%) felt that their gender limited their exposure to surgical cases and led to a worsening of their overall surgical training (p < .001). Finally, a larger proportion of male residents were interested in academic careers while a larger proportion of female residents were interested in a community practice (p = .024). Conclusion: While there is no evidence of differences in the volume of logged cases between genders, female surgical residents still feel that their respective gender limits their overall surgical training. Gender inequalities in training should be addressed by residency programs.
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Affiliation(s)
| | - Ali Salimi
- McGill University, Montreal, Quebec, Canada
| | - Peter Alam
- McGill University Health Centre, Montreal, Quebec, Canada
| | - Aneesh Karir
- University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | | | - Laura Halyk
- University of Ottawa, Ottawa, Ontario, Canada
| | | | - Hari Iyer
- Université de Montréal, Montréal, Québec, Canada
| | | | | | | | | | - Jeffrey E. Janis
- Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Winer LK, Kader S, Abelson JS, Hammaker AC, Eruchalu CN, Etheridge JC, Cho NL, Foote DC, Ivascu FA, Smith S, Postlewait LM, Greenwell K, Meister KM, Montgomery KB, Zmijewski P, Byrd SE, Kimbrough MK, Stopenski SJ, Nahmias JT, Harvey J, Farr D, Callahan ZM, Marks JA, Stahl CC, Al Yafi M, Sutton JM, Elsaadi A, Campbell SJ, Dodwad SJM, Adams SD, Woeste MR, Martin RC, Patel P, Anstadt MJ, Nasim BW, Willis RE, Patel JA, Newcomb MR, George BC, Quillin RC, Cortez AR. Disparities in the Operative Experience Between Female and Male General Surgery Residents: A Multi-institutional Study From the US ROPE Consortium. Ann Surg 2023; 278:1-7. [PMID: 36994704 PMCID: PMC10896185 DOI: 10.1097/sla.0000000000005847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
OBJECTIVE To examine differences in resident operative experience between male and female general surgery residents. BACKGROUND Despite increasing female representation in surgery, sex and gender disparities in residency experience continue to exist. The operative volume of male and female general surgery residents has not been compared on a multi-institutional level. METHODS Demographic characteristics and case logs were obtained for categorical general surgery graduates between 2010 and 2020 from the US Resident OPerative Experience Consortium database. Univariable, multivariable, and linear regression analyses were performed to compare differences in operative experience between male and female residents. RESULTS There were 1343 graduates from 20 Accreditation Council for Graduate Medical Education-accredited programs, and 476 (35%) were females. There were no differences in age, race/ethnicity, or proportion pursuing fellowship between groups. Female graduates were less likely to be high-volume residents (27% vs 36%, P < 0.01). On univariable analysis, female graduates performed fewer total cases than male graduates (1140 vs 1177, P < 0.01), largely due to a diminished surgeon junior experience (829 vs 863, P < 0.01). On adjusted multivariable analysis, female sex was negatively associated with being a high-volume resident (OR = 0.74, 95% CI: 0.56 to 0.98, P = 0.03). Over the 11-year study period, the annual total number of cases increased significantly for both groups, but female graduates (+16 cases/year) outpaced male graduates (+13 cases/year, P = 0.02). CONCLUSIONS Female general surgery graduates performed significantly fewer cases than male graduates. Reassuringly, this gap in operative experience may be narrowing. Further interventions are warranted to promote equitable training opportunities that support and engage female residents.
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Affiliation(s)
- Leah K. Winer
- Department of Surgery, Cincinnati Research on Education in Surgical Training (CREST), University of Cincinnati, Cincinnati, OH
| | - Sarah Kader
- Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA
| | | | - Austin C. Hammaker
- Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA
| | | | | | - Nancy L. Cho
- Department of Surgery, Brigham and Women’s Hospital, Boston, MA
| | - Darci C. Foote
- Department of Surgery, Beaumont Health, Royal Oak, MI
- Department of Surgery, Center for Surgical Training and Research (CSTAR), University of Michigan, Ann Arbor, MI
| | | | | | | | | | | | | | - Polina Zmijewski
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Samuel E. Byrd
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Mary K. Kimbrough
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR
| | | | | | - Jalen Harvey
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas TX
| | - Deborah Farr
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas TX
| | | | - Joshua A. Marks
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA
| | | | - Motaz Al Yafi
- Department of Surgery, University of Toledo, Toledo, OH
| | - Jeffrey M. Sutton
- Division of Oncologic and Endocrine Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC
| | - Ali Elsaadi
- Texas Tech University Health Sciences Center School of Medicine Lubbock, TX
| | - Samuel J. Campbell
- Texas Tech University Health Sciences Center School of Medicine Lubbock, TX
| | | | - Sasha D. Adams
- Department of Surgery, McGovern Medical School at UTHealth, Houston, TX
| | | | | | - Purvi Patel
- Department of Surgery, Loyola University, Maywood, IL
| | | | - Bilal Waqar Nasim
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Ross E. Willis
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Jitesh A. Patel
- Department of Surgery, University of Kentucky, Lexington, KY
| | | | - Brian C. George
- Department of Surgery, Center for Surgical Training and Research (CSTAR), University of Michigan, Ann Arbor, MI
| | - Ralph C. Quillin
- Department of Surgery, Cincinnati Research on Education in Surgical Training (CREST), University of Cincinnati, Cincinnati, OH
| | - Alexander R. Cortez
- Department of Surgery, Cincinnati Research on Education in Surgical Training (CREST), University of Cincinnati, Cincinnati, OH
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Olson EM, Sanborn DM, Dyster TG, Kelm DJ, Murray SG, Santhosh L, DesJardin JT. Gender Disparities in Critical Care Procedure Training of Internal Medicine Residents. ATS Sch 2023; 4:164-176. [PMID: 37538076 PMCID: PMC10394715 DOI: 10.34197/ats-scholar.2022-0025oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 12/22/2022] [Indexed: 08/05/2023] Open
Abstract
Background Procedural training is a required competency in internal medicine (IM) residency, yet limited data exist on residents' experience of procedural training. Objectives We sought to understand how gender impacts access to procedural training among IM residents. Methods A mixed-methods, explanatory sequential study was performed. Procedure volume for IM residents between 2016 and 2020 was assessed at two large academic residencies (Program A and Program B: 399 residents and 4,020 procedures). Procedural rates and actual versus expected procedure volume by gender were compared, with separate analyses by clinical environment (intensive care unit [ICU] or structured procedural service). Semistructured gender-congruent focus groups were conducted. Topics included identity formation as a proceduralist and the resident procedural learning experience, including perceived gender bias in procedure allocation. Results Compared with men, women residents performed disproportionately fewer ICU procedures per month at Program A (1.4 vs. 2.7; P < 0.05) but not at Program B (0.36 vs. 0.54; P = 0.23). At Program A, women performed only 47% of ICU procedures, significantly fewer than the 54% they were expected to perform on the basis of their time on ICU rotations (P < 0.001). For equal gender distribution of procedural volume at Program A, 11% of the procedures performed by men would have needed to have been performed by women instead. Gender was not associated with differences in the Program A structured procedural service (53% observed vs. 52% expected; P = 0.935), Program B structured procedural service (40% observed vs. 43% expected; P = 0.174), or in Program B ICUs (33% observed vs. 34% expected; P = 0.656). Focus group analysis identified that women from both residencies perceived that assertiveness was required for procedural training in unstructured learning environments. Residents felt that gender influenced access to procedural opportunities, ability to self-advocate for procedural experience, identity formation as a proceduralist, and confidence in acquiring procedural skills. Conclusion Gender disparities in access to procedural training during ICU rotations were seen at one institution but not another. There were ubiquitous perceptions that assertiveness was important to access procedural opportunities. We hypothesize that structured allocation of procedures would mitigate disparities by allowing all residents to access procedural training regardless of self-advocacy. Residency programs should adopt structured procedural training programs to counteract inequities.
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Affiliation(s)
| | | | | | - Diana J. Kelm
- Department of Medicine and
- Division of Pulmonary and Critical Care,
Mayo Clinic, Rochester, Minnesota
| | - Sara G. Murray
- Department of Medicine
- Division of Hospital Medicine, and
| | | | - Jacqueline T. DesJardin
- Department of Medicine
- Division of Cardiology, University of
California San Francisco, San Francisco, California
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Rei KM, Reddy V, Mohammed S, Kashyap S, Cathel A, Siddiqi J. Gender Differences in Surgical Case Volume Among Neurosurgery Residents. Cureus 2023; 15:e35798. [PMID: 37033513 PMCID: PMC10075184 DOI: 10.7759/cureus.35798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2023] [Indexed: 03/07/2023] Open
Abstract
OBJECTIVES Gender differences in surgical training opportunities, measured by case volume, have been demonstrated in the fields of otolaryngology and ophthalmology. We hypothesize that this gender disparity is not present among neurosurgery residents. This study compares median female and male case volumes stratified by postgraduate year (PGY) level for U.S. neurosurgery residents. METHODS This retrospective analysis included case log data from two southern California neurosurgery residency training programs, Riverside University Health System (RUHS) and Desert Regional Medical Center (DRMC), from 2015 to 2021. For each PGY level, gender differences in case volumes were summarized using median, SD, and two-sided t-tests. RESULTS Among 47 (19.1% female) neurosurgery residents, there were no significant gender differences in case volumes across any PGY levels. Female residents had greater median surgical cases during PGY-1 (median (SD), female 107.0 (13.1) vs male 102.0 (24.3); p=0.841) and PGY-7 (female 282.5 (17.7) vs male 246 (60.9); P=0.424), while male residents had greater median case volumes for all other PGY levels. CONCLUSIONS Although previous studies have found significant gender differences in case volumes among surgical residents in otolaryngology and ophthalmology, case log data from two neurosurgery residency programs in southern California, RUHS and DRMC, does not reflect this gender disparity at any PGY level.
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Moon J, Geloneck M, Bowden E, Crowell E, Edmond J. Directors of accredited pediatric ophthalmology fellowship programs: a descriptive analysis. J AAPOS 2023; 27:95.e1-95.e6. [PMID: 36813128 DOI: 10.1016/j.jaapos.2023.01.008] [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: 09/20/2022] [Revised: 01/14/2023] [Accepted: 01/22/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE To examine the characteristics of pediatric ophthalmology fellowship program directors (FPDs) through cross-sectional analysis. METHODS All pediatric ophthalmology FPDs whose programs participated in the San Francisco Match in January 2020 were included. Information was collected through publicly available sources. Scholarly activity was measured by peer-reviewed articles and the Hirsch index. RESULTS Of the 43 FPDs, 22 (51%) were male, and 21 (49%) were female. The mean age of current FPDs was 53.5 ± 8.8 years old. There was a significant difference between the current age of male and female FPDs (57.8 ± 8 vs 49 ± 7.3, resp. [P <0.0001]). The mean term length of female and male FPDs also differed (11.5 ± 4.5 vs 16.1 ± 8.9 [P = 0.042]). Thirty-eight FPDs (88%) attended medical school in the United States. Forty-two FPDs had an MD (98%). Thirty-nine (91%) FPDs completed ophthalmology residency in the United States. Ten (23%) of the FPDs were dual fellowship trained. There was a significantly higher Hirsch-index among male than female FPDs (23.9 ± 15.7 vs 10.3 ± 10.1 [P = 0.0017]). There was a higher number of publications for male (91 ± 89) than female FPDs (31.5 ± 48.6 [P = 0.0099]). CONCLUSIONS Pediatric ophthalmology fellowship programs have a uniquely equal representation of male and female FPDs as women continue to be underrepresented in ophthalmology. Female FPDs were younger and had spent less time in the position, suggesting a shift toward more female FPD over time.
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Affiliation(s)
- Jared Moon
- Mitchel and Shannon Wong Eye Institute, Dell Medical School at the University of Texas at Austin.
| | - Megan Geloneck
- Mitchel and Shannon Wong Eye Institute, Dell Medical School at the University of Texas at Austin
| | - Eileen Bowden
- Mitchel and Shannon Wong Eye Institute, Dell Medical School at the University of Texas at Austin
| | - Eric Crowell
- Mitchel and Shannon Wong Eye Institute, Dell Medical School at the University of Texas at Austin
| | - Jane Edmond
- Mitchel and Shannon Wong Eye Institute, Dell Medical School at the University of Texas at Austin
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Tien CW, Tao B, Khosa F. Gender disparity among ophthalmologists awarded Canadian institute of health research grants. Women Health 2023; 63:143-149. [PMID: 36593567 DOI: 10.1080/03630242.2022.2164113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Despite efforts toward equity, diversity, and inclusion in academic ophthalmology faculties, gender disparity continues to exist. Current evidence indicates that female ophthalmologists consistently hold lower academic ranks and receive less funding from the National Institutes of Health compared to their male colleagues. The extent of this disparity is unknown in the Canadian context. We sought to characterize the gender gap in Canadian Institutes of Health Research funding among ophthalmologists. From inception, funding decision data were collected from the official Canadian Institutes of Health Research website database hosted by the Government of Canada. Measures including gender, number of grants held over the study period, number of simultaneous grants, and total funding were collected. Female ophthalmologists were consistently awarded fewer grants (21.43 percent) compared to male counterparts and were less likely to hold multiple grants since 2008. An over five-fold disparity was found in total funding for female compared to male ophthalmologists. As well, females were less likely than males to hold a grant in each particular year except in 2020. Female ophthalmologists continue to face barriers to attaining academic support from Canadian Institute of Health Research funds. Continued action to mitigate this gender gap may improve gender-based parity in federal research funding.
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Affiliation(s)
- Chi-Wei Tien
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brendan Tao
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Faisal Khosa
- Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
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Hoyer A, Randolph A, Syed MF, Afkhamnejad E, Mirza RG. Enhancing Mentorship Networks through the Experiences of Women Professors of Ophthalmology. JOURNAL OF ACADEMIC OPHTHALMOLOGY (2017) 2023; 15:e1-e7. [PMID: 38737166 PMCID: PMC10804760 DOI: 10.1055/s-0042-1760206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/21/2022] [Indexed: 01/15/2023]
Abstract
Purpose The aim of this study is to identify and characterize women professors in ophthalmology to enhance professional development and equity of women in academic ophthalmology. Design Cross-sectional descriptive survey study. Participants Participants in the survey were women in ophthalmology departments who have obtained full professor rank at their respective institutions. Methods A cross-sectional study was conducted using data from an electronic survey of women ophthalmologists and researchers who had obtained full professorship rank in ophthalmology. The survey included questions about degree obtained, training path, fellowship, length and trajectory of academic career, family or medical leave participation, previous positions, and mentorship involvement. Statistical comparisons were made based on response. Main Outcome Measures Survey responses to questions pertaining to three domains: education and training, academic career, and mentorship. Results Women that obtained the professor title within ophthalmology largely held Doctor of Medicine/Doctor of Osteopathic Medicine degrees, were more likely to have completed fellowship training, and on average took 11 to 15 years to obtain the full professor title. The participants held a variety of other positions and titles throughout their academic careers. The vast majority of women reported having between 1 and 3 mentors during their careers with the majority also noting they currently participate in mentoring programs. Surveys were completed by 62 (30% response rate) women full professors of ophthalmology. Conclusion The experiences women have along the academic path to professorship are described in this survey and can help to inform junior faculty. Literature review highlights the importance of mentorship for work productivity, retention, and promotion within academic medicine which is an element seen in the vast majority of our participants' career paths. Guided by the identification of women professors within departments of ophthalmology and characterization of their experiences, a new initiative called Women Professors of Ophthalmology was formed under the Association of University Professors of Ophthalmology's organizational structure in 2021. This group that is tailored for women professors of ophthalmology to foster peer mentorship and guidance is poised to increase the retention and promotion of women in academic ophthalmology.
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Affiliation(s)
- Amanda Hoyer
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Amber Randolph
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Misha F. Syed
- Department of Ophthalmology and Visual Sciences, School of Medicine, The University of Texas Medical Branch, Galveston, Texas
| | - Elahhe Afkhamnejad
- Department of Ophthalmology and Visual Sciences, School of Medicine, The University of Texas Medical Branch, Galveston, Texas
| | - Rukhsana G. Mirza
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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List W, Steinwender G, Glatz W, Riedl R, Wedrich A, Ivastinovic D. The impact of surgeon's experience and sex on the incidence of cystoid macular edema after uneventful cataract surgery. PLoS One 2022; 17:e0279518. [PMID: 36574394 PMCID: PMC9794095 DOI: 10.1371/journal.pone.0279518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/22/2022] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To assess the rate of pseudophakic cystoid macular edema (pCME) in uneventful cataract surgery in surgeons in training vs experienced surgeons and to analyze the rate of pCME according to surgeon's sex. METHODS Medical reports post phacoemulsification between 2010 and 2018 at the Department of Ophthalmology, Medical University of Graz, Austria, were reviewed for pCME. A running lifetime number of preceding cataract surgeries was used to express hands-on experience. A cut-off number of 300 surgeries was defined to distinguish between surgeons in training and experienced surgeons. Outcome parameters were incidence of pCME, patient's sex and age, laterality of eye, coexistence of pseudoexfoliation syndrome (PEX), duration of surgery and surgeon's sex. RESULTS 25.422 surgeries on 18.266 patients were included. The majority was performed by experienced surgeons (23.139, 91.0%) vs 2.283 (9.0%) by surgeons in training (25 surgeons, 9 (36%) female and 16 (64%) male). pCME occurred in 32 eyes (1.4%) following surgery by surgeons in training and in 152 eyes (0.7%) following surgery by experienced surgeons. Chance for pCME was 1.57 higher in training surgeries (95% CI 1.03-2.41, p = 0.034) and longer duration (OR = 1.04; 95% CI 1.02-1.07, p = 0.001). After excluding the first 100 surgeries for every surgeon in training similar results were observed. No difference in risk for pCME was found between female and male surgeons in both groups (training and experienced surgeons). CONCLUSION In conclusion, the rate for pCME after uneventful cataract surgery is significantly higher for surgeons in training but steadily decreasing and associated to surgical time. No difference in the risk for pCME was found between female and male surgeons.
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Affiliation(s)
- Wolfgang List
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
- * E-mail:
| | | | - Wilfried Glatz
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Andreas Wedrich
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
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Gluckstein J. Diversity in Academic Ophthalmology: Disparities and Opportunities from Medical School to Practice. Semin Ophthalmol 2022; 38:338-343. [PMID: 36524756 DOI: 10.1080/08820538.2022.2157217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Compared to the United States population as a whole, physicians are more likely to identify as men, identify as Asian or non-hispanic White, and be raised in wealthier households. Racial, ethnic, gender, and socioeconomic representation in ophthalmology is often blamed on the pipeline of matriculants. METHODS This review collects recent data from the US census, AAMC, and primary literature on gender, racial, ethnic, and socioeconomic diversity from medical school to ophthalmology practice. RESULTS Data from the medical and ophthalmology literature shows that medical students are less diverse than medical school applicants, ophthalmology residencies are less diverse than graduating medical students, and ophthalmology departments are less diverse than those of most other specialties. DISCUSSION At each level, there are limitations in representation beyond the pipeline of medical school applicants or medical students applying to ophthalmology. There are many practical steps the field can take at each level of training to move the specialty toward more equitable representation.
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Gender and Other Factors Associated with Endoscopy Volume Among U.S. Gastroenterology Fellows. Clin Gastroenterol Hepatol 2022; 20:2911-2914.e4. [PMID: 34628079 DOI: 10.1016/j.cgh.2021.10.004] [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: 08/30/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 02/07/2023]
Abstract
Gastroenterology (GI) fellows' ability to perform procedures are evaluated by the level of competency in the cognitive and technical components of procedures in Accreditation Council for Graduate Medical Education-accredited fellowship programs.1 However, competency in endoscopic procedures correlates with the number of procedures performed.2 The American Society for Gastrointestinal Endoscopy has recommended that a minimum of 130 esophagogastroduodenoscopies (EGDs) and 275 colonoscopies be performed before procedural competency can be assessed.3 Few studies have examined program or trainee-related factors, such as trainee gender, that may influence procedural volume. In other procedural subspecialties, a gender gap exists in trainee procedural volumes, with female residents performing fewer surgical cases than males.4,5 However, whether gender-related disparities exist in endoscopy volume among GI trainees is unknown. The primary aim of this study was to determine the impact of GI fellow gender on endoscopic procedural volume during training. Secondary aims were to determine if fellow career choice or other training program-related factors, such as program size, location, or setting, affect procedure volume during fellowship.
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Tan NE, Wortz BT, Rosenberg ED, Radcliffe NM, Gupta PK. Impact of Heads-Up Display Use on Ophthalmologist Productivity, Wellness, and Musculoskeletal Symptoms: A Survey Study. J Curr Ophthalmol 2022; 34:305-311. [PMID: 36644468 PMCID: PMC9832462 DOI: 10.4103/joco.joco_115_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/08/2022] [Accepted: 05/12/2022] [Indexed: 12/11/2022] Open
Abstract
Purpose To explore how ophthalmologist productivity, wellness, and musculoskeletal (MSK) symptoms are affected by heads-up display (HUD) use. Methods A digital survey was emailed to the United States ophthalmologists. Questions covered topics including MSK health, surgical output, work hours, wellness hours, and factors related to HUD use. Results One hundred and forty-four ophthalmologists responded, and 99 completed all eligible questions. HUDs were utilized by 33 respondents, 29 of whom submitted complete surveys. HUD users worked 353 more hours annually (P = 0.01) and performed 673 more cases (P = 0.07) than nonusers. MSK symptom presence (P = 0.79), severity (P = 0.80), and frequency (P = 0.86) were independent of use. Over half (n = 16/29) of users identified symptomatic improvement attributable to the device, mostly in the cervical and lumbar regions. Mean job stress was moderate-severe for both users and nonusers (P = 0.10), and there was no significant difference in wellness hours (P = 0.44). Retina specialists (P = 0.02) and males (P = 0.03) were more likely to have operated with the technology. Nearly half of heads-up surgeons (n = 12/29) had obtained new equipment to target MSK symptoms, versus 1.4% of nonusers (n = 1/70; P = 0.0009). Most of those who operated with HUDs would recommend them to others (69.0%, n = 20/29), but 44.8% (n = 13/29) indicated ergonomic challenges. Primary concerns included awkward viewing angles, setup difficulties, and a lack of access. Conclusions HUD surgeons reported greater work output versus nonusers without significant compromises in wellness or MSK health. User feedback suggests that the technology may lessen neck and low back pains, but barriers including cost and system inconveniences may impede adoption.
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Affiliation(s)
- Nicholas E. Tan
- Department of Ophthalmology, College of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Brayden T. Wortz
- Department of Chemistry, Wake Forest University, Winston-Salem, NC, USA
| | - Eric D. Rosenberg
- Department of Ophthalmology, New York Medical College, Valhalla, NY, USA
| | - Nathan M. Radcliffe
- Department of Ophthalmology, Mount Sinai School of Medicine, New York, NY, USA,New York Eye Surgery Center, Bronx, NY, USA
| | - Preeya K. Gupta
- Triangle Eye Consultants, Raleigh, NC, USA,Tulane University, New Orleans, LA, USA,Address for correspondence: Preeya K. Gupta, 2075 Renaissance Park Pl, Cary, NC, USA. E-mail:
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Huh DD, Wang J, Fliotsos MJ, Beal CJ, Boente CS, Wisely CE, De Andrade LM, Lorch AC, Ramanathan S, Reinoso MA, Swamy RN, Waxman EL, Woreta FA, Srikumaran D. Association Between Parental Leave and Ophthalmology Resident Physician Performance. JAMA Ophthalmol 2022; 140:1066-1075. [PMID: 36173610 PMCID: PMC9523550 DOI: 10.1001/jamaophthalmol.2022.3778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/02/2022] [Indexed: 12/15/2022]
Abstract
Importance Although parental leave is essential in enhancing resident wellness and fostering inclusive workplace environments, residents may often feel discouraged from using parental leave owing to perceived stigma and concerns about possible negative effects on their training. Objective To examine parental leave usage across multiple institutions and compare residency performance metrics between residents who took parental leave vs their peers who did not take leave. Design, Setting, and Participants This was a retrospective cross-sectional analysis conducted from April 1, 2020, to July 28, 2022, of educational records. Multicenter data were obtained from 10 Accreditation Council for Graduate Medical Education (ACGME)-accredited ophthalmology programs across the US. Included ophthalmology residents graduated between 2015 and 2019. Data were analyzed from August 15, 2021, to July 25, 2022. Exposures Performance metrics of residents who used parental leave during residency were compared with those of residents who did not take parental leave. Main Outcomes and Measures Measures of performance included the Ophthalmic Knowledge Assessment Program (OKAP) scores, ACGME milestones scores, board examination pass rates, research activity, and surgical volumes. Results Of the 283 ophthalmology residents (149 male [52.7%]) included in the study, 44 (15.5%) took a median (IQR) parental leave of 4.5 (2-6) weeks. There were no differences in average OKAP percentiles, research activity, average ACGME milestones scores, or surgical volume between residents who took parental leave and those who did not. Residents who pursued fellowship were less likely to have taken parental leave (odds ratio [OR], 0.43; 95% CI, 0.27-0.68; P < .001), and residents who practiced in private settings after residency were more likely to have taken parental leave (OR, 3.56; 95% CI, 1.79-7.08; P < .001). When stratified by sex, no differences were identified in performance between female residents who took parental leave compared with residents who did not take leave, except a mild surgical number difference in 1 subspecialty category of keratorefractive procedures (difference in median values, -2; 95% CI, -3.7 to -0.3; P = .03). Conclusions and Relevance In this multicenter cross-sectional study, no differences in performance metrics were identified between residents taking parental leave compared with their peers. These findings may provide reassurance to trainees and program directors regarding the unlikelihood, on average, that taking adequate parental leave will affect performance metrics adversely.
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Affiliation(s)
- Dana D. Huh
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jiangxia Wang
- Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Michael J. Fliotsos
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Casey J. Beal
- Department of Ophthalmology, University of Florida, Gainesville
| | - Charline S. Boente
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis
| | - C. Ellis Wisely
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Lindsay M. De Andrade
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals & Clinics, Iowa City
| | - Alice C. Lorch
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
| | - Saras Ramanathan
- Department of Ophthalmology, University of California, San Francisco, San Francisco
| | - Maria A. Reinoso
- Department of Ophthalmology, Louisiana State University Health Science Center, New Orleans
| | - Ramya N. Swamy
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore
| | - Evan L. Waxman
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Fasika A. Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Divya Srikumaran
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Woreta FA, Gordon LK, Knight OJ, Randolph JD, Zebardast N, Pérez-González CE. Enhancing Diversity in the Ophthalmology Workforce. Ophthalmology 2022; 129:e127-e136. [PMID: 36058741 PMCID: PMC9509453 DOI: 10.1016/j.ophtha.2022.06.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/17/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022] Open
Abstract
Health care teams are most effective at addressing complex problems and improving health outcomes for underserved populations when team members bring diverse life experiences and perspectives to the effort. With rates of visual impairment expected to increase in the United States by 2050, especially among minority populations, diversification of the ophthalmology workforce will be critical in reducing disparities in access to and quality of vision health care. Currently, ophthalmology is less diverse with respect to race, ethnicity, and gender than graduating medical classes and other medical specialties, as well as the general US population. In addition, data on diversity in sexual orientation and gender identity, socioeconomic status, and disability are lacking in ophthalmology. The Minority Ophthalmology Mentoring and Rabb-Venable Excellence in Ophthalmology Programs are examples of initiatives to increase racial and ethnic diversity in the workforce and can serve as models for increasing other aspects of inclusiveness. Other strategies for improving vision health care for all Americans include continuing to support existing diversity programs and creating new ones; addressing unconscious and implicit bias in medical school, residency, and faculty selections; conducting holistic reviews of medical school and residency applications; diversifying selection committees and leadership; and encouraging faculty development of underrepresented groups.
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Affiliation(s)
- Fasika A Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lynn K Gordon
- Stein Eye Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - O'Rese J Knight
- Department of Ophthalmology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Jessica D Randolph
- Department of Ophthalmology, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Nazlee Zebardast
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - César E Pérez-González
- Office of the Scientific Director, National Eye Institute, National Institutes of Health, Bethesda, Maryland.
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Elam AR, Tseng VL, Rodriguez TM, Mike EV, Warren AK, Coleman AL. Disparities in Vision Health and Eye Care. Ophthalmology 2022; 129:e89-e113. [PMID: 36058735 PMCID: PMC10109525 DOI: 10.1016/j.ophtha.2022.07.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 10/14/2022] Open
Abstract
Significant disparities in vision health and eye care exist. To achieve health equity, we must understand the root causes and drivers of health disparities and inequities, including social determinants of health and systemic racism.
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Affiliation(s)
- Angela R Elam
- Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan; Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
| | - Victoria L Tseng
- UCLA Stein and Doheny Eye Institutes, David Geffen School of Medicine, University of California, Los Angeles, California
| | | | - Elise V Mike
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alexis K Warren
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois
| | - Anne L Coleman
- UCLA Stein and Doheny Eye Institutes, David Geffen School of Medicine, University of California, Los Angeles, California; Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
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Reeves MGR, Pasricha MV, Ludwig CA, Chandramohan A, Azad AD, Li AS, Rosenblatt TR, Sears CM, Kossler AL, Do DV, Pan CK. Trends in Leadership and Award Recognition Among Women in the American Society of Retina Specialists. JOURNAL OF VITREORETINAL DISEASES 2022; 6:374-380. [PMID: 37006904 PMCID: PMC9954927 DOI: 10.1177/24741264211021019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose This work evaluates trends in achievement of women in the retina field, through an analysis of gender representation in the American Society of Retina Specialists (ASRS). Methods This retrospective, longitudinal study spans 1983 to 2020. Historical data classified by male or female gender were collected from ASRS's overall membership, board of directors and officers, and recipients of the 4 society awards. The proportion of each benchmark held by women was compared with prior decades since the founding of ASRS using the Fisher's exact test. Results Women's representation increased from 11% of ASRS members in 2007 to 19.7% in 2020. From 2010 to 2019, women received a higher proportion of society awards (21.1%) compared with membership prior to the start of that decade. In 2020, women were proportionally well represented in board of director positions (21.9%) and held a significantly higher proportion of board positions than in the period 1983 to 1989 (P = .02). From 1983 to 2020, women held 4.3% (1 of 23) of presidencies. Conclusions Although the number of women in retina is increasing, women remain underrepresented in the leadership of ASRS. Interventions to increase exposure to female mentorship and improve childcare benefits are warranted to engage female ophthalmology trainees in retina and ultimately society leadership.
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Affiliation(s)
- Mary-Grace R. Reeves
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of
Medicine, Palo Alto, CA, USA
| | - Malini Veerappan Pasricha
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of
Medicine, Palo Alto, CA, USA
| | - Cassie A. Ludwig
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of
Medicine, Palo Alto, CA, USA
- Retina Service, Department of Ophthalmology, Massachusetts Eye and
Ear, Harvard Medical School, Boston, MA, USA
| | - Arthika Chandramohan
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of
Medicine, Palo Alto, CA, USA
- Division of Pediatric Ophthalmology, Department of Ophthalmology,
University of Washington School of Medicine, Seattle, WA, USA
| | - Amee D. Azad
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of
Medicine, Palo Alto, CA, USA
| | - Angela S. Li
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of
Medicine, Palo Alto, CA, USA
| | - Tatiana R. Rosenblatt
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of
Medicine, Palo Alto, CA, USA
| | - Connie Martin Sears
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of
Medicine, Palo Alto, CA, USA
| | - Andrea L. Kossler
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of
Medicine, Palo Alto, CA, USA
| | - Diana V. Do
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of
Medicine, Palo Alto, CA, USA
| | - Carolyn K. Pan
- Department of Ophthalmology, Byers Eye Institute, Stanford University School of
Medicine, Palo Alto, CA, USA
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Cai CX, Klawe J, Ahmad S, Zeger SL, Wang J, Sun G, Ramulu P, Srikumaran D. Geographic variations in gender differences in cataract surgery volume among a national cohort of ophthalmologists. J Cataract Refract Surg 2022; 48:1023-1030. [PMID: 35318293 PMCID: PMC9415203 DOI: 10.1097/j.jcrs.0000000000000938] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/16/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess factors associated with gender disparities in cataract surgery volume and evaluate how these differences have changed over time. SETTING Cataract surgeons in the 2012 to 2018 Medicare database. DESIGN Retrospective study. METHODS The association of provider gender with the number of cataract surgeries per office visit billed was assessed with negative binomial regression models, controlling for calendar year, years in practice, hospital affiliation, geographic region, rurality, density of ophthalmologists, and the national percentile of Area Deprivation Index (ADI) score for the practice location. RESULTS There were 8480 cataract surgeons, most of whom were male (78%). Male surgeons worked in more deprived areas with a higher ADI (median: 40 vs 33, P < .001). Female surgeons performed fewer cataracts per year (140 [95% CI, 126-154] vs 276 [95% CI, 263-288], P < .001) and billed fewer office visits (1038 [95% CI, 1008-1068] vs 1505 [95% CI, 1484-1526], P < .001). In multivariate analysis, the number of cataract surgeries per office visit was greater for males compared with females in all years in the South (average incidence rate ratio 1.80), Midwest (1.50), and West (1.53), but not in the Northeast (1.16). The relative rate of cataract surgeries between male and female surgeons in each region did not change significantly over time from 2012 to 2018 ( P > .05 in each region). CONCLUSIONS Gender disparities in cataract volume among male and female surgeons have remained unchanged over time from 2012 to 2018. The higher cataract volume among male surgeons may be explained in part by provider practice location. Further studies are needed to better understand and address gender disparities.
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Affiliation(s)
- Cindy X. Cai
- From the Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland (Cai, Ramulu, Srikumaran); Icahn School of Medicine of Mount Sinai, New York, New York (Klawe, Ahmad); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (Zeger, Wang); Department of Ophthalmology, Weill Cornell Medical College, New York, New York (Sun)
| | - Janek Klawe
- From the Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland (Cai, Ramulu, Srikumaran); Icahn School of Medicine of Mount Sinai, New York, New York (Klawe, Ahmad); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (Zeger, Wang); Department of Ophthalmology, Weill Cornell Medical College, New York, New York (Sun)
| | - Sumayya Ahmad
- From the Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland (Cai, Ramulu, Srikumaran); Icahn School of Medicine of Mount Sinai, New York, New York (Klawe, Ahmad); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (Zeger, Wang); Department of Ophthalmology, Weill Cornell Medical College, New York, New York (Sun)
| | - Scott L. Zeger
- From the Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland (Cai, Ramulu, Srikumaran); Icahn School of Medicine of Mount Sinai, New York, New York (Klawe, Ahmad); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (Zeger, Wang); Department of Ophthalmology, Weill Cornell Medical College, New York, New York (Sun)
| | - Jiangxia Wang
- From the Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland (Cai, Ramulu, Srikumaran); Icahn School of Medicine of Mount Sinai, New York, New York (Klawe, Ahmad); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (Zeger, Wang); Department of Ophthalmology, Weill Cornell Medical College, New York, New York (Sun)
| | - Grace Sun
- From the Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland (Cai, Ramulu, Srikumaran); Icahn School of Medicine of Mount Sinai, New York, New York (Klawe, Ahmad); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (Zeger, Wang); Department of Ophthalmology, Weill Cornell Medical College, New York, New York (Sun)
| | - Pradeep Ramulu
- From the Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland (Cai, Ramulu, Srikumaran); Icahn School of Medicine of Mount Sinai, New York, New York (Klawe, Ahmad); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (Zeger, Wang); Department of Ophthalmology, Weill Cornell Medical College, New York, New York (Sun)
| | - Divya Srikumaran
- From the Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland (Cai, Ramulu, Srikumaran); Icahn School of Medicine of Mount Sinai, New York, New York (Klawe, Ahmad); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (Zeger, Wang); Department of Ophthalmology, Weill Cornell Medical College, New York, New York (Sun)
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Halawa OA, Sekimitsu S, Boland MV, Zebardast N. Sex-Based Differences in Medicare Reimbursements among Ophthalmologists Persist across Time. Ophthalmology 2022; 129:1056-1063. [PMID: 35588946 PMCID: PMC9730864 DOI: 10.1016/j.ophtha.2022.05.006] [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] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/21/2022] [Accepted: 05/06/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate differences in Medicare reimbursements between male and female ophthalmologists between 2013 and 2019. DESIGN Retrospective cohort study. PARTICIPANTS Ophthalmologists receiving Medicare reimbursements between 2013 and 2019. METHODS The Centers for Medicare and Medicaid Services Physician and Other Supplier Public Use File was used to determine total reimbursements and number of services submitted by ophthalmologists between 2013 and 2019. Reimbursements were standardized to account for geographic differences in Medicare reimbursement per service. Data from the American Community Survey (ACS) were used to determine socioeconomic characteristics (unemployment, poverty, income, and education) by zip code for the location of each physician's practice. A multivariate linear regression model was used to evaluate differences in annual reimbursements by sex, accounting for calendar year, years of experience, total number of services, ACS zip code data, and proportion of procedural services. MAIN OUTCOME MEASURES Annual Medicare reimbursement and use of billing codes (e.g., outpatient office visits and eye examinations, diagnostic testing, laser treatment, and surgery). RESULTS Among 20 281 ophthalmologists who received Medicare reimbursements between 2013 and 2019, 15 451 (76%) were men. The most common billing codes submitted were for outpatient visits and eye examinations (13.8 million charges/year), diagnostic imaging of the retina (5.6 million charges/year), intravitreal injections (2.9 million charges/year), and removal of cataract with insertion of lens (2.4 million charges/year). Compared with men, female ophthalmologists received less in median annual reimbursements (median, $94 734.21 [interquartile range (IQR), $30 944.52-$195 701.70] for women vs. $194 176.90 [IQR, $76 380.76-$355 790.80] for men; P < 0.001) and billed for fewer annual median services (median, 1228 [IQR, 454-2433] vs. 2259 [IQR, 996-4075, respectively]; P < 0.001). After adjustment for covariates, female ophthalmologists billed for 1015 fewer services (95% confidence interval [CI], 1001-1029; P < 0.001) and received $20 209.12 less in reimbursements than men (95% CI, -$21 717.57 to -$18 700.66; P < 0.001). CONCLUSIONS Female ophthalmologists billed for fewer services and received less in reimbursement from Medicare than men over time and across all categories of billing codes. Disparities persisted after controlling for physician and practice characteristics.
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Affiliation(s)
- Omar Alaa Halawa
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Sayuri Sekimitsu
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts; Tufts University School of Medicine, Boston, Massachusetts
| | - Michael V Boland
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Nazlee Zebardast
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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Paul M, Dweck M, Chadha N. Ophthalmology Education Leadership Attitudes Towards Mentorship of Female Medical Students. Am J Ophthalmol 2022; 243:149-157. [PMID: 35932822 DOI: 10.1016/j.ajo.2022.07.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Numerous studies have emphasized the influence of gender-specific mentors in medical students' career decisions, but this has not been explored fully in ophthalmology. Therefore, this study evaluated ophthalmology educators' attitudes towards female mentorship, to better understand how this may relate to medical students' career development and training. DESIGN Cross-sectional study. METHODS A 22-question survey was sent to AUPO Chairs, Program Directors, and Medical Student Educators. The number of female students applying to ophthalmology residency was compared with the number of female ophthalmology faculty using AUPO and AAMC workforce data. Student's t-tests and chi square were used for analyses, all at a threshold significance level of p<0.05. RESULTS 75 members responded, including 30 of 72 MSEs (41.7%), 34 of 114 PDs (29.8%), and 17 of 135 Chairs (12.6%). Of respondents, 55.4% identified as female and 44.6% as male. Male and female members had 47.9% and 47.6% female mentees, respectively, (p=0.45). However, 21.2% of male and 56.1% of female members agreed that a mentee of the same gender was important, (p<0.01). Furthermore, 13 of 40 female members (32.5%) reported having a significant female mentor themselves vs. 1 of 29 male members (3%), (p<0.01). CONCLUSIONS Male and female AUPO members reported no difference in female mentees but females were more likely to feel gender-specific mentorship was important, suggesting room for further development of this resource. Expansion of female mentorship in ophthalmology can promote equity in training and help address the lack of female representation in leadership.
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Affiliation(s)
- Megan Paul
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1255, New York, NY 10029, USA.
| | - Monica Dweck
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1255, New York, NY 10029, USA; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai/New York Eye & Ear, Eye and Vision Research Institute, 17 E 102(nd) Street, 8(th) Floor West, New York, NY 10029, USA
| | - Nisha Chadha
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1255, New York, NY 10029, USA; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai/New York Eye & Ear, Eye and Vision Research Institute, 17 E 102(nd) Street, 8(th) Floor West, New York, NY 10029, USA
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Eruchalu CN, He K, Etheridge JC, Wu C, Ashley SW, Nitzschke SL, Smink DS, Cho NL. Gender and Racial/Ethnic Disparities in Operative Volumes of Graduating General Surgery Residents. J Surg Res 2022; 279:104-112. [PMID: 35759927 DOI: 10.1016/j.jss.2022.05.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/25/2022] [Accepted: 05/22/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Gender disparities in resident operative experience have been described; however, their etiology is poorly understood, and racial/ethnic disparities have not been explored. This study investigated the relationship between gender, race/ethnicity, and surgery resident case volumes. MATERIALS AND METHODS A retrospective analysis of graduating general surgery resident case logs (2010-2020) at an academic medical center was performed. Self-reported gender and race/ethnicity data were collected from program records. Residents were categorized as underrepresented in medicine (URM) (Black, Hispanic, Native American) or non-URM (White, Asian). Associations between gender and URM status and major, chief, and teaching assistant (TA) mean case volumes were analyzed using t-tests. RESULTS The cohort included 80 residents: 39 female (48.8%) and 17 URM (21.3%). Compared to male residents, female residents performed fewer TA cases (33 versus 47, P < 0.001). Compared to non-URM residents, URM residents graduated with fewer major (948 versus 1043, P = 0.008) and TA cases (32 versus 42, P = 0.038). Male URM residents performed fewer TA cases than male non-URM residents (32 versus 50, P = 0.031). Subanalysis stratified by graduation year demonstrated that from 2010 to 2015, female residents performed fewer chief (218 versus 248, P = 0.039) and TA cases (29 versus 50, P = 0.001) than male residents. However, from 2016 to 2020, when gender parity was achieved, no significant associations were observed between gender and case volumes. CONCLUSIONS Female and URM residents perform fewer TA and major cases than male non-URM residents, which may contribute to reduced operative autonomy, confidence, and entrustment. Prioritizing gender and URM parity may help decrease case volume gaps among underrepresented residents.
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Affiliation(s)
- Chukwuma N Eruchalu
- Harvard Medical School, Boston, Massachusetts; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Katherine He
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - James C Etheridge
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Ariadne Labs, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, Boston, Massachusetts
| | - Christine Wu
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Stanley W Ashley
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Stephanie L Nitzschke
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Douglas S Smink
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nancy L Cho
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
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Burton E, Jebaraj A, Eddington D, Brintz BJ, Simpson RG, Pettey JH. Gender Representation Among Presenters in Ophthalmology Subspecialties in 2019: A Retrospective Review. Am J Ophthalmol 2022; 242:18-25. [PMID: 35618022 DOI: 10.1016/j.ajo.2022.05.016] [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] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To describe gender representation at eight national ophthalmology conferences, stratified by role, session category, and sub-specialty. DESIGN Retrospective cross-sectional study. STUDY POPULATION 3,817 presenters at the 2019 American Academy of Ophthalmology subspecialty days, American Society of Cataract and Refractive Surgery, American Glaucoma Society, American Society of Retina Specialists, American Society of Ophthalmic Plastic and Reconstructive Surgery, American Association for Pediatric Ophthalmology and Strabismus, North American Neuro-Ophthalmology Society, and American Uveitis Society meetings. MAIN OUTCOME MEASURES Gender of presenters in seven sub-specialties stratified by category and role. RESULTS The proportion of female presenters was less than the ABO-estimated proportion of women in their respective fields in glaucoma (28.0% vs. 39.8%), neuro-ophthalmology (35.3% vs. 45.3%), and pediatrics (42.1% vs. 53.3%) and greater than expected in retina (24.6% vs. 19.8%). Overall, the proportion of female presenters exceeded the ABO-estimated proportion of females in ophthalmology (24.5%) for clinical (mean: 38.5%, 95% CI: [35.8%, 41.4%]) and scientific (39.4% [30.3%, 49.2%]) sessions. For clinical sub-specialty sessions, the proportion of female leaders exceeded the overall proportion of female leaders in the respective sub-specialty in cornea (35.1%, [30.4%, 40.1%] vs. 24.6% all sessions). Females represented fewer than the expected number of surgical session leaders in cornea (22.0% [19.9%, 24.3%]), glaucoma (18.0% [13.2%, 24.1%]), pediatrics (22.0% [14.4%, 32.1%]), and retina (18.6% [14.2%, 24.1%]). CONCLUSIONS Gender representation varied, with fewer than expected female presenters in glaucoma, neuro-ophthalmology, and pediatrics. Females led relatively more clinical sessions, but were underrepresented in surgical sessions, in most sub-specialties.
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Affiliation(s)
- Eleanor Burton
- From the Johns Hopkins University School of Medicine (E.B.), Baltimore, Maryland, USA
| | - Abigail Jebaraj
- University of Utah Health John A Moran Eye Center (A.J., R.G.S., J.H.P.), Salt Lake City, Utah, USA
| | - Devin Eddington
- Division of Epidemiology (D.E., B.J.B.), Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Ben J Brintz
- Division of Epidemiology (D.E., B.J.B.), Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Rachel G Simpson
- University of Utah Health John A Moran Eye Center (A.J., R.G.S., J.H.P.), Salt Lake City, Utah, USA
| | - Jeff H Pettey
- University of Utah Health John A Moran Eye Center (A.J., R.G.S., J.H.P.), Salt Lake City, Utah, USA.
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Fjørtoft K, Konge L, Christensen J, Thinggard E. Overcoming Gender Bias in Assessment of Surgical Skills. JOURNAL OF SURGICAL EDUCATION 2022; 79:753-760. [PMID: 35115269 DOI: 10.1016/j.jsurg.2022.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/20/2021] [Accepted: 01/08/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Female and male surgical residents are treated differently based on their gender. The use of assessment tools can help obtain objectivity in surgical skills assessment, avoid gender bias, and promote equal learning opportunities. The objective of the study was to explore whether knowledge of gender causes bias in the rating of surgical skills, and whether the raters' gender, surgical specialty, or experience affect ratings. DESIGN The study is designed as a cross-sectional study, where an anonymous video showing surgical performance was rated by surgeons from different surgical specialties and different levels of surgical experience. The same video was presented to two randomized groups as either a male or female surgical trainee performing the procedure. SETTING The participants used Objective Structured Assessment of Technical Skills (OSATS) to rate a video-recorded exam from a surgical skills course at Copenhagen Academy for Medical Education and Simulation (CAMES). The video rating was done through an internet-based platform and could thus be performed at home or at another location of choice. PARTICIPANTS Novice and experienced surgeons from departments of gastrointestinal surgery, gynaecology, and urology in Denmark. RESULTS There was no difference in OSATS rating score of the perceived female and male trainee (female trainee (n = 50):12.26 (SD = 3.08), male trainee (n = 57): 12.00 (SD = 3.28), p-value = 0.67). Rater characteristics: gender, age, surgical experience, and surgical specialty did not affect ratings. CONCLUSIONS When OSATS a systematic assessment tool was used in rating surgical trainees we did not find any significant implicit gender bias. The rating was unaffected by the raters' gender, age, surgical specialty, or experience.
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Affiliation(s)
- Karn Fjørtoft
- Department of Surgical Gastroenterology, Bispebjerg Hospital, Copenhagen, Denmark; Capital Region, Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark.
| | - Lars Konge
- Capital Region, Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark.
| | - John Christensen
- Capital Region, Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark.
| | - Ebbe Thinggard
- Capital Region, Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark; Department of Gynaecology and Obstetrics, Hvidovre Hospital, Hvidovre, Denmark.
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Andoh JE, Feng PW, Mir TA, Yoon J, Chadha N, Teng CC. Gender Differences in Ophthalmic Procedural Volume: A Study of Male versus Female Glaucoma Specialists. Ophthalmol Glaucoma 2022; 5:594-601. [PMID: 35405381 DOI: 10.1016/j.ogla.2022.03.010] [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: 08/04/2021] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate whether differences in procedural volume exist between practicing male and female glaucoma specialists. DESIGN A cross-sectional analysis SUBJECTS: A total of 213 female and 666 male glaucoma specialists who performed greater than or equal to 11 traditional incisional glaucoma procedures for Medicare beneficiaries between 2014 and 2018. METHODS The 2014-2018 Medicare Provider Utilization and Payment Data was queried using Current Procedural Terminology (CPT) and Evaluation and Management (E&M) codes to identify clinic visits, cataract, glaucoma drainage implant (GDI), trabeculectomy, minimally invasive glaucoma surgery (MIGS), and office-based glaucoma laser procedures. The number of procedures performed per provider was averaged and compared between male and female specialists. Univariate ordinary least squares linear regression analysis was used to investigate the effects of gender on procedural volume. Multivariate ordinary least squares linear regression analysis was used to examine the effects of gender, number of group practice members, and years after medical school graduation on cataract, GDI, trabeculectomy, MIGS, and glaucoma laser procedural volume. MAIN OUTCOME MEASURES Mean difference in the number of procedures by gender and predictors of procedural volume. RESULTS In the univariate analysis, males performed an estimated 7.8 more MIGS (95% Confidence Interval [CI] 2.7-12.9; p=0.003), 138.9 more cataract (95% CI 59.6-218.3; p=0.0006), and 1.99 more GDI procedures (95% CI 0.03-3.95; p=0.046) than their female counterparts. This relationship remained true for MIGS and cataract procedures in the multivariate analysis after controlling for clinical volume, number of group practice members, and years after medical school graduation (MIGS, ß=6.1 [95% CI 0.5-11.8], p=0.03; cataract, ß= 110.2 [95% CI 16.9-203.5]; p=0.02). Glaucoma drainage implant procedures were no longer associated with the gender of the surgeon in the multivariate analysis (ß= 2.1 [95% CI -0.1-4.2], p=0.06). The volume of trabeculectomy and office-based glaucoma laser procedures did not differ between genders in both the univariate (glaucoma laser, ß= 7.0 [95% CI -4.4-18.5], p=0.23; trabeculectomy, ß= 2.7 [95% CI -0.8-6.2], p=0.13) and multivariate analyses (glaucoma laser, ß= -7.3 [95% CI -18.7-4.1], p=0.21; trabeculectomy, ß= -1.7 [95% CI -5.6-2.1], p=0.38). CONCLUSIONS Female glaucoma specialists performed fewer MIGS and cataract procedures compared to their male counterparts, even after controlling for clinical volume, which can be seen as a relative measure of work productivity, years after medical school graduation, a proxy for experience, and number of group practice members. After controlling for these factors, there were no differences in incisional glaucoma or glaucoma laser procedure volume between male and female specialists. Further research is needed to understand factors contributing to these differences.
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Affiliation(s)
- Joana E Andoh
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut.
| | - Paula W Feng
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
| | - Tahreem A Mir
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
| | - James Yoon
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
| | - Nisha Chadha
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York Eye and Ear, Eye and Vision Research Institute, New York, New York
| | - Christopher C Teng
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
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An Eye on Gender Equality: A Review of the Evolving Role and Representation of Women in Ophthalmology. Am J Ophthalmol 2022; 236:232-240. [PMID: 34283980 DOI: 10.1016/j.ajo.2021.07.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/03/2021] [Accepted: 07/05/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE In recent decades, women have achieved greater representation in ophthalmology. Globally, women now constitute approximately 25%-30% of ophthalmologists and 35%-45% of trainees. Nevertheless, women remain under-represented in key areas, including positions of professional and academic leadership and ophthalmic surgical subspecialization. Furthermore, there is evidence that women in ophthalmology encounter more bias and discrimination across multiple domains than men, including a gender-pay gap that is wider than in many other surgical subspecialties. Women ophthalmologists and trainees report sharply differing training experiences from male peers, including fewer opportunities to operate, more bullying and harassment, less access to mentorship, and contrasting expectations around contributions to family life. DESIGN Perspective. METHODS An extensive literature search was undertaken to compile and review papers published with a focus on gender equity across ophthalmology, surgery, and medicine. RESULTS We identified 8 broad domains that were widely discussed: leadership, research and academics, income, surgical exposure and subspecialization, harassment, career satisfaction, mentorship, and family and marital differences. We have summarized the current research across each of these areas, and discussed possible solutions to reduce the inequities reported. CONCLUSIONS This review draws on current research published around representation and experiences of women in ophthalmology and suggests that there are opportunities to improve gender inequity.
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Influence of Author's Gender on the Peer-Review Process in Vision Science. Am J Ophthalmol 2022; 240:115-124. [PMID: 35227698 DOI: 10.1016/j.ajo.2022.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the gender gap in first/last authors in vision science and whether gender affects manuscript review times. DESIGN Observational retrospective database study. METHODS First/last author's gender and country were assigned to 30 438 PubMed records (data derived from Q1-Q2 Ophthalmology journals for 2016-2020). Using mixed models, the influence of First Author Female (FAF) and Last Author Female (LAF) were evaluated on the manuscripts' review timeline. This analysis was performed globally and in predefined subgroups (English names, Asian names, specific topics). Additionally, the gender GAP was explored by country, journal, and research topics. RESULTS The percentages of FAF/LAF were unevenly distributed by country; in the top 30 ophthalmology journals, FAF accounted for 40.0%±6.7% of the publications whereas LAF accounted for 27.1%±4.9%. Overall, FAF/LAF papers underwent significantly longer times to be reviewed (up to +10 days) and accepted (+5 days). These differences persisted when only English names-easily recognizable worldwide-were considered, but not for Asian names. Delays >1 month to get published were found for FAF in 3 of 4 topics analyzed (eg, amblyopia). CONCLUSIONS Significant differences were found in both review and acceptance times for FAF or LAF papers. The causes for this are likely multifactorial and could be explained by a combination of gender bias and by women's concerns with being held to higher standards, something that has been previously documented, thereby perhaps delaying the rebuttal to reviewers. Increased awareness of this source of potential bias may assist in the implementation of preventive and corrective measures.
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Gedde SJ, Feuer WJ, Crane AM, Shi W. Factors Influencing Career Decisions and Satisfaction Among Newly Practicing Ophthalmologists. Am J Ophthalmol 2022; 234:285-326. [PMID: 34157277 DOI: 10.1016/j.ajo.2021.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/12/2021] [Accepted: 06/12/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To describe the career choices of newly practicing ophthalmologists and explore factors influencing career decisions and satisfaction. METHODS A cross-sectional study was conducted using data from an electronic survey of ophthalmologists who completed training within the prior 5 years. The survey included questions about demographic information, medical education, current practice, factors affecting career choices, and career satisfaction. Statistical comparisons were made based on gender, type of practice, subspecialty training, and practice area. RESULTS Surveys were completed by 696 (32%) newly practicing ophthalmologists, including 276 (40%) women, 179 (29%) academicians, and 465 (67%) subspecialists. A higher proportion of female respondents entered academics than male respondents (36% vs 26%, P = .009). Female and male respondents pursued fellowship training with similar frequency (64% vs 68%, P = .32), but men were more likely to seek vitreoretinal fellowships (30% vs 11%, P < .001) and women were more likely to undertake fellowships in pediatric ophthalmology (21% vs 8%, P < .001), uveitis (10% vs 2%, P = .002), and neuro-ophthalmology (6% vs 2%, P = .042). A total of 514 (83%) respondents reported being happy with work life. CONCLUSIONS The career choices of newly practicing ophthalmologists differ based on gender, type of practice, subspecialty training, and practice area. Many factors affect career decisions, and they have varying influence on subgroups within ophthalmology. Ophthalmologists have high levels of career satisfaction. This information may prove useful when developing workforce strategies to meet future eye care needs. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
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Kong AW, Schallhorn JM, Ou Y. Single Ophthalmology Program Trends in Resident Surgical and Research Productivity by Gender, Underrepresented Minority Status, and Welcoming a Child. JOURNAL OF ACADEMIC OPHTHALMOLOGY 2021. [DOI: 10.1055/s-0041-1735580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Abstract
Objective The aim of the study is to identify differences for cataract surgery, total procedural volume, and publication rates between residents by gender, underrepresented minority (URM) status, and welcoming a child during ophthalmology residency.
Design This is a retrospective, cross-sectional study.
Participants A total of 89 residents graduating from 2002 to 2020 at a single program were included.
Methods A multiple linear regression model was created to determine factors predictive of the number of cataract surgeries performed as the primary surgeon, total procedural volume, number of publications, or first author publications. Independent variables included resident gender, URM status, PhD degree, welcoming a child during residency, and graduation year.
Results Of the 89 graduating residents included in this study, identifying as female (45 women, 50.6%) and as URM (eight identifying as URM, 9.0%) was not associated with a difference in surgical or research volume. Female residents performed a mean (SD) of 240.1 (55.1) cataract surgeries while male residents performed 210.6 (46.1) cataract surgeries. Residents identifying as URM completed 228.1 (41.9), while non-URM residents completed 234.8 (51.9) cataract surgeries. Since 2008, eight female residents (22.2%) and two male residents (6.9%) added children to their families. Welcoming a child to the family was also not associated with decreased surgical or publication volume. Number of cataract surgeries, total procedures, and number of publications did increase over time (p <0.001), as each graduation year was associated with 5.4 (95% CI: 3.9, 7.1) more cataract surgeries and 30.5 (95% CI: 25.7, 36.9) more procedures. Each year was also associated with 0.24 (95% CI: 0.09, 0.38) more publications and 0.18 (95% CI: 0.08, 0.28) more first author publications.
Conclusion Surgical and research productivity has increased, and female residents and residents who identify as URM did not have fewer cataract surgeries or procedures. Welcoming a child also did not correlate with differences in surgical or procedural volume. Programs should continue to promote equitable surgery and procedural distributions as well as identify more targeted strategies to encourage and recruit underrepresented medical students into ophthalmology.
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Affiliation(s)
- Alan W. Kong
- Department of Ophthalmology, School of Medicine, University of California San Francisco, San Francisco, California
| | - Julie M. Schallhorn
- Department of Ophthalmology, School of Medicine, University of California San Francisco, San Francisco, California
| | - Yvonne Ou
- Department of Ophthalmology, School of Medicine, University of California San Francisco, San Francisco, California
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Zur D, Loewenstein A. Is there a light at the end of the gender inequality tunnel? Clin Exp Ophthalmol 2021; 49:649-651. [PMID: 34601798 DOI: 10.1111/ceo.13998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Dinah Zur
- Ophthalmology Division, Tel Aviv Sourasky Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Loewenstein
- Ophthalmology Division, Tel Aviv Sourasky Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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AlHamzah M, Hussain MA, Greco E, Zamzam A, Jacob-Brassard J, Wheatcroft M, Forbes TL, Al-Omran M. Trends in operative case volumes of Canadian vascular surgery trainees. J Vasc Surg 2021; 75:687-694.e3. [PMID: 34461218 DOI: 10.1016/j.jvs.2021.07.230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Vascular surgery has evolved with increasing use of endovascular therapies and a decline in open surgery. The influence of these changes, in addition to a new vascular surgery training program introduced in 2012, on case volumes of vascular trainees is not known. We sought to evaluate trends in operative case volumes of Canadian vascular surgery trainees. METHODS A survey was administered to graduates of the Canadian Royal College-accredited Vascular Fellowships (VFs) and Integrated Vascular Surgery Residency (IVSR) programs (2007-2019) to record cases performed during their final 2 years of training. Procedures of interest were open abdominal aortic aneurysm (oAAA) repair, open thoracic/thoracoabdominal aortic (oTAA/TAAA) repair, lower extremity bypass (LEB), carotid endarterectomy (CEA), lower extremity endovascular intervention (LEEI), and endovascular abdominal, advanced, and thoracic aortic repair (EVAR, aEVAR, and TEVAR). Case volumes were analyzed overall, and by graduation year, type of training program, and resident demographics. RESULTS A total of 60 participants (10% female) from all the 10 Canadian training institutions responded (response rate, 63%). There was a declining trend in overall procedures performed since the introduction of IVSR in 2012 (median, 427 [interquartile range (IQR), 304-496] in 2007-2012 vs median, 342 [IQR, 279-405] in 2013-2019; P = .055), driven by a significant decline in open vascular surgery cases (median, 273 [IQR, 221-339] in 2007-2012 vs median, 156 [IQR, 128-181] in 2013-2019; P = .001). Case volumes of oAAA, LEB, and CEA declined by 44%, 40%, and 45%, respectively. Compared with vascular fellows, IVSR residents logged ∼2.5 times more aEVARs (median, 8; IQR, 2-11 vs median, 19; IQR, 8-27; P = .001) and ∼1.5 times more LEEIs (median, 60; IQR, 40-99 vs median, 93; IQR, 69-120; P = .018). Trainees were most confident (range, 90%-100%) in performing oAAA, EVAR, LEB, LEEI, and CEA after training, and least confident in performing oTAA/TAAA and aEVAR (20% and 49% confidence, respectively). CONCLUSIONS Operative case volumes of Canadian vascular surgery trainees since the introduction of IVSR program in 2012 have decreased, driven by declining exposure to open cases. However, trainees continue to receive adequate operative exposure to perform most standard vascular procedures confidently upon graduation.
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Affiliation(s)
- Musaad AlHamzah
- Department of Surgery, King Saud University, Riyadh, Saudia Arabia; Division of Vascular Surgery, King Saud University Medical City, Riyadh, Saudia Arabia
| | - Mohamad A Hussain
- Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, Mass; Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Mass; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Elisa Greco
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Vascular Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Abdelrahman Zamzam
- Division of Vascular Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | | | - Mark Wheatcroft
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Vascular Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Thomas L Forbes
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Vascular Surgery, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Mohammed Al-Omran
- Department of Surgery, King Saud University, Riyadh, Saudia Arabia; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Vascular Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
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Buys YM, Canizares M, Felfeli T, Jin YP. Trends in payments among male and female ophthalmologists in Ontario from 1992 to 2018. Can J Ophthalmol 2021; 57:47-57. [PMID: 34450046 DOI: 10.1016/j.jcjo.2021.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine sex differences in Ontario Health Insurance Plan (OHIP) payments from 1992 to 2018. DESIGN Population-based observational study. PARTICIPANTS Ophthalmologists submitting claims to OHIP from 1992 to 2018. METHODS Physician billing data over 27 years (1992-2018) were analyzed for yearly number of ophthalmologists, OHIP payments, distinct patients, and patient visits. RESULTS Yearly median OHIP payments to female ophthalmologists were less than to male ophthalmologists with a gap ratio of 0.55 in 1992 to 0.73 in 2018. Stratifying by full-time equivalent (FTE), there was little difference in median payments between males and females for 1 FTE. Median female-to-male payments ratio varied from 0.80 to 1.16 for <1 FTE and 1.14 to 0.84 for >1 FTE from 1992 to 2018. Among female ophthalmologists, 72.7% and 52.9% were <1 FTE and 11.4% and 19.2% were >1 FTE in 1992 and 2018, respectively. In comparison, for male ophthalmologists, 35.7% and 45.6% were <1 FTE and 43.4% and 45.6% were >1 FTE in 1992 and 2018, respectively. Overall, male ophthalmologists had more patients and patient visits than female ophthalmologists, but there was little difference between male and female ophthalmologists for 1 and >1 FTE. The results for <1 FTE varied by year. CONCLUSIONS Overall, female ophthalmologists have lower OHIP payments compared with males, but there was little difference for those stratified to 1 FTE. This overall payments difference by sex is largely explained by the higher proportion of <1 FTE females, lower proportion of >1 FTE females, and higher payments for >1 FTE males.
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Affiliation(s)
- Yvonne M Buys
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.
| | - Mayilee Canizares
- Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ont
| | - Tina Felfeli
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont; Dalla Lana School of Public Health, University of Toronto, Toronto, Ont
| | - Ya-Ping Jin
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont; Dalla Lana School of Public Health, University of Toronto, Toronto, Ont
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A Novel Approach to Quantifying Acute Stress in Cataract Surgeons to Investigate the Relationship Between Surgeon Experience and Intraoperative Stress. J Cataract Refract Surg 2021; 48:549-554. [PMID: 34533918 DOI: 10.1097/j.jcrs.0000000000000798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/18/2021] [Indexed: 11/26/2022]
Abstract
Purpose To quantify intraoperative stress levels in cataract surgeons and investigate the relationship between intraoperative stress and surgeon experience. Setting Department of Ophthalmology, Hanusch Krankenhaus, Vienna, Austria. Design Prospective, observational case series. Methods Five ophthalmologists with surgery experiences of 70 to 15,000 previous surgeries volunteered for this study. Surgeons' heart rate and heart rate variability (HRV) were measured during a total of 45 cataract surgeries. Heart rate and HRV values were normalized to the minimal heart rate and maximal HRV of an overnight baseline measurement. The resulting normalized heart rate measure and HRV stress index are stress dependent and comparable between subjects. No case selection was performed. Results Less experienced surgeons showed higher HRV stress indices; differences between the surgeons with less than 180 and 500 surgeries and the two with 600 and 1,500 surgeries were significant ([alpha] =0.05). No significant difference in stress indices was found between the 1,500 and 15,000 surgeries subjects, suggesting that there may be a plateau effect after 1,500 surgeries. HRV stress indices and case times were negatively correlated with the logarithm of experience in number of previously performed surgeries (r2 = 0.67 and 0.52). No significant stress build-up over multiple successive surgeries was found ([alpha] =0.05). Conclusions The novel HRV stress index is a simple but powerful tool for quantifying intraoperative stress in cataract surgeons. Decreases in stress with increasing experience are congruent with previous works on general surgeon's stress and follow a similar timeline as previously published, proficiency-based learning curves for cataract surgery.
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Hughes PJ. Gender Issues and Oral and Maxillofacial Surgery Advanced Education Program Accreditation. Oral Maxillofac Surg Clin North Am 2021; 33:429-433. [PMID: 34389229 DOI: 10.1016/j.coms.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The author explores gender issues related to oral and maxillofacial training programs and the role that accreditation should have to ensure gender equity, antidiscrimination, and support of women in the profession of oral and maxillofacial surgery.
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Affiliation(s)
- Pamela J Hughes
- Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, 3181 Sam Jackson Park Road, Portland, OR 97239, USA.
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Gill HK, Niederer RL, Danesh-Meyer HV. Gender differences in surgical case volume among ophthalmology trainees. Clin Exp Ophthalmol 2021; 49:664-671. [PMID: 34218497 DOI: 10.1111/ceo.13969] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/27/2021] [Accepted: 07/01/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND The number of females in ophthalmology has steadily increased over recent decades. The aim of this study was to evaluate whether there is a difference in procedural volume and cataract surgery between male and female trainees in the Royal Australian and New Zealand College of Ophthalmologists (RANZCO). METHODS A longitudinal retrospective review of de-identified surgical RANZCO trainee logbook data from 2008 to 2020 was undertaken. Data from 241 trainee logbooks were analysed for: location of training, gender, date of commencement of training, maternity/paternity leave status, number of surgeries observed, assisted, supervised and unsupervised. Surgical cases were grouped as: (1) all surgical cases; (2) complete cataract cases and (3) partial cataract cases. RESULTS Among 241 trainees (40.7% females), 197 263 procedures were performed. Total surgical volume was 21.1% lower at 4 years for females (median 665.5 vs. 843.5; p = 0.036). Completed cataract surgery was 21.5% lower at 18 months (median 87.5 vs. 111.5; p = 0.022) and 41.7% lower at 4 years (median 216 vs. 369; p < 0.001). Interrupted training was significantly more common in females (30.6% vs. 0.7%; p < 0.001). However, linear regression analysis did not identify parental leave or duration as a significant predictor for number of completed cataracts (p = 0.206). Complication rate was not different between males and females (p = 0.35). CONCLUSIONS Female trainees completed 41.7% fewer cataract operations at the end of their training compared to male counterparts with the gap widening between years 1 and 4 of training. The current data demonstrates that female and male RANZCO trainees are not receiving equivalent operating experiences.
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Affiliation(s)
- Hannah K Gill
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
| | - Rachael L Niederer
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
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