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McKeon M, Zhou A, Tang AL. Gender inequities in ENT: Insights from women speakers at American Head and Neck Society meetings. Head Neck 2024; 46:1406-1416. [PMID: 38544444 DOI: 10.1002/hed.27755] [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: 12/09/2023] [Revised: 03/07/2024] [Accepted: 03/14/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Gender inequity exists across national speakers at American Head and Neck Society (AHNS) conferences. This qualitative study explores potential causes of this disparity by surveying women invited to speak at AHNS between 2007 and 2019 and examining advice, resources, and meaningful actions from "those who made it." METHODS An internet search for contact information for the 131 female AHNS was performed. An electronic survey was distributed via email. Deidentified qualitative responses were coded by two independent researchers into themes. Themes characterize barriers that female head and neck (HN) surgeons face and describe ways to mitigate the impact of these for the next generation. RESULTS Contact information for 73/131 female AHNS speakers was obtained via internet search. Email responses were received from 22/73 (30%). Of those, respondents specialized in otolaryngology (n = 17), medical oncology (n = 2), palliative care (n = 1), vascular surgery (n = 1), and thoracic surgical oncology (n = 1). All speakers worked in academic settings at varying stages of their career with 81.8% (18/22) of respondents fellowship-trained (primarily HN surgery). Concerns about gender disparity in ENT were grouped into the following themes: (1) recruiting women to ENT, (2) removing barriers to career advancement, (3) diversifying ENT's national presence, and (4) improving the broader culture of HN surgery. Respondents emphasized a need for diversifying leadership, early exposure to otolaryngology in medical school, and connecting students with female role models. Outstanding research, involvement at annual meetings, and committee membership were consistently deemed important for establishing a national presence in the field. Implicit bias, "boys clubs" culture, and burdensome childcare responsibilities were described as barriers to career advancement. CONCLUSIONS While encouraging more women to enter otolaryngology residencies, increasing the number female role models and establishing strong mentoring networks may help to mitigate challenges. Meaningful progress requires the efforts of both male and female allies within the specialty. Simple solutions, such as educating on implicit bias, removing demographics from applications, and eliminating hidden penalties for maternity leave, may help improve diversity and mitigate barriers to career progression for underrepresented groups within ENT.
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Affiliation(s)
- Mallory McKeon
- Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Anna Zhou
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Alice L Tang
- Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Yesantharao LV, Sriram S, Litvack JR, Chandrasekhar SS, Galaiya DJ. Is a Simple Checklist Associated With Improvement in Gender Representation at the AAO-HNSF Annual Meeting? Otolaryngol Head Neck Surg 2024. [PMID: 38591747 DOI: 10.1002/ohn.743] [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: 09/24/2023] [Revised: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE In September 2017, the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) added 2 questions querying panel organizers if gender/racial diversity was considered in selecting panel presenters, beginning with the 2018 Annual Meeting (AM). This study examines how this checklist impacted the gender diversity of panel presenters at the AAO-HNS AM. STUDY DESIGN This was a cross-sectional investigation comparing female representation before and after the addition of questions inquiring about diversity in 2018. SETTING A review of abstract submissions for the AMs from 2015 to 2021. METHODS AM Official Program Abstracts were used to obtain presenter names and specialty area for each panel. The percentage of female presenters, in total and stratified by specialty area, were compared before and after 2018 to quantify changes following the addition of the checklist. RESULTS There was a significant increase in the proportion of female panel presenters from 22.3% (total n = 1199) in 2015 to 2017 to 33.0% (total n = 1868) in 2018 to 2021 (P < .001) and in all panel specialties. The number of female moderated panels also significantly increased after checklist implementation from 22% to 38% (P < .001). Correspondingly, the number of panels with no female representation decreased from 42% in 2015 to 2017 to 23% in 2018 to 2021 (P < .001). CONCLUSION The addition of a checklist asking panel organizers to consider diversity in selecting panelists was associated with an increased proportion of female presenters at the AM. This simple strategy can be implemented by all medical conferences to help close the gender gap.
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Affiliation(s)
- Lekha V Yesantharao
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Shreya Sriram
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Jamie R Litvack
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA
| | | | - Deepa J Galaiya
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA
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McMullen C, Kejner A, Nicolli E, Abouyared M, Coblens O, Fedder K, Thakkar P, Patel R. Parental leave and family building experiences among head and neck surgeons in the United States: Career impact and opportunities for improvement. Head Neck 2024. [PMID: 38511311 DOI: 10.1002/hed.27752] [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: 01/24/2024] [Revised: 03/05/2024] [Accepted: 03/14/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The availability of paid parental leave is an important factor for retention and wellness. The experiences of head and neck surgeons with parental leave have never been reported. METHODS A survey was electronically distributed to head and neck subspecialty surgeons in the United States. Responses were collected and analyzed. RESULTS Male surgeons had more children and took significantly less parental leave than women. Thirty percent of respondents reported that parental leave negatively impacted compensation, and 14% reported a delay in promotion due to leave, which impacted women more than men. The vast majority reported they are happy or neutral about covering those on leave. Most respondents utilized paid childcare, and approximately one quarter of respondents spending 11%-20% of their income on childcare. CONCLUSIONS This study illuminates the current disparities regarding parental leave-taking within the subspecialty of head and neck surgery in the United States. Women surgeons are more likely to be impacted professionally and financially.
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Affiliation(s)
- Caitlin McMullen
- Department of Head & Neck - Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Alexandra Kejner
- Department of Otorhinolaryngology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Elizabeth Nicolli
- Department of Otolaryngology - Head and Neck Surgery, University of Miami, Miami, Florida, USA
| | - Marianne Abouyared
- Department of Otolaryngology - Head and Neck Surgery, UC Davis, Sacramento, California, USA
| | - Orly Coblens
- Department of Otolaryngology - Head and Neck Surgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Katie Fedder
- Department of Otolaryngology - Head and Neck Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Punam Thakkar
- Department of Otolaryngology - Head and Neck Surgery, George Washington University, Washington, DC, USA
| | - Rusha Patel
- Division of Otolaryngology - Head and Neck Surgery, University of Oklahoma, Oklahoma City, Oklahoma, USA
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Wang E, Diaz A, Khan ML, Blair EA, Shogan AN. Regional distribution in female representation in US otolaryngology faculty. Laryngoscope Investig Otolaryngol 2023; 8:832-838. [PMID: 37621283 PMCID: PMC10446270 DOI: 10.1002/lio2.1099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 08/26/2023] Open
Abstract
Objectives To quantify the current proportion of women in otolaryngology at different levels of professorship and determine whether these proportions differ by US region. Methods Academic rank and gender at all ACGME-accredited otolaryngology programs in the United States were determined from departmental websites, Doximity, and LinkedIn from November 2021 to March 2022. Individuals were then further organized using US Census Bureau-designated regions. Results Among the 2682 faculty positions at 124 ACGME-accredited programs, women held 706 (26.3%) of these positions. Female representation was highest at the assistant professorship level, with women holding 286 (37.2%) positions out of a total 769. At the associate professorship level, women held 141 (27.6%) of the 511 total positions. The largest gender disparity is seen at the full professorship level; only 69 (13.6%) positions out of 508 were held by women. Out of every region and rank, only assistant professorship in the West had no significant difference in percentages of men and women (p = .710). Female representation of professors in the Northeast was significantly lower than that of our reference group (the South; β = -10.9, p = .020). Conclusions Otolaryngology has exhibited great progress in increasing female representation, with assistant professorship in the West reaching gender parity. However, the gender gap at other faculty levels still leaves much to be desired, particularly in senior ranks. The lack of otolaryngologists at senior ranks is detrimental to mentorship of junior faculty, residents, and medical students. Renewed efforts should be made to decrease the gender disparity in the South, Northeast, and particularly at the professorship level.
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Affiliation(s)
- Esther Wang
- Pritzker School of Medicine, University of ChicagoChicagoIllinoisUSA
| | - Ashley Diaz
- Pritzker School of Medicine, University of ChicagoChicagoIllinoisUSA
| | - Maha L. Khan
- Biological Sciences DivisionUniversity of ChicagoChicagoIllinoisUSA
| | - Elizabeth A. Blair
- Department of Surgery, Section of OtolaryngologyUniversity of Chicago MedicineChicagoIllinoisUSA
| | - Andrea N. Shogan
- Department of Surgery, Section of OtolaryngologyUniversity of Chicago MedicineChicagoIllinoisUSA
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Ioanidis K, Naismith K, Dzioba A, MacNeil SD, Paradis J, Nayan S, Strychowsky JE, Graham ME. Canadian Women in Otolaryngology-Head and Neck Surgery part 1: the relationship of gender identity to career trajectory and experiences of harassment. J Otolaryngol Head Neck Surg 2023; 52:31. [PMID: 37095567 PMCID: PMC10127062 DOI: 10.1186/s40463-023-00629-6] [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] [Received: 04/29/2022] [Accepted: 02/23/2023] [Indexed: 04/26/2023] Open
Abstract
INTRODUCTION Women in surgical specialties face different challenges than their male peers. However, there is a paucity of literature exploring these challenges and their effects on a Canadian surgeon's career. METHODS A REDCap® survey was distributed to Canadian Otolaryngology-Head and Neck Surgery (OHNS) staff and residents in March 2021 using the national society listserv and social media. Questions examined practice patterns, leadership positions, advancement, and experiences of harassment. Gender differences in survey responses were explored. RESULTS 183 completed surveys were obtained, representing 21.8% of the Canadian society membership [838 members with 205 (24.4%) women]. 83 respondents self-identified as female (40% response rate) and 100 as male (16% response rate). Female respondents reported significantly fewer residency peers and colleagues identifying as their gender (p < .001). Female respondents were significantly less likely to agree with the statement "My department had the same expectations of residents regardless of gender" (p < .001). Similar results were observed in questions about fair evaluation, equal treatment, and leadership opportunities (all p < .001). Male respondents held the majority of department chair (p = .028), site chief (p = .011), and division chief positions (p = .005). Women reported experiencing significantly more verbal sexual harassment during residency (p < .001), and more verbal non-sexual harassment as staff (p = .03) than their male colleagues. In both female residents and staff, this was more likely to originate from patients or family members (p < .03). DISCUSSION There is a gender difference in the experience and treatment of OHNS residents and staff. By shedding light on this topic, as a specialty we can and must move towards greater diversity and equality.
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Affiliation(s)
- Khrystyna Ioanidis
- Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Otolaryngology - Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada
| | - Kendra Naismith
- Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Agnieszka Dzioba
- Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Otolaryngology - Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada
| | - S Danielle MacNeil
- Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Otolaryngology - Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada
| | - Josée Paradis
- Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Otolaryngology - Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada
| | - Smriti Nayan
- Division of Otolaryngology - Head and Neck Surgery, Cambridge Memorial Hospital, McMaster University, Hamilton, ON, Canada
| | - Julie E Strychowsky
- Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Otolaryngology - Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada
| | - M Elise Graham
- Schulich School of Medicine and Dentistry, Western University, London, Canada.
- Department of Otolaryngology - Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada.
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Saadoun R, Risse E, Sadoun L, Kamal A, Pudszuhn A, Obermueller T. Gender distribution and women leadership in German Otolaryngology, Head and Neck Surgery. Laryngoscope Investig Otolaryngol 2023; 8:426-434. [PMID: 37090881 PMCID: PMC10116970 DOI: 10.1002/lio2.1050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/10/2023] [Indexed: 03/31/2023] Open
Abstract
Objective To determine the distribution of female physicians throughout the rank from resident to leadership positions in German Otolaryngology-Head and Neck Surgery (OHNS) departments. Methods This cross-sectional study collected data about the physician workforce in the German OHNS.The primary outcome was the proportion of female physicians. Data were collected from 165 departments from January 2022 to February 2022. The physician workforce was stratified based on gender and leadership. Results We included 2089 physicians from 165 departments of OHNS in German hospitals. Female residents and specialists outnumbered male peers (484/872 [55.5%] vs. 388/872 [44.5%] and 224/363 [61.71%] vs. 139/363 [38.29%], respectively). However, the women proportion decreased gradually with elevated hierarchical rank starting at the attending physician level to reaching its lowest extreme (14/165 [7.23%]) at the head of the department level. Holding a leadership position was associated with being male (n = 282 [85.2%] vs. n = 49 [14.8%], p < .0001). This persisted even after controlling the academic rank in a multivariable regression model (OR: 5.027, 95% CI: 3.536-7.146). The gap between the two genders in favor of men regarding leadership persisted in all kinds of hospitals. However, this disparity was lowest in university hospitals, (male: n = 83 [78.3%] vs. female: n = 23, [21.7%], p < .0001). Conclusions Even though women outnumbered men in resident and specialist positions, they are still underrepresented in leadership positions in OHNS. Continuous surveillance is needed to watch the dynamic changes in the gap between the two genders and address it with more sex equality-supporting policies. Level of Evidence IV.
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Affiliation(s)
- Rakan Saadoun
- Department of Plastic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
- Ruprecht Karls University of Heidelberg, Faculty of Medicine MannheimMannheimGermany
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Medical Centre MannheimMannheimGermany
| | - Eva‐Maria Risse
- Ruprecht Karls University of Heidelberg, Faculty of Medicine HeidelbergHeidelbergGermany
| | - Leen Sadoun
- University of Damascus, Faculty of PharmacyDamascusSyria
| | - Abdallah Kamal
- University of Pittsburgh Medical Center, Department of NeuroradiologyPittsburghPennsylvaniaUSA
| | - Annett Pudszuhn
- Department of OtorhinolaryngologyHead and Neck Surgery, Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt‐Universität zu Berlin and Berlin Institute of HealthCampus Benjamin FranklinBerlinGermany
| | - Theresa Obermueller
- Department of OtorhinolaryngologyHead and Neck Surgery, Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt‐Universität zu Berlin and Berlin Institute of HealthCampus Benjamin FranklinBerlinGermany
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Mallur P, Ikeda A, Patel A, Raol N, Ahanotu A, Suarez-Goris D, Randolph GW, Shin JJ. Evidence-Based Medicine in Otolaryngology Part 14: Falsehood and Bias. Otolaryngol Head Neck Surg 2023; 168:1584-1595. [PMID: 36808631 DOI: 10.1002/ohn.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 08/30/2022] [Accepted: 11/16/2022] [Indexed: 02/19/2023]
Abstract
OBJECTIVE Falsehood and bias can have tangible effects, whether related to the "hoax" of Corona virus disease/COVID-19 or the impact of personal protective equipment in city-wide news. The spread of false information requires the diversion of time and resources into rebolstering the truth. Our objective is thus to elucidate types of bias that may influence our daily work, along with ways to mitigate them. DATA SOURCES Publications are included which delineate specific aspects of bias or address how to preempt, mitigate, or correct bias, whether conscious or unconscious. REVIEW METHODS We discuss: (1) the background and rationale for proactively considering potential sources of bias, (2) relevant definitions and concepts, (3) potential means to limit effects of inaccurate data sources, and (4) evolving frontiers in the management of bias. In doing so, we review epidemiological concepts and susceptibility to bias within study designs, including database studies, observational studies, randomized controlled trials (RCTs), systematic reviews, and meta-analyses. We additionally discuss concepts such as the difference between disinformation and misinformation, differential or nondifferential misclassification, bias toward a null result, and unconscious bias, among others. CONCLUSION We have the means to mitigate sources of potential bias in database studies, observational studies, RCTs, and systematic reviews, beginning with education and awareness. IMPLICATIONS FOR PRACTICE False information may spread faster than true information, so it is beneficial to understand potential sources of falsehood we face, in order to safeguard our daily impressions and decisions. Awareness of potential sources of falsehood and bias forms the foundation for accuracy in our everyday work.
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Affiliation(s)
- Pavan Mallur
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Allison Ikeda
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Anju Patel
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Nikhila Raol
- Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA
| | - Adaobi Ahanotu
- Department of Otolaryngology-Head and Neck Surgery, University of Maryland, Baltimore, Maryland, USA
| | - Dany Suarez-Goris
- Division of Thoracic Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Gregory W Randolph
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer J Shin
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA.,Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Kemp A, Garland K, Graham E, Simpson A, Symonette C. Family Planning Among Canadian Plastic Surgeons and Trainees. Plast Surg (Oakv) 2023. [DOI: 10.1177/22925503221151187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Introduction: Despite increasing advocacy for family leave policies, few studies have described the current landscape and attitudes around family planning in Canadian plastic surgery. The purpose of this study was to survey Canadian plastic surgeons and trainees to examine their experience with family planning, parental leave, and breastfeeding. Methods: An anonymized survey was distributed to all members of the Canadian Society of Plastic Surgeons and all Canadian Plastic Surgery residents through their program administrators. Survey responses were recorded and analyzed through a customized REDCap™ database. Results were reported using descriptive statistics. Results: A total of 87 plastic surgeons and trainees completed the surgery. We found 72.3% of respondents had children; 67.8% felt their colleagues were supportive of parental leave; 45.6% felt that financial concerns affected their decision to take parental leave; 61.6% felt that their career did not influence the number of children they chose to have; 21.0% accessed fertility services and 9.8% used assisted-reproductive technologies; 80% of respondents who breastfeed felt they did not have enough time to pump at work, however, 79% did not experience any discrimination or criticism for pumping at work. Conclusion: Canadian plastic surgeons most often have children after completing training and choose to take shorter parental leaves as their careers progress. Parental leave and breastfeeding practices in the workplace are reported to have increased support from colleagues compared to previous literature. However, Canadian plastic surgeons continue to struggle with infertility and seek fertility services at rates higher than the general population.
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Affiliation(s)
- Austin Kemp
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Katie Garland
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Division of Plastic and Reconstructive Surgery, Western University, London, ON, Canada
| | - Elise Graham
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Division of Otolaryngology, Western University, London, ON, Canada
| | - Andrew Simpson
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Division of Plastic and Reconstructive Surgery, Western University, London, ON, Canada
| | - Caitlin Symonette
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Division of Plastic and Reconstructive Surgery, Western University, London, ON, Canada
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Roman KM, Bui AT, Birkenbeuel J, Tjoa T, Haidar YM, Kuan EC. Female Representation Among CORE Grant Recipients by Research Subspeciality. Otolaryngol Head Neck Surg 2022; 167:991-993. [PMID: 35133900 DOI: 10.1177/01945998221076091] [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: 01/07/2023]
Abstract
This study evaluates the gender distribution of Centralized Otolaryngology Research Efforts (CORE) grants by research subspeciality over the past decade. Demographic information on CORE grant recipients from 2010 to 2019 was extracted through an Internet search, and research projects were categorized by subspeciality. Of 343 grants awarded during this period, 127 (37%) were awarded to women. Analysis demonstrated lower absolute rates of CORE funding for women in all fields except pediatrics, but women receive a proportional number of grants for most subspecialities based on their representation within the field.
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Affiliation(s)
- Kelsey M Roman
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA
| | - Anh-Tram Bui
- Western University of Health Sciences, Pomona, California, USA
| | - Jack Birkenbeuel
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA
| | - Tjoson Tjoa
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA
| | - Yarah M Haidar
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA
| | - Edward C Kuan
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA
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Hamour AF, Chen T, Cottrell J, Campisi P, Witterick IJ, Chan Y. Discrimination, harassment, and intimidation amongst otolaryngology: head and neck surgeons in Canada. J Otolaryngol Head Neck Surg 2022; 51:35. [PMID: 36180943 PMCID: PMC9524112 DOI: 10.1186/s40463-022-00590-w] [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: 02/06/2022] [Accepted: 07/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding mistreatment within medicine is an important first step in creating and maintaining a safe and inclusive work environment. The objective of this study was to quantify the prevalence of perceived workplace mistreatment amongst otolaryngology-head and neck surgery (OHNS) faculty and trainees in Canada. METHODS This national cross-sectional survey was administered to practicing otolaryngologists and residents training in an otolaryngology program in Canada during the 2020-2021 academic year. The prevalence and sources of mistreatment (intimidation, harassment, and discrimination) were ascertained. The availability, awareness, and rate of utilization of institutional resources to address mistreatment were also studied. RESULTS The survey was administered to 519 individuals and had an overall response rate of 39.1% (189/519). The respondents included faculty (n = 107; 56.6%) and trainees (n = 82; 43.4%). Mistreatment (intimidation, harassment, or discrimination) was reported in 47.6% of respondents. Of note, harassment was reported at a higher rate in female respondents (57.0%) and White/Caucasian faculty and trainees experienced less discrimination than their non-White colleagues (22.7% vs. 54.5%). The two most common sources of mistreatment were OHNS faculty and patients. Only 14.9% of those experiencing mistreatment sought assistance from institutional resources to address mistreatment. The low utilization rate was primarily attributed to concerns about retribution. INTERPRETATION Mistreatment is prevalent amongst Canadian OHNS trainees and faculty. A concerning majority of respondents reporting mistreatment did not access resources due to fear of confidentiality and retribution. Understanding the source and prevalence of mistreatment is the first step to enabling goal-directed initiatives to address this issue and maintain a safe and inclusive working environment.
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Affiliation(s)
- Amr F Hamour
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, 6 Queen's Park Cres. W, Toronto, ON, M5S 3H2, Canada
| | - Tanya Chen
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, 6 Queen's Park Cres. W, Toronto, ON, M5S 3H2, Canada
| | - Justin Cottrell
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, 6 Queen's Park Cres. W, Toronto, ON, M5S 3H2, Canada
| | - Paolo Campisi
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, 6 Queen's Park Cres. W, Toronto, ON, M5S 3H2, Canada
| | - Ian J Witterick
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, 6 Queen's Park Cres. W, Toronto, ON, M5S 3H2, Canada
| | - Yvonne Chan
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, 6 Queen's Park Cres. W, Toronto, ON, M5S 3H2, Canada.
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Go B, Suresh N, Go C, Chorath K, Mirza N, Thaler E, Moreira A, Rajasekaran K. Gender analysis of the top classic papers in otolaryngology head and neck surgery. World J Otorhinolaryngol Head Neck Surg 2022. [DOI: 10.1002/wjo2.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Beatrice Go
- Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA
- Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia Pennsylvania USA
| | - Neeraj Suresh
- Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA
| | - Cammille Go
- Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - Kevin Chorath
- Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA
| | - Natasha Mirza
- Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA
| | - Erica Thaler
- Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA
| | - Alvaro Moreira
- Department of Pediatrics, Division of Neonatology The University of Texas Health Science Center at San Antonio San Antonio Texas USA
| | - Karthik Rajasekaran
- Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA
- Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia Pennsylvania USA
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Gianakos AL, Freischlag JA, Mercurio AM, Haring RS, LaPorte DM, Mulcahey MK, Cannada LK, Kennedy JG. Bullying, Discrimination, Harassment, Sexual Harassment, and the Fear of Retaliation During Surgical Residency Training: A Systematic Review. World J Surg 2022; 46:1587-1599. [PMID: 35006329 DOI: 10.1007/s00268-021-06432-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND The negative effects of bullying, discrimination, harassment, and sexual harassment (BDHS) on well-being and productivity of surgical residents in training have been well documented. Despite this, little has changed over the past decade and these behaviors continue. The purpose of this study was to determine the prevalence of each abusive behavior experienced by residents, identify the perpetrators, and examine the reporting tendency. METHODS A systematic review of articles published between 2010 and 2020 in the MEDLINE, EMBASE, and Cochrane databases was performed following PRISMA guidelines. The following search terms were used: bullying, harassment, sexual harassment, discrimination, abuse, residency, surgery, orthopedic surgery, general surgery, otolaryngology, obstetrics, gynecology, urology, plastic surgery, and training. RESULTS Twenty-five studies with 29,980 surgical residents were included. Sixty-three percent, 43, 29, and 27% of surgical residents experienced BDHS, respectively. Female residents reported experiencing all BDHS behaviors more often. Thirty-seven percent of resident respondents reported burnout, and 33% reported anxiety/depression. Attending surgeons, followed by senior co-residents, were the most common perpetrators. Seventy-one percent did not report the behavior to their institution. Fifty-one percent stated this was due to fear of retaliation. Of those who reported their experiences, 56% stated they had a negative experience reporting. CONCLUSION Our review demonstrates high prevalence rates of BDHS experienced by residents during surgical training, which have been associated with burnout, anxiety, and depression. The majority of residents did not report BDHS due to fear of retaliation. Residency programs need to devise methods to have a platform for residents to safely voice their complaints.
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Affiliation(s)
- Arianna L Gianakos
- Department of Orthopaedic Surgery, Harvard-Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
| | | | | | | | - Dawn M LaPorte
- Department of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Mary K Mulcahey
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Lisa K Cannada
- Department of Orthopaedic Surgery, Novant Health Orthopaedics, Charlotte, NC, USA
| | - John G Kennedy
- Department of Orthopedic Surgery, New York University Langone Health, New York, NY, USA
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13
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Casilla-Lennon M, Hanchuk S, Zheng S, Kim DD, Press B, Nguyen JV, Grimshaw A, Leapman MS, Cavallo JA. Pregnancy in physicians: A scoping review. Am J Surg 2022; 223:36-46. [PMID: 34315575 PMCID: PMC8688196 DOI: 10.1016/j.amjsurg.2021.07.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/11/2021] [Accepted: 07/13/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND The personal health and professional impact of physician pregnancy requires further study. We performed a comprehensive scoping review of physician pregnancy to synthesize and assess the evidence to aid decision-making for relevant stakeholders. METHODS A search of 7 databases resulted in 3733 citations. 407 manuscripts were included and scored for evidence level. Data were extracted into themes using template analysis. RESULTS Physician pregnancy impacted colleagues through perceived increased workload and resulted in persistent stigmatization and discrimination despite work productivity and academic metrics being independent of pregnancy events. Maternity leave policies were inconsistent and largely unsatisfactory. Women physicians incurred occupational hazard risk and had high rates of childbearing delay, abortion, and fertility treatment; obstetric and fetal complication rates compared to controls are conflicting. CONCLUSIONS Comprehensive literature review found that physician pregnancy impacts colleagues, elicits negative perceptions of productivity, and is inadequately addressed by current parental leave policies. Data are poor and insufficient to definitively determine the impact of physician pregnancy on maternal and fetal health. Prospective risk-matched observational studies of physician pregnancy should be pursued.
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Affiliation(s)
| | - Stephanie Hanchuk
- Department of Urology, Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Sijin Zheng
- Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - David D Kim
- Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Benjamin Press
- Department of Urology, Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Justin V Nguyen
- Department of Urology, Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Alyssa Grimshaw
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, USA.
| | - Michael S Leapman
- Department of Urology, Yale School of Medicine, Yale University, New Haven, CT, USA; Veterans Affairs Connecticut Healthcare System, West Haven and Newington, CT, USA.
| | - Jaime A Cavallo
- Department of Urology, Yale School of Medicine, Yale University, New Haven, CT, USA; Veterans Affairs Connecticut Healthcare System, West Haven and Newington, CT, USA.
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14
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Grose E, Chen T, Siu J, Campisi P, Witterick IJ, Chan Y. National Trends in Gender Diversity Among Trainees and Practicing Physicians in Otolaryngology-Head and Neck Surgery in Canada. JAMA Otolaryngol Head Neck Surg 2021; 148:13-19. [PMID: 34792563 DOI: 10.1001/jamaoto.2021.1431] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Importance Monitoring the evolution of gender diversity within medicine is essential to understanding the medical workforce and anticipating its future. Objective To evaluate gender distribution and trends among trainees and practicing physicians in the field of otolaryngology-head and neck surgery (OHNS) across Canada. Design, Setting, and Participants This cross-sectional study collected demographic data on the Canadian population, medical students, resident physicians, fellows, practicing physicians, and full-time professors from the following publicly available databases: the Canadian Post-MD Education Registry, the Canadian Medical Education Statistics from the Association of Faculties of Medicine of Canada, the Canadian Medical Association Masterfile, the Canadian Resident Matching Service archives, and the Canadian Institute for Health Information from 2000 to 2019. Information about the gender distribution in leadership positions and fellowships was obtained through publicly available websites where gender was either listed or assigned by authors. Main Outcomes and Measures The primary outcomes were the proportion of women in OHNS and the evolution of gender diversity over time. Results In 2019, 65 of 155 of OHNS trainees were female (41.9%), whereas female representation among all surgical trainees combined was 1225 of 2496 (49.1%). Female OHNS trainees and practicing physicians are underrepresented despite a 13.3% increase in female trainees and a 14.3% increase in female staff physicians from 2000 to 2019. Proportionally fewer female graduates pursued a fellowship during a 10-year period compared with their male counterparts, with otology and neurotology having the lowest female representation (6 of 27 [22.2%]). A minimal increase occurred in the number of women holding academic leadership positions (eg, 4 of 13 residency training programs had a previous or current female director). Conclusions and Relevance Despite the overall increase in the representation of women in the field of OHNS in Canada, these findings suggest that persistent gender gaps remain with respect to academic leadership positions and fellowship training. Continuous monitoring of the surgical workforce is important to highlight and address gender disparities within OHNS.
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Affiliation(s)
- Elysia Grose
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Tanya Chen
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Siu
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Paolo Campisi
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ian J Witterick
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Yvonne Chan
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, St Michael's Hospital, Toronto, Ontario, Canada
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15
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Suurna MV, Leibbrandt A. Underrepresented Women Leaders: Lasting Impact of Gender Homophily in Surgical Faculty Networks. Laryngoscope 2021; 132:20-25. [PMID: 34106470 DOI: 10.1002/lary.29681] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 05/06/2021] [Accepted: 06/01/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Despite the increase of women in surgical fields and resources toward advancing women, there is no corresponding increased representation of women in higher academic ranks and leadership. The following hypotheses are explored: 1) men and women build/maintain different relationship networks and 2) women are not similarly included within the organization and do not receive the same sponsorship as male counterparts. STUDY DESIGN Prospective observational study. METHODS Three months of prospective, passive organizational network data of full-time faculty at an academic medical center were collected by analysis of deidentified internal email communication logs. Data were analyzed and strength of network relationships was assessed using algorithms measuring the tie, or connection, score. Data analysis was performed with standard statistical methods and multivariable regression models, comparing network relationships based on gender and academic rank. RESULTS Among 345 full-time faculties from surgical departments, 45.2% were female Assistant Professors, but only 9.8% were female full Professors. Men had 55% more network relationships with other men than women had with men. Gender homophily was particularly pronounced at the higher academic ranks. Men compared to women in higher ranks had 157% more network relationships to other men in lower ranks. Multivariable regression models suggested direct association of these gender differences in relationships with more women in lower academic ranks. CONCLUSION Higher academic rank can be predicted by male gender, tenure, and number of meaningful relationships. Women are underrepresented at the leadership level in surgical departments. Gender homophily is present in collaboration networks among academic surgeons and is associated with impeded female career advancement. LEVEL OF EVIDENCE 2 Laryngoscope, 2021.
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Affiliation(s)
- Maria V Suurna
- Department of Otolaryngology/Head and Neck Surgery, Weill Cornell Medicine, New York, New York, U.S.A
| | - Andreas Leibbrandt
- Department of Economics, Monash University, Clayton, Victoria, Australia
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