[Careers of women in academic surgery]

Resident Operative Autonomy in Robotic Surgery Training: Unpacking Gender Disparities and Training Trends

OBJECTIVE

This study evaluated resident and program-level factors associated with resident-reported robotic operative autonomy at our institution.

DESIGN

This retrospective cohort study evaluates self-reported residents' robotic case logs detailing case type, console time, and portions of the case completed. The analysis included three procedures: pancreaticoduodenectomies, hernia repairs, and low anterior resection. Each procedure was divided into four key portions. Outcomes measured included minutes at the console and High Resident Autonomy (HRA), defined as >50% resident case participation. Independent variables included graduation cohort, pursued fellowship type, attending gender, underrepresented minority status, and hospital type. Univariable and multivariable logistic regression were performed.

SETTING

This study took place at the University of Texas Southwestern Medical Center General Surgery Residency between 2021 and 2023.

PARTICIPANTS

Twenty-nine chief residents (postgraduate year 5).

RESULTS

Of the 541 cases, 61% were hernia repairs, 26% were low anterior resections, and 13% were pancreaticoduodenectomies. Female residents were present in 60% of the cases. Male residents reported more HRA (76% vs. 54%) and longer console times (150 vs 120 minutes; p < 0.01). Multivariable analysis indicated female gender was associated with 74% lower odds of HRA (95% CI: 0.15 - 0.45; p < 0.001) and 18 fewer minutes of console time versus males (p < 0.01). The 2023 cohort had significantly higher odds of HRA than the 2021 cohort (OR: 4.46, 95% CI: 2.34 - 8.51; p < 0.001) and 15 more console minutes. Residents with aligned fellowships spent 37 more console minutes than those without (p < 0.001). No significant differences were found between attending gender, hospital, and minority status.

CONCLUSIONS

Our findings reveal significant gender disparities in self-reported operative autonomy and console time. The recent cohort showed improved training outcomes, and fellowship alignment with the case positively impacted console time. This suggests a need to refine training approaches, ensuring equity and optimizing training efficacy.

[Gender-Specific and Cross-Gender Reasons for Choosing 'Surgeon' as a Career - A Scoping Review]

INTRODUCTION

The availability of highly qualified surgical staff in Germany has been a challenge for years. Despite various initiatives to increase the attractiveness of surgical training programs, there are still problems in attracting motivated and qualified doctors to surgery. In order to develop customized offers for recruiting junior staff, the decision-making factors must be known.

OBJECTIVE

To present the gender-specific and cross-gender reasons for choosing a surgical specialist training program.

METHOD

As part of a scoping review, studies were identified using PubMed and a subsequent reverse search to answer the research question. Data extracted from the studies were summarized narratively and categories were defined.

RESULTS

The analysis of 12 studies revealed that men and women wanted to become a surgeon based on the characteristics of the surgical specialty, personal factors and factors related to the training position. Gender-specific differences were also identified.

CONCLUSION

Specific measures are proposed to promote the next generation of surgeons.

Participant perspectives on a department of surgery faculty mentoring program

BACKGROUND

Mentorship in academic medicine serves to promote career advancement and job satisfaction. This study was to evaluate the initial results of a faculty mentorship program in an academic Department of Surgery.

METHODS

A faculty mentorship program was initiated in July 2015 with 63 participants. Junior faculty mentees (n = 35) were assigned senior faculty mentors (n = 28). After three years, an electronic survey was administered and the results analyzed.

RESULTS

Response rate was 67% (n = 42). 34 (81%) respondents had met with their mentor/mentee at least once. Topics discussed included: research (76%), leadership (52%), work-life balance (45%), and promotion (5%). Mentees endorsed achieving promotion (n = 2), increasing research productivity (n = 2), and obtaining national committee positions (n = 2). 61% of mentors and 53% of mentees felt they benefitted personally from the program. Actionable improvements to the mentorship program were identified including more thoughtful pairing of mentors and mentees with similar research interests.

CONCLUSIONS

Participants felt the mentorship program was beneficial. Further investigation regarding the optimization of the mentor-mentee pairing is warranted to maximize the benefits from structured mentorship in academic surgery.

Enhancing Support for Women in Cardiothoracic Surgery through Allyship and Targeted Initiatives

BACKGROUND

Issues of diversity, equity, and inclusion in cardiothoracic surgery have garnered increased attention. While barriers persist for women in our field, they may be ameliorated through enhanced support from allies. We aimed to determine best practices for allyship to better support female cardiothoracic surgeons.

METHODS

A survey was electronically distributed to members of the Women in Thoracic Surgery, addressing presence of female colleagues, sense of allyship among colleagues/leadership, and supportive versus detrimental characteristics of colleagues. Qualitative responses were grouped and coded to identify key themes.

RESULTS

Of 309 Women in Thoracic Surgery members, 87(28%) responded. Over half of respondents felt supported by their male colleagues in the areas of clinical practice, research, teaching, and personal life. While 64% of respondents considered at least one woman in their division an ally, only 48% considered at least one man in their division an ally, and 53% considered their division chief or department chair an ally. A theme of mentorship, support, and sponsorship was reported as the most important quality of allies, regardless of gender. A theme of disrespect, discrimination, stereotyping, and unconscious bias was reported as the most detrimental characteristic of male colleagues, while a theme of competitiveness and undermining was reported as the most detrimental of female colleagues. Initiatives to enhance support for female cardiothoracic surgeons were identified, with increased access to mentorship and sponsorship consistently identified as an important endeavor.

CONCLUSIONS

Increasing access to mentors, promoting positive behavior, and minimizing detrimental behavior may enhance support for female cardiothoracic surgeons.

Gender and career in cardiology-a cross-sectional study

BACKGROUND

The proportion of women as leading physicians in cardiology in university medicine has stagnated and the share of women in senior positions in cardiology is low compared with other medical specialist fields. Here, we analyze the typical barriers for women as doctors in cardiology and point to issues that make the discipline less attractive for both genders.

METHODS

In a cross-sectional study, a standardized online questionnaire was sent to 3873 members of the German Cardiac Society (DGK). Answers from 567 (278 women, 289 men) were analyzed, using comparisons between groups, correlation analyses, and tests of normal distribution.

RESULTS

For 47.4% of respondents (52.0%, of women; 42.8%, of men; p = 0.049), training had lasted longer than anticipated. Average monthly gross income (full-time work) differed significantly between women and men as specialists (p = 0.004) and assistant doctors (p = 0.030). Of women, 32.1% had experienced sexual harassment in the workplace. The main arguments against a career in university medicine were an extremely competitive working climate (66.7% of women, 63.2% of men), lack of work-life balance (66.7% women, 55.3% men), and excessive workload (57.8% women, 62.5% men). As strategies to increase job attractiveness, both mentioned measures to improve the work-life balance, and the flexibility of working times and improved financial provision. Women asked for gender balance at management level (76.3% vs. 32.9% of men) and opportunities for sharing management tasks (82.4% vs. 57.9%). Flatter hierarchies were requested by more men (67.1 vs. 54.8%).

CONCLUSION

Further development of the work culture in cardiology seems necessary. In order to increase the attractiveness of the field overall and to provide equal opportunities in cardiology, more targeted support should be provided to young doctors and more flexibility introduced into work.

Social media in the mentorship and networking of physicians: Important role for women in surgical specialties

BACKGROUND

Social media may be a useful supplement to physician and trainee interactions; however, its role in enhancing mentorship has not been described.

METHODS

A 35-item survey investigating trainee and physician social media use was distributed. Responses were analyzed using descriptive statistics.

RESULTS

282 respondents completed the survey, among whom 136 (48.2%) reported careers in surgical specialties. Women in surgical specialties were more likely to describe the specialty as being dominated by the opposite sex (p < 0.001) and to be mentored by the opposite sex though wish to be mentored by individuals of the same sex (p < 0.001). Respondents in surgical specialties were also more likely to report using social media to build a network of same-sex mentorship (p = 0.031).

CONCLUSIONS

Social media serves as a valuable tool to enhance the networking and mentorship of surgeons, particularly for women in surgical specialties who may lack exposure to same-sex mentors at their own institution.

Under representation of women in surgery in Nigeria: by choice or by design?

BACKGROUND

Female Doctors' lack of interest in surgical careers has raised much concern in recent times. An understanding of the factors responsible for this lack of interest and evolving attitude is needed. The aim of this report was to determine the local factors that may be responsible and the most likely surgical specialty female doctors would prefer.

METHODS

This is a cross sectional study involving all female (consultant and resident) doctors in one teaching hospital. Information was obtained using a structured questionnaire which determined what formed the respondent's choice of present specialty. It also included the likely local factors that might have some bearings on the interest of female doctors in surgery. Data obtained were analyzed using SPSS version 11.5.

RESULTS

There were a total of 105 respondents. The age range was 26 - 63 years (mean: 26.88+2.19). The factors that were considered as deterrents to female doctor choice of surgical career were: a) the impact on their time for family and other social engagements 29 (27.6%); b) heavy work load 22 (21%); c) involvement of a lot of physical effort 18 (17.1%); d) lack of women in surgery 9 (8.6%); and e) lack of role models 4 (3.8%). Twenty three (21.9%) considered all the above factors. The subspecialty preferred by most female was plastic and reconstructive surgery, followed by Pediatric surgery.

CONCLUSION

The rigorous requirements of the training and practice of surgery deterred female doctors' interest in choosing and sustaining a surgical career. To maintain surgery as a premier career choice, female doctors should find surgery to be professionally and personally rewarding.

Issues in the mentor-mentee relationship in academic medicine: a qualitative study

PURPOSE

To explore the phenomenon of the mentor-mentee relationship and to characterize this relationship among people who have obtained early career support from a government funding agency, in order to facilitate the development of future mentorship programs.

METHOD

A qualitative study was completed involving clinician scientists who were awarded early career support from a provincial funding agency (Alberta Heritage Foundation for Medical Research, Edmonton, Alberta, Canada) and their mentors. Individual, semistructured interviews were completed, and transcripts of interviews were analyzed using a grounded theory approach.

RESULTS

Interviews with 21 population health or clinician investigators (mentees) and seven mentors were completed from October to December 2006. Several themes were identified including the experience with mentorship, experience of being assigned a mentor versus self-identification, roles of a mentor, characteristics of good mentoring, barriers to mentorship, and possible mentorship strategies. Participants believed mentorship to be important, but several experienced significant difficulty with finding mentors and establishing productive relationships.

CONCLUSIONS

Challenges exist within academic medicine around ensuring that clinician scientists receive appropriate mentorship. Strategies to enhance the mentorship process were identified, including the development of formal mentorship initiatives, the creation of workshops organized by funding agencies in partnership with universities, and the development and evaluation of a mentorship training initiative for mentors and mentees. These findings can be applied to any academic health sciences institution.

Importance of Gender-Specific Role Models in Vascular Surgery

The percentage of female physicians selecting vascular surgery for residency and/or fellowship lags behind percentages in general surgery selections. A number of factors, such as mentorship, gender biases, lifestyle, and job characteristics, have been proposed as explanations for the lower percentage of applicants. The purpose of this study was to investigate whether selective lifestyle, mentorship, and associated job considerations were more commonly identified by female vascular surgeons during their decision-making process for their specialty. The study used a survey sent to vascular surgery residents and fellows. Questions were related to mentorship, lifestyle, and job characteristics and were analyzed using a series of bivariate comparisons. The findings suggest that both men and women rarely report a female mentor in medical school, and that female vascular surgeons were less likely than others to have children. As in other studies, we found that females lack female role models during medical school. With respect to career choice, no lifestyle or job characteristics were statistically different between female vascular surgeons and male counterparts. This finding contrasts with previous reports. This study confirms the lack of female mentorship in vascular surgery and questions the importance of job and lifestyle characteristics in relation to career selection.