Participant perspectives on a department of surgery faculty mentoring program

Exploring the Impact of a Women's Mentorship Program in Surgery: Perspectives and Experiences of Mentees and Mentors

OBJECTIVE

This study aimed to assess the efficacy of a formal women's mentorship program in surgery at a single institution, evaluating its perceived benefits, challenges, and impacts from the perspectives of both mentees (medical students) and mentors (resident and attending surgeons).

DESIGN

This study utilized a qualitative approach with semi-structured interviews to explore the experiences and perspectives of participants in a women's mentorship program in surgery. Medical students, residents, and attending surgeons who had participated in the mentorship program were invited to be interviewed. Interviews were conducted virtually and audio-recorded for subsequent transcription and analysis.

SETTING

The study was conducted at Penn State College of Medicine in Hershey, Pennsylvania. Penn State Health is a tertiary-care facility.

PARTICIPANTS

14 mentees (medical students) and 7 mentors (resident and attending surgeons) who had participated in the mentorship program were interviewed.

RESULTS

Mentees valued the mentorship program for its networking opportunities, career guidance, and structured goal setting. They appreciated having women mentors who provided unique insights and support in navigating challenges specific to women in surgery. The program's flexibility and session frequency allowed mentees to explore multiple specialties early in their education. Mentors appreciated the program's flexibility and the chance to mentor motivated students early in their careers. They highlighted the importance of gender-specific mentorship and the opportunity to facilitate practical experiences like shadowing and research. Challenges included occasional communication gaps, suggesting the need for more check-ins from program leaders and a structured event to facilitate initial connections and enhance continuity in mentor-mentee relationships.

CONCLUSIONS

This study supported the effectiveness of a formal women's mentorship program in surgery, as perceived by both mentees and mentors. Recommendations included maintaining flexibility, organizing an annual structured event, and promoting continuity in mentorship relationships.

The development of surgical ability during pediatric urology fellowship and its evolution in the early years of practice

BACKGROUND

North American Pediatric Urology fellowship programs underwent a structural change in 2021 that allows more flexibility in training. Given this opportunity as well as widespread concern about the development of contemporary surgical trainees, it is prudent to understand in detail the current state of preparedness of pediatric urology fellowship graduates for independent practice.

OBJECTIVE

The study aimed to determine recent pediatric urology graduates' reported levels of comfort both at graduation and following the start of clinical practice in performing select index procedures. We also queried the aspects of training and clinical practice perceived to be the most valuable for the development of surgical confidence.

STUDY DESIGN

Graduates of ACGME approved pediatric urology fellowships from 2016 to 2021 were surveyed. Index procedures were described via brief case vignettes. Respondents were asked to indicate their comfort level with each index procedure following fellowship graduation and at the current time point. Comfort levels were defined by the degree of support that respondents would seek from senior colleagues in preparation for case booking. Respondents were also asked about the most helpful operative settings during training and factors contributing to high and low comfort.

RESULTS

Fifty-three pediatric urologists (49%) completed the survey out of 109 invited. Most respondents practiced at an academic center. Perceived comfort was very high for low complexity procedures. The responses varied more widely for procedures of moderate and significant complexity (Figure). Across the cohort, there was a substantial increase in comfort between graduation and the current time point for all procedures queried. The most highly valued operative settings in fellowship were those offering real or simulated independence. Respondents most often attributed high comfort to robust case volumes and overall surgical skill gained in fellowship.

DISCUSSION

New pediatric urology faculty differ widely in surgical confidence, particularly for more complex procedures. There is meaningful growth in the confidence and self-perceived independence of pediatric urologists during their initial years of practice. The early years are a critical time of continuing maturation and development that should be supported with structured systems of mentorship. Future challenges include low case volumes for rare conditions and the centralization of complex care.

CONCLUSION

These findings will provide valuable context for pediatric urology fellowship directors as they evaluate and redesign their programs under the new, more flexible structure. There are opportunities to formalize early practice mentorship to support the growth of new faculty.

Mentorship of Junior Surgical Faculty Across Academic Programs in Surgery

Importance

Because mentorship is critical for professional development and career advancement, it is essential to examine the status of mentorship and identify challenges that junior surgical faculty (assistant and associate professors) face obtaining effective mentorship.

Objective

To evaluate the mentorship experience for junior surgical faculty and highlight areas for improvement.

Design, Setting, and Participants

This qualitative study was an explanatory sequential mixed-methods study including an anonymous survey on mentorship followed by semistructured interviews to expand on survey findings. Junior surgical faculty from 18 US academic surgery programs were included in the anonymous survey and interviews. Survey responses between "formal" (assigned by the department) vs "informal" (sought out by the faculty) mentors and male vs female junior faculty were compared using χ2 tests. Interview responses were analyzed for themes until thematic saturation was achieved. Survey responses were collected from November 2022 to August 2023, and interviews conducted from July to December 2023.

Exposure

Mentorship from formal and/or informal mentors.

Main Outcomes and Measures

Survey gauged the availability and satisfaction with formal and informal mentorship; interviews assessed broad themes regarding mentorship.

Results

Of 825 survey recipients, 333 (40.4%) responded; 155 (51.7%) were male and 134 (44.6%) female. Nearly all respondents (319 [95.8%]) agreed or strongly agreed that mentorship is important to their surgical career, especially for professional networking (309 respondents [92.8%]), career advancement (301 [90.4%]), and research (294 [88.3%]). However, only 58 respondents (18.3%) had a formal mentor. More female than male faculty had informal mentors (123 [91.8%] vs 123 [79.4%]; P = .003). Overall satisfaction was higher with informal mentorship than formal mentorship (221 [85.0%] vs 40 [69.0%]; P = .01). Most male and female faculty reported no preferences in gender or race and ethnicity for their mentors. When asked if they had good mentor options if they wanted to change mentors, 141 (47.8%) responded no. From the interviews (n = 20), 6 themes were identified, including absence of mentorship infrastructure, preferred mentor characteristics, and optimizing mentorship.

Conclusions and Relevance

Academic junior surgical faculty agree mentorship is vital to their careers. However, this study found that few had formal mentors and almost half need more satisfactory options if they want to change mentors. Academic surgical programs should adopt a framework for facilitating mentorship and optimize mentor-mentee relationships through alignment of mentor-mentee goals and needs.

Show Me the Money: Industry Payments to American Association of Endocrine Surgeons Members

INTRODUCTION

The Open Payments Program (OPP) was created through the Physician Payments Sunshine Act to disclose transactions between physicians and industry. Various surgical subspecialties have evaluated trends in OPP; however, this has not been looked at among endocrine surgeons. Our objective was to describe OPP trends among members of the American Association of Endocrine Surgeons (AAES).

METHODS

A list of members from the AAES was compiled using membership information from the AAES annual meetings. These surgeons were queried in the OPP database from 2014 to 2020. Payments were classified as general payments and research payments.

RESULTS

From 2014 to 2020, 417 surgeons in the AAES received a total of $5,870,113 in general payments with an annual range from $542,945 to $1,010,564. The median payment was $701 (interquartile range [IQR] $145-$4641) over all years. The top 10th percentile received >85% of the payments ($5,058,207) with the median payment in this decile being $37,535.06 (IQR $26,599-$112,380). The most common category for payments was food and beverage (63.5%) followed by travel and lodging (22.6%) and consulting fees (4.1%). Regarding research payments, 30 surgeons received $9,522,374 with a median payment of $45,635.68 (IQR $12,050-$158,863).

CONCLUSIONS

Members of the AAES received a total of $15,392,487 in money from industry between 2014 and 2020 in general and research payments demonstrating that the industry relationship is substantial. The majority of these payments were given to only a small portion of surgeons. The transparency created by OPP is critical for endocrine surgeons to prevent public misconceptions and identify the potential for any conflicts of interest.

National Institutes of Health Funding Among Society of Asian Academic Surgery Members

INTRODUCTION

External funding is fundamental to surgeon-scientists and many Society of Asian Academic Surgeons (SAAS) members have received funding through National Institutes of Health (NIH) grants. The amount of funding through NIH awards amongst SAAS members has yet to be evaluated. Our objective was to quantify the amount and type of NIH funding among SAAS members.

METHODS

A list of all active SAAS members was compiled. The NIH Research Portfolio Online Reporting Tool's Expenditure and Results was queried to identify NIH funding among active members.

RESULTS

Among 585 active SAAS members, 165 (28%) received NIH funding during their career. Of these, 110 members (66.6%) were male and 55 members (33.3%) were female. A total of 420 NIH grants have been awarded totaling $518.7 million in funding. There are currently 47 active grants totaling $34.1 million in funding. When analyzing by type, there were 226 R research grants, 63 K career development awards, 53 T and F research training and fellowships awards, and 78 other awards. Of the 63 members who received a K award, 35 members (55%) have subsequently received an R award.

CONCLUSIONS

SAAS members are highly funded with 28% of members having received NIH funding totaling $518.7 million. SAAS' mission is to foster the personal and professional development of academic surgeons and we found that many SAAS members have the experience to mentor other surgeon-scientists through the process of obtaining NIH funding. Participation in organizations like SAAS can help nurture the success of future generations of surgeon-scientists.

Medical Student Perceptions of Family Planning During Residency Training in Surgical Fields

INTRODUCTION

Several studies have investigated surgical residents' perceptions of family planning, and many have investigated medical students' perceptions of surgical specialties; however, there is limited research on medical students' perceptions of the impact of family planning on the decision to pursue surgical training. This study aims to investigate male and female medical students' perceptions of family planning in residency.

METHODS

A survey was distributed to all medical students at a single medical school in the Midwest between February 2023 and June 2023. The survey was adapted from a prior study investigating resident perceptions of family planning. It included questions about parental leave, having children, and perceived barriers to family planning.

RESULTS

One hundred students completed surveys. Seventy-four (74%) respondents identified as female and 57 (57%) were interested in surgery. Approximately half (55, 55%) of the respondents were strongly or definitely considering having children during residency. However, only eight (8%) students were aware of policies applicable to having children during residency. A majority (85, 85%) felt the decision to pursue surgical residency would prevent or delay having children at their preferred time. Most students felt they would be negatively perceived by peers (62, 62%) and faculty (87, 87%) if they had children during training. The highest perceived barriers to having children during training were work-time demands, childcare barriers, and time away from training.

CONCLUSIONS

Both men and women are interested in having children during residency but are unaware of the relevant parental leave policies and are concerned about how training will be impacted by taking time away or a lack of flexibility. Without transparency and flexibility in surgical residency, both men and women may forgo having children during training or choose a specialty they perceive to be more conducive to childbearing.

LinkedIn Usage Trends Among Surgeons at a Large Academic Institute

INTRODUCTION

Social networking platforms have evolved into a self-promotional space. The LinkedIn platform allows users to share knowledge, research accomplishments, and network in an academic setting. Our objective was to determine LinkedIn usage trends among surgeons at a large academic institution.

METHODS

A list of surgeons within the department of surgery at a large academic institute was compiled. All publicly available profiles were analyzed for their LinkedIn activity and followership. Active accounts were defined as users who have posted or interacted with any posts within the last year. Comparisons of LinkedIn usage grouped by gender, surgery division, and rank were analyzed.

RESULTS

A total of 133 surgeons were included. Among these surgeons, 88 had a LinkedIn profile (66.2%); however, only 43 surgeons had active usage on this platform (32.3%). The median number of followers among surgeons with a profile was 110 (IQR [24-427]). Male surgeons had a higher median of followers (167 IQR [38-502]) compared to female (54 IQR [21-209]). A greater percentage of male surgeons had a profile compared to female surgeons (68.5% M versus 61.0% F, P = 0.12). The transplant surgery division had the highest percentage of LinkedIn accounts (90.9%) followed by surgical oncology (87.5%). However, active usage was led by the pediatric surgery division (80.0%), followed by the plastic surgery division (71.4%). Instructors, assistant professors, associate professors, and professors all had LinkedIn accounts; however, instructors were the least active users with 33.3% being active on their LinkedIn. The lowest percentage of those with LinkedIn accounts were instructors (50%). Professors were found to be the most active users at 57.1%.

CONCLUSIONS

Social media use is on the rise in academic surgery. Within a department of surgery at a large academic institution, only 32.3% were active users of LinkedIn, suggesting that there is room for improvement in utilizing this resource as a tool for mentorship, professional development, and networking.

The Rich Get Richer: The Matthew Effect in Open Payments

INTRODUCTION

The Matthew Effect refers to a pattern of accumulated advantage, specifically how social status can lead to increased wealth and recognition. The Physician Payments Sunshine Act of the Affordable Care Act requires industry payments and the affiliated hospital to be publicly available through the Open Payments Database (OPD). The US News and World Report (USNWR) publishes a ranking of best medical school (research) programs yearly. The Blue Ridge Institute for Medical Research (BRIMR) ranks medical schools annually by the amount of funding from the National Institutes of Health (NIH). Whether medical school-affiliated hospitals with higher social ranking and more NIH funding receive more industrial support is unknown. This study aims to evaluate the relationship between open payment of medical school-affiliated hospitals and USNWR and BRIMR ranking.

METHODS

We performed a cross-sectional analysis of the OPD for the fiscal year of 2021. Hospital industry payment information was collected for affiliated hospitals in general and research categories. NIH funding data and program rankings were collected from BRIMR and USNWR, respectively. All data were collected for the fiscal year of 2021. The open payments of schools ranked in the top 50 for USNWR (n = 50) and BRIMR (n = 49) were compared to the schools not ranked in the top 50 using SPSS with chi-squared and Mann-Whitney U tests. A multivariate linear regression was performed to evaluate the association between open payments, USNWR ranking, and BRIMR ranking.

RESULTS

A total of 91 medical schools were included in this study. The top 50 ranked medical schools by BRIMR were found to have a higher median of total open payment ($5,652,628 versus $2,558,372, P < 0.001), open payment in research ($4,707,297 versus $1,992,597, P = 0.003), and general open payment ($1,083,018 versus $392,045, P < 0.001). When ranked by USNWR, the top 50 ranked medical schools were found similarly to have a higher median of total open payment (P < 0.001), open payment in research (P < 0.001), and general open payment (P < 0.001). USNWR ranking was an independent predictor of more total open payment (Coefficient 0.016, 95% confidence interval 0.002-0.029, P = 0.026) and research open payment (coefficient 0.018, 95% confidence interval 0.002-0.034, P = 0.028). USNWR ranking was not found to predict general open payments. BRIMR ranking was not associated with open payment in total, research, or general.

CONCLUSIONS

Hospital open payments were associated with the social reputation of their medical schools. NIH funding was not associated with open payments. A Matthew effect exists in current industry payments to medical school-affiliated hospitals.