1
|
Simons ECG, Ardines KEZ, Penaloza NG, Does S, Washington SL, Tandel MD, Braddock CH, Downs TM, Saigal C. Racial and Ethnic Differences in Medical Student Timing and Perceived Quality of Exposure to Urology. Urology 2022; 168:50-58. [PMID: 35718136 DOI: 10.1016/j.urology.2022.06.006] [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: 01/09/2022] [Revised: 04/06/2022] [Accepted: 06/07/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To contextualize the low representation of Under-Represented in Medicine (URiM) in urology, we examine differences in timing and perceived quality of urology clinical and research exposures for medical students across race/ethnicity. METHODS A cross-sectional survey was distributed to all medical students at UCLA. Dependent variables were timing of urology exposure and perceived quality of urology exposure. Descriptive statistics and multivariate analyses were used to compare variables across race/ethnicity. Logistic regression was used to determine odds of early exposure to urology across race/ethnicity. RESULTS Black and Latinx students were significantly less likely to discover urology before MS3 (P<.001). Although URiM students were more likely to recall receiving a urology interest group invitation (Asian 46%, Black 53%, Latinx 67%, White 48%, P=.03), they were less likely to attend an event (Asian 23%, Black 4%, Latinx 3% and White 15%, P<.001) despite being more likely to be interested in urology (Asian 32%, Black 38%, Latinx 50%, White 28%, P=.01). Black students were more likely to gain exposure via family/friend with a urological diagnosis. Black and Latinx students were twice as dissatisfied with timing and method of medical school exposure to urology versus their peers. There were differences across race/ethnicity for whether or not a student had engaged in urology research (Asian 10%, Black 5%, Latinx 2%, White 2%, P=.01). CONCLUSIONS Racial/ethnic disparities exist in early exposure to urology, involvement in urology interest group, access to research, and satisfaction with exposure to urology. Interventions addressing the timing and quality of urology exposures may optimize recruitment of URiM students into urology.
Collapse
Affiliation(s)
- Efe C Ghanney Simons
- David Geffen School of Medicine (DGSOM) at the University of California, Los Angeles (UCLA).
| | | | | | | | | | - Megha D Tandel
- David Geffen School of Medicine (DGSOM) at the University of California, Los Angeles (UCLA)
| | - Clarence H Braddock
- David Geffen School of Medicine (DGSOM) at the University of California, Los Angeles (UCLA)
| | - Tracy M Downs
- University of Virginia; R Frank Jones Urological Society
| | - Christopher Saigal
- David Geffen School of Medicine (DGSOM) at the University of California, Los Angeles (UCLA)
| |
Collapse
|
2
|
Current landscape of andrology fellowship programs and the effect of gender on post-fellowship practice patterns. Urology 2022; 166:98-103. [DOI: 10.1016/j.urology.2022.02.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/28/2022] [Accepted: 02/15/2022] [Indexed: 11/23/2022]
|
3
|
Cheng W, Lin SY, Fan YH, Chen SW. Retrospective study of the differences in patient characteristics and revenue between male and female surgeons in Taiwan. Sci Rep 2021; 11:23744. [PMID: 34887512 PMCID: PMC8660838 DOI: 10.1038/s41598-021-03289-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/30/2021] [Indexed: 11/09/2022] Open
Abstract
Surgery is traditionally a male-dominated field, and gender differences exist despite the growing numbers of female surgeons. A handful of studies have evaluated the condition in Asian societies. We aimed to examine the difference between female and male surgeons in urology, general surgery, and gynecology by analyzing a nationwide, population-based database. We identified surgeons with a clinical experience of six to thirteen years between 1995 to 2013 from the National Health Insurance Research Database. We collected patient numbers and revenue per month in outpatient and inpatient care, as well as monthly numbers of surgeries conducted by female and male surgeons in urology, general surgery, and gynecology, for analysis. Original student’s t-test and wilcoxon rank sum test was used to compare the differences between female and male surgeons, and p values less than 0.05 were considered statistically significant. Female urologists and general surgeons had a significantly higher ratio of female patients in Taiwan. Female urologists had patient numbers, revenues, and numbers of surgeries comparable to male urologists. In contrast, female general surgeons had significantly less involvement in outpatient and inpatient care and had low monthly revenues. Female general surgeons contradictorily performed more oncological surgeries per month than males. However, the difference in numbers of oncological surgeries was not significant after excluding breast cancer surgeries. Female gynecologists had a similar amount of outpatients and outpatient revenue but significantly less inpatient care and numbers of surgeries per month. A gender-based gap exists among surgeons in Taiwan. The gap between females and males appeared narrower in urology than in general surgery and gynecology. Management of diseases related to female sex organs, including breast, were more common among female surgeons. Efforts should be made to decrease gender stereotypes, to ensure that patients receive the best care regardless of the sex of the surgeons.
Collapse
Affiliation(s)
- Weiming Cheng
- Division of Urology, Department of Surgery, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan.,Program in Molecular Medicine, School of Life Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Biopharmaceutical Science, School of Life Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Urology, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shu-Yi Lin
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Yu-Hua Fan
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan. .,Program in Molecular Medicine, School of Life Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Sheng-Wen Chen
- Division of Urology, Department of Surgery, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan. .,Urological Center, No.87, Tongde Road, Nangang District, Taipei, 11556, Taiwan.
| |
Collapse
|
4
|
El-Arabi AM, Alam SM, Dai J, Thompson J, Baden M, Siculietano J, Kerley P, Englert S, Nitti VW, Hussman DA, Thrasher JB, Brannigan RE, Sandlow JI, Nangia AK. Impact of Fellowship-Trained Andrology and Sexual Medicine Specialists on Performance on the Annual American Urological Association In-Service Examination. Urology 2021; 157:51-56. [PMID: 34186132 DOI: 10.1016/j.urology.2021.05.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/01/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To demonstrate the distribution and impact of fellowship-trained andrology and/or sexual medicine urological specialists (FTAUS) on resident in-service examination (ISE) performance. METHODS Residency program websites were accessed to create a database of FTAUS in the United States between 2007 and 2017. This database was reviewed by three separate FTAUS and cross referenced with membership lists to the Sexual Medicine of North America Society and the Society for the Study of Male Reproduction. De-identified ISE scores were obtained from the American Urological Association from 2007-2017 and scores from trainees at programs with a FTAUS were identified for comparison. Resident performance was analyzed using a linear model of the effect of a resident being at a program with an FTAUS, adjusting for post-graduate year. RESULTS ISE data from 13,757 residents were obtained for the years 2007-2017. The number of FTAUS in the United States increased from 40-102 during this study period. Mean raw scores on the "Sexual Dysfunction, Endocrinopathy, Fertility Problems" (SDEFP) section of the ISE ranged from 52.1% ± 17.7% to 65.7% ± 16% (mean ± SD). Throughout the study period, there was no difference in performance within the SDEFP section (P < .01). Residents at a program with a FTAUS answered 0.95% more questions correctly in the SDEFP than those without a FTAUS (P < .001). For these residents, there was an improvement of approximately 0.66% on the percentage of questions answered correctly on the ISE overall (P < .001). Performance improved significantly as residents progressed from PGY-2-PGY-5. CONCLUSION There is a small but statistically significant improvement in overall ISE and SDEFP sub-section performance.
Collapse
Affiliation(s)
- Ahmad M El-Arabi
- Department of Urology, University of Kansas Health System, Kansas City, KS
| | - Syed M Alam
- Department of Urology, University of Kansas Health System, Kansas City, KS
| | - Junqiang Dai
- Department of Biostatistics, University of Kansas Health System, Kansas City, KS
| | - Jeffrey Thompson
- Department of Biostatistics, University of Kansas Health System, Kansas City, KS
| | | | | | - Patrick Kerley
- Office of Education, American Urological Association, Linthicum, MD
| | - Shelby Englert
- Office of Education, American Urological Association, Linthicum, MD
| | - Victor W Nitti
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | | | | | | | - Jay I Sandlow
- Department of Urology, Medical College of Wisconsin, Milwaukee, WI
| | - Ajay K Nangia
- Department of Urology, University of Kansas Health System, Kansas City, KS.
| |
Collapse
|
5
|
Jokubaitis M, Kõrv J, Karelis G, Jatužis D, Vaitkus A, Ryliškienė K. Subspecialty training of neurology residents and junior neurologists in the Baltic States. Eur J Neurol 2021; 28:3584-3590. [PMID: 34129702 DOI: 10.1111/ene.14978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Neurology is a field of increasing subspecialization. There is no published data regarding the proportion of neurology subspecialists in the Baltic States. The aim of this cross-sectional study was to identify factors associated with neurology subspecialty choice, to examine possible differences between neurology residents' and junior neurologists' view of subspecialty, and to assess perceived subspecialty acquisition opportunities and subspecialty attractiveness. METHODS The research was conducted as an anonymous online survey between December 28, 2020, and January 24, 2021 of neurology residents and neurologists who completed their residency during the last 5 years in the Baltic States. RESULTS In total, 72 residents and 65 neurologists participated. "Cerebrovascular diseases" and "multiple sclerosis and autoimmune diseases of the nervous system" were rated as the two most attractive subspecialties by residents, whereas "headache" and "clinical neurophysiology" were the most attractive among junior neurologists. "Vertigo and dizziness" and "dementia" were ranked the least attractive among both groups. "Cerebrovascular diseases" were perceived as having the most acquisition opportunities. The two most common determinants of subspecialty choice were "medical content of the subspecialty" and "influence of mentor during undergraduate studies or residency". CONCLUSIONS Two-thirds of junior neurologists subspecialize in at least one subspecialty, and one-third of residents are already determined to pursue subspecialty training. Junior neurologists rated most outpatient-related subspecialties as more attractive than neurology residents. Between the Baltic States' universities, there was a significant difference in the number of residents who were determined to pursue subspecialty training.
Collapse
Affiliation(s)
| | - Janika Kõrv
- Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia
| | - Guntis Karelis
- Department of Neurology and Neurosurgery, Riga East Clinical University Hospital, Riga, Latvia.,Department of Infectology, Riga Stradiņš University, Riga, Latvia
| | - Dalius Jatužis
- Clinic of Neurology and Neurosurgery, Vilnius University, Vilnius, Lithuania
| | - Antanas Vaitkus
- Department of Neurology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Kristina Ryliškienė
- Clinic of Neurology and Neurosurgery, Vilnius University, Vilnius, Lithuania
| |
Collapse
|
6
|
Abstract
The millennial generation has become the largest generation thus far and continues to grow, as it makes up a substantial part of the workforce. Often misunderstood, those identifying as millennials offer skills, traits, and characteristics that previous generations have been unable to provide. Learning to understand these millennials and all they have to offer serves key to a successful training program or practice. A millennial's understanding of technology, grasp of patient-provider relationships, and desire to work hard contribute to their success as urologists.
Collapse
Affiliation(s)
- Jake Quarles
- Michigan Institute of Urology, 130 Town Center Drive, Suite 101, Troy, MI 48084, USA
| | - Jason Hafron
- William Beaumont School of Medicine, Beaumont Health, Michigan Institute of Urology, 130 Town Center Drive, Suite 101, Troy, MI 48084, USA.
| |
Collapse
|
7
|
Abstract
PURPOSE OF REVIEW In light of the announcement that the United States Medical Licensing Examination Step 1 exam will transition to pass/fail reporting, we reviewed recent literature on evaluating residency applicants with a focus on identifying objective measurements of applicant potential. RECENT FINDINGS References from attending urologists, Step 1 scores, overall academic performance, and research publications are among the most important criteria used to assess applicants. There has been a substantial increase in the average number of applications submitted per applicant, with both applicants and residency directors indicating support for a cap on the number of applications that may be submitted. Additionally, there are increasing efforts to promote diversity with the goal of improving care and representation in urology. Despite progress in standardizing interview protocols, inappropriate questioning remains an issue. Opportunities to improve residency application include promoting diversity, enforcing prohibitions of illegal practices, limiting application numbers, and finding more transparent and equitable screening measures to replace Step 1.
Collapse
Affiliation(s)
- Mitchell M Huang
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Park 213, Baltimore, MD, 21287, USA.
| | - Marisa M Clifton
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Park 213, Baltimore, MD, 21287, USA
| |
Collapse
|