Training women surgeons and their academic advancement

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.

The Art and Science of Mentorship in Cardiothoracic Surgery: A Systematic Review of the Literature

BACKGROUND

As academic cardiothoracic surgeons focus on producing a new generation of successful surgeon leaders, mentorship has emerged as one of the most important variables influencing professional and personal success and satisfaction. We explore the literature to determine the benefits, qualities and features of the mentor relationship.

METHODS

A comprehensive review was performed in February for 2020 of Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and the SCOPUS Database using 'mentor' as a primary search term. The titles and abstracts of these publications were then reviewed by 2 of the authors to identify relevant sources addressing topics related to mentorship in cardiothoracic surgery and identify 4 specific areas of focus (1) the value of mentorship, (2) the skills needed to be an effective mentor, (3) effective approaches for identifying and receiving mentorship, and (4) the unique considerations associated with mentorship for traditionally underrepresented populations in surgery.

RESULTS

Of 16,469 articles reviewed, 167 relevant manuscripts were identified and 62 were included.

CONCLUSIONS

There is undeniable value in mentorship when navigating a career in cardiothoracic surgery. By sharing the most significant features and skills of both ideal mentors and mentees, we hope to provide a framework to improve the quality of mentorship from both sides.

Bibliometric Analysis of the Top 100 Most Cited Articles in the First 50 Years of Heart Transplantation

The world celebrates over 50 years since the first human-to-human heart transplant. Bibliometric analysis is a statistical concept that has recently evolved, enabling scientists to study citation patterns and identify characteristics of highly cited scholarly work in different fields. Although it has been widely utilized, such analyses have not been conducted to date on heart transplant literature. We sought to assess the characteristics of the top 100 most referenced citations in the field of heart transplantation. We searched the Scopus database (www.scopus.com) to identify all articles relating to heart transplantation. The articles were arranged in descending order from most cited to least cited and selected articles were scrutinized for data extraction. One hundred articles were included in the final list. Of the total 40,660 citations identified, 3,210 (8.0%) were self-citations, which impacted the final rank order. The articles were published in 25 different journals between 1960 and 2013. The most productive 5-year time period was between 2000 and 2005, when 24 of the 100 most cited publications were produced. There was no correlation between the journals' impact factors and the number of articles produced per journal. The presence and type of funding were not associated with the number of citations. Over 85% of first and senior investigators were men. In conclusion, our study highlights key features of the most highly cited scientific literature on heart transplantation and provides insights into trends of published work in this field. Additionally, this work may serve as a useful guide to researchers and funding bodies by highlighting the most prolific areas of cardiac transplant research to date.

Colorectal surgeons: gender differences in perceptions of a career

PURPOSE

The outlook of surgeons is changing. There has been recent interest in looking at job perception towards general surgery, which further has been divided into looking at gender differences.

METHODS

A questionnaire with nine sections/63 questions was mailed to all 1799 ASCRS members (244 women) who were on the ASCRS mailing list from the USA. The returned questionnaires were analyzed.

RESULTS

A total of 498/1,799 (28%) were returned; 109/498 were female (22%), which represented 109/244 (45%) of the ASCRS female membership vs.389/1,655 (23%) of the ASCRS male membership. The mean age was 49 years (females 42 years, males 51 years, p < 0.001). Demographically significant findings were that more female colorectal surgeons (FCR) were single 12% vs. 2% (p < 0.001). Male colorectal surgeons (MCR) overall earned more than their female counterparts (p < 0.001) and 11% FCR's had a salary of >$350,000 vs. 33% MCR. More MCR found work atmosphere (p < 0.004) and casemix (p < 0.001) were satisfactory elements of their job. A majority of the colorectal surgeons polled, would not change their careers however more FCR (21%) than MCR (13%) would do so (p = 0.03). When queried specifically, FCR also indicated they affected the OR in a positive way (p < 0.001). FCR were more sensitive to their colleagues opinion of their capabilities (p < 0.001), MCR however felt that their colleagues had a high impression of their capabilities (p < 0.001). FCR agreed that women mentors were few because of lack of time (p < 0.001) and also felt their views were not considered when executive decisions were made (p < 0.001).

CONCLUSIONS

Interestingly, proportionally more younger, single FCR than MCR returned the questionnaires. The significance of this finding is uncertain. Acknowledgment of these differences will promote more understanding and job satisfaction in both academic and private practice.

Reliability and Usefulness of Clinical Encounter Cards for a Third-Year Surgical Clerkship

BACKGROUND

Third-year medical students (MS3) were given clinical encounter cards (CECs) to stimulate feedback during their surgery clerkship. This study analyzes the feedback given on their clinical performance using CECs.

METHODS

Two hundred one students enrolled in the 12-week surgery clerkship were given CECs. Each card contained the chief focus of the encounter, which was rated on a six-point Likert scale. The CECs were analyzed to determine if they provided reliable formative information, identified marginal performances, and identified differences between raters, settings, rotations, and aspects of clinical performance evaluated.

RESULTS

Seven thousand three hundred eight CECs were submitted from 201 students. The CECs were completed most often (65%) in the inpatient setting. Technical skills were evaluated on 49% of CECs, history/physical examinations on 40%, and case presentations on 30%. There were comments written on half of the CECs and 89% of these were strictly positive. Women (52.8%) and faculty (63.3%) were more likely to provide written comments. The students were most likely to seek feedback from the interns and faculty who gave significantly higher ratings. The Cronbach-alpha reliability coefficient was 0.69, based on 12 raters per student. There was a significant positive correlation (P < 0.05) between the CEC composite rating and the clinical performance rating (r = 0.356), NBME score (r = 0.258), and the final grade (r = 0.250).

CONCLUSIONS

The implementation of CECs in a surgery clerkship provided a large quantity of positive feedback. The quality was limited because there were minimal recommendations for improvement and they were a poor predictor of overall clinical performance.

Status of women in urology: based on a report to the Society of University Urologists

PURPOSE

Written responses from American trained women in urological surgery were obtained to evaluate practice patterns, career choices and workplace satisfaction.

MATERIALS AND METHODS

A 3-page unblinded questionnaire was mailed in March 2003 to American trained women in urological surgery available through the databases of the Society of Women in Urology with subsequent statistical analysis.

RESULTS

The response rate was 60% but inclusive of all women in current academic practice in the United States. A total of 61% reported working 51 or more hours a week whereas 2% have left practice due to retirement or medical infirmity. There were 41% who had completed fellowships including 87% reporting active practice within their subspecialty, whereas 62% of fellowship trained surgeons remained in an academic practice. Among United States women in academic urological practice, academic progression has occurred in a third of this cohort.

CONCLUSIONS

Threats to successful practice, consistent with other workplace surveys of physicians and professional women including gender based role limitation and inadequate mentoring, were commonly reported. These correctable workplace deficiencies represent an opportunity for American urology to enhance the professional workplace for all urologists regardless of gender.