Factors Associated With Attainment of Specialty Board Qualifications and Doctor of Medical Science Degrees Among Japanese Female Doctors

Authorship by gender in anesthesiology journals: a retrospective cross-sectional study for Japan

PURPOSE

Although it is important to recognize gender disparities in publishing to achieve gender diversity, women's authorship in Japan remains unclear. Therefore, this study aimed to investigate the percentage and analyze the trends of articles authored and published in anesthesiology journals by Japanese female authors.

METHODS

The genders of the first and last authors affiliated with Japanese institutions were surveyed in the Journal of Anesthesia (JA) (1990, 1995, and 2000-2022) and 11 international anesthesiology journals (2010-2022).

RESULTS

We included 845 and 819 original research articles from JA in the analyses of the first and last authors, respectively. The proportion of female first authors significantly increased from 41 (11.7%) out of 351 before 2009 to 119 (24.1%) out of 494 after 2010 (p < 0.001). The proportion of female last authors was 11 (3.3%) out of 335 before 2009 and 22 (4.5%) out of 484 after 2010, respectively, with no significant difference (p = 0.470). We included 624 and 572 original research articles from international anesthesiology journals in the analyses of first and last authors, respectively. Among these, there were 134 (21.5%) and 23 (4.0%) female first and last authors, respectively. These proportions in international anesthesiology journals did not significantly differ from those in JA (p = 0.334, p = 0.789, respectively).

CONCLUSION

The percentage of female first authors has increased, commensurate with the percentage of female anesthesiologists. However, the percentage of female last authors has not increased and remains low in Japan.

Emotional exhaustion in cancer clinicians: A mixed methods exploration

Objectives: The aim of the current study was to explore the associations of emotional exhaustion in oncology clinicians and perceptions of doctors about their work–life balance in a developing country. Methods: The current study used quantitative semi-structured interviews and qualitative in-depth interviews to explore emotional exhaustion and burnout in doctors in a tertiary care cancer center. Sociodemographic details, Maslach Burnout Inventory, and Patient Health Questionnaire were used for the quantitative analysis. Results: Increased work pressure (adjusted odds ratio [AOR]: 5.39, 95% confidence interval [CI]: 2.01–14.47, P < 0.01), reduced job-related satisfaction (AOR: 3.56, 95% CI: 1.37–9.25, P < 0.01), being a woman (AOR: 3.4, 95% CI: 1.2–9.5, P < 0.01), and having higher anxiety and depression scores (AOR: 2.89, 95% CI: 1.11–7.46, P = 0.03) were independently associated with higher levels of emotional exhaustion. In the qualitative interviews, many doctors felt working in oncology a satisfying as well as stressful experience. Dealing with palliative and end-of-life situations and counseling patients and their family members about various treatment options contributed to the stress. Male and female clinicians viewed work–life balance differently. Female doctors charted a larger area of influence for which they felt responsible in work and life. Conclusion: Increased work pressure, reduced job satisfaction, and increased affective symptoms contribute to emotional exhaustion in oncology clinicians, and the risk increases especially in female doctors. Having gender-sensitive and employee-friendly policies will likely help in having a nurturing work environment.

Influence of national culture on mentoring relationship: a qualitative study of Japanese physician-scientists

BACKGROUND

Nurturing of physician-scientists is an important mission of academic medical institutes. Although the importance of mentorship in developing future physician-scientists internationally is well established, not much information is available about how they are mentored and how national cultures influence the mentoring relationship. This study explores the cultural characteristics of mentoring relationships between senior mentors and junior mentees of Japanese physician-scientists.

METHOD

A qualitative approach has been employed to explore mentoring relationships of Japanese physician-scientists from cultural viewpoints, through semi-structured interviews with 17 mentees who had the experience of working overseas as post-doctoral research fellow. The reflection of their experiences and the perception of mentoring relationships before going abroad were thematically analyzed by applying Hofstede's model of six cultural dimensions as a theoretical framework.

RESULTS

Twelve characteristic themes for mentoring were observed, including trustworthy dependency on mentor, embracing paternalistic mentoring, mentee's initiative within expectations of mentor based on power distance, a sense of loyalty to mentor/organization/colleagues, family-like relationship with mentor based on collectivism, sense of security on being led by mentor through uncertainty avoidance, motivation by role modeling for the competitive academic world, and adaption of female mentee/mentor to a male-dominated academic structure based on masculinity, a long-term relationship between mentor and mentee, receiving advice for organizational continuity based on long-term orientation, putting work before leisure, and friendly relationship between mentor and mentee outside of work based on indulgence.

CONCLUSIONS

This study identified the characteristic mentoring relationships of postgraduate mentees of Japanese physician-scientists. Considering the importance of mentoring for physician-scientists in a globalized society, understanding the characteristics of national cultures would help in ensuring culture-sensitive mentoring and would contribute to the development of academic medicine.

Experiences of breast feeding at work for physicians, residents and medical students: a scoping review

OBJECTIVE

To review and summarise the available literature regarding breastfeeding experiences of medical students, residents and physicians.

ELIGIBILITY CRITERIA

Articles of any design, including non-peer reviewed data that examine the experiences of breast feeding of medical students, residents and staff physicians.

INFORMATION SOURCES

Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid EMBASE, Scopus and Web of Science.

RISK OF BIAS

All peer-reviewed studies underwent risk-of-bias assessment using relevant tools, depending on the study design.

INCLUDED STUDIES

We included 71 citations; 51 surveys, 3 narrative descriptions, 9 editorials or letters to the editor, and 3 reviews.

SYNTHESIS OF RESULTS

Included articles were heterogeneous with respect to their study design, target population and outcomes reported. Most articles had a high risk of bias. Only five articles reported the impact of an intervention.

DESCRIPTION OF EFFECT

Despite heterogeneity, the majority of articles described important barriers to breast feeding for physicians, residents and medical students. These barriers were similar across studies, and included inadequate and inaccessible space, time constraints and inflexible scheduling, and lack of colleague support. The consequences of these barriers included low milk supply and early discontinuation of breast feeding.

STRENGTHS AND LIMITATIONS OF EVIDENCE

Due to the observed heterogeneity of articles identified in this review, we are unable to assess trends in barriers or duration of breastfeeding over time.

INTERPRETATION

Interventions to overcome systemic and cultural barriers to breast feeding are needed to meet legal obligations of workplaces for physicians and trainees. These interventions should be formally evaluated using implementation science or quality improvement methods.

Leadership, recognition awards, and publication by men and women in the American Academy of Neurology

Objective

To study sex differences with respect to publications, leadership, and recognition awards in the American Academy of Neurology (AAN) in light of recent research highlighting inequities in these domains.

Methods

We examined medical school graduation, neurology residency (using American Medical Association and American Council for Graduate Medical Education data), membership in the AAN, first and last authorship in Neurology®, membership on AAN committees, and AAN recognition awards by sex for 1997, 2007, and 2017.

Results

Female medical students were less likely to enter neurology residency in 1997 only. In 2007 and 2017, there was no proportionate difference between men and women as last author, a surrogate for senior member of the author panel. In 2017, women were proportionately more likely to be first authors than men, a surrogate for principal investigator of the study. Committee membership was less for women in 1997 and 2007 (p < 0.001) but was not proportionately different in 2017 (p = 0.534). Women were proportionately more likely to receive recognition awards in all years studied (1997 p = 0.008, 2007 p < 0.001, 2017 p < 0.001), although absolute numbers of women were lower.

Conclusions

Female membership, leadership (through committee membership), and publications as last author were lower in 1997 in the AAN. These same metrics demonstrated substantial proportionate changes, with no differences in last authorship in 2007 and 2017, greater likelihood for women to be first author in 2017, no differences in committee membership in 2017, and greater likelihood of receiving awards determined by merit in all 3 years.

Effects of gaps in priorities between ideal and real lives on psychological burnout among academic faculty members at a medical university in Japan: a cross-sectional study

Background

Accumulating evidence from medical workforce research indicates that poor work/life balance and increased work/home conflict induce psychological distress. In this study we aim to examine the existence of a priority gap between ideal and real lives, and its association with psychological burnout among academic professionals.

Methods

This cross-sectional survey, conducted in 2014, included faculty members (228 men, 102 women) at a single medical university in Tokyo, Japan. The outcome of interest was psychological burnout, measured with a validated inventory. Discordance between ideal- and real-life priorities, based on participants’ responses (work, family, individual life, combinations thereof), was defined as a priority gap.

Results

The majority (64%) of participants chose “work” as the greatest priority in real life, but only 28% chose “work” as the greatest priority in their conception of an ideal life. Priority gaps were identified in 59.5% of respondents. A stepwise multivariable general linear model demonstrated that burnout scores were associated positively with respondents’ current position (P < 0.0018) and the presence of a priority gap (P < 0.0001), and negatively with the presence of social support (P < 0.0001). Among participants reporting priority gaps, burnout scores were significantly lower in those with children than in those with no children (P_interaction = 0.011); no such trend was observed in participants with no priority gap.

Conclusions

A gap in priorities between an ideal and real life was associated with an increased risk of burnout, and the presence of children, which is a type of “family” social support, had a mitigating effect on burnout among those reporting priority gaps.