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Finkelstein ER, Clark M, Ha M, Singh D, Xu KY, Mella-Catinchi J, Rasko Y. Lymphedema Surgical Education and Faculty Demographics in United States Plastic Surgery Residency Programs. J Reconstr Microsurg 2024; 40:348-356. [PMID: 37751881 DOI: 10.1055/a-2182-1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
BACKGROUND Recent advancements in supermicrosurgery and promising preliminary outcomes have led to a surge in physiologic lymphedema surgery. This study is the first to evaluate lymphedema surgical education among U.S. plastic surgery residency programs, along with the background and experience of plastic surgeons subspecializing in the field. METHODS Cross-sectional evaluation of 103 accredited U.S. plastic surgery residency programs was performed in January 2023. Web-based searches of program curricula, faculty profiles, and main institutional pages indicated whether a program provided nonclinical or clinical exposure to lymphedema surgery. Review of online faculty profiles, surname searches, Doximity, and Scopus determined the perceived demographics, academic productivity, and procedures performed by lymphedema surgeons. RESULTS Compared with the 11 programs that incorporated lymphedema surgery into their online curriculum, 67 programs had a rotation site with a surgeon performing lymphedema procedures. Of the 33 programs without evidence of clinical exposure, 76% (n = 25) did not provide or specify providing elective time. Faculty perceived to be female or a race underrepresented in plastic surgery had significantly more assistant professor titles (p < 0.0214) and significantly fewer years of experience (p < 0.0293) than their counterparts. CONCLUSION Great variation in lymphedema surgical education exists among U.S. plastic surgery residency programs. While few programs incorporate lymphedema surgery into their advertised curriculum, programs without clinical exposure frequently did not provide elective time to obtain it. Faculty that were female or a race underrepresented in plastic surgery were most often early in their career, suggesting lymphedema surgeons may grow increasingly diverse in years to come.
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Affiliation(s)
- Emily R Finkelstein
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Meaghan Clark
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Michael Ha
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland
| | - Devinder Singh
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Kyle Y Xu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Juan Mella-Catinchi
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Yvonne Rasko
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland
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Aref Y, Engel PV, Miao X, Givant M, Seify H. An Analysis of the Characteristics and Trends in Practicing Plastic Surgeons in California. Ann Plast Surg 2024; 92:S336-S339. [PMID: 38689415 DOI: 10.1097/sap.0000000000003846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
BACKGROUND Studies suggest an increasing trend of plastic surgeons choosing private practice after training, with up to 90% pursuing private practice without future fellowships.1 Previous data showed that 66.7% of graduates from plastic surgery residency programs chose to pursue private practice without future fellowship, while more recent studies estimate this statistic has risen close to 90%.1,2 The literature has yet to characterize the current plastic surgery workforce and changes in its composition over time. This study aims to analyze the characteristics and training of plastic surgeons in California through a comparative study with general surgeons. METHODS Surgeon demographics were extracted from the Centers for Medicare and Medicaid Services open database. Urban/rural classification and academic affiliation were crosslinked from the Inpatient Prospective System database and sole proprietorship status was cross-linked from the NPI Registry. Summary statistics and logistic regressions with chi-squared analysis were analyzed using STATA/MP17. RESULTS Our analysis consisted of 3871 plastic and general surgeons in California. Compared to general surgeons, plastic surgeons were less likely to be females (P < 0.000), and more likely to be sole proprietors (P < 0.000), and affiliated with a teaching hospital (P < 0.005). There was no statistically significant difference in the percentage of rural-practicing plastic and general surgeons (P = 0.590). More recent plastic surgery graduates were more likely to be affiliated with an academic hospital (P < 0.0000). The composition of females significantly increased from the older graduated cohort to the most recent one. There was no significant difference in sole proprietorship and rural practice status between the oldest and youngest graduating cohorts. CONCLUSIONS Although the California plastic surgery workforce is gaining female plastic surgeons and shifting to academic institutions, significant progress in serving rural communities is yet to be made. Our study suggests that there may be a shift in the trend of plastic surgeons opting for private practice, possibly driven by a desire for more stable positions in academia. Continued improvement in diversity and training of future plastic surgeons is needed to alleviate the rural care gap.
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Affiliation(s)
- Youssef Aref
- From the California University of Science and Medicine School of Medicine, Colton
| | - Priya Vedula Engel
- From the California University of Science and Medicine School of Medicine, Colton
| | - Xinfei Miao
- From the California University of Science and Medicine School of Medicine, Colton
| | - Madeleine Givant
- From the California University of Science and Medicine School of Medicine, Colton
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Swanson E. Diversity, Equity, and Inclusion in Plastic Surgery: A Systematic Review. Ann Plast Surg 2024; 92:353-366. [PMID: 38527336 DOI: 10.1097/sap.0000000000003936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
BACKGROUND The number of publications on the subject of diversity, equity, and inclusion has surged in the last 5 years. However, a systematic review of this topic has not been published. METHOD Six top plastic surgery journals were queried from 2018 to 2023 using the search term "diversity." Methods, conclusions, and recommendations were tabulated. RESULTS A total of 138 publications were identified; 68 studies presented data suitable for analysis. All studies were retrospective. Currently, over 40% of plastic surgery residency applicants are women. The proportion of women in integrated plastic surgery residents is now 43%. In 2021 and 2022, the percentage of female first-year residents exceeded men. The percentage of female presenters at meetings (34%) is double the number in the workforce (17%). Twenty-five percent of academic faculty positions and 22% of program director positions are now held by women. Underrepresented minorities account for fewer than 10% of applicants to integrated plastic surgery residencies. DISCUSSION The proportion of Black and Hispanic applicants to integrated plastic surgery residencies (6% and 8%, respectively) mirrors the proportion of Black and Hispanic medical students (7% and 6%, respectively). Numerous recommendations have been made to increase the proportion of underrepresented minorities in plastic surgery programs. CONCLUSIONS The representation of women in plastic surgery has increased dramatically. A lack of Hispanics and Blacks reflects a small pool of applicants, as opposed to a "leaky pipeline."
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Okoro O, Umaru O, Ray M. Women of Color in the Health Professions: A Scoping Review of the Literature. PHARMACY 2024; 12:29. [PMID: 38392936 PMCID: PMC10893211 DOI: 10.3390/pharmacy12010029] [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: 11/05/2023] [Revised: 01/15/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
Women of color (WoC) in the health professions encounter challenges in advancement to higher positions, disparities in wages, discrimination, lack of expectation to achieve leadership positions, and absence of extensive support networks. Articles in the literature have addressed race and/or gender in the context of professional development. However, applying an intersectional lens or framework to better understand the contextual issues of professional development for WoC remains to be addressed. Thus, this scoping review aimed to (i) identify health professions literature that addresses disparities affecting WoC, and (ii) describe strategies and approaches to support WoC in the health professions. Methods: The literature searches were conducted in multiple databases, including PubMed and MEDLINE (Ovid); and Google and Google Scholar were used to "hand search" further articles including gray literature. Three independent reviewers reviewed and screened articles for inclusion in accordance with a guide. Search included articles on pharmacy or healthcare professions, published in English, and which met three content criteria: racial disparities/inequities, professional development/career advancement, and women or gender disparities Results: A total of 31 articles were included-medicine (17), nursing (1), pharmacy (7), other (4), and multiple health professions (2). Key findings included underrepresentation of women and minority groups, inequities in professional advancement and leadership positions for WoC, and greater dissatisfaction and attrition among minority and women professionals. Conclusion: WoC face unique and distinct challenges and barriers in their professional careers resulting from the intersectionality of not only race and gender, but also lived experiences and opportunities. Strategies to improve diversity and representation should include an intersectional framework or lens and be critically evaluated.
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Affiliation(s)
- Olihe Okoro
- Department of Pharmacy Practice and Pharmaceutical Sciences, University of Minnesota, Duluth, MN 55812, USA;
| | - Omolayo Umaru
- Department of Pharmaceutical Care & Health Systems, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Meghana Ray
- HEED Lab, LLC, Health Analytics Network, LLC, Rockville, MD 20852, USA
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Levy JJ, Hooper RC. A Historical Review of Racial, Ethnic, and Gender Diversity in Plastic Surgery at the University of Michigan. Semin Plast Surg 2024; 38:69-73. [PMID: 38495058 PMCID: PMC10942829 DOI: 10.1055/s-0043-1778044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
In this article, we examine the 60-year history of diversity efforts within the Section of Plastic Surgery at the University of Michigan (UofM) in the context of national trends. We describe the experiences of pioneering Underrepresented in Medicine (URiM) and female graduates of the program. James Norris, MD, and Christine Sullivan, MD, were the first URiM and female graduates from UofM in 1974 and 1989, respectively. Currently, women constitute over one-half the plastic surgery trainees at UofM, but URiM trainee representation remains limited. Dr. Adeyiza Momoh and Dr. Amy Alderman were the first URiM and female faculty members hired in 2011 and 2004, respectively. At present, there are four URiM and seven female faculty members in the Section. With a shared vision, supportive leadership, and motivation to change, faculty diversity has increased substantially. Additional strategies, including ongoing pipeline programs in medicine and science for URiM and women, are needed to further increase workforce diversity in plastic surgery.
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Affiliation(s)
- Julien J.S. Levy
- Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Rachel C. Hooper
- Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan
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Malapati H, Yusuf CT, Lopez CD, Jenny H, Barone AL, Redett RJ, Yang R. Socioeconomic Status Diversity of Trainees and Faculty in Residency Programs: A Pilot Study in Plastic Surgery. JOURNAL OF SURGICAL EDUCATION 2023; 80:1432-1444. [PMID: 37580239 DOI: 10.1016/j.jsurg.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/26/2023] [Accepted: 07/06/2023] [Indexed: 08/16/2023]
Abstract
INTRODUCTION The socioeconomic diversity of residents, fellows, and faculty members in any medical or surgical specialty is currently unknown making it difficult to understand socioeconomic status (SES) disparities and create programs to improve diversity. Additionally, the career trajectories of residents and faculty members who come from different SES backgrounds have not been explored. We have performed a survey-based research study to understand the SES composition and career trajectories of residents and faculty members within U.S. Plastic and Reconstructive Surgery (PRS) residency programs. METHODS An anonymous online survey was administered to 754 recipients within plastic surgery residency programs in the United States. Self-reported SES information such as household income prior to age 18 and parental education level was collected. Data regarding career trajectories was obtained through questions about away rotations and research productivity. RESULTS A total of 196 fellows, and faculty members participated in the study, with an estimated survey respondent rate of 25.9%. Only 9.9% (10 of 101) of residents and fellows reported a childhood (under age 18) family income less than $40,000. When analyzing parental education and occupation (EO-status), 42.6% (43 of 101) of residents and fellows had at least 1 parent in an executive, managerial, or professional position with a doctorate/professional degree. Low-income and low EO-status were associated with increased utilization of federal and state assistance programs (p = 0.0001) and approval for AAMC's Fee Assistance Program (FAP) (p = 0.0001). Residents and fellows who identified as White were not as likely to be from low EO-status households as those who identified as Asian (OR 0.3 and p = 0.015 vs. OR 2.9 and p = 0.038). Residents and fellows from low EO-status backgrounds were more likely to take a gap in education (87% vs. 65.4%, p = 0.047) compared to their high EO-status peers. Notably, more current residents and fellows performed away rotations and had first-author publications during or before medical school compared to full professors (p = 0.0001). CONCLUSION Understanding the backgrounds and career trajectories of trainees and faculty in medicine is essential, yet it has not been performed at the resident or faculty level. This survey is the first to demonstrate the lack of socioeconomic diversity in a specialty (PRS) and identifies variation in career trajectories among those from different SES backgrounds. Large-scale research efforts are necessary to understand current SES diversity and barriers encountered by trainees and educators from low-SES backgrounds in all medical and surgical specialties.
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Affiliation(s)
- Harsha Malapati
- Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts.
| | - Cynthia T Yusuf
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Christopher D Lopez
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Hillary Jenny
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Angelo L Barone
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Richard J Redett
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Robin Yang
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
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Finkelstein ER, Ha M, Anderson J, Akhavan AA, Yoon J, Furnas H, Slezak S, Rasko YM. Gender and Racial Representation of Invited Speakers From The Aesthetic Society Annual Meetings Over a 5-Year Period. Ann Plast Surg 2023; 91:326-330. [PMID: 37405878 DOI: 10.1097/sap.0000000000003606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
BACKGROUND Increased representation from both women and non-White ethnicities remains a topic of discussion in plastic surgery. Speakers at academic conferences are a form of visual representation of diversity within the field. This study determined the current demographic landscape of aesthetic plastic surgery and evaluated whether underrepresented populations receive equal opportunities to be invited speakers at The Aesthetic Society meetings. METHODS Invited speaker's names, roles, and allotted time for presentation were extracted from the 2017 to 2021 meeting programs. Perceived gender and ethnicity were determined by visual analysis of photographs, whereas parameters of academic productivity and professorship were collected from Doximity, LinkedIn, Scopus, and institutional profiles. Differences in opportunities to present and academic credentials were compared between groups. RESULTS Of the 1447 invited speakers between 2017 and 2021, 20% (n = 294) were women and 23% (n = 316) belonged to a non-White ethnicity. Representation from women significantly increased between 2017 and 2021 (14% vs 30%, P < 0.001), whereas the proportion of non-White speakers did not (25% vs 25%, P > 0.050) despite comparable h-indexes (15.3 vs 17.2) and publications (54.9 vs 75.9) to White speakers. Non-White speakers oftentimes had more academic titles, significant in 2019 ( P < 0.020). CONCLUSIONS The proportion of female invited speakers has increased, with room for further improvement. Representation from non-White speakers has not changed. However, significantly more non-White speakers holding assistant professor titles may indicate increased ethnicity diversity in years to come. Future efforts should focus on improving diversity in positions of leadership while promoting functions that target young minority career individuals.
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Affiliation(s)
| | - Michael Ha
- Department of Surgery, Division of Plastic Surgery, University of Maryland School of Medicine, Baltimore, MD
| | | | - Arya Andre Akhavan
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital
| | - Joshua Yoon
- Department of Surgery, Division of Plastic and Reconstructive Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD
| | - Heather Furnas
- Department of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, CA
| | - Sheri Slezak
- Department of Surgery, Division of Plastic Surgery, University of Maryland School of Medicine, Baltimore, MD
| | - Yvonne M Rasko
- Department of Surgery, Division of Plastic Surgery, University of Maryland School of Medicine, Baltimore, MD
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Koljonen JL, Petro JA, Sommer NZ. Early Women Pioneers and the Evolution of Women in Plastic Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5165. [PMID: 37577242 PMCID: PMC10419354 DOI: 10.1097/gox.0000000000005165] [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: 05/16/2023] [Accepted: 06/23/2023] [Indexed: 08/15/2023]
Abstract
The history of women in surgery has been documented since ancient times. Despite this, women physicians have historically encountered unique obstacles in achieving the same respect and privileges as their male counterparts. Early female physicians overcame many challenges to complete their training following graduation from medical school. The first woman in the field of plastic surgery in the United States was Dr. Alma Dea Morani, who became a member of the American Society of Plastic and Reconstructive Surgeons (ASPRS, now ASPS) in 1948. She applied for plastic surgery training six different times over 6 years, until she was accepted at a position where she had shadowing-only privileges. Yet, her steadfast determination and perseverance led her to build a successful career, becoming a role model and advocate for women in plastic surgery. The Women Plastic Surgeons Forum within ASPRS was officially established in 1992; however, informal events began as early as 1979. This group fostered mentorship among emerging female leaders, allowing women to take on leadership roles within national plastic surgery organizations. These women, in turn, have become role models for subsequent generations of women in this field. Plastic surgery has historically seen a higher percentage of female residents relative to other surgical specialties. Studies have shown that female role models are the most influential factor for female medical students interested in plastic surgery, a powerful fact considering women now comprise over 50% of graduating medical students. Female mentorship is essential in fostering the future generation of female plastic surgeons.
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Affiliation(s)
- Jessie L Koljonen
- From the Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, Ill
| | | | - Nicole Z Sommer
- From the Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, Ill
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Helliwell LA, Hyland CJ, Gonte MR, Malapati SH, Bain PA, Ranganathan K, Pusic AL. Bias in Surgical Residency Evaluations: A Scoping Review. JOURNAL OF SURGICAL EDUCATION 2023; 80:922-947. [PMID: 37142488 DOI: 10.1016/j.jsurg.2023.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/21/2023] [Accepted: 04/13/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Given widespread disparities in the surgical workforce and the advent of competency-based training models that rely on objective evaluations of resident performance, this review aims to describe the landscape of bias in the evaluation methods of residents in surgical training programs in the United States. DESIGN A scoping review was conducted within PubMed, Embase, Web of Science, and ERIC in May 2022, without a date restriction. Studies were screened and reviewed in duplicate by 3 reviewers. Data were described descriptively. SETTING/PARTICIPANTS English-language studies conducted in the United States that assessed bias in the evaluation of surgical residents were included. RESULTS The search yielded 1641 studies, of which 53 met inclusion criteria. Of the included studies, 26 (49.1%) were retrospective cohort studies, 25 (47.2%) were cross-sectional studies, and 2 (3.8%) were prospective cohort studies. The majority included general surgery residents (n = 30, 56.6%) and nonstandardized examination modalities (n = 38, 71.7%), such as video-based skills evaluations (n = 5, 13.2%). The most common performance metric evaluated was operative skill (n = 22, 41.5%). Overall, the majority of studies demonstrated bias (n = 38, 73.6%) and most investigated gender bias (n = 46, 86.8%). Most studies reported disadvantages for female trainees regarding standardized examinations (80.0%), self-evaluations (73.7%), and program-level evaluations (71.4%). Four studies (7.6%) assessed racial bias, of which all reported disadvantages for trainees underrepresented in surgery. CONCLUSIONS Evaluation methods for surgery residents may be prone to bias, particularly with regard to female trainees. Research is warranted regarding other implicit and explicit biases, such as racial bias, as well as for nongeneral surgery subspecialties.
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Affiliation(s)
| | | | - Madeleine R Gonte
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Wayne State University School of Medicine, Detroit, Michigan
| | | | - Paul A Bain
- Countway Library, Harvard Medical School, Boston, Massachusetts
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Tolson HC, Raikar DAH, Morris BE, Ferguson EMN, Shahriary E. Ethnic and Sex Diversity in Academic Plastic Surgery: A Cross-sectional Study. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4991. [PMID: 37396840 PMCID: PMC10313300 DOI: 10.1097/gox.0000000000004991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/22/2023] [Indexed: 07/04/2023]
Abstract
Ethnic, racial, and sex disparities continue to persist in medicine despite efforts to diversify the profession. In competitive surgical specialties such as plastic surgery, those disparities are particularly pronounced. This study aims to evaluate racial, ethnic, and sex diversity in academic plastic surgery. Methods We compiled a list of major plastic surgery professional societies, plastic surgery journal editorial boards, and plastic surgery accreditation boards to evaluate ethnic and sex diversity in society, research, and accreditation domains, respectively. Demographic data were collected and analyzed using the Mann-Whitney U test and the Kruskal-Wallis test. Results White individuals are significantly overrepresented across the professional and research domains, and Asian individuals are overrepresented in the professional domain when compared to non-white races. White individuals make up a total of 74% of the society domain, 67% of the research domain, and 86% of the accreditation domain when compared to all non-white surgeons. Male surgeons made up 79% of the society domain, 83% of the research domain, and 77% of the accreditation domain when compared to all non-male surgeons. Conclusions Ethnic, racial, and sex disparities persist in academic plastic surgery. This study, which looked at societies, editorial boards, and accreditation boards, demonstrated a persistent ethnic, racial, and sex homogeneity among leadership. Changes are required to continue to diversify the field and provide women and underrepresented minorities the tools needed to succeed.
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Affiliation(s)
- Hannah C. Tolson
- From the University of Arizona College of Medicine Phoenix, Phoenix, Ariz
| | | | - Bryn E. Morris
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Ariz
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Shaffrey EC, Moura SP, Wirth PJ, Attaluri PK, Schappe A, Edalatpour A, Bentz ML, Rao VK. Objective Residency Applicant Assessment Using a Linear Rank Model. JOURNAL OF SURGICAL EDUCATION 2023; 80:776-785. [PMID: 37012141 DOI: 10.1016/j.jsurg.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES Residency applicant assessment is imperfect, with little objectivity built into the process, which, unfortunately, impacts recruitment diversity. Linear rank modeling (LRM) is an algorithm that standardizes applicant assessment to model expert judgment. Over the last 5 years, we have used LRM to assist with screening and ranking integrated plastic surgery (PRS) residency applicants. This study's primary objective was to determine if LRM scores are predictive of match success and, secondarily, to compare LRM scores between gender and self-identified race categories. DESIGN Data was collected on applicant demographics, traditional application metrics, global intuition rank, and match success. LRM scores were calculated for screened and interviewed applicants, and scores were compared by demographic groups. Univariate logistic regression was used to evaluate the association of LRM scores and traditional application metrics with match success. SETTING University of Wisconsin, Division of Plastic and Reconstructive Surgery. Academic institution. PARTICIPANTS Six hundred seventeen candidates who applied to a single institution over 4 application cycles (2019-2022). RESULTS Using area under the curve modeling, LRM score was the most predictive indicator for match success. With every one-point increase in LRM score, there was an 11% and 8.3% increase in the likelihood of screened and interviewed applicant match success (p < 0.001). An algorithm was developed to estimate the probability of match success based on LRM score. No significant differences in LRM scores were appreciated for interviewed applicant gender or self-identified race groups. CONCLUSIONS LRM score is the most predictive indicator of match success for PRS applicants and can be used to estimate an applicant's probability of successfully matching into an integrated PRS residency. Furthermore, it provides a holistic evaluation of the applicant that can streamline the application process and improve recruitment diversity. In the future, this model could be applied to assist in the match process for other specialties.
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Affiliation(s)
- Ellen C Shaffrey
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Steven P Moura
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Peter J Wirth
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Pradeep K Attaluri
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Alyssa Schappe
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Armin Edalatpour
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Michael L Bentz
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Venkat K Rao
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin.
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12
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Girard AO, Lopez CD, Khoo KH, Lake IV, Yusuf CT, Lopez J, Redett RJ, Yang R. The Impact of Socioeconomic Factors on the 2022 Plastic Surgery Match. Ann Plast Surg 2023; 90:366-375. [PMID: 36880766 DOI: 10.1097/sap.0000000000003503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
BACKGROUND In 2022, the plastic and reconstructive surgery (PRS) match faced unprecedented system-wide transitions that have redefined conventional measures of applicant success. This challenges the equitable assessment of student competitiveness and diversity in the field. METHODS A survey of demography, application content, and 2022 match outcomes was distributed to applicants to a single PRS residency program. Comparative statistics and regression models were performed to assess the predictive value of factors in match success and quality. RESULTS A total of 151 respondents (response rate 49.7%) were analyzed. Although step 1 and step 2 CK scores were significantly higher among matched applicants, neither examination predicted match success. Most respondents (52.3%) were women, although gender was also not significantly associated with match success. Underrepresented in medicine applicants made up 19.2% of responses and 16.7% of matches, and the plurality of respondents (22.5%) were raised with a household income ≥$300,000. Both Black race and household income ≤$100,000 were associated with lower odds of scoring above a 240 on either step 1 or step 2 CK (Black: OR, 0.03 and 0.06; P < 0.05 and P < 0.001; income: OR, 0.07-0.47 and 0.1 to 0.8, among income subgroups), receiving interview offers (OR, -9.4; P < 0.05; OR, -11.0 to -5.4), and matching into PRS (OR, 0.2; P < 0.05; OR, 0.2 to 0.5), compared with White and high-income applicants, respectively. CONCLUSIONS Systemic inequities in the match process disadvantage underrepresented in medicine candidates and those from lower household incomes. As the residency match continues to evolve, programs must understand and mitigate the impacts of bias in various application components.
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Affiliation(s)
- Alisa O Girard
- From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
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Chawla S, Faheem S, Moreton ML, Sekhon A, Amornteerasawas OM, Ding J, Khosa F. Analysis of Additional Degrees in Academic Plastic Surgery Faculty. Plast Surg (Oakv) 2022. [DOI: 10.1177/22925503221144039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: As plastic surgery continues to evolve, an increasing number of surgeons are attaining additional degrees (ADs). Prior studies illustrate this trend of increased AD attainment among plastic surgery faculty within the United States. Yet, no such study has documented AD attainment variability and influence within Canadian plastic surgery faculty. Objectives: Our objective was to investigate the relationship between AD attainment and gender, alongside research productivity, and academic rank of Canadian plastic surgery faculty members. Methods: All Canadian academic plastic surgery faculty members were identified and information regarding gender, academic rank, research productivity, timing of AD attainment was recorded. AD was defined as any degree beyond a medical degree or equivalent. Results: A total of 299 faculty members were identified. Of these, 33% (N = 99) attained an AD. A higher percentage of females (40%) obtained ADs compared to males (30%) ( P = .0402). When controlling for number of years in practice, there was a significantly larger proportion of females than males with ADs as assistant and associate professor ( P = .033). Faculty with ADs were associated with higher research productivity and higher academic rank than those with MDs ( P < .05). ADs were commonly obtained post-residency (38%) and most common ADs were MSc (51%) and PhDs (21%). It was found that the Canadian plastic surgeons were less likely to pursue MBAs than US plastic surgeons ( P = .002). Conclusion: One-third of Canadian academic plastic surgeons had ADs. Those with ADs present with higher research productivity and academic rank. When segmented by gender, there were significant differences among AD holders. The results of this study will lend support to ongoing endeavors voicing the need for gender equity in academic plastic surgery.
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Affiliation(s)
- Sahil Chawla
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sarim Faheem
- Faculty of Science, University of British Columbia, Kelowna, BC, Canada
| | - Michael L. Moreton
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Amardeep Sekhon
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Jeffrey Ding
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Faisal Khosa
- Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada
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Factors Influencing Preferences for Plastic Surgery Conferences: A Conjoint Analysis. Plast Reconstr Surg Glob Open 2022; 10:e4646. [PMID: 36405046 PMCID: PMC9668553 DOI: 10.1097/gox.0000000000004646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 09/08/2022] [Indexed: 01/25/2023]
Abstract
UNLABELLED The increase in virtual conferences during the COVID-19 pandemic provided unexpected advantages such as increased accessibility, while also creating concern about the effectiveness of online networking and career development. Given that a variety of conference attributes are impacted by changes in conference format, we sought to investigate how plastic surgeons prioritize key aspects of conference conduct. METHODS We sent a survey based on conjoint analysis, a statistical method for evaluating consumer preferences, to active members of the American Society of Plastic Surgeons. Respondents were asked to choose between pairs of conference options, each with unique attributes. Their answers were used to calculate feature importance values and utility coefficients for the conference attributes. Subgroup analyses were conducted based on demographic factors. RESULTS A total of 263 respondents completed the survey. Respondents were mostly White (181 individuals [68.8%]) and men (186 [70.7%]). Nearly half (122 [46.4%]) had been practicing 20 or more years. Conference attributes with the highest feature importance values (SDs) were cost of attendance (30.4% [14.2%]) and conference format (28.8% [14.2%]). Equity initiatives (14.5% [10.1%]), reimbursement for cost (11.1% [5.7%]), and opportunities for networking (9.5% [6.0%]) had intermediate feature importance values. Environmental impact had the lowest feature importance (5.7% [3.8%]). CONCLUSIONS Surgeons' conference preferences depend highly on format and the presence of equity initiatives, both of which can be incorporated or modified in future conferences to ensure inclusive and successful events. Meanwhile, environmental impact is less important to surgeons, suggesting a pressing need to bring sustainability issues to their attention.
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Rivera JC, Juan HY, Hauc SC, Katave C, Almeida M, Persing JA, Alperovich M. Gender diversity in microsurgery academic faculty across the United States. Microsurgery 2022; 42:742-743. [PMID: 36056627 DOI: 10.1002/micr.30952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/24/2022] [Accepted: 08/12/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Jean Carlo Rivera
- Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Hui Yu Juan
- Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Sacha C Hauc
- Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Coral Katave
- Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Mariana Almeida
- Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - John A Persing
- Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Michael Alperovich
- Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
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Snell L, Valiquette CR, Avery E, Moltaji S, Forrest CR. Improving Equity, Diversity, and Inclusion in Plastic, Reconstructive, and Aesthetic Surgery in Canada: A Call to Action. Plast Surg (Oakv) 2022; 30:94-101. [PMID: 35572078 PMCID: PMC9096862 DOI: 10.1177/22925503221083287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The global COVID-19 pandemic has brought to light the significant inequities in the delivery of healthcare, vaccine inequity, and differential access to life-saving treatments, which have disproportionately impacted marginalized and racialized populations. In this article, we acknowledge and recognize the centuries-old legacies perpetuating inequity, injustice, and oppression, we discuss the principles of Equity, Diversity, and Inclusion (EDI) and we call our Canadian plastic surgery colleagues and trainees to action. We propose a plan for (1) Education, (2) Mitigating Disparities in the Clinical Setting, and (3) Policy, Societies, and Leadership Education.
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