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Heisler CA, Godecker AL, Verran D, Sinha MS, Byam J, Miller P. Workplace microaggressions: results of a survey of the American College of Surgeons members. Am J Obstet Gynecol 2024:S0002-9378(24)00570-2. [PMID: 38710272 DOI: 10.1016/j.ajog.2024.04.044] [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: 01/06/2024] [Revised: 04/11/2024] [Accepted: 04/30/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Workplace microaggressions are a longstanding but understudied problem in the surgical specialties. Microaggressions in health care are linked to negative emotional and physical health outcomes and can contribute to burnout and suboptimal delivery of patient care. They also negatively impact recruitment, retention, and promotion, which often results in attrition. Further attrition at the time of an impending surgical workforce shortage risks compromising the delivery of health care to the diverse US population, and may jeopardize the financial stability of health care organizations. To date, studies on microaggressions have consisted of small focus groups comprising women faculty or trainees at a single institution. To our knowledge, there are no large, multiorganizational, gender-inclusive studies on microaggressions experienced by practicing surgeons. OBJECTIVE This study aimed to examine the demographic and occupational characteristics of surgeons who do and do not report experiencing workplace microaggressions and whether these experiences would influence a decision to pursue a career in surgery again. STUDY DESIGN We developed and internally validated a web-based survey to assess surgeon experiences with microaggressions and the associated sequelae. The survey was distributed through a convenience sample of 9 American College of Surgeons online Communities from November 2022 to January 2023. All American College of Surgeons Communities comprised members who had completed residency or fellowship training and had experience in the surgical workforce. The survey contained demographic, occupational, and validated microaggression items. Analyses include descriptive and chi-square statistics, t tests, and bivariable and multivariable logistic regression. RESULTS The survey was completed by 377 American College of Surgeons members with the following characteristics: working as a surgeon (80.9%), non-Hispanic White (71.8%), general surgeons (71.0%), aged ≥50 years (67.4%), fellowship-trained (61.0%), and women (58.4%). A total of 254 (67.4%) respondents reported experiencing microaggressions. Younger surgeons (P=.002), women (P<.001), and fellowship-trained surgeons (P=.001) were more likely to report experiencing microaggressions than their counterparts. Surgeons working in academic medical centers or health care systems with teaching responsibilities were more likely to experience microaggressions than those in private practice (P<.01). Surgeons currently working as a surgeon or those who are unable to work reported more experience with microaggressions (P=.003). There was no difference in microaggressions experienced among respondents based on surgical specialty, race/ethnicity, or whether the surgeons reported having a disability. In multivariable logistic regression, women had higher odds of experiencing microaggressions compared with men (adjusted odds ratio, 15.9; 95% confidence interval, 7.7-32.8), and surgeons in private practice had significantly lower odds of experiencing microaggressions compared with surgeons in academic medicine (adjusted odds ratio, 0.3; 95% confidence interval, 0.1-0.8) or in health care systems with teaching responsibilities (adjusted odds ratio, 0.2; 95% confidence interval, 0.1-0.6). Among surgeons responding to an online survey, respondents reporting microaggressions were less likely to say that they would choose a career in surgery again (P<.001). CONCLUSION Surgeons reporting experience with microaggressions represent a diverse range of surgical specialties and subspecialties. With the continued expansion of surgeon gender and race/ethnicity representation, deliberate efforts to address and eliminate workplace microaggressions could have broad implications for improving recruitment and retention of surgeons.
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Affiliation(s)
- Christine A Heisler
- Departments of Obstetrics and Gynecology and Urology, University of Wisconsin, Madison, WI.
| | - Amy L Godecker
- Departments of Obstetrics and Gynecology, University of Wisconsin, Madison, WI
| | - Deborah Verran
- Surgical Services, Ramsay Health Care, Sydney, Australia
| | - Michael S Sinha
- Center for Health Law Studies, Saint Louis University School of Law, St. Louis, MO
| | - Jerome Byam
- Division of Acute Care Surgery, Johns Hopkins School of Medicine, Baltimore, MD
| | - Pringl Miller
- Founder and Executive Director, Physician Just Equity, Bodega Bay, CA
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Santry HP, Lee C, Charles A, Angelos P, Crandall M. Academic surgery after the overturning of Roe vs. Wade. Am J Surg 2024; 231:134-136. [PMID: 38143215 DOI: 10.1016/j.amjsurg.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/16/2023] [Accepted: 12/17/2023] [Indexed: 12/26/2023]
Affiliation(s)
- Heena P Santry
- Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Clara Lee
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Anthony Charles
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | | | - Marie Crandall
- University of Florida College of Medicine, Jacksonville, FL, USA.
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Ibáñez B, Jones AT, Jeyarajah DR, Dent DL, Prendergast C, Barry CL. A Look at Demographics and Transition to Virtual Assessments: An Analysis of Bias in the American Board of Surgery General Surgery Certifying Exams. JOURNAL OF SURGICAL EDUCATION 2024; 81:578-588. [PMID: 38402095 DOI: 10.1016/j.jsurg.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/16/2023] [Accepted: 01/04/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE The goals of this study were (1) to assess if examiner ratings in the American Board of Surgery (ABS) General Surgery Cetifying Exam (CE) are biased based on the gender, race, and ethnicity of the candidate or the examiners, and (2) if the format of delivering of the exams, in-person or virtual, affects how examiners rate candidates. DESIGN We included every candidate-examiner combination for first time takers of the general surgery oral exam. Total scores and pass/fail outcomes based on the 4 scores given by examiners to candidates were analyzed using multilevel models, with candidates as random effects. Explanatory variables included the gender, race, and ethnicity of candidates and examiners, and the format of the exam (in-person or virtual). Candidates' first attempt scores on the ABS General Surgery Qualifying Exam (QE) were also included in the models to control for the baseline knowledge of the candidate. Three sets of models were evaluated for each demographic variable (gender, race, ethnicity) due to missingness in data. p-values and coefficients of determination R2 were used to quantify the statistical and practical significance of the model coefficients (an existent relationship between the explored variables on CE scores was considered statistically and practically significant if the p-value was lower than 0.01 and R2 higher than 1%). PARTICIPANTS All first-time takers of the American Board of Surgery General Surgery Certifying Exam from 2016 to 2022 that had demographic data, and the examiners that participated in those exams. RESULTS The number of candidates/examiners for the 3 sets of models was 8665/514 (gender), 5906/465 (race), and 4678/295 (ethnicity). The demographic variables, format of the exam, or their interactions were not found to significantly relate to examiner-candidate ratings or pass/fail outcomes. The only variable that was significantly related to CE scores was candidates' QE scores, which was added to the models as a measure of candidates' initial knowledge; this held for all models for total scores (F[1,8659] = 1069.89, p-value < 0.01, R2 = 5% [gender models], F(1,5696.3) = 589.13, p-value < 0.01, R2 = 5% [race models], F(1,4459.5) = 278.33, p-value < 0.01, R2 = 5% [ethnicity models]), and pass/fail outcomes (CI = 1.61-1.73, p-value < 0.01, R2 = 3% [gender models], CI = 1.67-1.85, p-value < 0.01, R2 = 3% [race models], CI = 2.17-2.90, p-value < 0.01, R2 = 3% [ethnicity models]). CONCLUSIONS This study shows that there is not a relationship between candidate and examiner gender, race, or ethnicity, and exam outcomes based on statistical models looking at examiner-candidate ratings and pass/fail outcomes. In addition, the delivery of the certifying exam in a virtual format appears to have no statistical impact on outcomes compared to in-person delivery. This suggests that the ABS is performing well in both demographic bias and virtual space.
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Affiliation(s)
| | | | | | | | | | - Carol L Barry
- American Board of Surgery, Philadelphia, Pennsylvania
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Newsom MR, McGuire KP. Mind the gap: Closing the gender divide in academic surgery. Am J Surg 2024; 228:3-4. [PMID: 37923659 DOI: 10.1016/j.amjsurg.2023.10.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Megan R Newsom
- Virginia Commonwealth University, Department of Surgery, Division of Plastic Surgery, USA
| | - Kandace P McGuire
- Virginia Commonwealth University, Department of Surgery, Division of Surgical Oncology, USA.
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Seese L, Sell-Dottin KA, Halub ME, Sade RM. Women have what it takes, and more: Recruiting the next generation of surgeons. J Thorac Cardiovasc Surg 2024:S0022-5223(24)00028-X. [PMID: 38242201 DOI: 10.1016/j.jtcvs.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 01/21/2024]
Affiliation(s)
- Laura Seese
- Division of Pediatric Cardiac Surgery, Department of Cardiothoracic Surgery, Children's Hospital of Pittsburgh, Pittsburgh, Pa
| | - Kristen A Sell-Dottin
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Mayo Clinic, Phoenix, Ariz
| | - Meghan E Halub
- Cardiovascular Surgery Department, Cleveland Clinic, Cleveland, Ohio
| | - Robert M Sade
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC.
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Lechien JR, Kan K, Sims HS. Workplace Environment Microaggressions in Otolaryngology-Head and Neck Surgery: An International Survey. Otolaryngol Head Neck Surg 2023; 169:1481-1490. [PMID: 37300899 DOI: 10.1002/ohn.400] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/30/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To survey members of the otolaryngology community about their personal and observed experiences of being treated differently because of one's physical attributes, cultural norms, or preferences in the workplace. STUDY DESIGN Cross-sectional survey. SETTING International Electronic Survey. METHODS We invited members of the international otolaryngology community including 3 European or American otorhinolaryngological Societies to complete a survey about personal/observed experience of differential treatment in the workplace related to age, biological sex; disability, gender identity, language proficiency, military experience, citizenship, ethnicity/race, political belief, and sexual orientation. Results were analyzed according to participant ethnicity/race (white vs non-white) and gender (male vs female) RESULTS: Four hundred seven participants completed the evaluations: 301 white (74%) and 106 non-white (26%) participants. Non-white participants reported significantly more experiences of differential treatment (microaggressions) than white participants (p < .05). Non-white participants more frequently felt that they needed to work harder for the same opportunities as their peers and were more likely to consider leaving a position because of an unsupportive environment. In general, females reported more frequent experiences with differential treatment related to sexual orientation, biological sex, and gender identity than males. CONCLUSION We recognized reports of differential treatment as a proxy for microaggressions. Non-white members of the otolaryngology community self-report experiencing or observing more microaggressions than white members in the workplace. Acknowledging the existence and impact of microaggressions in the field of Otolaryngology is the first step towards cultivating an inclusive, diverse workforce where all members feel supported, validated, and welcomed.
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Affiliation(s)
- Jerome R Lechien
- Department of Otolaryngology and Head and Neck Surgery, Division of Laryngology and Broncho-Esophagology, EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium
- Department of Otolaryngology Head Neck Surgery, CHU Saint-Pierre, Brussels, Belgium
- Otolaryngology Head Neck Surgery, Elsan Polyclinic of Poitiers, Poitiers, France
| | - Krystal Kan
- Department of Otolaryngology-Head & Neck Surgery, University of Illinois at Chicago, Chicago, Illinois, USA
| | - H Steven Sims
- Department of Otolaryngology-Head & Neck Surgery, Chicago Institute for Voice Care, University of Illinois at Chicago, Chicago, Illinois, USA
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de Almeida NRC, Bentes LGDB, Aranha MFDAC, Lemos RS, dos Santos DR, Yasojima EY. Women in surgery: do surgical specialties keep up with the feminization of medicine in Brazil? Rev Col Bras Cir 2023; 50:e20233614. [PMID: 37991063 PMCID: PMC10644865 DOI: 10.1590/0100-6991e-20233614-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/04/2023] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION historically, surgical medical specialties are mostly male, a scenario which, in recent years, has undergone changes. In this sense, despite the relevance of the growth of female participation in the medical career, little is discussed about the distribution between genders of the main surgical medical specialties in the country. OBJECTIVE discuss the process of feminization in surgical specialties in Brazil over the last few years, tracing a distribution profile of these specialties. METHODS this is a retrospective and cross-sectional study with secondary data from the Censuses of Medical Demography in Brazil in the years 2011, 2013, 2015, 2018, 2020 and 2023, including the surgical specialties: Urology, Orthopedics and Traumatology, Thoracic Surgery, Neurosurgery, Digestive System Surgery, Cardiovascular Surgery, Hand Surgery, General Surgery, Head and Neck Surgery, Vascular Surgery, Plastic Surgery, Ophthalmology, Coloproctology, Otorhinolaryngology, Pediatric Surgery, and Gynecology and Obstetrics. RESULTS males prevails in numbers, among the surgical specialties, however, with a lower growth rate compared to females. Specialties such as urology, orthopedics and traumatology and neurosurgery are mostly male, while gynecology and obstetrics are female. CONCLUSION it is evident that female participation in the surgical medical field has increased significantly over the last few years.
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Affiliation(s)
| | | | | | - Rafael Silva Lemos
- - Universidade do Estado do Pará, Laboratório de Cirurgia Experimental - Belém - PA - Brasil
| | - Deivid Ramos dos Santos
- - Universidade do Estado do Pará, Laboratório de Cirurgia Experimental - Belém - PA - Brasil
| | - Edson Yuzur Yasojima
- - Universidade do Estado do Pará, Laboratório de Cirurgia Experimental - Belém - PA - Brasil
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Shah NR, Maselli KM, Lotakis DM, Henry MC, Newman EA, Gadepalli SK, Perrone EE. Beyond Parity: Gender Diversity of National and International Pediatric Surgery Societal Leadership. J Pediatr Surg 2023; 58:2181-2186. [PMID: 37286414 DOI: 10.1016/j.jpedsurg.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/18/2023] [Accepted: 05/01/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE Despite trends toward equal gender representation among medical school graduates, surgical trainees and fellows, diversity in higher levels of pediatric surgery is largely unstudied. This study aims to quantify gender diversity among leadership of pediatric surgical associations and societies across the globe. METHODS National and international pediatric surgical organizations were identified from the websites of the American Pediatric Surgical Association (APSA) and World Federation of Associations of Pediatric Surgery (WOFAPS). Compositional gender data of current and past organizational leadership was collected by examining publicly available archives of executive membership rosters. If roster pictures were not available, member names were input into social media sites and other search engines to ensure accurate gender denotation. Univariate analyses of organizational metrics and aggregate data of 5-year time intervals were performed via Fischer's Exact Test with significance of p < 0.05. RESULTS Nineteen pediatric surgical organizations were included for study analysis. Of 189 current organizational leaders, 50 (26.4%) are women. Eight organizations (42.1%) have less than 20% of leadership positions filled by women members, while two executive boards have no women members. Four organizations (22.2%) have a current woman seated as president/chairperson. Historical gender distribution stratified by organization demonstrates a range of 0-7.8% (p = 0.99), with one organization having yet to elect a woman president/chairperson. Longitudinally, women presidential representation remained consistently low (5-11%) across all time intervals from 1993 to 2022 (p = 0.35). CONCLUSIONS Despite advances in diversity in medical school graduates, surgical training, and workforce recruitment, there are still significant disparities in gender representation within pediatric surgery societal leadership. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Nikhil R Shah
- University of Michigan, Michigan Medicine, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, 1540 E. Hospital Dr, Ann Arbor, MI, 48109-4211, USA
| | - Kathryn M Maselli
- University of Michigan, Michigan Medicine, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, 1540 E. Hospital Dr, Ann Arbor, MI, 48109-4211, USA
| | - Dimitra M Lotakis
- University of Michigan, Michigan Medicine, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, 1540 E. Hospital Dr, Ann Arbor, MI, 48109-4211, USA
| | - Marion C Henry
- University of Chicago, Department of Surgery, Section of Pediatric Surgery, Comer Children's Hospital, Chicago, IL, 60637, USA
| | - Erika A Newman
- University of Michigan, Michigan Medicine, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, 1540 E. Hospital Dr, Ann Arbor, MI, 48109-4211, USA
| | - Samir K Gadepalli
- University of Michigan, Michigan Medicine, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, 1540 E. Hospital Dr, Ann Arbor, MI, 48109-4211, USA
| | - Erin E Perrone
- University of Michigan, Michigan Medicine, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, 1540 E. Hospital Dr, Ann Arbor, MI, 48109-4211, USA.
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Fleming CA, Augustinus S, Lemmers DHL, López-López V, Nitschke C, Farges O, Salminen P, O'Connell PR, Campos RR, Caiazzo R. Career Needs Assessment for Early Career Academic Surgeons Using a Modified Accelerated Delphi Process. Ann Surg 2023; 278:655-661. [PMID: 37465982 DOI: 10.1097/sla.0000000000006014] [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: 07/20/2023]
Abstract
INTRODUCTION Over the past 2 decades, physicians' wellbeing has become a topic of interest. It is currently unclear what the current needs are of early career academic surgeons (ECAS). METHODS Consensus statements on academic needs were developed during a Delphi process, including all presenters from the previous European Surgical Association (ESA) meetings (2018-2022). The Delphi involved (1) a literature review, (2) Delphi form generation, and (3) an accelerated Delphi process. The Delphi form was generated by a steering group that discussed findings identified within the literature. The modified accelerated e-consensus approach included 3 rounds over a 4-week period. Consensus was defined as >80% agreement in any round. RESULTS Forty respondents completed all 3 rounds of the Delphi. Median age was 37 years (interquartile range 5), and 53% were female. Majority were consultant/attending (52.5%), followed by PhD (22.5%), fellowship (15%), and residency (10%). ECAS was defined as a surgeon in 'development' years of clinical and academic practice relative to their career goals (87.9% agreement). Access to split academic and clinical contracts is desirable (87.5%). Consensus on the factors contributing to ECAS underperformance included: burnout (94.6%), lack of funding (80%), lack of mentorship (80%), and excessive clinical commitments (80%). Desirable factors to support ECAS development included: access to e-learning (90.9%), face-to-face networking opportunities (95%), support for research team development (100%), and specific formal mentorship (93.9%). CONCLUSION The evolving role and responsibilities of ECAS require increasing strategic support, mentorship, and guidance on structured career planning. This will facilitate workforce sustainability in academic surgery in the future.
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Affiliation(s)
- Christina A Fleming
- Department of Colorectal Surgery, University of Limerick Hospital Group, Limerick, Ireland
- PROGRESS Fellow, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Simone Augustinus
- Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam
- Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Daan H L Lemmers
- Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam
- Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Surgery, Fondazione Poliambulanza, Brescia, Italy
| | - Victor López-López
- Department of Surgery and Liver and Pancreas Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB-Arrixaca, Murcia, Spain
| | - Christine Nitschke
- Department of General Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olivier Farges
- Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Clichy, France
| | - Paulina Salminen
- Departments of Acute and Digestive Surgery, Turku University Hospital, Turku, Finland
| | | | - Ricardo Robles Campos
- Department of Surgery and Liver and Pancreas Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB-Arrixaca, Murcia, Spain
| | - Robert Caiazzo
- Department of Endocrine Surgery, Lille University Hospital, Lille, France
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Enani GN, Brydges R, MacRae HM, Louridas M. Exploring mentorship in surgery: An interview study on how people stick together. MEDICAL EDUCATION 2023; 57:1028-1035. [PMID: 37485632 DOI: 10.1111/medu.15157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/01/2023] [Accepted: 06/10/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE The objective is to explore the processes contributing to how and why mentors and mentees initiate, maintain and grow in their mentorship relationships in surgery. BACKGROUND To explore the processes contributing to how and why mentors and mentees initiate, maintain and grow their mentorship relationships in surgery. Evidence suggests that mentorship has a positive impact on physicians' success. Consequently, mentorship programmes have been incorporated into many medicine environments, albeit with variable success. METHODS We designed an interview-based study using a constructivist grounded theory approach to explore the dynamics of mentorship between junior and experienced surgeons. Recruited mentees were asked to nominate a senior surgeon they identified as a mentor. Both mentee and mentors were then interviewed separately. Transcripts were analysed using constant comparison to a create a final coding framework and to generate themes. RESULTS We interviewed nine faculty mentors and 10 junior faculty mentees. Our analysis identified key themes describing how to initiate, maintain and grow a mentorship relationship. Mentorship starts with ensuring a 'good fit', persists through satisfying a reciprocal loop with timely communication and deepens the relationship through cycles of mutual investment, learning, and success. Participants also discussed how to navigate through tensions to avoid relationship breakdown, balancing formality and friendship, knowing when to transition a relationship to a new dynamic and finding areas of realistic contribution. CONCLUSIONS We found that successful mentorship relationships are viewed as dynamic and thus require active investment and shared responsibility between mentees and mentors. Our results also emphasise the value of co-regulation in the relationship, where cycles of mutual investment can contribute to mutual learning and growth.
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Affiliation(s)
- Ghada N Enani
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Ryan Brydges
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Helen M MacRae
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Marisa Louridas
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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11
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Yanagawa B, Ibrahim M, Lawton J. Women in Cardiac Surgery: Closing the Equity Gap. Circulation 2023; 148:1292-1294. [PMID: 37871238 DOI: 10.1161/circulationaha.123.063656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Affiliation(s)
- Bobby Yanagawa
- Division of Cardiac Surgery, St Michael's Hospital, University of Toronto, Ontario, Canada (B.Y.)
| | - Marina Ibrahim
- Division of Cardiac Surgery, Montreal Heart Institute, University of Montreal, Canada (M.I.)
| | - Jennifer Lawton
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD (J.L.)
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Fulton-Ward T, Bain R, Khoury EG, Keshwara SM, Joseph PJS, Selby P, Millward CP. Benefits of Mentoring in Oncology Education for Mentors and Mentees: Pre-Post Interventional Study of the British Oncology Network for Undergraduate Societies' National Oncology Mentorship Scheme. JMIR MEDICAL EDUCATION 2023; 9:e48263. [PMID: 37695662 PMCID: PMC10520773 DOI: 10.2196/48263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Formal education of oncology is lacking in many undergraduate medical curricula. Mentoring schemes can expose participants to specific areas of medicine and may address the shortfalls in oncology education. Few mentoring schemes have been designed within the United Kingdom, especially within oncology. There is a need to understand reasons for mentor and mentee participation in such schemes and to identify ways to minimize barriers to engagement. OBJECTIVE This study identifies motivations for participation in an oncology mentoring scheme and its benefits and limitations to both the mentee and the mentor. METHODS The British Oncology Network for Undergraduate Societies launched a National Oncology Mentorship Scheme (NOMS) on September 1, 2021. Mentees (medical student or foundation doctor) were paired with mentors (specialty registrar or consultant), for 6 months of mentoring. In total, 86 mentors and 112 mentees were recruited to the scheme. The mentees and mentors were asked to meet at least 3 times during this period and suggestions were provided on the content of mentoring. Mentees and mentors were invited to complete a prescheme questionnaire, exploring motivations for involvement in the scheme, current experiences within oncology, and knowledge and interests in the field. At the end of the scheme, mentors and mentees were asked to complete a postscheme questionnaire exploring experiences and benefits or limitations of participation. Paired analysis was performed using the Wilcoxon signed-rank test. For free text data, content analysis was applied to summarize the main themes in the data. RESULTS Of the 66 (59%) mentees who completed the prescheme questionnaire, 41 (62%) were clinical, 21 (32%) preclinical medical students, and the remainder were junior doctors. For mentees, networking was the primary reason for joining the scheme (n=25, 38%). Mentees ranked experience of oncology at medical school at 3 on 10 (IQR 2-5). In this, 46 (53%) mentors completed the prescheme questionnaire, 35 (76%) were registrar level, and the remainder were consultant level (n=11). The most common reason for mentor participation was to increase awareness and interest in the field (n=29, 63%). Of those who completed the prescheme questionnaire, 23 (35%) mentees and 25 (54%) mentors completed the postscheme questionnaire. Knowledge in all areas of oncology assessed significantly increased during the scheme (P<.001). Most mentees (n=21, 91%) and mentors (n=18, 72%) felt they had benefited from the scheme. Mentees cited gaining insights into oncology as most beneficial; and mentors, opportunities to develop professionally. Whilst mentees did not report any barriers to participating in the scheme, mentors stated lack of time as the greatest barrier to mentoring. CONCLUSIONS British Oncology Network for Undergraduate Societies' NOMS is expanding and is beneficial for mentees through increasing knowledge, providing exposure, and career advice in oncology. Mentors benefit from improving their mentoring skills and personal satisfaction.
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Affiliation(s)
- Taylor Fulton-Ward
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Robert Bain
- School of Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Emma G Khoury
- Academic Cancer Sciences Unit, University Hospital Southampton, Southampton, United Kingdom
| | - Sumirat M Keshwara
- Institute of Systems, Molecular, & Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | | | - Peter Selby
- University of Leeds, Leeds, United Kingdom
- University of Lincoln, Lincoln, United Kingdom
| | - Christopher P Millward
- Institute of Systems, Molecular, & Integrative Biology, University of Liverpool, Liverpool, United Kingdom
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13
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Freudenberger DC, Herremans KM, Riner AN, Vudatha V, McGuire KP, Anand RJ, Trevino JG. General Surgery Faculty Knowledge and Perceptions of Breast Pumping Amongst Postpartum Surgical Residents. World J Surg 2023; 47:2092-2100. [PMID: 37103559 PMCID: PMC10387458 DOI: 10.1007/s00268-023-07005-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND There is a lack of data regarding the knowledge and perceptions teaching faculty possess about breast pumping among general surgery residents despite breast pumping becoming more common during training. This study aimed to examine faculty knowledge and perceptions of breast pumping amongst general surgery residents. METHODS A 29-question survey measuring knowledge and perceptions about breast pumping was administered online to United States teaching faculty from March-April 2022. Descriptive statistics were used to characterize responses, Fisher's exact test was used to report differences in responses by surgeon sex and age, and qualitative analysis identified recurrent themes. RESULTS 156 responses were analyzed; 58.6% were male and 41.4% were female, and the majority (63.5%) were less than 50 years old. Nearly all (97.7%) women with children breast pumped, while 75.3% of men with children had partners who pumped. Men more often than women indicated "I don't know" when asked about frequency (24.7 vs. 7.9%, p = 0.041) and duration (25.0 vs. 9.5%, p = 0.007) of pumping. Nearly all surgeons are comfortable (97.4%) discussing lactation needs and support (98.1%) breast pumping, yet only two-thirds feel their institutions are supportive. Almost half (41.0%) of surgeons agreed that breast pumping does not impact operating room workflow. Recurring themes included normalizing breast pumping, creating change to better support residents, and communicating needs between all parties. CONCLUSIONS Teaching faculty may have supportive perceptions about breast pumping, but knowledge gaps may hinder greater levels of support. Opportunities exist for increased faculty education, communication, and policies to better support breast pumping residents.
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Affiliation(s)
- Devon C Freudenberger
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA
| | - Kelly M Herremans
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Rd., Gainesville, FL, 32608, USA
| | - Andrea N Riner
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Rd., Gainesville, FL, 32608, USA
| | - Vignesh Vudatha
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA
| | - Kandace P McGuire
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA
| | - Rahul J Anand
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA
| | - Jose G Trevino
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA.
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14
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Hakami N, Madkhali A, Hakami F, ALshekh M, Masmali E, Hamithi D, Zogel B. Obstacles Deterring Medical Students From Pursuing a Career in the Field of Surgery in Jazan University, Saudi Arabia. Cureus 2023; 15:e43233. [PMID: 37692738 PMCID: PMC10491465 DOI: 10.7759/cureus.43233] [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: 07/16/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Particularly in Saudi Arabia, there is a dearth of trained specialists in the field of surgery. Understanding the obstacles that discourage medical students and residents from pursuing a surgical career is essential for resolving this shortage. This study intended to investigate the characteristics that influence medical students and trainees at Jazan University, Saudi Arabia, to pursue a career in surgery. METHODOLOGY This observational study employed a descriptive, cross-sectional approach. The intended audience consisted of fourth- to sixth-year medical students and medical residents. The questionnaire gathered information on demographics, academic year, previous surgical experience, perceptions of surgery as a specialty, and variables influencing career selections. RESULTS Out of 413 participants, 74.3% were considering a surgical career, with 24.4% interested in general surgery, followed by cardiac surgery (14.3%) and pediatric surgery (12.4%). Factors influencing career decisions included potential income (82%), the possibility of part-time work (82%), and partial leave (74%). A significant proportion of participants agreed or strongly agreed that the incidence of suicide (62%) and the risk of depression (72%) are higher in surgical specialties. Female participants were more likely to agree that their chance of becoming a spouse could be affected by a surgical career (p=0.002) and that meeting role models could influence their choice of surgical specialty (p=0.015). CONCLUSION Work-life balance, long working hours, and mental health concerns are identified as variables that discourage medical students and residents from pursuing a surgical career in the study. Efforts to encourage work-life balance, minimize workload, and provide support and resources for mental health issues should help surgeons suffer less stress and burnout. Moreover, encouraging an open-minded attitude and de-stigmatizing mental health concerns in the medical field should encourage individuals to seek assistance when necessary and lower the incidence of suicide and depression. Finally, tackling gender discrimination and encouraging diversity and inclusion in surgical specialties could attract more skilled surgeons.
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Affiliation(s)
| | | | | | | | - Enas Masmali
- Faculty of Medicine, Jazan University, Jazan, SAU
| | | | - Basem Zogel
- Faculty of Medicine, Jazan University, Jazan, SAU
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15
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Silver JK, Gavini N. The Push-Pull Mentoring Model: Ensuring the Success of Mentors and Mentees. J Med Internet Res 2023; 25:e48037. [PMID: 37227764 DOI: 10.2196/48037] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 05/03/2023] [Indexed: 05/26/2023] Open
Abstract
Mentorship is vital for professional development in academic research and clinical practice, yet it faces challenges due to a limited number of experienced mentors and a lack of protected time for mentorship that may disproportionately affect women mentors in midcareer who are doing much of this "invisible work." The Push-Pull Mentoring Model offers a potential solution by emphasizing shared responsibility and active engagement between mentors and mentees; it fosters a flexible and collaborative approach that is mutually (though not necessarily equally) supportive of both individuals' career goals, with mentees pushing mentors up and facilitating opportunities in their realm of influence, including but not limited to sponsorship, while mentors are simultaneously pulling them up. The Push-Pull Mentoring Model provides a promising alternative to traditional mentoring models and may help institutions address the challenges associated with limited mentorship resources.
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Affiliation(s)
- Julie K Silver
- Spaulding Rehabilitation Hospital, Charlestown, MA, United States
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
- Massachusetts General Hospital, Boston, MA, United States
- Brigham and Women's Hospital, Boston, MA, United States
| | - Nara Gavini
- Spaulding Rehabilitation Hospital, Charlestown, MA, United States
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
- MGH Institute of Health Professions, Boston, MA, United States
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16
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Pierobon ES, Capelli G, Frigerio I, Spolverato G. Mentor WIS: an Italian mentorship programme for female surgeons. Br J Surg 2023:7156954. [PMID: 37155362 DOI: 10.1093/bjs/znad112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 04/10/2023] [Indexed: 05/10/2023]
Affiliation(s)
- Elisa Sefora Pierobon
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Giulia Capelli
- Department of Surgery, ASST Bergamo Est, Seriate, Bergamo, Italy
| | - Isabella Frigerio
- Department of Surgery, Pederzoli Hospital, Peschiera del Garda, Verona, Italy
| | - Gaya Spolverato
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
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17
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Zheng H, Al-Refaie W, Chou J, Galli F, Lai V, Felger EA. Gender Disparity in Earliest Phase of Academic Surgical Training: An Area for Intervention. J Am Coll Surg 2023; 236:687-694. [PMID: 36744799 DOI: 10.1097/xcs.0000000000000641] [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: 02/07/2023]
Abstract
BACKGROUND To overcome persistent gender disparities in academic surgery, it is critical to examine the earliest phase of surgical training. This national study sought to assess whether gender disparities also existed among surgical interns, as a proxy for medical school research experience in both quantity and quality. STUDY DESIGN Using the 2021 to 2022 public information of 1,493 US-graduated categorical general surgery interns, a bibliometric evaluation was conducted to assess medical school research experience. Multivariable linear regressions with response log-transformed were performed to evaluate the impact of intern gender on (1) total number of peer-reviewed publications, (2) total impact factor (TIF), and (3) adjusted TIF based on authorship placement (aTIF). Back-transformed estimates were presented. RESULTS Of these interns, 52.3% were female. Significant differences were observed in TIF (male 6.4 vs female 5.3, p = 0.029), aTIF (male 10.8 vs female 8.7, p = 0.035), gender concordance with senior authors (male 79.9% vs female 34.1%, p < 0.001), Hirsch index (male 21.0 vs female 18.0, p = 0.026), and the geographic region of their medical schools (p = 0.036). Multivariable linear regressions revealed that female interns were associated with lower TIF (0.858, p = 0.033) and aTIF (0.851, p = 0.044). Due to a significant gender-by-region interaction, adjusted pairwise comparisons showed that male interns in the Northeast had approximately 70% higher TIF (1.708, p = 0.003) and aTIF (1.697, p = 0.013) than female interns in the South. CONCLUSIONS Gender disparities existed in the quality of research experience in the earliest phase of surgical training. These timely results call for additional interventions by the stakeholders of graduate medical education.
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Affiliation(s)
- Hui Zheng
- From the Department of Surgery, MedStar Washington Hospital Center/Georgetown University Hospital, Washington, DC (Zheng)
| | - Waddah Al-Refaie
- MedStar Health, Georgetown University Medical Center, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (Al-Refaie, Galli)
| | - Jiling Chou
- Center of Biostatistics, Informatics and Data Science, Medstar Health Research Institute, Rockville, MD (Chou)
| | - Francesca Galli
- MedStar Health, Georgetown University Medical Center, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (Al-Refaie, Galli)
| | - Victoria Lai
- the Division of Endocrine Surgery, MedStar Washington Hospital Center, Washington, DC (Lai, Felger)
| | - Erin A Felger
- the Division of Endocrine Surgery, MedStar Washington Hospital Center, Washington, DC (Lai, Felger)
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