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Ali S, Chowdhury R, Bittner K, Oxentenko AS, Kothari S. Assessing Family Leave Policies and Pregnancy Outcomes Among Gastroenterologists: A Survey of Physicians in the American College of Gastroenterology. Am J Gastroenterol 2023; 118:2294-2300. [PMID: 37463424 DOI: 10.14309/ajg.0000000000002408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION Given variability in parental leave policies in gastroenterology (GI) with little data on outcomes, the American College of Gastroenterology conducted a survey to assess policies and outcomes. METHODS A survey was distributed to American College of Gastroenterology members with questions on demographics, fertility, pregnancy outcomes, and parental leave policies. RESULTS There were 796 responses, with 52.5% female individuals. Many (57%) delayed parenting. High rates of infertility (21%) and pregnancy complications (68%) were observed. Satisfaction with parental leave policies in GI was low (35%). DISCUSSION Our survey highlights the need for policies that support the well-being of our GI colleagues and families.
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Affiliation(s)
- Shazia Ali
- The Permanente Medical Group, San Jose, California, USA
| | | | - Krystle Bittner
- University of Rochester Medical Center, Rochester, New York, USA
| | | | - Shivangi Kothari
- University of Rochester Medical Center, Rochester, New York, USA
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Feld LD, Oxentenko AS, Sears D, Charabaty A, Rabinowitz LG, Silver JK. Parental Leave and Return-to-Work Policies: A Practical Model for Implementation in Gastroenterology. Clin Gastroenterol Hepatol 2023; 21:2709-2715. [PMID: 37741653 DOI: 10.1016/j.cgh.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Indexed: 09/25/2023]
Affiliation(s)
- Lauren D Feld
- Division of Gastroenterology, Diversity, Equity, Belonging and Inclusion, Department of Medicine, UMass Chan Medical School, Worcester, Massachusetts
| | - Amy S Oxentenko
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Dawn Sears
- U.S. Department of Veterans Affairs, Central Texas VA, Texas A&M School of Medicine, Temple, Texas
| | - Aline Charabaty
- IBD Center, Johns Hopkins School of Medicine, Division of Gastroenterology Sibley Memorial Hospital, Washington, District of Columbia
| | - Loren G Rabinowitz
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess, Harvard Medical School, Boston, Massachusetts
| | - Julie K Silver
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Feld LD, Oxentenko AS, Sears D, Charabaty A, Rabinowitz LG, Silver JK. Parental Leave and Return-to-Work Policies: A Practical Model for Implementation in Gastroenterology. Gastroenterology 2023; 165:813-818. [PMID: 37741651 DOI: 10.1053/j.gastro.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Affiliation(s)
- Lauren D Feld
- Division of Gastroenterology, Diversity, Equity, Belonging and Inclusion, Department of Medicine, UMass Chan Medical School, Worcester, Massachusetts
| | - Amy S Oxentenko
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Dawn Sears
- U.S. Department of Veterans Affairs, Central Texas VA, Texas A&M School of Medicine, Temple, Texas
| | - Aline Charabaty
- IBD Center, Johns Hopkins School of Medicine, Division of Gastroenterology, Sibley Memorial Hospital, Washington, District of Columbia
| | - Loren G Rabinowitz
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess, Harvard Medical School, Boston, Massachusetts
| | - Julie K Silver
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Feld LD, Sarkar M, Au JS, Flemming JA, Gripshover J, Kardashian A, Muir AJ, Nephew L, Orloff SL, Terrault N, Rabinowitz L, Volerman A, Arora V, Farnan J, Villa E. Parental leave, childcare policies, and workplace bias for hepatology professionals: A national survey. Hepatol Commun 2023; 7:e0214. [PMID: 37639705 PMCID: PMC10461944 DOI: 10.1097/hc9.0000000000000214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/22/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The presence of workplace bias around child-rearing and inadequate parental leave may negatively impact childbearing decisions and sex equity in hepatology. This study aimed to understand the influence of parental leave and child-rearing on career advancement in hepatology. METHODS A cross-sectional survey of physician members of the American Association for the Study of Liver Diseases (AASLD) was distributed through email listserv in January 2021. The 33-item survey included demographic questions, questions about bias, altering training, career plans, family planning, parental leave, and work accommodations. RESULTS Among 199 US physician respondents, 65.3% were women, and 83.4% (n = 166) were attendings. Sex and racial differences were reported in several domains, including paid leave, perceptions of bias, and child-rearing. Most women (79.3%) took fewer than the recommended 12 paid weeks of parental leave for their first child (average paid leave 7.5 wk for women and 1.7 for men). A majority (75.2%) of women reported workplace discrimination, including 83.3% of Black and 62.5% of Hispanic women. Twenty percent of women were asked about their/their partners' pregnancy intentions or child-rearing plans during interviews for training. Women were more likely to alter career plans due to child-rearing (30.0% vs. 15.9%, p = 0.030). Women were also more likely to delay having children than men (69.5% vs.35.9%). CONCLUSIONS Women reported sex and maternity bias in the workplace and during training interviews, which was more frequently experienced by Black and Hispanic women. As two-thirds of women had children during training, it is a particularly influential time to reevaluate programmatic support to address long-term gender disparities in career advancement.
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Affiliation(s)
- Lauren D. Feld
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Massachusetts, Worcester, Massachusetts, USA
| | - Monika Sarkar
- Department of Medicine, Division of Gastroenterology & Hepatology, University of California San Francisco, San Francisco, California, USA
| | - Jennifer S. Au
- Department of Organ Transplant, Division of Gastroenterology and Hepatology, Scripps Clinic, La Jolla, California, USA
| | - Jennifer A. Flemming
- Department of Medicine and Public Health Sciences, Queen’s University, Ontario, Canada
| | - Janet Gripshover
- Department of Transplant Surgery, Ronald Regan UCLA Medical Center, Los Angeles, California, USA
| | - Ani Kardashian
- Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Andrew J. Muir
- Department of Medicine, Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Lauren Nephew
- Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Susan L. Orloff
- Department of Surgery, Division of Abdominal Organ Transplantation, Oregon Health & Science University School of Medicine, Portland, Oregon, USA
| | - Norah Terrault
- Department of Medicine, Division of Gastroenterology and Liver, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Loren Rabinowitz
- Department of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Anna Volerman
- Departments of Medicine and Pediatrics, University of Chicago, Chicago, Illinois, USA
| | - Vineet Arora
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Jeanne Farnan
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Erica Villa
- Dipartimento di Specialità Mediche, Struttura Complessa di Gastroenterologia, Universita Degli Studi Di Modena E Reggio Emilia, Modena, Italy
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Jamorabo DS, Khander A, Koulouris V, Feith JE, Briggs WM, Renelus BD. Fellowship program directors and trainees across the United States find parental leave policies to be inconsistent, inaccessible, and inadequate. PLoS One 2021; 16:e0260057. [PMID: 34788326 PMCID: PMC8598025 DOI: 10.1371/journal.pone.0260057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/31/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Determine the consistency, accessibility, and adequacy of parental leave policies for adult and pediatric medicine fellowship programs. Methods We administered a 40-question survey to fellowship program directors (PDs) and trainees in adult and pediatric cardiology, hematology/oncology, gastroenterology, and pulmonology/critical care fellowship programs in the United States. We used Chi-square tests to compare proportions for categorical variables and t-tests to compare means for continuous variables. Results A total of 190 PDs from 500 programs (38.0%) and 236 trainees from 142 programs (28.4%) responded. Most respondents did not believe that parental leave policies were accessible publicly (322/426; 75.6%), on password-protected intranet (343/426; 80.5%), or upon request (240/426; 56.3%). The PDs and trainees broadly felt that parental leave for fellows should be 5–10 weeks (156/426; 36.6%) or 11–15 weeks (165/426; 38.7%). A majority of PDs felt that there was no increased burden upon other fellows (122/190; 64.2%) or change in overall well-being (110/190; 57.9%). When asked about the biggest barrier to parental leave support, most PDs noted time constrains of fellowship (101/190; 53.1%) and the limited number of fellows (43/190; 22.6%). Trainees similarly selected the time constraints of training (88/236; 37.3%), but nearly one-fifth chose the culture in medicine (44/236; 18.6%). There were no statistically significant differences in answers based on the respondents’ sex, specialty, or subspecialty. Discussion Parental leave policies are broadly in place, but did not feel these were readily accessible, standardized, or of optimum length. PDs and trainees noted several barriers that undermine support for better parental leave policies, including time constraints of fellowship, the limited number of fellows for coverage, and workplace culture. Standardization of parental leave policies is advisable to allow trainees to pursue fellowship training and care for their newborns without undermining their educational experiences.
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Affiliation(s)
- Daniel Sabido Jamorabo
- Department of Medicine, Stony Brook Medicine, Stony Brook, New York, United States of America
- * E-mail: ,
| | - Amrin Khander
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York, United States of America
| | - Vasilios Koulouris
- Department of Medicine, Montefiore Medical Center, Bronx, New York, United States of America
| | - Jeremy Eli Feith
- Department of Neurosciences, State University of New York-Binghamton, Binghamton, New York, United States of America
| | - William Matthew Briggs
- Department of Biostatistics, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States of America
| | - Benjamin Dwight Renelus
- Department of Medicine, Johns Hopkins Medicine, Baltimore, Maryland, United States of America
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Response to Uchida and Rabinowitz, et al. Am J Gastroenterol 2021; 116:2302. [PMID: 34212894 DOI: 10.14309/ajg.0000000000001370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Advanced Gastroenterology Trainees Should Be Included in National Trainee Parental Leave Policies. Am J Gastroenterol 2021; 116:2302. [PMID: 34131084 DOI: 10.14309/ajg.0000000000001338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Gender parity in editorial boards and senior authorship: a long but hopeful road ahead. Gastrointest Endosc 2021; 94:724-726. [PMID: 34392982 DOI: 10.1016/j.gie.2021.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 06/18/2021] [Indexed: 12/11/2022]
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David YN, Dixon RE, Kakked G, Rabinowitz LG, Grinspan LT, Anandasabapathy S, Greenwald DA, Kim MK, Sethi A, Kumta NA. Pregnancy and the Working Gastroenterologist: Perceptions, Realities, and Systemic Challenges. Gastroenterology 2021; 161:756-760. [PMID: 34089733 DOI: 10.1053/j.gastro.2021.05.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 12/17/2022]
Affiliation(s)
- Yakira N David
- Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Rebekah E Dixon
- Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Gaurav Kakked
- Division of Gastroenterology, Beaumont Hospital, Royal Oak, Michigan
| | - Loren G Rabinowitz
- Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lauren T Grinspan
- Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - David A Greenwald
- Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Michelle K Kim
- Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Amrita Sethi
- Division of Gastroenterology, Columbia University Irving Medical Center, New York, New York
| | - Nikhil A Kumta
- Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
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The Time Is Now to Understand and Address Sex-Related Disparities in Gastroenterology and Hepatology. Am J Gastroenterol 2021; 116:441-443. [PMID: 33657032 DOI: 10.14309/ajg.0000000000001185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/11/2021] [Indexed: 12/11/2022]
Abstract
Many gastrointestinal disorders, autoimmune diseases, and pregnancy-related conditions preferentially impact women. This issue of The American Journal of Gastroenterology focuses on women's health in the context of gastrointestinal and liver disease. This editorial highlights the current issue's contents and seeks to spark the conversations to bring awareness to the many issues faced by women as both patients and practitioners.
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