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Coyle A, Graves EKM, Hannah TC, Yong V, Rostmeyer K, Erkmen CP, Erkmen K. Dear Program Director: An Evaluation of Implicit Bias in Letters of Recommendation for Neurosurgery Residency. Neurosurgery 2024:00006123-990000000-01173. [PMID: 38771088 DOI: 10.1227/neu.0000000000003002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/29/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Despite comprising half of medical students, women represent only 29.6% of neurosurgery applicants and 17% of residents, suggesting a "leak" in the career pipeline for women neurosurgeons. Surveys persistently show that neurosurgery programs identify United States Medical Licensing Examination (USMLE®) Step 1 score and letters of recommendation (LORs) as the most important factors in selecting applicants to interview. A previous study in neurosurgery found no differences in LORs. However, multiple studies in other specialties have demonstrated implicit gender bias in LORs, which may influence resident selection. Our objective is to evaluate neurosurgery residency LORs for evidence of implicit gender bias. METHODS Retrospective analysis of LORs for interviewed neurosurgery applicants at a single institution during the 2014 to 2020 National Residency Matching Program (NRMP®) match cycles. Letters were evaluated using Linguistic Inquiry & Word Count (LIWC) software (Pennebaker Conglomerates), and additional applicant data were obtained from candidate applications. LIWC (Pennebaker Conglomerates) output data included custom dictionary categories and terms that were analyzed using Prism 10 and Rstudio. RESULTS Two hundred eighteen applications were reviewed for a total of 827 letters. LIWC (Pennebaker Conglomerates) analysis showed significant differences in word count (331 vs 297, difference = 34, 95% CI: 9-61, P = .008). LORs for applicants who were men were more likely to mention Alpha Omega Alpha Honor Medical Society (1.17 vs 0.778, difference = 0.4, 95% CI: 0.13-0.67, P = .023). USMLE® Step 1 scores were significantly lower for women (241 vs 247, difference = 6, 95% CI: 2-10, P = .004). There was no significant difference between letters for men and women for all categories evaluated in the linguistic evaluation. CONCLUSION LORs are vital to the neurosurgical residency application process. The data exhibit some differences between the men and women applicants but few differences in their LORs, consistent with the results of the previous neurosurgical study.
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Affiliation(s)
- Anne Coyle
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Erin K M Graves
- Department of Neurosurgery, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Theodore C Hannah
- Department of Neurosurgery, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Valeda Yong
- Division of Thoracic Surgery, Department of Surgery, Temple University Health Systems, Philadelphia, Pennsylvania, USA
| | - Kaleb Rostmeyer
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Cherie P Erkmen
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
- Division of Thoracic Surgery, Department of Surgery, Temple University Health Systems, Philadelphia, Pennsylvania, USA
| | - Kadir Erkmen
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
- Department of Neurosurgery, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
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Oshinowo TO, Rallo MS, Schirmer CM, Chambless LB. Gender Differences in Medicare Practice and Payments to Neurosurgeons. JAMA Surg 2024; 159:35-42. [PMID: 37819669 PMCID: PMC10568441 DOI: 10.1001/jamasurg.2023.4988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/16/2023] [Indexed: 10/13/2023]
Abstract
Importance Despite efforts to promote diversity within the neurosurgical workforce, individuals from underrepresented groups face significant challenges. Objective To compare practice metrics and earning potential between female and male neurosurgeons and investigate factors associated with gender disparity in Medicare reimbursement. Design, Setting, and Participants This retrospective cross-sectional study used publicly accessible Medicare data on reimbursements to female and male neurosurgeons for procedural and evaluation and management services delivered in both inpatient and outpatient settings between January 1, 2013, and December 31, 2020. Data were analyzed from December 9, 2021, to December 5, 2022. Main Outcomes and Measures The primary outcome was the mean annual payments received and charges submitted by female and male neurosurgeons for services rendered between 2013 and 2020. Secondary outcomes included the total number and types of services rendered each year and the number of beneficiaries treated. Univariate and multivariable analyses quantified differences in payment, practice volume, and composition. Results A total of 6052 neurosurgeons (5540 men [91.54%]; 512 women [8.46%]) served the Medicare fee-for-service patient population. Female neurosurgeons billed for lesser Medicare charges (mean [SE], $395 851.62 [$19 449.39] vs $766 006.80 [$11 751.66]; P < .001) and were reimbursed substantially less (mean [SE], $69 520.89 [$2701.30] vs $124 324.64 [$1467.93]; P < .001). Multivariable regression controlling for practice volume metrics revealed a persistent reimbursement gap (-$24 885.29 [95% CI, -$27 964.72 to -$21 805.85]; P < .001). Females were reimbursed $24.61 less per service than males even after matching services by code (P = .02). Conclusions and Relevance This study found significant gender-based variation in practice patterns and reimbursement among neurosurgeons serving the Medicare fee-for-service population. Female surgeons were reimbursed less than male surgeons when both performed the same primary procedure. Lower mean reimbursement per service may represent divergence in billing and coding practices among females and males that could be the focus of future research or educational initiatives.
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Affiliation(s)
- Temitope O. Oshinowo
- Department of Neurological Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Michael S. Rallo
- Department of Neurological Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Clemens M. Schirmer
- Department of Neurosurgery and Neuroscience Institute, Geisinger Health System, Danville, Pennsylvania
| | - Lola B. Chambless
- Department of Neurological Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee
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Trenchfield D, Murdock CJ, Destine H, Jain A, Lord E, Aiyer A. Trends in Racial, Ethnic, and Gender Diversity in Orthopedic Surgery Spine Fellowships From 2007 to 2021. Spine (Phila Pa 1976) 2023; 48:E349-E354. [PMID: 36940267 DOI: 10.1097/brs.0000000000004633] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/24/2023] [Indexed: 03/22/2023]
Abstract
STUDY DESIGN Descriptive. OBJECTIVE The objective of this study is to analyze trends in racial, ethnic, and gender diversity in orthopedic spine surgery fellowship trainees. SUMMARY OF BACKGROUND DATA Orthopedic surgery has consistently been labeled as one of the least diverse fields in Medicine. Although some effort has been made to combat this in recent years at the residency level, it is uncertain whether spine fellowships have had any changes in fellow demographics. MATERIALS AND METHODS Fellowship demographic data were collected through the Accreditation Council for Graduate Medical Education. Data collected included gender (male, female, and not reported) and race (White, Asian, Black, Hispanic, Native Hawaiians, American Indian or Alaskan Native, other, and unknown). Percentage equivalents were calculated for each group from 2007 to 2008 to 2020 to 2021. A χ 2 test for trend (Cochran-Armitage test) was done to determine whether there was a significant change in percentages of each race and gender during the study period. The results were considered statistically significant at P <0.05. RESULTS White, Non-Hispanic males represent the largest proportion of orthopedic spine fellowship positions each year. From 2007 to 2021, there were no significant changes in the representation of any race or gender of orthopedic spine fellows. Males ranged from 81% to 95%, Whites from 28% to 66%, Asians from 9% to 28%, Blacks from 3% to 16%, and Hispanics from 0% to 10%. Native Hawaiians and American Indians remained at 0% for all years included in the study. Females and all races, excluding Whites, continue to be under-represented in orthopedic spine fellowship. CONCLUSIONS Orthopedic spine surgery fellowship programs have not made substantial progress in diversifying its population. More attention is needed to increase diversity in residency programs through pipeline programs, increased mentorship and sponsorship, and early exposure to the field. LEVEL OF EVIDENCE 1.
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Affiliation(s)
| | | | - Henson Destine
- University of Miami Miller School of Medicine, Miami, FL
| | - Amit Jain
- Johns Hopkins University Orthopaedic Surgery, Baltimore, MD
| | - Elizabeth Lord
- Department of Orthopaedic Surgery, UCLA, Los Angeles, CA
| | - Amiethab Aiyer
- Johns Hopkins University Orthopaedic Surgery, Baltimore, MD
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Hayden Gephart M, Holly LT, Amin-Hanjani S, Zipfel GJ, Mack WJ, Tennekoon M, Korn S. Roadmap for Development of a Strong, Diverse Research Workforce in Neurosurgery. Neurosurgery 2023; 93:e53-e58. [PMID: 37581448 PMCID: PMC10552973 DOI: 10.1227/neu.0000000000002602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/12/2023] [Indexed: 08/16/2023] Open
Abstract
A benchmark of success for the neurosurgeon-scientist includes obtaining individual research funding from the National Institutes of Health. Successful roadmaps to this goal highlight diversity, individual commitment and resiliency, innovative research goals, intentional mentoring, protected research time, and financial support. We must equip neurosurgery residents to surmount obstacles such as long periods of training, gaps in research productivity, and limited protected time for research to ensure successful transition to independent research careers. Strong individual, departmental, and national commitment to scientific development of a diverse cohort of residents and junior faculty will increase the number and diversity of National Institutes of Health-funded neurosurgeon-scientists.
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Affiliation(s)
- Melanie Hayden Gephart
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Langston T. Holly
- Department of Neurosurgery, David Geffen UCLA School of Medicine, Los Angeles, California, USA
| | - Sepideh Amin-Hanjani
- Department of Neurosurgery, University Hospitals/Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Gregory J. Zipfel
- Department of Neurosurgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - William J. Mack
- Department of Neurological Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Michael Tennekoon
- Office of Training & Workforce Development, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA
| | - Stephen Korn
- Office of Training & Workforce Development, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA
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Samuel N, McQueen SA, Barnett RR, Everson MC, Fiala C, Lau R, Zadeh G. Parenting and Childbearing in Neurosurgical Residency: Perspectives from the United States and Canada. JOURNAL OF SURGICAL EDUCATION 2023; 80:572-580. [PMID: 36737307 DOI: 10.1016/j.jsurg.2023.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/27/2022] [Accepted: 01/15/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Despite growing interest in family planning alongside surgical training, significant barriers exist including time constraints, stigma, and lack of paid leave and formal policies. We currently lack a deep understanding of the challenges residents face and how practice cultures may prohibit successful policy enactment. OBJECTIVE To investigate residents' perspectives surrounding parenting and childbearing during neurosurgical residency in the United States and Canada. METHODS A cross-sectional, qualitative study methodology was used, including focus groups with neurosurgical residents. Purposive sampling was employed to capture a broad range of perspectives including stage of training, geographical location, and gender. Data collection and analysis occurred in parallel, using a thematic analysis approach. Data collection continued until no new themes relating to the research questions were identified. RESULTS Notable challenges included lack of formal family leave policies, time constraints, insufficient clinical human resources, physical health concerns, lack of lactation accommodations, and lack of mentorship. A subset of barriers were uncovered that stem specifically from workplace cultures, including gender norms, difficulty in asking for help, concerns for inconveniencing others, and pressures to time parental leave during research blocks. Several positive changes were identified including growing awareness and female representation, and benefits of the dual surgeon-parent identity. CONCLUSION While parenting during neurosurgery residency is becoming increasingly common, significant practical and cultural barriers persist including a marked absence of formal policies. Culture shifts are essential in ensuring opportunities for life outside of medicine for all residents, irrespective of family status.
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Affiliation(s)
- Nardin Samuel
- Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - Sydney A McQueen
- Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | | | - Megan C Everson
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota
| | - Clare Fiala
- Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ruth Lau
- Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - Gelareh Zadeh
- Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada.
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Sobel AD, Lavorgna TR, Ames SE, Templeton KJ, Mulcahey MK. Interpersonal Interactions and Biases in Orthopaedic Surgery Residency: Do Experiences Differ Based on Gender? Clin Orthop Relat Res 2023; 481:369-378. [PMID: 36668700 PMCID: PMC9831198 DOI: 10.1097/corr.0000000000002457] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 09/22/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Women residents are underrepresented in orthopaedic surgery. The causes of the deficit of women in orthopaedic surgery are multifactorial, but by identifying the perceptions of women in orthopaedic residency training and comparing them with the perceptions of men, we can improve our understanding of ways to enhance the recruitment of qualified and diverse candidates. QUESTIONS/PURPOSES (1) What differences exist in the perceived experiences of residents identifying as women and men regarding professional, social, and personal interactions during residency training? (2) Are there differences in the percentage of women and men residents who have experienced harassment or discrimination in preresidency interviews, and are there differences in the type of harassment or discrimination experienced? METHODS A survey was generated using Academy of Critical Care: Development, Evaluation, and Methodology guidelines. Two focus groups with seven attending orthopaedic surgeons who participate in the Collaborative Orthopaedic Education Research Group and who are experts on gender diversity in orthopaedics were held to improve survey validity. The survey included binary-response, Likert, and free-text questions on the perception of professional, social, and personal interactions held by the resident being surveyed. The questions focused on a respondent's perception of interactions with staff members, patients, resident colleagues, and attending surgeons, as well as sexual harassment. Program directors at 10 selected Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic residency programs that participate in the Collaborative Orthopaedic Education Research Group shared the survey with residents at their institutions. There were 95 programs in the Collaborative Orthopaedic Education Research Group at the time this survey was distributed. In this program, directors or other interested teaching faculty in orthopaedic residency programs voluntarily participate to discuss and develop quality research on resident and fellow education. These 95 programs account for 46% of the ACGME-accredited programs in the United States at the time the survey was created and distributed. The 10 residency programs had a total of 232 enrolled residents; 15% (34) identified as women. This gender distribution models the national sample of orthopaedic residents. Survey reliability was assessed by calculating the Cronbach alpha after determining the variance in each relevant (nondemographic) survey item. The final survey was found to have excellent internal reliability (alpha = 0.95). Responses from residents identifying as women and those identifying as men were compared using Fisher exact tests for all categorical data, and two-tailed independent t-tests were used for all continuous data. Differences in each survey category (professional interactions, social interactions, personal interactions, and sexual harassment in preresidency interview experiences) were calculated. RESULTS Women reported experiencing microaggressions (left undefined to the survey respondent, but generally considered to be subtle, stunning, often automatic, and nonverbal exchanges that are "put downs") at work more frequently than men did (40% [six of 15] versus 5% [four of 74]; p < 0.001). Specifically, women perceived being interrupted (53% [eight of 15] versus 5% [four of 75]); p < 0.001) by men colleagues, called by their first name (67% [10 of 15] versus 4% [3 of 72]; p < 0.001), and given administrative tasks (27% [four of 15] versus 1% [one of 75]; p = 0.004) more often than men. More women than men perceived that patients (33% [five of 15] versus 0 of 74 [0%]; p < 0.001) and hospital staff (27% [four of 15] versus 7% [five of 74]; p = 0.01) respected their opinion less than that of men. More women than men perceived that group humor negatively targeted their gender (47% [seven of 15] versus 1% [one of 75]; p < 0.001) and that criticism of their surgical skill was based on their gender rather than their ability (33% [five of 15] versus 5% [four of 78]; p = 0.005). In residency or subinternship interviews, 20% of women reported experiencing sexual harassment as defined by a listing of known types of harassment in the question stem, compared with 0% of men (p = 0.004). Women reported harassment in the form of verbal remarks of a sexual nature and obscene images in the workplace, whereas men did not report any form of harassment during interviews. CONCLUSION These findings suggest that the greatest discrepancies in the perceived experiences of women and men residents lie in professional interactions, and women residents are more likely to experience sexual harassment and disparaging humor than men residents. CLINICAL RELEVANCE Addressing these discrepancies, particularly in the professional setting, will help to create a more inclusive work environment and attract more women to orthopaedic surgery. Annual distribution of the survey used in this study by program directors to residents in their programs can help to identify discrepant perceptions that, coupled with the collection of objective data, can be targeted for improvement.
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Affiliation(s)
- Andrew D. Sobel
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Tessa R. Lavorgna
- Department of Orthopaedic Surgery, Tulane Medical Center, New Orleans, LA, USA
| | - S. Elizabeth Ames
- Department of Orthopaedics and Rehabilitation, the University of Vermont College of Medicine, Burlington, VT, USA
| | - Kimberly J. Templeton
- Department of Orthopaedic Surgery, the University of Kansas Medical Center, Kansas City, KS, USA
| | - Mary K. Mulcahey
- Department of Orthopaedic Surgery, Tulane Medical Center, New Orleans, LA, USA
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Feghali J, Antar A, Wicks EE, Sattari SA, Li S, Witham TF, Brem H, Huang J. Recruitment of women in neurosurgery: a 7-year quantitative analysis. J Neurosurg 2023; 138:251-260. [PMID: 35901758 DOI: 10.3171/2022.4.jns22410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/07/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The authors aimed to characterize which US medical schools have the most female neurosurgery residents and to identify potential associations between medical school characteristics and successful recruitment of women pursuing a neurosurgery career. METHODS The authors evaluated a total of 1572 residents in US neurosurgery programs accredited by the Accreditation Council for Graduate Medical Education as of February 2021, representing match cohorts from 2014 to 2020. The authors extracted US medical school characteristics and ranked schools based on the percentages of women graduates entering neurosurgery. They additionally studied yearly trends of the percentage of women constituting incoming neurosurgery resident cohorts as well as associations between female recruitment percentage and medical school characteristics using univariable and stepwise multivariable linear regression (including significant univariable factors). RESULTS The cohort consisted of 1255 male and 317 (20%) female residents. Yearly trends indicated a significant drop in incoming female residents in 2016, followed by significant increases in 2017 and 2019. On multivariable analysis, the following factors were associated with a higher average percentage of female graduates entering neurosurgery: total affiliated neurosurgery clinical faculty (β = 0.006, 95% CI 0.001-0.011, p = 0.01), allopathic versus osteopathic schools (β = 0.231, 95% CI 0.053-0.409, p = 0.01), and top 10 U.S. News & World Report ranking (β = 0.380, 95% CI 0.129-0.589, p < 0.01). When the number of female clinical faculty was added to the model, the variable was not statistically significant. Multivariable bibliometric analyses indicated a higher mean preresidency H-index for men, with an even greater gender difference identified in the 2021 H-index. CONCLUSIONS This study characterizes which medical schools are most successful at recruiting female students who constituted the total neurosurgery resident workforce of the 2020-2021 academic year. The overall number of clinical neurosurgery faculty rather than faculty gender was independently associated with female recruitment. Gender differences in research productivity persisted with control for confounders and increased between preresidency and 2021 time points. Such understanding of factors that influence the recruitment of women can help improve female representation in neurosurgery residency training moving forward.
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Affiliation(s)
- James Feghali
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Albert Antar
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Elizabeth E Wicks
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Shahab Aldin Sattari
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Sean Li
- 2Pratt School of Engineering, Duke University, Durham, North Carolina
| | - Timothy F Witham
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Henry Brem
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Judy Huang
- 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
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Vallejo FA, Schachner B, VanderVeer-Harris N, Torres AA, Weng J, Chang H, Bollo R, Ragheb J. A snapshot of contemporary leadership at pediatric neurosurgery fellowships. J Neurosurg Pediatr 2022; 30:532-537. [PMID: 36087318 DOI: 10.3171/2022.7.peds22133] [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: 04/13/2022] [Accepted: 07/25/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Many pathways to positions of leadership exist within pediatric neurological surgery. The authors sought to investigate common trends in leadership among pediatric neurosurgery fellowship directors (FDs) and describe how formalized pediatric neurosurgical training arrived at its current state. METHODS Fellowship programs were identified using the Accreditation Council for Pediatric Neurosurgery Fellowships website. Demographic, training, membership, and research information was collected via email, telephone, curricula vitae, and online searches. RESULTS The authors' survey was sent to all 35 identified FDs, and 21 responses were received. Response data were supplemented with curricula vitae and online data prior to analysis. FDs were predominantly male, self-identified predominantly as Caucasian, and had a mean age of 53 years. The mean duration from residency graduation until FD appointment was 13.4 years. The top training programs to produce future FDs were New York University and Washington University in St. Louis (residency) and Washington University in St. Louis (fellowship). CONCLUSIONS This study characterizes the current state of pediatric neurosurgery fellowship program leadership. The data serve as an important point of reference to compare with future leadership as well as contrast with neurosurgery and other surgical disciplines in general.
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Affiliation(s)
| | | | | | - Adrian A Torres
- 3Florida State University College of Medicine, Tallahassee, Florida
| | - John Weng
- 3Florida State University College of Medicine, Tallahassee, Florida
| | - Henry Chang
- 1University of Miami Miller School of Medicine, Miami
| | - Robert Bollo
- 4Division of Pediatric Neurosurgery, University of Utah, Salt Lake City, Utah
| | - John Ragheb
- 5Department of Neurosurgery, University of Miami Miller School of Medicine, Miami; and
- 6Division of Neurosurgery, Brain Institute, Nicklaus Children's Hospital, Miami, Florida
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Siddiqui N, Reddy VP, Rogers JL, Detchou DKE, Casubhoy I, Gopali R, Bhalla S, Janbahan M, Morris E, Peesapati MP, Agarwal N. Trends in Matriculation from Neurological Surgery Training Programs into Academic Versus Private Practice. World Neurosurg 2022; 165:e635-e642. [PMID: 35779756 DOI: 10.1016/j.wneu.2022.06.119] [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: 11/13/2021] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE A career in academic neurosurgery is an arduous endeavor. Specific factors influencing physician practice preferences remain unclear. This study analyzes data from the American Association of Neurological Surgeons membership identifying the impact of several demographic and educational characteristics influencing neurosurgical career choices centered on academia, private practice, or a combination in the United States. METHODS A list of all current neurosurgeons was obtained from the American Association of Neurological Surgeons membership, and information on physician characteristics was collected via internet searches and institutional databases. The practice type of all neurosurgeons considered in this study were categorized as follows: private practice, academic, or a combination of private practice and academic, termed privademic. These data were subsequently correlated to race, gender, current age, training at a top 40 National Institutes of Health-funded medical school or residency program, and current practice. RESULTS The median age of private practice and academic neurosurgeons was 58.18 and 53.61 years, respectively (P < 0.001). Age was significantly associated with practicing in an academic setting (odds ratio 0.96), with younger neurosurgeons pursuing careers in academia. Data indicated a positive and statistically significant contribution of female gender (P < 0.001) and training at a top-40 National Institutes of Health-funded institution to practicing in an academic setting (P < 0.01). CONCLUSIONS Neurosurgery as a field has grown significantly over the past century. The authors recommend that future efforts seek to diversify the neurosurgical workforce by considering practice setting, demographic characteristics, and educational background.
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Affiliation(s)
- Neha Siddiqui
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Vamsi P Reddy
- Department of Neurosurgery, UT Southwestern Medical Center, Dallas, Texas, USA
| | - James L Rogers
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Donald K E Detchou
- Department of Neurosurgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Imaima Casubhoy
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Rhea Gopali
- North Carolina State University, Raleigh, North Carolina, USA
| | - Subhang Bhalla
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Mika Janbahan
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Emily Morris
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Nitin Agarwal
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
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Wilson CM, Mackenzie ES, Yudien MA, Charles AJ, Tissot MIJ, Churchill SJ, Brown NJ, Shulkin JM, Detchou DKE, Reddy VP, Chambless LB. Letter to the Editor. Overcoming obstacles and breaking barriers for women in neurosurgery. J Neurosurg 2021; 136:935-936. [PMID: 34653976 DOI: 10.3171/2021.5.jns211269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Chidinma M Wilson
- 1Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Evalyn S Mackenzie
- 1Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Mikhal A Yudien
- 1Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | | | - Marianne I J Tissot
- 3Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Sydney J Churchill
- 3Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | | | - Jared M Shulkin
- 5Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Donald K E Detchou
- 6Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.,7Hospital of the University of Pennsylvania, Philadelphia, PA
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11
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Wilson CM, Brown NJ, Detchou DKE. Letters to the Editor. Black women in neurosurgery: a proposal for increased recruitment. Neurosurg Focus 2021; 51:E12. [PMID: 34598128 DOI: 10.3171/2021.6.focus21366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Chidinma M Wilson
- 1Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Donald K E Detchou
- 1Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,3Hospital of the University of Pennsylvania, Philadelphia, PA
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Wilson CM, Brown NJ, Detchou DKE. Letter to the Editor. USMLE examination and implications of a recent change. J Neurosurg 2021; 136:316-317. [PMID: 34560632 DOI: 10.3171/2021.5.jns211104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Chidinma M Wilson
- 1Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Donald K E Detchou
- 3Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,4Hospital of the University of Pennsylvania, Philadelphia, PA
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