Evaluating gender discrepancies in the time to successful match into a small animal surgery residency program

OBJECTIVE

To determine any association between gender and likelihood of first attempt match and overall time to match into an American College of Veterinary Surgery (ACVS)-registered small animal surgical residency program (SASRP).

STUDY DESIGN

Online survey.

SAMPLE POPULATION

A total of 100 (77 female, 23 male) ACVS small animal surgery residents or diplomates participating in a SASRP during the past 5 years.

METHODS

An online survey was sent to eligible individuals. Respondents anonymously provided information related to demographics, postgraduate internships, and qualifications at the time of each surgical residency application. First attempt and overall match success were evaluated by gender through univariable analysis and then via a multivariable model.

RESULTS

Men were 2.89 times more likely to match directly into a SASRP following a rotating internship than women (p = .041), and women completed more total internships than men prior to successful match into a SASRP (p = .030); however, men were found to have more publications at the time of first residency application (p < .001) or successful match (p = .018). Multivariable analysis revealed no association between gender on overall match success or first attempt match rate when considering all other qualifications.

CONCLUSION

No evidence for gender bias was found during the Veterinary Internship and Residency Matching Program (VIRMP) SASRP applicant selection process; however, gender specific patterns in research qualifications were identified.

IMPACT

Gender-blinded assessment is not considered necessary for the VIRMP small animal surgical resident selection process. Efforts should be made to educate applicants about the impact of research on the residency selection process and encourage research engagement of female students and graduates.

Gender differences in research collaborations and academic advancement among veterinary medical college faculty

OBJECTIVE

To examine patterns of collaborative research behavior by gender among veterinary academic faculty to determine whether differences exist in how men and women access resources as a contributing factor to the advancement gap.

SAMPLE

710 faculty from 23 veterinary medical colleges.

PROCEDURES

An online questionnaire was sent through listservs at participating institutions and data were collected anonymously. Responses related to professional demographics, resources, collaboration, and elements of environmental culture were analyzed to identify associations among variables. Proportional odds logistic regression was utilized to examine the effect of gender on academic rank.

RESULTS

Male and female faculty reported participating in collaborations at equal rates. Men were more likely to engage in research collaborations with other men. These collaborations were more common than collaborations between women or between women and men. Men had 47% higher odds of more advanced academic rank compared with women and controlling for relevant factors. While there was no difference in the value of startup packages listed by men and women, women were more likely to report gender as a disadvantage in accessing resources and opportunities.

CLINICAL RELEVANCE

Research productivity is a main factor driving academic promotion. To improve gender equity in career advancement and to support scholarship among all faculty, the creation of institutional development programs focused on facilitating collaborations and resource sharing may be a strategic area for veterinary academic leaders to consider.

Client perceptions improve with collaborative care when managing dogs with cancer: a Collaborative Care Coalition study

OBJECTIVE

Collaboration between primary care veterinarians (pcVets) and veterinary oncologists is common for dogs diagnosed with cancer, but no data exist that explore dog owner utilization and perceptions of collaborative care. The objectives were to describe dog owner perceptions of the value of collaborative veterinary cancer care and identify drivers of a positive collaborative care experience between the pcVet and oncologic specialists.

SAMPLE

890 US dog owners who had pets diagnosed with cancer in the past 3 years.

PROCEDURES

Online contextual survey. Data were analyzed using group comparisons and multiple regression analysis. Significance was set at P < .05.

RESULTS

76% of clients sought specialty care following cancer diagnosis in their dog. Seventy percent of owners across all income brackets indicated that referral to a specialist was a very good value based on money spent and outcomes. Delayed referral resulted in lower client satisfaction scores for pcVets. Top predictors of client satisfaction with pcVets were as follows: responsiveness to questions, staying involved with their dog's care, and willingness to work with other veterinarians and specialists. For specialists, top predictors were as follows: providing accurate cost estimates, cancer knowledge, and effectiveness of care. Client perceptions of pcVets were 6 times more likely to improve following referral to a specialist. All were significant predictors of owner advocacy (P < .0001).

CLINICAL RELEVANCE

Dog owners perceived early collaboration between pcVets and specialists favorably, fostering client satisfaction and positive perceptions of the value for service provided for dogs diagnosed with cancer.

Resident and intern salaries: can tracking our progress help us understand our future?

Salaries apportioned to veterinary interns and residents have been historically low. The impact of this financial strain on the lives and career choices of young veterinarians has recently been evaluated. Subsequent effects of low remuneration are not limited to simple personal finances; rather, the implications may be more far-reaching, including playing a role in mental and physical wellness, affecting diversity in various segments of the profession, influencing career paths, creating barriers to educational and professional opportunities, and shaping decisions regarding family. We evaluated progress made in salaries offered for positions listed in the Veterinary Internship and Residency Matching Program between the previous analysis in 2021 and at present for the 2023 match. In addition to considering financial improvements, we discuss potential drivers contributing to change, including recent documentation of living wage requirements relative to salaries, labor market forces, and the increasingly competitive salaries offered through other career paths. We also consider implications for increasing intern and resident compensation; besides well-being, diversity, career path, and family factors, we discuss the potential relationship of postgraduate educational programs to hospital revenues and implications for how educational program structure may be affected. While compensation is far from the only element that drives career selection or satisfaction, understanding the effects of a fiscal overhaul to this educational experience can play a critical role in solving components of the workforce issues in our profession.

The Influence of Messaging on Perceptions of Careers in Veterinary Medicine: Do Gender Stereotypes Matter?

The veterinary medical workforce is increasingly female; occupational feminization often transfers stereotypes associated with the predominant gender onto the profession. It is unknown whether within veterinary medicine a feminized public image is a possible contributor to the reduction in male applicants to training programs. The influence of stereotypically gendered messaging on how male and female undergraduate students perceive veterinary medicine was investigated in 482 undergraduate students enrolled in five introductory or second-level biology courses. Two short videos introducing the field of veterinary medicine were developed with imagery and language selected to emphasize either stereotypic feminine (communal) or masculine (agentic) aspects of the field. Participant groups were randomly assigned one of the two videos (feminine/communal or masculine/agentic) or no video (no exposure). An outcome survey elicited impressions of the field of veterinary medicine and gathered demographic data. There was a significant linear trend of condition on perception of the profession as feminine or masculine and on perception of the activities of a veterinarian as feminine/communal or masculine/agentic. Female participants were significantly more likely to agree that someone of their gender would be valued in the profession. Male participants reported significantly higher self-efficacy scores for performing the tasks of a veterinarian when they viewed the feminine stereotype video. These results demonstrate that gendered perceptions of the field can be manipulated. Intentional gendered messaging should be further explored as one strategy to broaden the talent pool in the workforce by attracting men back to the field.

Perception of gender discrimination among spine surgeons across Latin America: a web-based survey

BACKGROUND CONTEXT

Female physicians rarely choose spine surgery as their specialty. Although the specialty's nature and its associated lifestyle are potential barriers, gender-related issues may play an important part.

PURPOSE

To evaluate the gender discrimination among spine surgeons across Latin America.

STUDY DESIGN

Cross-sectional survey.

PATIENT SAMPLE

The participants in this study were 223 AO Spine Latin America (AOSLA) registered members who answered the web-based survey.

OUTCOME MEASURES

Personal and professional demographics; gender-related objective and subjective experiences regarding career and personal life.

METHODS

A survey link containing a 24-item questionnaire was sent to the members' e-mails in September 2019. The survey was designed to evaluate the perception of gender discrimination by spine surgeons during their academic and professional lives.

RESULTS

Out of 223 members who answered the survey, 196 (87.96%) were male and 27 (12.11%) female. Most were orthopedic surgeons (64.13%), ≥40 years of age (55.16%), and had <20 years of experience (69.95%). Gender discrimination was more frequent among women than among men (66.67% vs. 1.02%), as did discouragement from becoming a spine surgeon, orthopedic surgeon, or neurosurgeon (81.48% vs. 0.51%). Females reported higher rates of sexual harassment (44.44% vs. 7.65%) and more often felt disadvantaged because of gender (55.56% vs. 2.55%). Working harder than men to achieve the same prestige and lack of female mentorship were the most common obstacles reported by women (55.56%). Residency/fellowship influenced the decision to postpone/avoid having children for 66.67% of women but only 37.75% of men. Creation of a Women's Committee in AO Spine was supported by 74.07% of women and 38.78% of men.

CONCLUSIONS

Gender-based discrimination affects women more frequently than men in spine surgery. These experiences likely contribute to the low prevalence of female spine surgeons. Efforts to mitigate bias and support the professional development of women in neurosurgery, orthopedics and spine communities are encouraged.

Comparison of resident and intern salaries with the current living wage as a quantitative estimate of financial strain among postgraduate veterinary trainees

OBJECTIVE

To compare resident and intern salaries with current regional living wages as a quantitative estimate of financial strain.

SAMPLE

152 residency programs and 141 internship programs listed with the Veterinary Internship and Residency Matching Program for the 2021-2022 training year.

PROCEDURES

Data were collected for program annual salary and location. Regional living wage for each location was determined with the Massachusetts Institute of Technology Living Wage Calculator, and annual salary was compared with living wage to estimate income surplus before and after taxes. Results for programs in academia and private practice were compared. Spearman correlation was used to determine whether program annual salary was significantly associated with regional living wage.

RESULTS

Mean ± SD income surplus before taxes was $7,786 ± 9,426 for clinical residency programs, $16,672 ± 5,105 for laboratory animal programs, and $5,829 ± 8,119 for internships. Academic residencies and internships offered salaries significantly lower than those offered in private practice, and income surpluses before and after taxes were significantly lower for academic programs than for private practice programs. There were weak and moderate, respectively, correlations between program annual salary and regional living wage for residency (r = 0.369) and internship (r = 0.570) programs.

CLINICAL RELEVANCE

Postgraduate training prolongs financial instability, and annual salaries generally do not meet the minimum income standard of a living wage. Financial stress has implications for mental health and diversity, and these findings invite deeper consideration of current remuneration practices for veterinary residents and interns.

Impact of endotracheal tube size and cuff pressure on tracheal and laryngeal mucosa of adult horses

OBJECTIVE

To assess the effects of two sizes of silicone endotracheal tubes with internal diameter 26 mm (ETT₂₆) and 30 mm (ETT₃₀) inflated to minimum occlusive volume on tracheal and laryngeal mucosa of adult horses anesthetized for 2 hours with isoflurane.

STUDY DESIGN

Prospective, randomized, blinded, crossover experimental study.

ANIMALS

A total of eight healthy adult mares.

METHODS

Upper airway endoscopy and ultrasound measurements of internal tracheal diameter were performed the day before anesthesia. Horses were anesthetized and orotracheally intubated with ETT₂₆ or ETT₃₀. Ease of intubation was scored. The cuff was inflated in 10 mL increments to produce a seal. Final volume of air used and intracuff (IC) pressure (measured by pressure transducer) were recorded. At the end of anesthesia, a manometer was used to measure IC pressure and these measurements compared against measurements from the pressure transducer. Laryngeal and tracheal mucosa were assessed via endoscopy and assigned a score 0-3 before anesthesia, and at 2 and 24 hours following extubation.

RESULTS

Data are from seven horses because one horse with laryngeal hemiplegia was excluded. Mean tracheal ultrasound measurement was 3.5 ± 0.4 cm. No significant differences were noted between endotracheal tube sizes for intubation score, IC pressures, inflation volumes or tracheal or laryngeal injury scores at any time point. IC pressure measured by manometer was slightly higher than that by transducer (+1.0 ± 2.8 mmHg).

CONCLUSIONS AND CLINICAL RELEVANCE

Results identified no clear advantage of one endotracheal tube size over the other in the population of horses studied, when endotracheal intubation is properly applied and IC pressure is carefully monitored. However, given that ETT₂₆ was associated with the highest observed IC pressures and the only observed incidents of tracheal circumferential erythema, the larger ETT₃₀ may be the better choice in most cases where tracheal size is sufficient.

Occupational segregation by gender in veterinary specialties: Who we are choosing, or who is choosing us

OBJECTIVE

Gender demographics vary across specialties including surgery, internal medicine, cardiology, neurology, and oncology. Our objective was to determine whether residency selection or the decision to apply for training drives these differences.

STUDY DESIGN

Retrospective cohort study.

SAMPLE POPULATION

Matched and unmatched residents lists from Veterinary Internship and Residency Matching Program (VIRMP) from 2011 to 2020. Comparative Data Reports from the American Association of Veterinary Medical Colleges from 2010 to 2019.

METHODS

Names for matched and unmatched residents with addresses in the United States or Canada were coded for gender for seven programs: large and small animal surgery, large and small animal medicine, cardiology, neurology, and oncology. Match rate by gender was compared using chi-square tests. Gender demographics of applicants were compared to demographics of graduates using tests of two proportions.

RESULTS

No differences were observed between genders for the likelihood of successfully matching into each residency program evaluated except in large animal internal medicine. Women (44.2%) were slightly more likely to match, overall, than men (39.0%, p = .003). The proportions of women applying for residencies overall (70.7%), in large and small animal surgery (66.1%, 62.2%), cardiology (70.2%), and neurology (70.7%) were lower than the proportion of female graduates (79%; p's < .001).

CONCLUSION

No evidence for gender bias was detected in the VIRMP resident selection process. Female veterinary graduates seemed less likely to apply for residencies than their male counterparts.

IMPACT

Occupational segregation seems to stem from the decision to apply for residency. Interventions aimed at altering gender demographics in specialized medicine should target potential applicants.

Work, life, and the gender effect: Perspectives of ACVIM Diplomates in 2017. Part 2-The intersection of personal life and professional career

BACKGROUND

In the field of veterinary surgery, women neither marry nor have children at the same rate as men, and those who do may experience more career disruption as a result. The American College of Veterinary Internal Medicine (ACVIM) is 1 of the few areas of specialized medicine that is predominantly female; it is unknown if such a demographic shift would produce a different environment for individuals cultivating their personal life.

HYPOTHESIS/OBJECTIVES

To report data regarding subjective and objective aspects of the intersection of the personal and professional lives of Diplomates of the ACVIM.

SAMPLE

Eight hundred ninety-six surveys (781 completed) of ACVIM Diplomates, including cardiology, large and small animal internal medicine, neurology, and oncology.

METHODS

An 82-item online survey was distributed to ACVIM Diplomates via Diplomate college listservs. Participation was voluntary.

RESULTS

Men were more likely to be married and have children than were women. Women had or adopted their first child at a later career stage compared with men, and agreed more strongly that career stage was an influential factor in family planning. Those with children worked fewer hours compared with those without, and this effect was greater among women. Women were more likely to require external childcare, but most men and women shared childcare responsibilities equally outside of working hours.

CONCLUSIONS AND CLINICAL IMPORTANCE

The intersection of personal and professional life differs between men and women in the ACVIM, which may create different needs, preferences, or barriers to work-life balance in the workforce.

Work, life, and the gender effect: Perspectives of ACVIM Diplomates in 2017. Part 1-Specialty demographics and measures of professional achievement

BACKGROUND

Barriers to achieving work-life balance, as well as gender-based differences, exist in the male-dominated surgical specialty in veterinary medicine. Similar information does not exist for the more feminized American College of Veterinary Internal Medicine (ACVIM).

HYPOTHESIS/OBJECTIVES

To provide data on the professional and personal lives of Diplomates of the ACVIM so as to help define the state of the specialty, including gender-related differences, and identify areas requiring intervention to improve work-life balance.

SAMPLE

A total of 896 surveys (781 completed) of Diplomates of the ACVIM, including cardiology, large animal internal medicine, neurology, oncology, and small animal internal medicine.

METHODS

An 82-item online survey was distributed in February 2017 to ACVIM Diplomates via their respective ACVIM listserv. Participation was voluntary.

RESULTS

Thirty percent of the total ACVIM registered membership responded and 26% completed surveys; 25% were men and 75% were women. Specialists in academia worked significantly more hours, with larger numbers of diplomates per specialty section, and made less money compared with those in private practice. Women were less likely to report full-time employment, practice ownership, or higher academic rank, and reported 20% lower income overall (after adjustment for relevant factors) as compared with men. Men and women differed in their subjective assessment of the effect of gender in the workplace. Eighty-three percent of respondents were somewhat satisfied or better with their career.

CONCLUSIONS AND CLINICAL IMPORTANCE

Specialization in the ACVIM is a satisfying and potentially profitable career. However, despite a highly feminized workforce, significant gender-related imbalances are evident.

Demographics, measures of professional achievement, and gender differences for diplomates of the American College of Veterinary Surgeons in 2015

OBJECTIVE

To characterize elements of employment, professional success, and personal life for American College of Veterinary Surgeons (ACVS) diplomates and identify elements of practice that may serve as barriers to work-life balance or affect men and women differently.

SAMPLE

836 ACVS diplomates.

PROCEDURES

An 81-item questionnaire was sent to 1,450 ACVS diplomates in 2015 via email and conducted by means of an online platform. Responses were analyzed to identify associations among selected variables.

RESULTS

The survey response rate was 58% (836/1,450). The median age category among respondents was 41 to 45 years. The ratio of male to female diplomates was equivalent among those < 40 years old. Respondents in small animal private practice worked the fewest number of hours; those in equine or large animal private practice worked the most and had the most on-call responsibility. Women were more likely than men to be employed in academia. In both private practice and academia, respondents in small animal practice earned more than did those in equine or large animal practice, and women earned less than did men, even after adjustment for relevant covariates. Women were less likely than men to be practice owners or to hold a prestigious academic title and rank. Perceptions about the effect of gender in the workplace differed between men and women.

CONCLUSIONS AND CLINICAL RELEVANCE

Findings suggested that the veterinary surgical profession is demanding for both genders, although increased flexibility in certain areas may improve work-life balance.

Gender differences in academic rank among faculty surgeons at US veterinary schools in 2019

OBJECTIVE

To describe academic rank, gender, surgical career length, and publication record of academic veterinary surgeons and to estimate the association between gender and higher academic rank.

STUDY DESIGN

Cross-sectional study.

SAMPLE

Residency-trained surgeons at US veterinary schools in 2019.

METHODS

Surgeons were identified via institutional websites. Data including surgeon gender, academic title, and year of board certification were collected from public resources. Publication record was measured by using author h-indices obtained from Scopus. Data were analyzed with descriptive and inferential statistics.

RESULTS

Three hundred eighteen surgeons were identified from 30 institutions, including 162 (51%) women and 156 (49%) men. Women represented 66% of instructors and assistant professors, and men represented 60% of associate and full professors. This distribution differed significantly (P < .001). Author h-index was associated with career length but not gender. Men were 2.5 times more likely than women to be associate or full professors (odds ratio 2.52, 95% CI 1.03-6.14, P = .042) after adjustment for career length and h-index.

CONCLUSION

Female surgery faculty at US veterinary schools in 2019 were concentrated in lower academic ranks and were less likely than male surgery faculty to be associate or full professors after adjustment for career length and publication record.

IMPACT

A gender gap exists in academic veterinary surgery in the United States. It is critical to recognize that women's increasing participation in veterinary medicine has not been matched by equal representation in all areas. Additional efforts are warranted to identify contributing factors and implement strategies to improve gender inclusion.

The intersection of personal and professional lives for male and female diplomates of the American College of Veterinary Surgeons in 2015

OBJECTIVE

To characterize objective and subjective elements of the personal lives of American College of Veterinary Surgeons (ACVS) diplomates and identify elements of personal life associated with professional life or career success.

SAMPLE

836 ACVS diplomates.

PROCEDURES

An 81-item questionnaire was sent to 1,450 diplomates in 2015 via email and conducted by means of an online platform. Responses were analyzed to summarize trends and identify associations among selected variables.

RESULTS

Men were more likely than women to be married or in a domestic partnership (88% vs 68%, respectively) and to have children (77% vs 47%). Among women but not men, respondents in large animal practice were less likely than were those in small animal practice to be represented in these categories. Women had children later in their career than did men and indicated that their stage of training played an important role in family planning. Respondents with children worked significantly fewer hours than did those without children, with a greater reduction in hours for women versus men (6.0 vs 3.1 hours, respectively). Women were more likely to require external childcare services than were men. Women were more likely to report that having children had negatively impacted their professional lives. No negative associations between measures of professional success (eg, advancement or personal income) and parenthood were identified.

CONCLUSIONS AND CLINICAL RELEVANCE

Family demographics differed between male and female ACVS diplomates, yet no objective impact on career success was identified. Work-life balance may play an important role in recruitment, retention, and job satisfaction of veterinary surgeons.

In vitro biomechanical evaluation of four surgical techniques for fusion of equine centrodistal and tarsometatarsal joints

OBJECTIVE To evaluate the biomechanical properties of 4 methods for fusion of the centrodistal and tarsometatarsal joints in horses and compare them among each other and with control tarsi. SAMPLE 24 sets of paired tarsi without substantial signs of osteoarthritis harvested from equine cadavers. PROCEDURES Test constructs (n = 6/type) were prepared from 1 tarsus from each pair to represent surgical drilling; 2 medially to laterally placed kerf-cut cylinders (MLKCs); a single large, dorsally applied kerf-cut cylinder (DKC); and a dorsomedially applied locking compression plate (DMLCP). Constructs and their contralateral control tarsi were evaluated in 4-point bending in the dorsoplantar, lateromedial, and mediolateral directions; internal and external rotation; and axial compression. Bending, torsional, and axial stiffness values were calculated. RESULTS Mean stiffness values were consistently lower for surgical drilling constructs than for contralateral control tarsi. Over all biomechanical testing, surgical drilling significantly reduced joint stability. The MLKC constructs had superior biomechanical properties to those of control tarsi for 4-point bending but inferior properties for external and internal rotation. The DMLCP and DKC constructs were superior to control tarsi in dorsoplantar, rotational, and axial compression directions only; DMLCP constructs had no superior stiffness in lateromedial or mediolateral directions. Only the DKC constructs had greater stiffness in the mediolateral direction than did control tarsi. Over all biomechanical testing, DMLCP and DKC constructs were superior to the other constructs. CONCLUSIONS AND CLINICAL RELEVANCE These biomechanical results suggested that a surgical drilling approach to joint fusion may reduce tarsal stability in horses without clinical osteoarthritis, compared with stability with no intervention, whereas the DMLCP and DKC approaches may significantly enhance stability.

Laser vaporization of the dorsal turbinate as an alternative method of accessing and evaluating the paranasal sinuses

OBJECTIVE

To report a technique for stoma creation into the conchofrontal sinus (CFS) through the dorsal turbinate and to evaluate stoma as a site for sinoscopy.

STUDY DESIGN

Prospective experimental study.

ANIMALS

Cadaveric equine heads (n=2) and normal adult horses (5).

METHODS

Technique feasibility was established on 2 cadaver heads. A diode laser fiber with a contact probe was passed into the nasal passage through a custom built, laser introducer rod (LIR). A videoendoscope was passed ventral to the LIR. A site on the caudal, medial aspect of the turbinate overlying the dorsal conchal sinus (DCS) was identified. A stoma to facilitate endoscope passage was created through the turbinate and sinoscopy performed to identify structures within the CFS and caudal maxillary sinus (CMS) and to evaluate the quality of the approach. The procedure was then performed in standing, sedated horses. Time required, laser energy used and complications were recorded. Endoscopy was performed ≥5 weeks postoperatively to assess stoma size and long-term effects of the procedure.

RESULTS

A stoma was successfully created through the turbinate in both cadaveric skulls and in 4 horses; the stoma persisted for ≥5 weeks. The location of the stoma in 1 horse precluded sinoscopy.

CONCLUSIONS

Laser vaporization of the dorsal turbinate through the nasal passage creates a stoma that lasts for at least 5 weeks providing a portal to the paranasal sinuses. Based on experience in 1 horse stoma location is critical to ensure adequate endoscope manipulation and sinoscopy.

CLINICAL RELEVANCE

Standing endoscopic sinusotomy within the nasal cavity through the DCS is an alternative to more invasive sinusotomy techniques with fewer potential complications and a cosmetic result.