LinkedIn Usage Trends Among Surgeons at a Large Academic Institute

INTRODUCTION

Social networking platforms have evolved into a self-promotional space. The LinkedIn platform allows users to share knowledge, research accomplishments, and network in an academic setting. Our objective was to determine LinkedIn usage trends among surgeons at a large academic institution.

METHODS

A list of surgeons within the department of surgery at a large academic institute was compiled. All publicly available profiles were analyzed for their LinkedIn activity and followership. Active accounts were defined as users who have posted or interacted with any posts within the last year. Comparisons of LinkedIn usage grouped by gender, surgery division, and rank were analyzed.

RESULTS

A total of 133 surgeons were included. Among these surgeons, 88 had a LinkedIn profile (66.2%); however, only 43 surgeons had active usage on this platform (32.3%). The median number of followers among surgeons with a profile was 110 (IQR [24-427]). Male surgeons had a higher median of followers (167 IQR [38-502]) compared to female (54 IQR [21-209]). A greater percentage of male surgeons had a profile compared to female surgeons (68.5% M versus 61.0% F, P = 0.12). The transplant surgery division had the highest percentage of LinkedIn accounts (90.9%) followed by surgical oncology (87.5%). However, active usage was led by the pediatric surgery division (80.0%), followed by the plastic surgery division (71.4%). Instructors, assistant professors, associate professors, and professors all had LinkedIn accounts; however, instructors were the least active users with 33.3% being active on their LinkedIn. The lowest percentage of those with LinkedIn accounts were instructors (50%). Professors were found to be the most active users at 57.1%.

CONCLUSIONS

Social media use is on the rise in academic surgery. Within a department of surgery at a large academic institution, only 32.3% were active users of LinkedIn, suggesting that there is room for improvement in utilizing this resource as a tool for mentorship, professional development, and networking.

Barriers to Academic Surgery in the US Armed Forces: A Study of the AAS Military Committee

INTRODUCTION

The purpose of this study is to explore current perceptions within the military surgery community to stratify key obstacles to pursuing a career in academic surgery and identify opportunities for mitigation.

METHODS

After receiving institutional review board approval, an anonymous electronic survey was distributed to military surgeons across all branches. Survey response data were collected and analyzed using chi-square test.

RESULTS

The response rate was approximately 22%. Of those who responded to the survey, most are interested in an academic career (61.5%); however, 64% believe this to be much more difficult as a military surgeon than as a civilian surgeon. The top three perceived obstacles include administrative obstacles (76.4%), operational commitments (65.8%), and lack of funding for academic pursuits (62.7%). Most respondents indicated that they have never received formal education regarding how to apply for research funding (84.5%) and most do not have a research mentor (60.9%). Additionally, 42.9% state that obstacles to an academic career in surgery impact their decision to leave the military. Younger surgeons were more likely to leave the military upon completion of their service commitment (67.9% versus 46.4% aged 20-39 y, P = 0.02).

CONCLUSIONS

We characterized the perceived challenges to academic surgery within the military. These barriers between academic surgery and military service risk medical force attrition, particularly in future generations of surgeons. Dedicated faculty billets (positions) with limited operational demands as well as associated mentorship and research funding may enhance the retention and productivity of military surgeons.

Impact of Clinical Anatomy Peer Mentorship Program on Student Leaders: A Mixed-Methods Study

INTRODUCTION

Clinical Anatomy Mentorship Program (CAMP) was developed as a student-led approach to providing hands-on surgical experience and mentorship to third-year medical students during their surgery clerkship at an academic institution. Fourth-year medical students were selected to lead these educational events, teaching underclassmen surgical curriculum and skills in a near-peer method of clinical teaching.

METHODS

A focus group and survey were administered to the fourth-year medical students who served as CAMP leaders from fall 2021 to spring 2022 to assess how their leadership role impacted their personal and professional development.

RESULTS

A 10-question survey was administered to 19 students, with 14 responding, for a response rate of 74%. Serving as a mentor facilitated the development of students' professional interests, including increased interest in future teaching roles (93%) and leadership positions (86%), particularly as surgical clerkship director (70%) and program director (90%). All students reported that their involvement in CAMP increased their confidence in teaching and surgical knowledge, and 86% reported improved surgical skills. A subset analysis of seven CAMP leaders via the focus group demonstrated several reported benefits to serving as a peer mentor in CAMP, including increased interaction with peers, improved sense of comradery and support, more authentic peer-mentorship connections, and increased confidence and perceived preparedness for surgical residency.

CONCLUSIONS

The confidence, leadership, and improved surgical knowledge and skills obtained through the CAMP leadership role led to improved personal and professional development of student leaders.

Unconscious bias in speaker introductions at a national vascular surgery meeting: The impact of rank, race and gender

OBJECTIVES

Unconscious bias can impact manner of speaker introductions in formal academic settings. We examined speaker introductions at the Society of Vascular Surgeons Annual Meeting to determine factors associated with non-professional address.

METHODS

We examined speaker introductions from the 2019 SVS Vascular Annual Meeting. Professional title with either full name or last name was considered professional address. Speaker and moderator demographics were collected. Univariate and multivariate logistic regression analyses were performed to identify associations between introduction and speaker and moderator characteristics.

RESULTS

336 talks met inclusion criteria. Both speakers and moderators were more likely to be white (63.4 ​% and 65.8 ​%,p ​= ​0.92), man (75.6 ​% and 74.4 ​%,p ​= ​0.82) and full professor rank (34.5 ​% and 42.3 ​%, p ​< ​0.001). On multivariable regression, non-professional address was associated with speaker rank of trainee (OR 3.13, p ​= ​0.05) and when moderator was white (OR 2.42, p ​= ​0.03).

CONCLUSIONS

This study emphasizes the potential negative impact of unconscious bias at a national meeting for vascular surgeons and the need to mitigate this effect at the organization level.

The Gender Gap in Promotions: Inhibitors and Catalysts, Strategies to Close the Gap

The gender gap is an amalgam of gender disparity issues in the workplace ranging from fewer opportunities to network, decreased funding for research, microaggressions, nebulous promotional criteria and difficulty achieving the perception of professionalism because of inherent gender bias. Contributing home factors include more substantial household duties for women typically, spouses who also have a career, and the inherent delay associated with maternity leave for those who choose to have children. This article subdivides gender disparity that impedes promotion into experiences inside and outside the workplace. Disparities within the workplace are divided into directly quantified versus qualitative differences.

Undeserved authorship in surgical research: an underestimated bias with potential side effects on academic careers

The incidence of courtesy authorship in research over time has probably increased due to the enormous pressure to publish to increase the bibliometric indexes necessary to achieve an academic role. The aim of this survey was to quantify and characterize this research malpractice among a very selected group of surgeons from different surgical specialties belonging to the European Association of Surgery (ESA). E-mail addresses for the invitation to take part to the survey were collected by the Twenty-eighth Annual Meeting final program. Five-item were designed and developed by the authors using an online platform. Eighty-six members from 21 countries completed the survey (female/male ratio: 0.09). In the last 10 years, almost half of the responders (41, 47.7%, 37 academics) have included colleagues for courtesy authorship. The most common reason of courtesy authorships was to support the academic career of another researcher (62.5%). Other reasons were fear of retaliation (12.5%), reciprocal authorship (12.5%) or support for a partner (10%). This survey showed that undeserved authorship is sadly confirmed to be a common research misconduct across any countries and medical specialties, even among a very selected group of surgeons with international reputation irrespective of the academic position.

Attributions and perpetrators of incivility in academic surgery

Purpose

Although incivility has been described in other specialties, little is known about the attributes and perpetrators of it in academic surgery. The goal of this study was to identify attributes and commonly associated perpetrators of incivility experienced by trainees and faculty at academic surgery programs in the U.S.

Methods

A web-based survey including the Workplace Incivility Scale (WIS) and questions regarding attributions and perpetrators of incivility was sent to trainees and faculty at academic institutions across the U.S. In addition to descriptive statistics, multivariable regression models were built to determine the impact of perpetrator type and number on overall incivility scores.

Results

We received 367 of 2,661 (13.8%) responses. Top three reasons for incivility were surgery hierarchy (50.1%), respondent's gender (33.8%) and intergenerational differences (28.1%). Faculty (58.6%), patients (36.8%), and nursing staff (31.9%) were the most reported parties responsible for incivility. Female surgeons reported experiencing incivility more frequently from all three top responsible parties (i.e., faculty, patients, and nurses) when compared to other gender identities. Additionally, those who reported faculty (β = 0.61, 95%CI 0.39-0.82) or nurses (β = 0.23, 95%CI 0.009-0.45) as perpetrators of incivility reported an increase in overall incivility scores.

Conclusions

Incivility in surgery is frequently attributed to surgery hierarchy, gender, and intergenerational differences. Surgical trainees and faculty reported that faculty, patients, and nurses were the most commonly identified as responsible for uncivil events in the surgical workforce. Exposure to a greater variety of perpetrators of incivility increases overall levels of incivility, emphasizing the importance of eliminating incivility from all sources.

Supplementary Information

The online version contains supplementary material available at 10.1007/s44186-023-00129-1.

Dispersion of NIH Funding to Departments of Surgery is Contracting

INTRODUCTION

NIH funding to departments of surgery reported as benchmark Blue Ridge Institute for Medical Research (BRIMR) rankings are unclear.

METHODS

We analyzed inflation-adjusted BRIMR-reported NIH funding to departments of surgery and medicine between 2011 and 2021.

RESULTS

NIH funding to departments of surgery and medicine both increased 40% from 2011 to 2021 ($325 million to $454 million; $3.8 billion to $5.3 billion, P < 0.001 for both). The number of BRIMR-ranked departments of surgery decreased 14% during this period while departments of medicine increased 5% (88 to 76 versus 111 to 116; P < 0.001). There was a greater increase in the total number of medicine PIs versus surgery PIs during this period (4377 to 5224 versus 557 to 649; P < 0.001). These trends translated to further concentration of NIH-funded PIs in medicine versus surgery departments (45 PIs/program versus 8.5 PIs/program; P < 0.001). NIH funding and PIs/program in 2021 were respectively 32 and 20 times greater for the top versus lowest 15 BRIMR-ranked surgery departments ($244 million versus $7.5 million [P < 0.01]; 20.5 versus 1.3 [P < 0.001]). Twelve (80%) of the top 15 surgery departments maintained this ranking over the 10-year study period.

CONCLUSIONS

Although NIH funding to departments of surgery and medicine is growing at a similar rate, departments of medicine and top-funded surgery departments have greater funding and concentration of PIs/program versus surgery departments overall and lowest-funded surgery departments. Strategies used by top-performing departments to obtain and maintain funding may assist less well-funded departments in obtaining extramural research funding, thus broadening the access of surgeon-scientists to perform NIH-supported research.

Participant perspectives on a department of surgery faculty mentoring program

BACKGROUND

Mentorship in academic medicine serves to promote career advancement and job satisfaction. This study was to evaluate the initial results of a faculty mentorship program in an academic Department of Surgery.

METHODS

A faculty mentorship program was initiated in July 2015 with 63 participants. Junior faculty mentees (n = 35) were assigned senior faculty mentors (n = 28). After three years, an electronic survey was administered and the results analyzed.

RESULTS

Response rate was 67% (n = 42). 34 (81%) respondents had met with their mentor/mentee at least once. Topics discussed included: research (76%), leadership (52%), work-life balance (45%), and promotion (5%). Mentees endorsed achieving promotion (n = 2), increasing research productivity (n = 2), and obtaining national committee positions (n = 2). 61% of mentors and 53% of mentees felt they benefitted personally from the program. Actionable improvements to the mentorship program were identified including more thoughtful pairing of mentors and mentees with similar research interests.

CONCLUSIONS

Participants felt the mentorship program was beneficial. Further investigation regarding the optimization of the mentor-mentee pairing is warranted to maximize the benefits from structured mentorship in academic surgery.

Canadian Pediatric Surgeon Workforce: Characterization of Training, Trends Over Time, and 10-year Model for Pediatric Surgery Need

BACKGROUND

Graduate and fellowship training trends for Canadian pediatric surgeons remain uncharacterized. Similarly, updated workforce planning for pediatric surgeons is required. We aimed to characterize graduate degree and fellowship trends for Canadian pediatric surgeons, with modelling to inform workforce planning.

METHODS

We performed a cross sectional observational study evaluating Canadian pediatric surgeons in January 2022. Surgeon demographics collected included year of medical degree (MD) conferment, MD location, fellowship location, and graduate degree achievement. Our primary outcome was to evaluate training characteristics over time. Secondary outcomes evaluated surgeon supply and demand from 2021 to 2031. Supply was extrapolated from current Canadian pediatric surgery fellows assuming static fellowship matriculation, while retirement was estimated using a 31-, 36-, or 41-year career following MD conferral.

RESULTS

Of included surgeons (n = 77), 64 (83%) completed fellowship training in Canada and 46 (60%) have graduate degrees. No surgeons graduating ≤1980 hold graduate degrees, compared to 8 (100%) surgeons with MD ≥ 2011 (p < 0.001). Similarly, more surgeons with MD ≥ 2011 appear to have a Canadian MD (n = 7, 87.5%) and Canadian fellowship (n = 8, 100%). Modelling predicts that 19-49 (25%-64%) surgeons will retire between 2021 and 2031, while 37 fellows will graduate with intention to work in Canada, creating between a 12 surgeon deficit up to an 18 surgeon surplus depending on career length.

CONCLUSIONS

Trends in graduate degree achievement and fellowship location suggest increasing competition for Canadian pediatric surgery positions. Additionally, a substantial number of Canadian-trained fellows will need positions outside of Canada in the next decade. Overall, results support previous work demonstrating saturation of the Canadian pediatric workforce.

LEVEL OF EVIDENCE

Level IV.

ACGME COMPETENCY ADDRESSED

Medical Knowledge.

Microaggressions and Implicit Bias in Hand Surgery

Implicit bias and microaggressions are well-known phenomenon and have recently been acknowledged as contributing to health care disparities. Within Hand Surgery, implicit bias and microaggressions occur in patient-surgeon, surgeon-peer, surgeon-staff, and training environment interactions. Although racial and gender biases are well studied, biases can also be based on age, sexual orientation, socioeconomic background, and/or hierarchal rank. Academia has well-documented evidence of implicit bias and microaggressions, contributing to current disparate demographics of trainees, physicians, and leaders within Hand Surgery. Awareness is fundamental to combating bias and microaggressions; however, actions must be taken to minimize negative effects and change culture.

Gender trends in applicants to general surgery residency programs in Canada

BACKGROUND

Surgical disciplines lag behind non-surgical disciplines in attracting female trainees. Female representation of Canadian General Surgeons has not been evaluated in recent years in the literature. The objectives of this study were to assess gender trends in applicants to Canadian General Surgery residency programs and practicing general surgeons and subspecialists.

METHODS

This retrospective cross-sectional study analyzed gender data for residency applicants ranking General Surgery as their first-choice discipline from publicly-available annual Canadian Residency Matching Service (CaRMS) R-1 match reports from 1998 to 2021. Aggregate gender data for practicing female physicians in General Surgery and related subspecialties, including Pediatric Surgery, obtained from annual Canadian Medical Association (CMA) census from 2000 to 2019 was also analysed.

RESULTS

There was a significant increase in the proportion of female applicants from 34% in 1998 to 67% in 2021 (p < 0.001) and of successfully matched candidates from 39% to 68% (p = 0.002) from 1998 to 2021. Success rates between male and female candidates were significantly different in 1998 (p < 0.001), but not in 2021 (p = 0.29). The proportion of practicing female General Surgeons also significantly increased from 10.1% in 2000 to 27.9% in 2019 (p = 0.0013), with variable trends in subspecialties.

CONCLUSION

Gender inequality in General Surgery residency matches has normalized since 1998. Despite females representing more than 40% of applicants and successfully matched candidates to General Surgery since 2008, a gender gap still exists amongst practicing General Surgeons and subspecialists. This suggests the need for further cultural and systemic change to mitigate gender disparities.

TYPE OF STUDY

Original research article, clinical research.

LEVEL OF EVIDENCE

Level III (Retrospective cross-sectional study).

A Clinician's Guide to Conducting Research on Causal Effects

Surgeons are uniquely poised to conduct research to improve patient care, yet a gap often exists between the clinician's desire to guide patient care with causal evidence and having adequate training necessary to produce causal evidence. This guide aims to address this gap by providing clinically relevant examples to illustrate necessary assumptions required for clinical research to produce causal estimates.

The 2020 Pandemics: Lessons Learned in Academic Surgery and Beyond

2020 was a significant year because of the occurrence of two simultaneous public health crises: the coronavirus pandemic and the public health crisis of racism brought into the spotlight by the murder of George Floyd. The coronavirus pandemic has affected all aspects of health care, particularly the delivery of surgical care, surgical education, and academic productivity. The concomitant public health crisis of racism and health inequality during the viral pandemic highlighted opportunities for action to address gaps in surgical care and the delivery of public health services. At the 2021 Academic Surgical Congress Hot Topics session on flexibility and leadership, we also explored how our military surgeon colleagues can provide guidance in leadership during times of crisis. The following is a summary of the issues discussed during the session and reflections on the important lessons learned in academic surgery over the past year.

Proceedings From the Advances in Surgery Channel Diversity, Equity, and Inclusion Series: Lessons Learned From Asian Academic Surgeons

In this series of talks and the accompanying panel session, leaders from the Society of Asian Academic Surgeons discuss issues faced by Asian Americans and the importance of the role of mentors and allyship in professional development in the advancement of Asian Americans in leadership roles. Barriers, including the model minority myth, are addressed. The heterogeneity of the Asian American population and disparities in healthcare and in research, specifically as relates to Asian Americans, also are examined.

Gender Disparities in Academic Productivity and Promotion Among Endocrine Surgery Faculty

INTRODUCTION

Academic rank and metrics such as total publications (pubs) and H-index are indicators to measure academic achievement. This study aims to determine whether there are gender differences in academic productivity or faculty appointments among endocrine surgeons in the United States.

METHODS

A database was generated from the American Association of Endocrine Surgeons (AAES) website. Community or academic practice was designated by institution affiliation and faculty appointment. Academic metrics, including pubs, H-index, and weighted-RCR (relative citation ratio), were obtained from public databases.

RESULTS

A total of 258 AAES members were affiliated with an academic institution. The majority were men (58%). Overall, men in endocrine surgery had higher academic metrics: pubs (56.0 [26-134], 23.0 [11-56], P < 0.0001), H-index (19.0 [11-35], 9.0 [5-21], P < 0.0001), weighted-RCR (63.5 [22-193], 24.1 [8-74], P < 0.005) and rank (associate professor or professor, P < 0.0001). Subgroup analysis accounting for time in practice found no difference in total publications, weighted RCR, or faculty appointments between genders in practice for 0-5 y. However, among surgeons in practice for 6-10 y, men had higher academic metrics (pubs: 31.0 [16-79], 18.5 [9-33]; RCR: 46.0 [14-102], 13.3 [9-34]) and faculty appointments (all P < 0.05).

CONCLUSIONS

There are gender disparities in academic productivity and faculty appointment among US endocrine surgeons. While junior faculty show no gender differences in most indicators of academic productivity or rank, men with 6-10 y in practice have higher average academic metrics and rank. Whether the absence of gender disparities among junior faculty is a sustainable reflection of recent efforts to encourage equal mentorship and professional opportunities or whether disparities will manifest as faculty progress remains to be determined.

Gender Distribution of First and Senior Authorship Across Most Cited Studies Within the Top Ten Surgical Journals From 2015-2020: Cementing Women Academic Surgery Representation

INTRODUCTION

The aim of this study is to investigate the gender distribution of first and senior authors in the most highly cited original research studies published in the top 10 surgical journals from 2015 to 2020 to identify disparities and changes over time.

METHODS

A retrospective study analyzing the gender distribution of first and senior authors in the top 10 most cited studies from the top 10 surgical journals from 2015 to 2020. The genders of the first and senior authors of each study were assessed using National Provider Identifier (NPI) numbers or pronouns from institutional biographies or news articles.

RESULTS

The genders of 1200 first and senior authors from 600 original research studies were assessed. First author gender distribution consisted of 71.8% men, 22.3% women, 0% non-binary, and 5.8% unknown. Senior author gender distribution was 82.3% men, 14.3% women, 0% non-binary, and 3.3% unknown. Studies published by first authors who are women received more citations than those published by first authors that are men in 2015 (169.1 versus 112.9, P = 0.002) and 2016 (144.2 versus 101.5, P = 0.011). There was an increase in first authorship among men from 2015 to 2020 (P = 0.035).

CONCLUSIONS

Men represent a significantly higher proportion of both first and senior authorships in top surgical research and the gap has widened from 2015 to 2020. However, studies written by women first authors received significantly more citations than those written by men.

Using the H-index as a factor in the promotion of surgical faculty

Introduction

Academic productivity is an important determinant for promotion. However, the measurement of academic productivity is ill-defined. The aim of this study is to demonstrate the academic productivity at the time of promotions at our institution.

Methods

We reviewed the data of 33 faculty from Department of Surgery at our institution who were promoted from 2006 to 2021. Gender, academic productivity at hiring, and each promotion were obtained. Academic productivity was assessed by bibliometric indices including total number of publications and citations, and H-index, which were obtained from Web of Science. T-test, Mann-Whitney U test, Fisher’s exact test and linear regression analysis were used to assess the association of H-index with length of promotion and gender. P < 0.050 were considered statistically significant.

Results

The medians (interquartile ranges) of indexes at hiring, at promotions from assistant professors to associate professors, and from associate professors to full professors were 6.0 (1.5–9.5), 11.0 (9.0–18.0) and 17.0 (9.0–23.0) respectively. A simple linear regression showed significant correlation between the length of promotion to associate professors and their H-indexes at hiring. (F (1, 27) = 10.55, p = 0.003, R² of 0.281.) There was no statistical significance in the difference of H-indexes at promotions between male and female faculty.

Conclusion

At our institution, the median H-indexes at the time of promotions from assistant professor to associate professor and from associate professor to full professor are 11.0 and 17.0. Using the H-index as an objective measure can be a useful tool to junior surgical faculty as reference for applying promotion.

"How to" Course for Resident Reviewers: from the Resident and Fellow Education Committee of the Society for Surgery of the Alimentary Tract (SSAT)

The Resident and Fellow Education Committee of the Society for Surgery of the Alimentary Tract (SSAT) hosted a "How to" course for resident reviewers at the 2021 Annual Meeting at Digestive Disease Week. This panel drew from their extensive experience to help neophyte reviewers perform high quality, comprehensive peer reviews. Dr. Snyder kicked off the session with "Why Should I be a Resident Reviewer?" Dr. Talamini followed by "Defining the Review Process," while Dr. Keller presented "OK, You Are Ready to Review, Where to Start?" Dr. Pawlik ended the session with "How to Be an Excellent Reviewer." Residents are encouraged to apply the content from these sessions to volunteer as reviewers and develop critical skills to help further their academic surgery career.

Is surgical subspecialization associated with hand grip strength and manual dexterity? A cross-sectional study

BACKGROUND

The aim of this study was to compare hand grip strength (HGS) and manual dexterity of academic, subspecialized surgeons.

METHODS

A single-center cross-sectional study was performed among 61 surgeons. HGS was analysed with a hand dynamometer and manual dexterity was extensively analysed with a Purdue Pegboard Test. Correlations between HGS and manual dexterity and specific characteristics of the surgeons were analysed using Pearson's correlation coefficient (r).

RESULTS

HGS and manual dexterity were comparable between surgeons from different specialities. HGS was positively correlated with male gender (r = 0.59, p < 0.001) and hand glove size (r = 0.61, p < 0.001), whereas manual dexterity was negatively correlated with male gender (r = -0.35, p = 0.006), age (r = -0.39, = 0.002), and hand glove size (r = -0.46, p < 0.001).

CONCLUSIONS

Surgical subspecialization was not correlated with HGS or manual dexterity. Male surgeons have greater HGS, whereas female surgeons have better manual dexterity. Manual dexterity is also correlated with age, showing better scores for younger surgeons.

An In-Depth Examination of Surgeon-Scientists' NIH-Funded Areas of Research

Background

Few studies have examined which National Institutes of Health (NIH) Institutes or Centers (ICs) provide most of the funding to surgeons, nor examined the specifics of their research focus areas. A better understanding of both the goals of ICs and research focus areas for surgeons may facilitate further alignment of the two.

Methods

A previously created database of NIH-funded surgeons was queried. To understand trends in funding, total grant cost was calculated for each IC in 2010 and 2020, and distribution of IC funds to each principal investigator (PI) category (surgeons, other physicians, and PhDs without a medical degree) was compared. Finally, total cost for Research Condition and Disease Categorization (RCDC) areas funded to surgeons compared to all of NIH was calculated. Statistical analyses were performed; a two-tailed p value of < 0.05 was considered significant.

Results

The National Cancer Institute (NCI) awarded the largest percentage of all 2020 surgeon funding, 34.3% ($298.9M). Compared to the other ICs, surgeons held the largest percentage of the National Eye Institute's (NEI) total funding in 2010 and 2020 at 8.7% and 9.0%, respectively. The RCDC super category comprising the most funding for surgeons was health disparities with 14.5% of all surgeon funding, followed by neurology (13.8%) and cancer (11.4%). Surgeons were awarded 10.8% of NIH's transplant-related research, 7.0% of ophthalmology-related research, and 3.4% of cancer-related research in 2020.

Conclusions

Our study shows surgeons have positioned themselves to examine new and myriad research topics while maintaining a focus on health disparities and cancer-related research.

Academic Global Surgery Curricula: Current Status and a Call for a More Equitable Approach

INTRODUCTION

We aimed to search the literature for global surgical curricula, assess if published resources align with existing competency frameworks in global health and surgical education, and determine if there is consensus around a fundamental set of competencies for the developing field of academic global surgery.

METHODS

We reviewed SciVerse SCOPUS, PubMed, African Medicus Index, African Journals Online (AJOL), SciELO, Latin American and Caribbean Health Sciences Literature (LILACS) and Bioline for manuscripts on global surgery curricula and evaluated the results using existing competency frameworks in global health and surgical education from Consortium of the Universities for Global Health (CUGH) and Accreditation Council for Graduate Medical Education (ACGME) professional competencies.

RESULTS

Our search generated 250 publications, of which 18 were eligible: (1) a total of 10 reported existing competency-based curricula that were concurrent with international experiences, (2) two reported existing pre-departure competency-based curricula, (3) six proposed theoretical competency-based curricula for future global surgery education. All, but one, were based in high-income countries (HICs) and focused on the needs of HIC trainees. None met all 17 competencies, none cited the CUGH competency on "Health Equity and Social Justice" and only one mentioned "Social and Environmental Determinants of Health." Only 22% (n = 4) were available as open-access.

CONCLUSION

Currently, there is no universally accepted set of competencies on the fundamentals of academic global surgery. Existing literature are predominantly by and for HIC institutions and trainees. Current frameworks are inadequate for this emerging academic field. The field needs competencies with explicit input from LMIC experts to ensure creation of educational resources that are accessible and relevant to trainees from around the world.

A step-by-step guide to creating an academic surgery interest group: Review article

An academic interest group in medicine is defined as a collective that can be made up of undergraduate students, residents, and/or teachers, who share as an object of interest the advancement and growth of a specific area of medicine. It is organized to carry out extracurricular academic and research activities. It is essential to stimulate participation in these interest groups, which allow the personal and professional growth of their members, being a tool that promotes and provides better opportunities for entry as candidates for graduate studies. The American College of Surgeons is one of the largest medical scientific societies with the participation of undergraduate students with an interest in surgery. This society mentions the benefits of participating in interest groups in surgery, specifically, it highlights the importance of contributing to these when looking for a surgical specialty, because they address issues such as: what is the mentioned specialty itself?, what are the details about the application process for each surgical specialty?, these groups can provide information on different residency programs, lifestyle benefits, and/or cons; in addition to improving practical skills through surgical technique workshops or various organized activities. Based on the above, the objective of this manuscript is to design a Step-by-step guide for the creation of a surgical interest group, in order to encourage participation by medical students, residents, and teachers in the research and academic field.

•

An academic interest group in surgery reinforces skills and knowledge.

•An academic interest group in surgery can be coordinated by undergraduate students.

•Academic interest groups in surgery generate national and international knowledge networks.

The sticky surgical floor: An analysis of female authorship trends in vascular surgery

OBJECTIVE

Prior research in vascular surgery has identified significant gender disparities in leadership positions, but few data exist regarding gender disparities in vascular publications. This study aims to evaluate authorship trends by gender in the three highest impact factor vascular surgery journals.

METHODS

In this bibliometric analysis, PubMed was searched for articles published in the European Journal of Vascular and Endovascular Surgery, the Journal of Vascular Surgery, and Annals of Vascular Surgery from 2015 to 2019. The web-based application Genderize used predictive algorithms to classify names of first and last authors as male or female. Statistical analyses regarding trends in authorship were performed using Stata16.

RESULTS

A total of 6457 articles were analyzed, with first author gender predicted with >90% confidence in 83% (4889/5796) and last author gender in 88% (5078/5796). Overall, 25% (1223/4889) of articles had women first authors, and 10% (501/5078) had women last authors. From 2015 to 2019, there was a slight increase in the proportion of articles written by women first authors (P = .001), but no increase in the proportion of articles written by women last authors (P = .204). The proportion of articles written by women last authors was lower than the proportion of active women vascular surgeons in 2015 (8% of articles vs 11% of surgeons; P = .015), 2017 (9% of articles vs 13% of surgeons; P < .001), and 2019 (11% of articles vs 15% of practicing surgeons; P < .001). The average number of last-author publications was higher for men (2.35 ± 3.76) than for women (1.62 ± 1.88, P = .001). The proportion of unique authors who were women was less than the proportion of active women vascular surgeons in 2017 (10% unique authors vs 13% surgeons; P = .047), but not in 2015 (9% unique authors vs 11% surgeons; P = .192) or 2019 (13% unique authors vs 15% surgeons; P = .345). Notably, a woman last author was associated with 1.45 higher odds of having a woman first author (95% confidence interval, 1.17-1.79; P = .001).

CONCLUSIONS

Over the past 5 years, there has been no significant increase in women last authors among top-tier journals in vascular surgery. Women remain under-represented as last authors in terms of proportion of published articles, but not in terms of proportion of unique authors. Nevertheless, women last authors are more likely to publish with women first authors, indicating the importance of women-led mentorship in achieving publication gender equity. Support for women surgeons through grants and promotions is essential not only for advancing last authorship gender equity, but for advancing junior faculty and trainee academic careers.

How to Optimize Your Research During a Pandemic - A Summary of Discussions From the Association for Academic Surgery Town Hall and Lessons Learned From 2020

The year 2020 was an unprecedented year for all of us, including for the academic surgery research community. Both stay-at-home and social distancing restrictions posed challenges to our personal and professional lives. The Association for Academic Surgery held its inaugural webinar-based panel discussion titled Association for Academic Surgery Town Hall with its topic on how to optimize research during a pandemic. This article summarizes the highlights from that discussion and lessons learned from the academic surgery research community in 2020.

Gender disparities among leadership in academic surgical publishing over the past decade

BACKGROUND

Women account for 19 % of practicing surgeons in the United States, with representation decreasing with higher academic rank. Less is known about the proportion of women in editorial leadership positions at surgical journals. The objective of this study was to examine gender representation among editorial leadership at high-impact surgical journals.

METHODS

The five journals with the highest impact factors in general, cardiothoracic, plastics, otolaryngology, orthopedics, urology, vascular, and neurosurgery were identified. Data were abstracted on the proportion of women editors-in-chief (EIC) and editorial board members between 2010 and 2020 to determine how these demographics changed over time.

RESULTS

Multiple fields had no women EIC over the past decade (orthopedics, urology, cardiothoracic, neurosurgery). In all other fields, women were a minority of EIC. In 2020, women made up 7.9 % of EIC and 11.1 % of editorial boards in surgical journals.

CONCLUSIONS

Women remain under-represented among leadership at high-impact surgical journals, with varying improvement over the past decade among different subspecialties.

Lacking Advanced Degrees are Not a Barrier to Entry into Academic Surgery Leadership

BACKGROUND

Undergraduate and graduate medical education offerings continue to create opportunities for medical students to pursue MD+ degree education. These educational endeavors provide formal education in fields related to surgery, which gives trainees and surgeons diverse perspectives on surgical care. This study sought to assess current prevalence of additional advanced degrees among leaders in academic surgery to assess the relationship between dual degree attainment and holding various leadership positions within surgical departments.

METHODS

The Association for Program Directors in Surgery database was used to identify academic surgical programs, which comprised our study population. Each department of surgery website in the APDS database was interrogated for departmental leaders and their reported academic degrees.

RESULTS

Among 3223 identified surgeon leaders, 14.6% (470/3223) were found to possess MD+ degrees. Most common degrees possessed included MBA, MPH, and PhD. In comparing different types of surgeon leaders such as chairs, program directors, and division chiefs, no group was found to have a significantly higher prevalence of MD+ degrees than others.

CONCLUSION

Prevalence of MD+ degrees among current academic surgery leaders is low, and the lack of an advanced degree should not be considered a barrier to entry into leadership positions. We hypothesize that these findings are likely to evolve as larger proportions of trainees obtain MD+ degrees during medical school and academic development time throughout residency.

A Cross-sectional Review of Cardiothoracic Surgery Department Chairs and Program Directors

OBJECTIVE

Departmental leadership, namely the chair and program director, are sought after positions among academic cardiothoracic surgeons. However, the path to achieving these positions remains unclear. This study sought to characterize the demographics, educational pathways, and career trajectories of current cardiothoracic academic leaders in the United States.

METHODS

A comprehensive list of ACGME accredited thoracic surgery residency and fellowship programs was obtained. Department chairs and program directors were identified for each program from May to June 2019. For each surgeon, demographic data, education, and training institutions were identified. Information was obtained primarily using institutional based websites.

RESULTS

A total of 72 department chairs or division chiefs and 77 program directors were identified. A minority of chairs and program directors were female (4.2%, 10.4%) or had PhD degrees (4.2%, 6.5%). A large number of surgeons trained in the North East region (35%), with Brigham and Women's hospital being the most common training institution (8%). Few chairs (31%) and program directors (39%) hold leadership positions at the institution at which they trained, however a larger proportion (52.8%, 58.4%) remain or return to the same region. Finally, 34.7% of chairs and 32.5% of program directors had some institutional exposure to where they currently practice, through medical school or training.

CONCLUSION

Cardiothoracic department chairs and program directors represent an important group of surgical leaders within our evolving field. As we better understand this group of surgeon-leaders, young trainees and junior faculty that aspire for leadership positions may have a clearer idea of the path to these positions.

Academic paediatric surgery in Australia and New Zealand: Its governance, drivers, successes and challenges

Traditionally, academic surgeons have been expected to excel in research, administration, teaching and clinical work. For many, to be strong in all of these areas is aspirational rather than a reality - and it may not always be a desirable expectation. It is more likely that future academic surgeons will have exceptional ability in several of these domains, but probably not all. Clinical expertise (even if it is within a narrow field) is critical to gaining credibility with non-academic surgical colleagues; and research leadership and substantial ongoing academic output is critical to maintaining credibility among academic surgical colleagues - and facilitates funding success. The Board of Paediatric Surgery is the specialty training board of the Royal Australasian College of Surgeons (RACS) that is responsible for the training program in paediatric surgery for both Australia and New Zealand. "Scholarship and teaching" is designated as being one of the nine competencies RACS expects of all surgeons. Expertise in the domain of scholarship (and research) occurs at two levels: (1) A working knowledge of scientific method, having a critical and curious mind matched with an ability to formulate a research question and contribute to research studies, and an ability to analyse research data and to use it to inform clinical practice. This is expected of all surgeons; and (2) A career academic surgeon with a formal commitment to research which becomes a major component of their work, with the requisite expertise in scientific method to be able to design, set up and complete research studies. The RACS provides support for academia in surgery to flourish in multiple ways and at various stages in the surgeons' career, as described in this chapter. Increasingly, the academic surgeon has to forge links and to collaborate with other research groups. At least in Australia and New Zealand, departments should work to ensure that their academic surgeons are not excessively burdened with departmental leadership and governance roles that do not require specific academic expertise. Arguably, future academic paediatric surgeons will expect to have a better balance in their lives than some of their predecessors!

'Paediatric surgical research in the UK - Challenges and opportunities'

Academic pediatric surgery faces challenges and opportunity. The author provides a brief overview of the landscape of academic surgery from a UK perspective and based on his considerable experience, makes suggestions for present and future directions.

Academic paediatric surgery - Why not?…

This article offers a brief overview of academic pediatric surgery in its broadest perspective(s). These include the challenge of the surgeons' journey in the pursuit of becoming an academic surgeon and acquiring excellence in clinical pediatric surgery to become university faculty leaders. The marriage of these demanding roles serving "two masters" notably clinical hospital services and academic institution(s) requires 'life skills' training coupled with buckets of resilience. It could be argued an academic pediatric surgical career is not for the 'faint hearted'. Success is rewarded by personal growth and inspiring those around us every day. Witnessing the birth of new academic pediatric surgeons we are privileged to train is very special. Scientific Discovery and research (clinical and / or basic sciences) are worthy vocational pursuits for surgeons. Good luck on your journey! ….

Academic paediatric surgery and work-life balance: Insights from Mexico

Academic pediatric surgery in Mexico has many challenges and opportunities. Work life balance, health service delivery and committements to our many students and residents must be tailored to goals and aspirations respecting talent at every opportunity when we encounter it. This article offers a perspective on the landscape and how we can shape the future in our nation to embrace new leadership in academic pediatric surgery.

Academic pediatric surgery - The German perspective

Today Pediatric surgery has become well established as fix point in the operative care of infants and children in Germany. The academic platform has traditionally been a strong driver for this development. However, as in other places around the world, academic pediatric surgery in Germany is currently facing relevant challenges. These challenges include internal aspects of the field (for example the broad spectrum with a rapidly ongoing development towards sub-specialization) but also external aspects (for example political specifications in form of the working hours act). Out of over 230 pediatric surgical institutions in Germany, only 33 are University-based. Sixteen of those 33 institutions are completely independent, whereas the other 18 are based within adult surgical University departments. In this article the authors give an overview over the current status of academic Pediatric surgery in Germany with its challenges and perspectives.

Pediatric surgery is academic by essence: The French perspective

This article offers a personal view on academic pediatric surgery from France. The author shares reflections and looks to the future of the speciality with the desire to encourage and embrace research and innovation. National and international collaboration is emphasized. Surgeons must seize these opportunities to become the next generation of academic pediatric surgeons in France.

Uncovering Disparities in Scholarly Productivity among Junior Surgical Society Grant Recipients

BACKGROUND

Despite increasing the number of women and ethnic minority groups in surgery, the academic advancement of such individuals within surgical fields lags behind Caucasian men. We sought to identify gender and ethnic inequalities in the receipt of surgical society research grants for young faculty investigators and compare the scholarly productivity of these groups.

MATERIALS AND METHODS

In this cross-sectional and retrospective study, the gender and race of surgical society grant recipients were determined from surgical society Web sites. Surgical society grants aimed at providing research grants for junior faculty investigators were analyzed. Using the Scopus database, each recipient's scholarly productivity was determined by means of h-index, a standardized measure of the quantity and impact of an individual's published articles. We generated descriptive statistics to compare the gender, race, and h-index of grant recipients in the years 2006-2008 and 2016-2018.

RESULTS

Between 2006 and 2008, there were 68 research grant recipients. Of these recipients, 79% were men and 21% were women. The racial breakdown was 54% Caucasian men, 22% Asian men, 1.4% African American men, 1.4% Hispanic men, 12% Caucasian women, 7% Asian Women, and 1.4% African American women. The average h-index of the male and female recipients is 25 (±14) and 24 (±14), respectively (P = 0.81). Between 2016 and 2018, there were 113 research grant recipients. Of these recipients, 66% were men and 34% were women. The racial breakdown was 47% Caucasian men, 16% Asian men, 3.5% African American men, 1% Hispanic men, 26% Caucasian women, 3.5% Asian women, and 3.5% African American women. The average h-index of the male and female recipients is 12 (±8) and 9 (±6), respectively (P = 0.046). Caucasian women had the only statistically significant change in the proportion of grant recipients from 2006-2008 to 2016-2018, with an increase from 12% to 26% (P = 0.02).

CONCLUSIONS

Most surgical society research grants for young investigators continue to be awarded to Caucasian men, with Caucasian women earning a distant second in the 2016-2018 cohort. Ethnic minorities continue to be awarded less research grants than Caucasian recipients. Overall, the average h-index of women was less than men. This study highlights the persistent need for surgical societies to consider gender and ethnic disparities when awarding junior investigator grants, including barriers minority groups may face in achieving the same h-index as Caucasian men.

How to Support a Surgeon Scientist: Lessons from National Institutes of Health K-Award Recipients

BACKGROUND

Success in academic surgery is challenging and research cannot survive without funding. NIH K-awards are designed to mentor junior investigators to achieve independence. As a result we aimed to study K awardees in departments of surgery and learn from their experience.

MATERIAL AND METHODS

Utilizing the NIH RePORTer database and filtering by department of surgery, clinically active surgeons receiving a K-award between 2008 and 2018 were asked to complete an online survey. Qualitative data from two open-ended questions were coded independently using standard qualitative methods by three researchers. Using grounded theory, major themes emerged from the codes.

RESULTS

Of the 144 academic surgeons identified, 89 (62%) completed the survey. The average age was 39 ± 3 when the K-award was granted. Most identified as white (69%). Men (70%) were more likely to be married (P = 0.02) and have children (P = 0.05). To identify intention to pursue R01 funding, surgeons having a K-award for 5 y or more were analyzed (n = 45). Most either intended to (11%) or had already applied (80%) of which 36% were successful. Men were more likely to apply (P = 0.05). Major themes to succeed include protected time, mentorship, and support from leadership. Common barriers to overcome include balancing time, pressures to be clinically productive, and funding.

CONCLUSIONS

The demographics and career trajectory of NIH K-awarded surgeons is described. The lack of underrepresented minorities receiving grants is concerning. Most recipients required more than one application attempt and plan to or have applied for R01 funding. The major themes were very similar; a supportive environment and time available for research are the most crucial factors to succeed as an academic surgeon.

Representation of women in speaking roles at annual surgical society meetings

BACKGROUND

Women are disproportionately underrepresented in American academic surgery and surgical society leadership; we investigated the proportion of speaking roles held by women across a wide variety of surgical society meetings.

METHODS

Publicly-available data on invited speakers, panelists, and moderators at 23 national surgical societies' annual meetings from 2002 to 2019 were collected. Mixed effects logistic regression was used to evaluate the adjusted trend of gender representation over time for each role.

RESULTS

15.9% of invited speakers were women. Adjusted analysis showed an 8% increase in odds of having female speakers per year (OR1.08, p = 0.002, 95%CI 1.03-1.14). 24.4% of moderators and 22.5% of panelists were female; there was increasing trend in adjusted analysis for both moderators (OR1.09, p < 0.001, 95%CI 1.07-1.11) and panelists (OR1.13, p < 0.001, 95%CI 1.11-1.43).

CONCLUSIONS

There is a wide range in speaking roles held by women at surgical society meetings, but an encouraging trend towards greater parity was seen overall.

Can an Academic RVU Model Balance the Clinical and Research Challenges in Surgery?

OBJECTIVE

The purpose of this study is to identify perceptions of academic surgeons regarding academic productivity and assess its relationship to clinical productivity. We hypothesized that these perceptions would vary based on respondent characteristics including clinical activity and leadership roles.

DESIGN

This retrospective, survey-based study was performed from August 26, 2019 to September 26, 2019.

SETTING

The setting was academic surgical departments across the US.

PARTICIPANTS

The survey instrument was administered to faculty members of the Association of Program Directors in Surgery. A total of 105 academic surgeons responded.

RESULTS

Most respondents were Program Directors (59%) of general surgery programs. Of the participants, 30% identified as Professor, 36% as Associate Professor, and 15% as Assistant Professor. Respondents agreed that multiple academic pursuits or factors should count towards academic productivity including the following (in descending order): completing a first-authored manuscript (98.8%), completing a senior-authored manuscript (97.7%), chairing a national committee (94.1%), serving on a national committee (88.2%), completing a second-authored manuscript (88.0%), completing a first lecture (83.7%), completing a middle-authored manuscript (71.8%), completing a lecture (whether or not repeated) (70.9%), impact factor of journal (60.7%), and attendance at grand rounds (57.0%). Perspectives did not vary significantly based on surgeon demographics, clinical setting, or leadership role (p > 0.05).

CONCLUSIONS

Perceptions regarding what constitutes academic productivity and merit a reduction in clinical expectation are remarkably similar across multiple surgeon characteristics including demographics, academic title, leadership role, and practice environment.

Does gender influence leadership roles in academic surgery in the United States of America? A cross-sectional study

BACKGROUND

Gender disparity remains prevalent in the field of academic surgery with an under-representation of women at senior leadership ranks. A wide variety of causes are reported to contribute to this gender-based discrimination but a current quantitative analysis in the US has significant importance. This cross-sectional study aims to document gender disparity in academic and leadership positions in surgery as well as its relationship with scholarly productivity.

MATERIAL AND METHODS

The American Medical Association's Fellowship and Residency Electronic Interactive Database (FREIDA), was used to identify General Surgery programs. Each institution's website was used to identify its faculty's primary profiles for data collection. Individuals with an MD or DO, and an academic ranking of Professor, Associate Professor or Assistant Professor were included. Academic productivity was quantified by recording H-index, number of publications, number of citations, and years of active research of a physician. All statistical analysis was performed on SPSS Statistics version 20.0.

RESULTS

A total of 144 academic programs were including in our analysis constituting 4085 surgeons, only one-fifth (n = 873, 21%) of which were women. Furthermore, only 19% of all leadership positions were assumed by female surgeons. Leadership positions and academic rank correlated significantly with increasing research productivity. The difference in H-index between genders was statistically significant (P < 0.05) with men possessing a higher median for H-index [13] than women [9]. Transplantation Surgery [17] had the highest median H-indices for female surgeons. Male surgeons (n = 18) were twice as likely to be Departmental Chairs as their female counterparts (n = 9). However, female surgical oncologists held the highest proportion of leadership positions (31%).

CONCLUSION

A significant gender-based disparity was found in leadership positions and academic ranks. Research productivity appeared to be integral for academic and leadership appointments. Institution-level measures that enhance support, mentorship, and sponsorship for women are imperative to achieve overall parity in general surgery.

Unconscious Bias in Speaker Introductions at a Surgical Oncology Meeting: Hierarchy Reigns Over Gender

BACKGROUND

Recent reviews of medical conferences have shown that women were less likely to receive a formal introduction compared with men. We examined speaker introductions at the Society of Surgical Oncology (SSO) annual meeting to determine whether similar biases exist within our organization.

METHODS

An observational study of video-archived speaker introductions at the 2018 and 2019 SSO annual meetings was conducted. Professional address was defined as professional title followed by full name or last name. Multivariable logistic regression was used to identify factors associated with form of address.

RESULTS

There were 499 speaker introductions reviewed. Speakers included 290 (58%) men and 238 (49%) post-graduate trainees (residents and fellows). A non-professional form of address was used to introduce 148 (30%) speakers and was most often used for post-graduate trainees (33%). Full professors were more likely than junior faculty to introduce speakers with a non-professional form of address (37% of full professors vs 18% of assistant professors, p < 0.001). In multivariable regression analysis these findings persisted. Trainees were 2.8 times more likely to receive a non-professional form of address (p = 0.003). Use of a non-professional introduction did not significantly vary by the speaker's nor the introducer's gender.

CONCLUSIONS

Residents and fellows were more likely to receive a non-professional form of address, and the likelihood of this increased with rising seniority of the introducer. The manner of speaker introduction did not vary by gender in our organization. More research is needed to explore the influence of these disparities on academic advancement for the next generation of surgical oncologists.

Nationwide patterns in industry payments to academic vascular surgeons

OBJECTIVE

Financial relationships between vascular surgeons and industry are essential to the development and adoption of innovative technology. However, these relationships may establish competing interests. Our objective was to describe publicly available financial transactions between industry and academic vascular surgeons.

METHODS

Academic vascular surgeons were identified and characterized on the basis of publicly available data correlated with Accreditation Council for Graduate Medical Education and Association of American Medical Colleges data to identify academic practice settings. Vascular surgeons were linked to Open Payments data for 2017 as reported by the Centers for Medicare & Medicaid Services. Univariate and nonparametric tests were used for analysis.

RESULTS

Of 1158 academic vascular surgeons identified, 997 (86%) received industry payments totaling $8,548,034. Overall, the median of total payments received was $814 (interquartile range [IQR], $124-$2863). The top paid decile of vascular surgeons received $29,645 (IQR, $16,128-$61,701). Payments to the top decile accounted for 81% of all payments. Payments did not vary by academic rank but did vary by sex, with male vascular surgeons (n = 954) receiving $889 (IQR, $146-$3217) vs female vascular surgeons (n = 204) receiving $467 (IQR, $87-$1533; P = .002). By leadership role, division chiefs received the highest median payment amount ($1571; IQR, $368-$11,281) compared with department chairs ($424; IQR, $56-$2698) and vascular surgeons without leadership role ($769; IQR, $117-$2592; P = .002). Differences in payments were also seen on the basis of U.S. census region: Northeast, $571 (IQR, $90-2462); Midwest, $590 (IQR, $75-$2364); South, $1085 (IQR, $241-$3405); and West, $1044 (IQR, $161-$4887; P = .001). The most common categories of payments were food and beverage (paid to 85% of all vascular surgeons), travel and lodging (35%), and consulting fees (13%). Among the top decile of vascular surgeons, median payments exceeded $10,000 for three categories: consulting fees, compensation, and honoraria. Payments were made by 178 distinct entities with median total payments of $286 (IQR, $70-$6285). The three top entities paid a total of $5,004,061, which accounted for 59% of all payments. Payments from at least one of the top three entities reached 76% of vascular surgeons.

CONCLUSIONS

Most academic vascular surgeons receive publicly reported industry payments that are paid by a limited number of entities, typically for food and beverage or travel and lodging. The top 10% of vascular surgeons received higher median payment amounts, totaling 81% of all industry payments. Vascular surgeons should be aware of publicly reported payment information and the potential for conflicts of interest.

The Society of Black Academic Surgeons CV benchmarking initiative: Early career trends of academic surgical leaders

BACKGROUND

Surgeons from under-represented backgrounds are less likely to receive academic tenure and obtain leadership positions. Our objective was to query the curriculum vitaes (CVs) of SBAS leadership to develop a benchmarking tool to promote and guide careers in academic surgery.

METHODS

CVs from academic leaders were reviewed for academic productivity at early career stages-the first 5-and 10-years. Variables queried: peer-reviewed publications, grant funding, surgical societal involvement, invited lectureships and visiting professorships.

RESULTS

Of 20 CVs, 41 leadership positions including 13 SBAS Presidents were identified. At 5- and 10-years, respectively, the academic productivity increased: 20.6 and 52.3 publications; 4.7 and 9.7 grants; 18 and 42.6 lectures/professorships.

CONCLUSION

The CV benchmarking tool may be a useful framework for aspiring academic surgeons to track their progress relative to successful SBAS members. Creative strategies like these, paired with faculty mentorship and sponsorship are necessary to improve the ethnic diversity in academic surgery.

The Role of Gender, Academic Affiliation, and Subspecialty in Relation to Industry Payments to Orthopaedic Surgeons

BACKGROUND

The Physician-Payments-Sunshine-Act (PPSA) was introduced in 2010 to provide transparency regarding physician-industry payments by making these payments publicly available. Given potential ethical implications, it is important to understand how these payments are being distributed, particularly as the women orthopaedic workforce increases. The purpose of this study was thus to determine the role of gender and academic affiliation in relation to industry payments within the orthopaedic subspecialties.

METHODS

The PPSA website was used to abstract industry payments to Orthopaedic surgeons. The internet was then queried to identify each surgeon's professional listing and gender. Mann-Whitney U, Chi-square tests, and multivariable regression were used to explore the relationships. Significance was set at a value of P < 0.05.

RESULTS

In total, 22,352 orthopaedic surgeons were included in the study. Payments were compared between 21,053 men and 1299 women, 2756 academic and 19,596 community surgeons, and across orthopaedic subspecialties. Women surgeons received smaller research and non-research payments than men (both, P < 0.001). There was a larger percentage of women in academics than men (15.9% vs 12.1%, P < 0.001). Subspecialties with a higher percentage of women (Foot & Ankle, Hand, and Pediatrics) were also the subspecialties with the lowest mean industry payments (all P < 0.001). Academic surgeons on average, received larger research and non-research industry payments, than community surgeons (both, P < 0.001). Multivariable linear regression demonstrated that male gender (P = 0.006, P = 0.029), adult reconstruction (both, P < 0.001) and spine (P = 0.008, P < 0.001) subspecialties, and academic rank (both, P < 0.001) were independent predictors of larger industry research and non-research payments.

CONCLUSIONS

A large proportion of the US orthopaedic surgeon workforce received industry payments in 2014. Academic surgeons received larger payments than community surgeons. Despite having a larger percentage of surgeons in academia, women surgeons received lower payments than their male counterparts. Women also had a larger representation in the subspecialties with the lowest payments.

The surgical blog: An important supplement to traditional scientific literature

BACKGROUND

Blogging is a new and innovative means of information exchange in the surgical community. We examined the Association of Women Surgeons (AWS) blog to understand its audience and most read content.

METHODS

Google Analytics was used to assess the AWS blog site data. A search was performed from February 2018 to February 2019. Demographic data, blog posts, and tags sorted by unique pageviews were recorded.

RESULTS

There were 31,221 unique pageviews during the search period. The AWS Blog readership was mostly women (75%), ages 25-44 years (70.3%). The three tags that elicited the most pageviews were "residency (16.95%)," "medical students (12.12%)," and "family life (10.38%)." The most read blog post was responsible for 9.7% of total pageviews.

DISCUSSION & CONCLUSION

Most of the AWS Blog readership are young, women, and interested in content related to graduate and postgraduate medical education or family life. Blogging may be a good vehicle for topics not covered in traditional scientific literature.

Faculty Development: Using Education for Career Advancement

Faculty development is important at any level of academic rank but is especially important in early stages. The clinical educator is a rewarding pathway that is emerging as a special track for promotion and advancement. Success is achievable through development of skills, measurement of progress, obtaining funding, and completion of projects through publication. Advanced degrees, mentorship, and persistence are keys to achievement.

Surgeon as Basic Bench Scientist: A Play in Three Acts

There is an ongoing national narrative on the diminishing number of surgeons willing and able to carry out meaningful basic science research as academic surgeons. Various analyses have come to the conclusion that the pressure to be clinically productive has overshadowed individual aspirations to perform bench-level science as a practicing academic surgeon. This review challenges various aspects of this conclusion and offers a path forward to rethink our approach to basic science as performed by practicing surgeons in an academic environment.