H-Index and Promotion in Academic Radiation Oncology.

Influence of participant and reviewer characteristics in application scores for a hematology research training program

Overemphasis of Step 1 Scores May Affect Application Pool Diversity in Radiation Oncology

Multiple Mini-Interviews (MMIs) are increasingly used in medical school admissions. We previously reported that while under-represented minority (URM) status was not associated with MMI scores, self-designated disadvantaged applicants had lower MMI scores, possibly affecting their matriculation prospects. No studies have examined how URM status or socioeconomic disadvantage (SED) are associated with academic performance following admission through an MMI. We examined the adjusted associations of MMI scores, SED, and URM status with U.S. Medical Licensing Examination Steps 1 and 2 performance and third-year clerkship Honors, measures affecting residency matching. While URM status was not associated with the measures, students with greater SED had lower Step 1 scores and fewer Honors. Students with higher MMI scores had more Step 1 failures, but more Honors. The findings identify areas to address in medical school admissions, student support, and evaluation processes, which is important given the need for a more representative physician workforce.

Gender-Based Analysis of the Academic Pediatric Radiation Oncology Workforce

Learner ratings are an important source of data regarding teaching effectiveness. We examine ratings of faculty teaching for the effects of faculty-resident gender and underrepresented minority (URM) status concordance. Factorial ANOVAS and t tests were used to examine gender and URM status in 10,443 teaching effectiveness evaluations for 720 faculty members, provided by 516 residents across 18 clinical departments. Significant interaction effects were found for gender (P < .001) and URM status (P < .05) on the individual evaluation record level. Analyses of faculty-level data showed effect sizes were small except for large positive effects for URM faculty evaluated by URM residents (ES = 0.61). Overall, gender and minority status seem to have a negligible role in residents' evaluations of clinical faculty. However, the apparent beneficial effects for URM-URM pairs need more study.

Objective The aim of the study is to identify differences for cataract surgery, total procedural volume, and publication rates between residents by gender, underrepresented minority (URM) status, and welcoming a child during ophthalmology residency. Design This is a retrospective, cross-sectional study. Participants A total of 89 residents graduating from 2002 to 2020 at a single program were included. Methods A multiple linear regression model was created to determine factors predictive of the number of cataract surgeries performed as the primary surgeon, total procedural volume, number of publications, or first author publications. Independent variables included resident gender, URM status, PhD degree, welcoming a child during residency, and graduation year. Results Of the 89 graduating residents included in this study, identifying as female (45 women, 50.6%) and as URM (eight identifying as URM, 9.0%) was not associated with a difference in surgical or research volume. Female residents performed a mean (SD) of 240.1 (55.1) cataract surgeries while male residents performed 210.6 (46.1) cataract surgeries. Residents identifying as URM completed 228.1 (41.9), while non-URM residents completed 234.8 (51.9) cataract surgeries. Since 2008, eight female residents (22.2%) and two male residents (6.9%) added children to their families. Welcoming a child to the family was also not associated with decreased surgical or publication volume. Number of cataract surgeries, total procedures, and number of publications did increase over time (p &lt;0.001), as each graduation year was associated with 5.4 (95% CI: 3.9, 7.1) more cataract surgeries and 30.5 (95% CI: 25.7, 36.9) more procedures. Each year was also associated with 0.24 (95% CI: 0.09, 0.38) more publications and 0.18 (95% CI: 0.08, 0.28) more first author publications. Conclusion Surgical and research productivity has increased, and female residents and residents who identify as URM did not have fewer cataract surgeries or procedures. Welcoming a child also did not correlate with differences in surgical or procedural volume. Programs should continue to promote equitable surgery and procedural distributions as well as identify more targeted strategies to encourage and recruit underrepresented medical students into ophthalmology.

In varied educational settings, narrative evaluations have revealed systematic and deleterious differences in language describing women and those underrepresented in their fields. In medicine, limited qualitative studies show differences in narrative language by gender and under-represented minority (URM) status. To identify and enumerate text descriptors in a database of medical student evaluations using natural language processing, and identify differences by gender and URM status in descriptions. An observational study of core clerkship evaluations of third-year medical students, including data on student gender, URM status, clerkship grade, and specialty. A total of 87,922 clerkship evaluations from core clinical rotations at two medical schools in different geographic areas. We employed natural language processing to identify differences in the text of evaluations for women compared to men and for URM compared to non-URM students. We found that of the ten most common words, such as "energetic" and "dependable," none differed by gender or URM status. Of the 37 words that differed by gender, 62% represented personal attributes, such as "lovely" appearing more frequently in evaluations of women (p < 0.001), while 19% represented competency-related behaviors, such as "scientific" appearing more frequently in evaluations of men (p < 0.001). Of the 53 words that differed by URM status, 30% represented personal attributes, such as "pleasant" appearing more frequently in evaluations of URM students (p < 0.001), and 28% represented competency-related behaviors, such as "knowledgeable" appearing more frequently in evaluations of non-URM students (p < 0.001). Many words and phrases reflected students' personal attributes rather than competency-related behaviors, suggesting a gap in implementing competency-based evaluation of students. We observed a significant difference in narrative evaluations associated with gender and URM status, even among students receiving the same grade. This finding raises concern for implicit bias in narrative evaluation, consistent with prior studies, and suggests opportunities for improvement.

Objectives To identify differences in letters of recommendation (LORs) of applicants to a single ophthalmology residency program by gender, race, academic performance, and match outcome. Design This was a retrospective analysis of LORS for 2,523 applicants (7,569 letters) to the University of California, Irvine ophthalmology residency program from 2011 to 2018. Methods Programming scripts were employed to determine the number of times 22 key words from four thematic categories (standout words, ability, grindstone, and compassion) appeared in LORs for each applicant. A chi-square test was performed to assess for possible differences in the presence of each key word by the following characteristics: gender, underrepresented minority (URM) status, Alpha Omega Alpha (AOA) membership, the United States Medical Licensing Exam (USMLE) Step 1 score, and match outcome. Linear regressions were created to determine the frequency at which words in each thematic category appeared according to the same baseline characteristics. Results In the LORs, females were more likely to be described as “empathetic” (p = 0.002), URMs were more likely to be described as “caring” (p = 0.002), high Step 1 scorers (≥240) were more likely to be described as “outstanding” (p = 0.002), and matched students were more likely to be described as “exceptional” (p = 0.001), “outstanding” (p &lt; 0.001), and “superb” (p = 0.001). Standout words appeared more often in the LORs of AOA members, matched candidates, and high Step 1 scorers (p &lt; 0.001 for all comparisons). “Competent” appeared more commonly in LORs for low Step 1 scorers (p &lt; 0.001) and unmatched applicants (p = 0.001). Conclusion This study identifies differences in LORs by gender, URM status, and achievement including successful ophthalmology residency match. Females and URMs were more likely to be described as “empathetic” and “caring,” respectively; otherwise, we detected no gender or racial disparities in key word use in LORs. Candidates with high USMLE Step 1 scores or AOA membership had a higher frequency of standout words in their LORs. Whether they were truly more qualified in various dimensions or if they benefited from a halo effect bias warrants further investigation. There was a significant difference in the number of standout words in LORs between matched and unmatched applicants, suggesting that key word frequency may be a relevant metric for LOR appraisal.

Chemistry self-efficacy (CSE) was identified as a critical affective construct to predict student success in chemistry classrooms. We surveyed students at the beginning and toward the end of a semester to measure students’ CSE beliefs in introductory and general chemistry courses at a Hispanic-serving institution in the United States. First, the relationships between CSE (initial and toward the end) and student achievement measured by course GPA were examined. Second, trends of changes in student CSE beliefs over a semester in relation to several aspects of student characteristics including course level, gender, underrepresented minority (URM) status were investigated. Lastly, the gaps in specific areas of CSE still remain between student groups after a semester of instruction were revealed. The results showed that CSE toward the end of the semester significantly predicted students’ course GPA in lower-division chemistry courses. Even though the CSE of different student groups all increased to some extent after a semester of instruction, the levels of changes were influenced significantly by certain factors such as course level and URM status but not gender. While URM students' CSE beliefs increased more than non-URM students after a semester of instruction, there were still gaps in certain areas between the two student groups. The remaining gaps in CSE beliefs between URM and non-URM students were found to be in the areas of interpreting chemical equations and choosing appropriate formulas to solve chemistry problems. Meanwhile, students who completed introductory chemistry still lagged behind in interpreting chemical equations as compared to students who completed general chemistry. Research literature related to these two specific areas in CSE with gaps between student groups was reviewed, instructional strategies and research directions along with theoretical perspectives for closing those equity gaps in college lower-division chemistry classrooms are discussed.

Aesthetic surgery is a core competency within plastic surgery training. In 2014, the Accreditation Council for Graduate Medical Education (ACGME) raised the minimum required aesthetic cases from 50 to 150. Since then, no comprehensive national analysis of aesthetic case logs has been performed. The goal of this study is to characterize the aesthetic operative experience among US plastic surgery residents over a 9-year period. A retrospective cohort study of ACGME case logs was performed for all graduating plastic surgery residents from 2014 to 2023. Primary outcomes included total aesthetic case volumes, analyzed across aesthetic subcategories and stratified by training pathway (integrated versus independent), sex, underrepresented minority (URM) status, program size, geographic region, and relation to the COVID-19 academic year. A total of 1902 residents (1043 integrated; 859 independent) were included. Average total aesthetic case volume increased from 493 cases in academic year 2014/2015 to 618 in academic year 2022/2023 (P = 0.030). No evidence of a difference in total aesthetic cases was found between integrated and independent residents (560 versus 541, respectively, P = 0.319). Men and women logged similar total aesthetic case volumes (P = 0.409), as did URM residents compared to non-URM trainees (P = 0.400). No detectable differences in volume were found based on program size (P = 0.296). Graduates of programs in the Northeast and South, and postpandemic trainees reported significantly higher case volumes. Aesthetic case exposure has increased over time with residents exceeding ACGME case minima. No evidence of a difference was found with respect to gender, URM status, training pathway, and program size, suggesting equitable aesthetic exposure in plastic surgery training.

03:00 PM Abstract No. 344 Bridging the gap: why aren’t underrepresented minorities pursuing careers in interventional radiology?

The aim of this study was to assess the initial levels of moral reasoning among four cohorts of dental students in the first semester of their first year of study. All 332 students at one U.S. dental school were invited to take the Defining Issues Test 2 (DIT2) during the first semester of their first year while enrolled in a mandatory ethics course in 2015-18. Students' mean scores on the DIT2 subscales were compared to their gender, underrepresented minority (URM) status, citizenship, English as primary language, and single status. The four subscales were personal interests (PI), in which self-motivated interests are the main focus; maintaining norms (MN), which takes into consideration what is expected from society; post-conventional (PC), which upholds ethical principles that promote the good of society; and N2 index, which indicates one's ability to discriminate between lower stage and higher stage items. A total of 245 students participated (74% response rate). The results showed no differences between gender, URM status, citizenship, or English as primary language and any of the DIT2 subscales. Single participants scored significantly higher on the PC and N2 subscales and significantly lower on the MN subscale. There was a significant correlation between humanitarian liberalism (HL) and all four subscales. Religious (Christian) orthodoxy (RO) was significantly correlated with MN, PC, and N2. The DIT2 subscale scores were not impacted by various exploratory variables, with the exception of relationship status, which had significantly higher MN and N2 scores. Participants with higher scores on HL and RO had higher moral reasoning scores, and females had higher levels of moral reasoning than males on their PC and N2 scores. These findings have implications for implementing educational activities that may help develop students' moral reasoning abilities over the course of dental school.

There has been an increase in diversity initiatives regarding selecting speakers for the American Academy of Orthopaedic Surgeons (AAOS) annual meeting and courses. The purpose of this study was to determine the percentage of female or underrepresented minority (URM) speakers for instructional course lectures (ICLs) and AAOS courses over the past 2 decades including a surrogate for expertise. For 2002, 2012, and 2022, the academic and demographic information of speakers and the number of publications at the time of their speaking role were obtained and compared by sex and URM status. Owing to the unequal sample sizes between male versus female cohorts and URM versus non-URM cohorts, the Welch t -test was used. The percentage of ICL and AAOS course speakers who were female increased over time (ICL, AAOS courses): 2002 (2.6%, 3.3%), 2012 (3.9%, 6.3%), and 2022 (11.8%, 15.5%) ( P < 0.001, P < 0.001). The percentage of female AAOS fellows in these years was 2.9%, 4.7%, and 7.4%, respectively. For ICLs and AAOS course speakers, female presenters had fewer publications than male counterparts (ICL, AAOS courses): 2002 ( P < 0.001, P = 0.048), 2012 ( P = 0.003, P < 0.001), and 2022 ( P < 0.001, P < 0.001). For ICLs in 2022, URM speakers had a similar number of publications compared with non-URM speakers. In 2022, URMs comprised 6.9% of ICL speakers and 4% of AAOS fellows. For 2022 ICLs, there were no significant differences in academic institution, position, or region when compared by sex or URM status. For AAOS courses, the percentage of URM speakers increased over time: 2002 (1.1%), 2012 (4.5%), and 2022 (8.6%). For AAOS courses, URM presenters had similar publications compared with non-URM presenters in 2002 and 2022 but less in 2012 ( P = 0.027). The percentage of women and URMs presenting ICLs and AAOS courses has increased over the past 2 decades and exceeded the percentage they represent in the AAOS by over 50%. The female cohort has fewer publications, on average, than the male cohort for all years evaluated, indicating no institutional bias against female speakers.

Although concerns continue to be raised about the diversity of the US physician workforce, there has never been a nationwide survey of both the sex and underrepresented minority (URM) composition of medical school admission committees. To document US medical school admission committee membership in several demographic domains, including sex and URM (African American, Mexican American, mainland Puerto Rican, Native American, Native Hawaiian, and Native Alaskan) status. Mailed survey. Deans or directors of admission at 85 US medical schools that were members of the Association of American Medical Colleges (response rate, 70%). Prevalence of 1999-2000 school-year committee members in demographic categories, such as sex, URM status, physician or medical student status; compensation status. The overall ratio of men to women on admission committees was 1.77 to 1. On average, 16% of committee members were from URM groups. Physicians with URM status comprised 8% of committee membership; 51% of committees had 1 or 0 URM physicians. Seventy-four percent of committees had at least 1 medical student; medical students comprised 15% of total membership. Ninety-one percent of committees operated on a volunteer basis. Although representation of women and persons with URM status on medical school admission committees has improved since 1972, URM membership, in particular, remains low. JAMA. 2000;284:1111-1113

11001 Background: Academic radiation oncology represents a constantly changing landscape. We sought to determine the demographic makeup of the current academic radiation oncology workforce. Methods: Internet searches of the 51 National Cancer Institute-designated Comprehensive Cancer Centers were conducted in September 2019. The Scopus database was subsequently searched in December 2019 to ascertain the h-index for each radiation oncologist. H-indices were analyzed by faculty rank (junior faculty versus associate professor versus full professor) and gender. Variables were coalesced for statistical analysis using Fisher’s exact test and two-tailed t-tests. Results: Analysis of 993 radiation oncologists revealed that 53.6% are junior faculty, 24.8% are associate professors, and 21.7% are full professors. The average radiation oncologist has been an MD for 19.6 years; 32.5% (232/993) are women, and less than 5% (47/993) are underrepresented minorities (URM). Of the 51 department chairs, 11.8% are women and 5.6% are underrepresented minorities. Women are significantly underrepresented among full professors (odds ratio = 1.78; p = 0.010) and departmental chairs (odds ratio = 3.80; p = 0.0007); there was no significant difference for assistant professorship (p = 0.067) nor associate professorship (p = 0.348). The overall mean h-index for all faculty was 17.64. Mean h-index was 8.21 for junior faculty, 18.46 for associate professors, and 40.05 for full professors; these differences were statistically significant (p &lt; 0.0001). The overall mean h-index was 19.35 for men (n = 668) and 14.11 for women (n = 323); this difference was statistically significant (p &lt; 0.0001). Conclusions: The majority of academic radiation oncologists are assistant professors; fewer than 5% are underrepresented minorities. Men comprise more than two-thirds of the workforce, and are significantly overrepresented at the full professor (by 78%) and departmental chair (by 280%) levels in academic radiation oncology. The average radiation oncologist at a comprehensive cancer center has published more than 17 manuscripts cited at least 17 times. Contrary to previous findings comparing male and female residents, the difference in academic productivity by gender among faculty was statistically significant. These findings provide objective data to assess the radiation oncology academic workforce and provide a useful benchmark to measure change going forward.