Additional Advanced Degrees Research Articles

“Does an Additional Advanced Degree Influence Career Trajectory as a Shoulder and Elbow Surgeon?”

BackgroundAs orthopedic surgery becomes increasingly competitive, orthopedic surgeons are now pursuing advanced degrees more frequently to enhance their resumes or gain additional expertise. The specific impact of this additional training and education on a surgeon’s career trajectory is not well defined. The purpose of this study was to understand the impact of an advanced degree on the academic career of orthopedic shoulder and elbow surgeons. MethodsOrthopedic shoulder and elbow fellowship-trained surgeons were identified using the directory listed on the American Shoulder and Elbow Surgeons website. Demographics, education, and current professional roles were obtained. Research productivity was obtained using SCOPUS and Google Scholar. Advanced degrees were defined as those additional to the primary medical degree (Doctor of Medicine [MD] or Doctor of Osteopathic Medicine [DO]). Outcome measures collected included timing of advanced degree obtainment, current academic and leadership roles, leadership on journal editorial boards, and research productivity. Statistical analysis was performed using the chi-square test and Mann-Whitney U test to determine the association of advanced degrees on outcome measures. ResultsIn total, 893 orthopedic shoulder and elbow surgeons were identified, of whom 129 had advanced degrees. Most common advanced degrees included Master of Science (MS/MSc; 43%), Master of Business Administration (MBA; 23%), and Doctor of Philosophy (PhD; 13%). The most common period of degree obtainment was before medical school (35%) with the least common times being after medical school/before residency (0.9%) and between residency and fellowship training (0.9%). Surgeons who held advanced degrees demonstrated greater research productivity, with a higher h-index (p < 0.001), a greater number of citations (p < 0.001), and more publications (p < 0.001). Of the 523 shoulder and elbow surgeons who worked at an academic institution, those holding advanced degrees were more likely to serve as orthopedic department chair (p < 0.001) and serve an editorial board position (< 0.001). ConclusionThis study found that having an advanced degree as an orthopedic shoulder and elbow surgeon was linked to higher research impact and productivity and an increased likelihood of becoming a department chair and holding an editorial position. These significant findings can help future trainees and department leadership in understanding the importance and impact of additional training on career trajectories for academic faculty.

Doctors Who Attend Policy School: Who Are They and Where Do They Work?

Many physicians are pursuing additional advanced degrees, though no study has evaluated the characteristics and career choices of physicians who have pursued graduate policy degrees. We therefore searched employment and alumni data from the Harvard Kennedy School of Government in addition to publicly available information to identify physicians who graduated with a policy degree from 1964 to 2002. We identified 258 physicians with policy degrees and found that they are increasing in number, though females are underrepresented when compared to the female physician workforce; likely to pursue clinical training in specialties highly proximate to public policy challenges, with most physicians remaining medically licensed after residency; and more likely to hold nonclinical roles in academia, clinical leadership, and the private sector than in nonprofits and government. We conclude that the importance of integrating physicians with policy training throughout various organizations warrants further research into the growth, characteristics, and career choices of these physicians.

Factors Influencing Graduates of American Academy of Facial Plastic and Reconstructive Surgery Fellowships Career Choice of Academic or Private Practice: A 20-Year Review.

Background: Absence of published literature on facial plastic and reconstructive surgery (FPRS) fellows' pursuit of academic careers hampers informed decision making for those interested in the specialty, fellowship program directors, and leaders in the American Academy of Facial Plastic and Reconstructive Surgery. Objective: To examine career choices among FPRS fellows from 2000 to 2019 and identify factors linked to academic or private practice employment after fellowship. Methods: Data from 796 fellows were analyzed, including gender, medical school, residency program, fellowship program, fellowship year, and degrees, to categorize them based on academic or nonacademic career placement. Logistic regression analyses were conducted to explore the association between demographic factors and academic career placement. Results: Forty-three percent (n = 345) obtained academic positions, with significant associations found between academic placement and additional advanced degrees, completion of fellowship training in the northeast, and residency training at an institution offering FPRS fellowship. Conclusion: Although fellows in FPRS predominantly pursue private practice, the decision to pursue academia is influenced by complex and multifactorial factors among graduates in the field.

Composition and Gender Distribution of Editorial Boards for Top Neurosurgical Journals

Though women now comprise approximately 21.5% of all neurosurgery residents in the United States, women only represent 10% of practicing neurosurgeons nationally. Serving as a journal editor is 1 measure of academic success. We investigated characteristics of editorial boards for top neurosurgical journals to identify factors influencing membership on editorial boards. We sought to identify gender differences to explain the paucity of women on editorial boards. This is a cross-sectional study of editorial boards for the top 10 English-language neurosurgical journals. Data were obtained from journal websites, program faculty lists, or physician online profiles. Gender differences were compared using Student t test and χ2 analysis. Seven hundred twenty-two editorial board members were examined (female n= 65; male n= 650; unidentified n= 7). Overall, women had fewer years in practice (P= 0.002) and more often had additional advanced degrees (P= 0.009) while men had higher h-indices (P < 0.0001). Within the boards of Neurosurgery and Acta Neurochirurgica, men had been in practice longer (P= 0.014; P= 0.023) and had higher h-indices (P= 0.003; P= 0.025). Male editors for Journal of Neurosurgery: Spine and World Neurosurgery had higher h-indices (P= 0.007; P= 0.018). Women constitute ∼9% of editorial boards for top neurosurgical journals, a percentage comparable to the amount of practicing female academic neurosurgeons. This finding is encouraging as in that there appears to be no readily identifiable bias in the selection of editorial board members. The differences in years in practice and h-index suggest that gender distribution may equalize with time as more women enter practice and produce scientific literature. Efforts to recruit and retain women in neurosurgery should be pursued to rectify this discrepancy.

Letter to the Editor Regarding “Case Series and Systematic Review of Electronic Scooter Crashes and Severe Traumatic Brain Injury”

Though women now comprise approximately 21.5% of all neurosurgery residents in the United States, women only represent 10% of practicing neurosurgeons nationally. Serving as a journal editor is 1 measure of academic success. We investigated characteristics of editorial boards for top neurosurgical journals to identify factors influencing membership on editorial boards. We sought to identify gender differences to explain the paucity of women on editorial boards.This is a cross-sectional study of editorial boards for the top 10 English-language neurosurgical journals. Data were obtained from journal websites, program faculty lists, or physician online profiles. Gender differences were compared using Student t test and χ2 analysis.Seven hundred twenty-two editorial board members were examined (female n = 65; male n = 650; unidentified n = 7). Overall, women had fewer years in practice (P = 0.002) and more often had additional advanced degrees (P = 0.009) while men had higher h-indices (P < 0.0001). Within the boards of Neurosurgery and Acta Neurochirurgica, men had been in practice longer (P = 0.014; P = 0.023) and had higher h-indices (P = 0.003; P = 0.025). Male editors for Journal of Neurosurgery: Spine and World Neurosurgery had higher h-indices (P = 0.007; P = 0.018).Women constitute ∼9% of editorial boards for top neurosurgical journals, a percentage comparable to the amount of practicing female academic neurosurgeons. This finding is encouraging as in that there appears to be no readily identifiable bias in the selection of editorial board members. The differences in years in practice and h-index suggest that gender distribution may equalize with time as more women enter practice and produce scientific literature. Efforts to recruit and retain women in neurosurgery should be pursued to rectify this discrepancy.

Preparing pharmacy faculty through a postgraduate year one pharmacy residency program that includes a master of science in education degree

AbstractAn effective pharmacist workforce requires highly qualified and effective pharmacy educators. Qualifications required of pharmacy practice faculty may vary by academic institution but the American College of Clinical Pharmacy recommends completion of a residency or fellowship that includes structured teaching experiences and scholarly activities. Although teaching and learning certificate programs may offer a way for residents to gain this experience, program quality may vary and there is evidence that department chairs and other administrators may value additional advanced degrees over these certificate programs. However, less than 20% of the faculty surveyed obtained an additional degree beyond the Doctor of Pharmacy. Advanced degree programs are also a relatively uncommon component of pharmacy residency programs, with a Master of Science in Health‐System Pharmacy Administration being the most common. The first year of an innovative postgraduate 24‐month pharmacy practice residency program that includes completion of a Master of Science in Education degree offers the breadth and depth of ambulatory care practice, teaching, service, and research/scholarship that is beneficial for pharmacists seeking pharmacy practice faculty appointments. Eight key residency elements critical for success are detailed. A description of core coursework highlighted the intentional design of the Master of Science in Education degree program. Previous resident graduates reflected on the value of the Master of Science in Education degree program and the overall pharmacy residency program. This unique post‐graduate training program may serve as a model for preparing pharmacy practice faculty.

Letter to the Editor Regarding “Bibliometric Analysis of Publications from 2011–2020 in 6 Major Neurosurgical Journals (Part 1): Geographic, Demographic, and Article Type Trends”

Women have historically been underrepresented in academic medicine, particularly in surgical subspecialties. This study investigated potential associations between gender and promoting practices in academic neurosurgery.Faculty data, including time from residency, professorship, specialty, and h-index, were obtained from websites of the institutions listed in the American Association of Neurological Surgeons Neurosurgical Residency Training Program Directory. Demographics, training, and appointments were compared between male and female neurosurgeons. Predictors of professorship, chair, directorship, and division leadership were identified using multivariable models.The study examined 1629 faculty members. Women were more likely to be assistant professors (P < 0.0001), while men were more likely to be full professors (P < 0.0001), hold chair positions (P = 0.007), lead subspecialty divisions (P = 0.008), and have a higher Scopus h-index (P < 0.0001). In a multivariable analysis, years from training (P < 0.001), fellowship (P = 0.009), h-index (P < 0.001), and chair/program director/division leadership position (P < 0.001) were significant positive predictors of full professorship. Holding additional advanced degrees (P = 0.010), leading a subspecialty division (P = 0.005), and having a higher h-index (P = 0.002) positively predicted chair position. However, when accounting for all other factors, gender was not a significant predictor of full professorship, division leadership, chair, or program directorship.While significantly more men hold leadership positions in U.S. academic institutions, after controlling for contributing variables, there did not appear to be an association between gender and full professorship, division leadership, chair, or program directorship in academic neurosurgery. While the field still has significant work to do to achieve gender equity, these results may serve as encouragement to women who are looking to advance their careers in academic neurosurgery.

Leadership and Advanced Degrees: Evaluating the Association Between Dual Degrees and Leadership Roles in Academic Plastic Surgery.

There are increasingly prevalent formal educational programs for physicians who seek to be better trained to advance their fields. Although higher education and advanced degrees are not necessarily linked to leadership, we hypothesize that leaders in plastic surgery commonly have dual degrees. We sought to evaluate the prevalence of and association between additional advanced degrees in academic plastic surgery and plastic surgery leadership. Plastic surgery faculty from 96 academic training programs and all executive committee and board of directors' members from national, regional, and local plastic surgery societies were evaluated. Surgeons' institutional online profile pages, personal web pages, societal websites, and LinkedIn profiles were all evaluated for current/past leadership roles, as well as for advanced degree. Odds ratios (ORs) were used to determine if the presence of extra degrees increased their likelihood of leadership roles. A total of 1036 plastic surgeons were evaluated. Sixteen percent of academic faculty have a dual degree. Furthermore, 25.5% of plastic surgeons holding formal academic leadership roles have a dual degree (OR, 2.15; P = 0.043), as do 34.4% of those serving on the executive committee or board of directors in national plastic surgery societies (OR, 2.23; P = 0.026) and 29.2% of those serving in local/regional societal leadership roles (OR, 1.96; P = 0.043). Among all dual degrees, Masters in Business Administration has the highest association with leadership roles (OR, 3.45; P = 0.002). Academic plastic surgeons with dual degrees are approximately twice as likely to hold a formal academic or societal leadership role. Additional studies are needed to determine if causative relationships exist.

Gender Equity of Promoting Practices in Academic Neurosurgery in the United States

Women have historically been underrepresented in academic medicine, particularly in surgical subspecialties. This study investigated potential associations between gender and promoting practices in academic neurosurgery. Faculty data, including time from residency, professorship, specialty, and h-index, were obtained from websites of the institutions listed in the American Association of Neurological Surgeons Neurosurgical Residency Training Program Directory. Demographics, training, and appointments were compared between male and female neurosurgeons. Predictors of professorship, chair, directorship, and division leadership were identified using multivariable models. The study examined 1629 faculty members. Women were more likely to be assistant professors (P < 0.0001), while men were more likely to be full professors (P < 0.0001), hold chair positions (P= 0.007), lead subspecialty divisions (P= 0.008), and have a higher Scopus h-index (P < 0.0001). In a multivariable analysis, years from training (P < 0.001), fellowship (P= 0.009), h-index (P < 0.001), and chair/program director/division leadership position (P < 0.001) were significant positive predictors of full professorship. Holding additional advanced degrees (P= 0.010), leading a subspecialty division (P= 0.005), and having a higher h-index (P= 0.002) positively predicted chair position. However, when accounting for all other factors, gender was not a significant predictor of full professorship, division leadership, chair, or program directorship. While significantly more men hold leadership positions in U.S. academic institutions, after controlling for contributing variables, there did not appear to be an association between gender and full professorship, division leadership, chair, or program directorship in academic neurosurgery. While the field still has significant work to do to achieve gender equity, these results may serve as encouragement to women who are looking to advance their careers in academic neurosurgery.

Implicit Bias and the Association of Redaction of Identifiers With Residency Application Screening Scores

Diversity in the ophthalmology profession is important when providing care for an increasingly diverse patient population. However, implicit bias may inadvertently disadvantage underrepresented applicants during resident recruitment and selection. To evaluate the association of the redaction of applicant identifiers with the review scores on ophthalmology residency applications as an intervention to address implicit bias. In this quality improvement study, 46 faculty members reviewed randomized sets of 462 redacted and unredacted applications from a single academic institution during the 2019-2020 ophthalmology residency application cycle. Applications electronically redacted for applicant identifiers, including name, sex or gender, race and ethnicity, and related terms. The main outcome was the distribution of scores on redacted and unredacted applications, stratified by applicant's sex, underrepresentation in medicine (URiM; traditionally comprising American Indian or Alaskan Native, Black, and Hispanic individuals) status, and international medical graduate (IMG) status; the application score β coefficients for redaction and the applicant and reviewer characteristics were calculated. Applications were scored on a scale of 1 to 9, where 1 was the best score and 9 was the worst score. Scores were evaluated for a significant difference based on redaction among female, URiM, and IMG applicants. Linear regression was used to evaluate the adjusted association of redaction, self-reported applicant characteristics, and reviewer characteristics with scores on ophthalmology residency applications. In this study, 277 applicants (60.0%) were male and 71 (15.4%) had URiM status; 32 faculty reviewers (69.6%) were male and 2 (0.4%) had URiM status. The distribution of scores was similar for redacted vs unredacted applications, with no difference based on sex, URiM status, or IMG status. Applicant's sex, URiM status, and IMG status had no association with scores in multivariable analysis (sex, β = -0.08; 95% CI, -0.32 to 0.15; P = .26; URiM status, β = -0.03; (95% CI, -0.36 to 0.30; P = .94; and IMG status, β = 0.39; 95% CI, -0.24 to 1.02; P = .35). In adjusted regression, redaction was not associated with differences in scores (β = -0.06 points on a 1-9 scale; 95% CI, -0.22 to 0.10 points; P = .48). Factors most associated with better scores were attending a top 20 medical school (β = -1.06; 95% CI, -1.37 to -0.76; P < .001), holding an additional advanced degree (β = -0.86; 95% CI, -1.22 to -0.50; P < .001), and having a higher United States Medical Licensing Examination Step 1 score (β = -0.35 per 10-point increase; 95% CI, -0.45 to -0.26; P < .001). This quality improvement study did not detect an association between the redaction of applicant characteristics on ophthalmology residency applications and the application review scores among underrepresented candidates at this institution. Although the study may not have been powered adequately to find a difference, these findings suggest that the association of redaction with application review scores may be preempted by additional approaches to enhance diversity, including pipeline programs, implicit bias training, diversity-centered culture and priorities, and targeted applicant outreach. Programs may adapt this study design to probe their own application screening biases and track over time before-and-after bias-related interventions.

Orthopaedic Sports Medicine Fellowship Directors Are Predominantly White Men With a High Degree of Research Productivity

PurposeTo determine the objective characteristics of fellowship directors (FDs) in orthopaedic sports medicine by focusing on the demographics, academic background, institutional history, research experience, and professional affiliations of FDs in this field. MethodsData was collected for each FD via institutional biographies or publicly available curriculum vitae (CV). The data collected for each FD included age, gender, race/ethnicity, previous training institutions, residency and fellowship graduation years, additional advanced degrees, military affiliation, institutional loyalty, year hired by current institution, career timeline, Scopus H-index, number of publications, and total number of citations. ResultsOf the 88 FDs, 87 (98.9%) were male and 1 (1.1%) was female. The mean age for all FDs was 54.7 years (± 9.1 standard deviation). The majority of FDs were White (n = 80; 90.9%). The mean Scopus H-index, total number of publications, and total number of citations were 22.5 ± 16.6, 90.0 ± 91.6, and 2773.9 ± 3962.9, respectively. On average, it took 9.5 ± 7.3 years from fellowship graduation until FD appointment. Additionally, the mean number of years of employment or affiliation with the current institution was 17.2 ± 9.4, and the mean number of years in an FD role was 10.9 ± 9.3. ConclusionOrthopaedic sports medicine fellowship directors are largely distinguished by their high level of research productivity and accomplishment. Additionally, orthopaedic training pedigree seems to play a role in FD role attainment, with a handful of orthopaedic residency and sports medicine fellowship programs producing a large percentage of current FDs. Finally, FDs are overwhelmingly white males with little female or minority representation. Clinical RelevanceThis study outlines some of the most important characteristics among orthopaedic sports medicine fellowship directors and identifies racial and gender disparities within this population of leaders that may have detrimental effects on the field as a whole.

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

BackgroundUndergraduate 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. MethodsThe 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. ConclusionPrevalence 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.

Association of Surgeon Representation on NIH Study Sections With Receipt of Funding by Surgeon-scientists.

Our goal was to evaluate the relationship between surgeon representation on NIH study sections and success in grant funding. NIH funding for surgeon-scientists is declining. Prior work has called for increased surgeon participation in the grant review process as a strategy to increase receipt of funding by surgeon-scientists. A retrospective review of surgeon (primary department: General, Urology, Orthopedic, Ophthalmology, Otolaryngology, Neurosurgery) representation on NIH study sections and receipt of funding was performed using NIH Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) and 2019 Blue Ridge Institute for Medical Research data. NIH chartered study section panels and ad hoc reviewers for each 2019 review date were also obtained. In 2019, 9239 individuals reviewed in at least 1 of the 168 study sections [190 (2.1%) surgeons, 64 (0.7%) standing members, 126 (1.4%) ad-hoc]. Most surgeons on study sections were male (65%) professors (63%). Surgeons most commonly served on bioengineering, technology, and surgical sciences (29.6% surgeons), diseases and pathophysiology of the visual system (28.3%), and surgery, anesthesiology and trauma (21%). In 2019, 773 surgeons received 1235 NIH grants (>$580 M) out of a total of 55,012 awards (2.2%). Funded surgeons were predominantly male (79%), White (68%), non-Hispanic (97%), full professors (50%), and 43% had additional advanced degrees (MPH/PhD/MBA). surgery, anesthesiology and trauma, diseases and pathophysiology of the visual system, and bioengineering, technology, and surgical sciences were the most common study sections that reviewed funded grants to surgeon-scientists. Ninety-two surgeons both received grant funding and served on study section. Study sections with higher surgeon representation were more likely to fund surgeon-scientists (P < 0.001). Surgeon representation on NIH study sections is strongly associated with receipt of funding by surgeon-scientists. Increasing NIH study section representation by surgeons may help to preserve the surgeon-scientist phenotype.

Assessing Contemporary Trends in Female Speakership within Urologic Oncology

ObjectiveTo evaluate multidisciplinary female representation at urologic oncology conferences, we reviewed speakership trends at contemporary Society of Urologic Oncology (SUO) and American Society of Clinical Oncology Genitourinary Symposium (GU-ASCO) annual meetings. MethodsMeeting programs from SUO and GU-ASCO from 2015 to 2019 were analyzed. Biographical information was determined by querying institutional websites and social/professional media platforms. Statistical analyses were performed to assess for differences and relationships between male and female authorship based on gender, specialty, professional, and educational factors. ResultsWe identified 1102 speakers at genitourinary oncology conferences. Overall, 222 (20%) were female. There was no significant difference between female speakership rates at SUO and GU-ASCO. The overall proportion of female speakers increased over time, but not when analyzing each individual subspecialty conference separately. Several professional and educational differences were noted between genders. Female speakers were more likely to be medical oncologists (P <.001), have more recent years of graduation (2001 vs 1996, P <.001), hold an additional advanced degree (OR 2.09, P = .005), and speak in sessions where other women served as chair (OR 1.42, P = .044). Conversely, female speakers had lower odds of delivering a plenary or keynote address (OR 0.28, P = .015). ConclusionWe identified a significantly positive trend towards increased female representation within contemporary genitourinary conferences over time; these trends did not remain significant when analyzing each meeting separately. Several important disparities between men and women speakers were identified. Our data suggests that inclusion of women in planning committees may help reduce gender bias and promote diversity within urologic oncology.

Salary Disparities in Academic Urogynecology: Despite Increased Transparency, Men Still Earn More Than Women.

To understand the compensation differences between male and female academic urogynecologists at public institutions. Urogynecologists at public universities with publicly available salary data as of June 2019 were eligible for the study. We collected characteristics, including sex, additional advanced degrees, years of training, board certification, leadership roles, number of authored scientific publications, and total National Institutes of Health funding projects and number of registered clinical trials for which the physician was a principal or co-investigator. We also collected total number of Medicare beneficiaries treated and total Medicare reimbursement as reported by the Centers for Medicare & Medicaid Services. We used linear regression to adjust for potential confounders. We identified 85 academic urogynecologists at 29 public state academic institutions with available salary data eligible for inclusion in the study. Males were more likely to be an associate or a full professor (81%) compared with females (55%) and were more likely to serve as department chair, vice chair, or division director (59%) compared with females (30%). The mean annual salary was significantly higher among males ($323,227 ± $97,338) than females ($268,990 ± $72,311, P = 0.004). After adjusting for academic rank and leadership roles and years since residency, the discrepancy persisted, with females compensated on average $37,955 less annually. Salaries are higher for male urogynecologists than female urogynecologists, even when accounting for variables such as academic rank and leadership roles. Physician compensation is complex; the differences observed may be due to variables that are not captured in this study. Nevertheless, the magnitude of disparity found in our study warrants further critical assessment of potential biases within the field.

Lack of Additional Advanced Graduate Training by Orthopaedic Surgeons in Academic Practice: Current Employment and Recruitment Trends.

Background:Orthopaedic surgery is ever changing and depends on diverse technical and intellectual skill sets. The purpose of the current study was to evaluate the percentage of academic orthopaedic surgeons with additional graduate degrees in the United States.Methods:Data including advanced degree(s) (eg, PhD, MS, MBA, MPH, JD, and DVM), academic rank, leadership position, subspecialty, years since training completion, and sex were collected from websites for all academic orthopaedic surgery departments in the United States. Univariate analyses were performed to evaluate for differences in demographic data based on the advanced degree status. Data from the National Resident Matching Program (NRMP) were used to characterize graduate degree-holding US senior medical students who ranked orthopaedic surgery first relative to peers without additional advanced degrees and to applicants who ranked other specialties first.Results:Of 4,519 faculty at 175 academic orthopaedic surgery departments in the United States, 7.1% held a graduate degree in addition to a medical doctorate. There was no difference in the percentage of faculty who held departmental leadership positions (P = 0.62) or who were full professors (P = 0.66) based on holding an additional graduate degree. Of 678 US senior applicants who ranked orthopaedic surgery first and successfully matched into the specialty in 2018, 12.5% held an additional graduate degree and 1.3% were MD-PhDs. Orthopaedic surgery had the second lowest percentage of matched medical students with additional advanced degrees, which was significantly lower than the top 10 specialties (range 16.1% to 21.6%; P < 0.05). Orthopaedic surgery recruited 1.6% of all MD-PhD applicants in 2018.Discussion:Few academic orthopaedic surgery faculty and admitted orthopaedic residency candidates have additional graduate school training. The low percentage of orthopaedic faculty and trainees with additional advanced degrees relative to other specialties may represent a missed opportunity to recruit individuals with diverse skills to advance the field of orthopaedic surgery.

How Well Does Undergraduate Education Prepare College Students for the Employment Outlook? A Secondary Data Analysis of Baccalaureate and Beyond Longitudinal Study (B&amp;B)

The trajectory of successfully completing an undergraduate educational program, attaining postgraduate employment, and beginning advanced degree programs was examined using the Baccalaureate and Beyond Longitudinal Study (B&amp;amp;B: 2008/2012), a large U.S. nationally representative longitudinal sample survey of college graduates who completed the requirements for a baccalaureate degree. The third cohort of this longitudinal study was used to compare participants&amp;rsquo; status at the time of graduation and four years post-graduation. It was hypothesized that graduates whose post baccalaureate employment experiences related to their baccalaureate majors would be more likely to enroll in additional advanced degree studies, and that the post-baccalaureate field of study would be similar to the undergraduate major among those who pursued a graduate degree. Race, gender, disability, and immigration status were entered as control variables. Findings show that within two years, 42.1% of graduates had initiated postsecondary education. These data indicate that graduates were more likely to pursue degrees which were similar to their baccalaureate degree majors. If their bachelor degree majors were health professions, the likelihood that they pursued graduate-level health professional training and related sciences were highest (p&amp;lt;.001). By attending and finishing college, baccalaureate degree recipients heavily invest in their career by using their financial and non-financial resources. College students with fewer resources are less likely to successfully graduate, attain post-graduate employment in their field, and pursue post-baccalaureate studies. Instituting a competency-based curriculum in baccalaureate programs may improve opportunities for students to gain successful employment experiences, increase labor market outcomes, thus narrowing the divide between students with and without financial and non-financial resources.

Leveraging Vertically Integrated Courses and Problem-Based Learning to Improve Students’ Performance and Skills

Commonly adopted engineering pedagogy tends to be lecture based, and places students in a passive and often secondary role in the classroom. Research in the field of engineering education highlights the ineffectiveness of such strategies and advocates adopting strategies that actively engage learners. Various pedagogical techniques promote student engagement; this paper focuses on two specific techniques: problem-based learning (PBL) and vertical integration. The authors created engaging classroom environments through vertically integrated courses that implemented PBL through shared course projects. Specifically, the authors created a framework for pairing two different student bodies across two disciplines, integrating a graduate civil engineering course (32 students) and an undergraduate construction management course (22 students). Implementation of the Spring 2016 framework improves student performance on course projects and students’ self-reported professional skill level and confidence in said skills, developed in part through participation in the framework. Further, the framework has a positive impact on undergraduate students’ intention to stay in their major and both student bodies report more interest in completing an additional advanced degree after participating in the vertically integrated courses. Finally, students report that the experience teaches professional skills they expect will be required in their own future careers. It is notable that undergraduates recognized more benefits of this implementation, especially that they have more potential for improvement than advanced graduate students. This paper contributes to the engineering education body of knowledge by delivering a proof of concept that PBL through vertical integration of different disciplines across undergraduate and graduate students supports improved performance and encourages professional skill development and confidence. The paper presents the framework itself, as well as evaluative results from framework implementation.

A cross-sectional study of neurosurgical department chairs in the United States.

OBJECTIVEThe position of neurosurgery department chair undergoes constant evolution as the health care landscape changes. The authors' aim in this paper was to characterize career attributes of neurosurgery department chairs in order to define temporal trends in qualities being sought in neurosurgical leaders. Specifically, they investigated the hypothesis that increased qualifications in the form of additional advanced degrees and research acumen are becoming more common in recently hired chairs, possibly related to the increased complexity of their role.METHODSThe authors performed a retrospective study in which they collected data on 105 neurosurgeons who were neurosurgery department chairs as of December 31, 2016, at accredited academic institutions with a neurosurgery residency program in the United States. Descriptive data on the career of neurosurgery chairs, such as the residency program attended, primary subspecialty focus, and age at which they accepted their position as chair, were collected.RESULTSThe median age and number of years in practice postresidency of neurosurgery chairs on acceptance of the position were 47 years (range 36-63 years) and 14 years (range 6-33 years), respectively, and 87% (n = 91) were first-time chairs. The median duration that chairs had been holding their positions as of December 31, 2016, was 10 years (range 1-34 years). The most common subspecialties were vascular (35%) and tumor/skull base (27%), although the tendency to hire from these specialties diminished over time (p = 0.02). More recently hired chairs were more likely to be older (p = 0.02), have more publications (p = 0.007), and have higher h-indices (p < 0.001) at the time of hire. Prior to being named chair, 13% (n = 14) had a PhD, 4% (n = 4) had an MBA, and 23% (n = 24) were awarded a National Institutes of Health R01 grant, tendencies that were stable over time (p = 0.09-0.23), although when additional degrees were analyzed as a binary variable, chairs hired in 2010 or after were more likely to have an MBA and/or PhD versus those hired before 2010 (26% vs 10%, p = 0.04). The 3 most common residency programs attended by the neurosurgery chairs were Massachusetts General Hospital (n = 8, 8%), University of California, San Francisco (n = 8, 8%), and University of Michigan (n = 6, 6%). Most chairs (n = 63, 61%) attended residency at the institution and/or were staff at the institution before they were named chair, a tendency that persisted over time (p = 0.86).CONCLUSIONSMost neurosurgery department chairs matriculated into the position before the age of 50 years and, despite selection processes usually involving a national search, most chairs had a previous affiliation with the department, a phenomenon that has been relatively stable over time. In recent years, a large increase has occurred in the proportion of chairs with additional advanced degrees and more extensive research experience, underscoring how neurosurgical leadership has come to require scientific skills and the ability to procure grants, as well as the financial skills needed to navigate the ever-changing financial health care landscape.

Asian/Pacific Librarians Career Choices: A Mixed Method Study

This is a mixed method study of Asian/Pacificlibrarians career choices related to leadershippositions. The statistical analyses are based ondata from 91 librarians in survey Q1 distributedto 600+ CALA and APALA members. Thecorrelation, prediction of association, cross-tabbing,and ANOVA tests were applied to the survey.The result shows that the leadership position iscorrelated with number of years worked in thelibrary profession, number of publications,number of voluntary job changes, and nationalprofessional association’s involvement. Therewas a suggested correlation between leadershippositions and additional advanced degrees andover half of librarians with a doctoral degree arein chief librarian positions. The study also nullifiesthe hypothesis that achieving leadership position is less likely for first generation immigrants orimmigrants who did not receive k-12 orundergraduate education in the North America.In addition, the differences in professional,community, and political involvement areexamined among professional librarians,supervising librarians and chief librarians.The comments from the quantitative surveyQ1 contain rich data which can’t be interpretedby existing statistical methods. The Q1 commentsbecame the first section of a follow-up qualitativestudy using situation coding and subjectperspective coding method. A separate qualitativesurvey Q2 was sent to 12 Asian/Pacific chieflibrarians only. Eight chief librarians completedQ2 covering biographical information andin-depth questions on perceptions of leadershipachievement gap among Asian/Pacific Americanlibrarians. Comparison of comments of Q1for professional librarians and Q2 for chieflibrarians suggested many similar themesemerged. The triangulation from differentAsian/Pacific librarian population validatedthe finding.