Trained Males Research Articles

Likelihood of fitness improvements during a standardised physical fitness programme in US Army trainees of different fitness levels

IntroductionUS Army Initial Entry Training (IET) aims to develop general fitness and conditioning among large groups of trainees. Despite group mean improvement in physical fitness during IET, some trainees experience...

Sex, Race, and Ethnic Diversity of the Emerging US Orthopaedic Sports Medicine Workforce is Limited

The purpose of this study was to analyze the demographics and trends of orthopaedic surgeons entering the US orthopaedic sports medicine workforce over the past decade. This was a cross-sectional study of allopathic medical students, orthopaedic surgery residents, and orthopaedic sports medicine fellows in the US (2013-2022) leveraging data from the Accreditation Council for Graduate Medical Education and American Medical Association. Disparities in demographic representation between orthopaedic sports medicine fellows and the 2020 US population census were quantified with participation-to-prevalence ratios (PPRs). A PPR between 0.8-1.2 was classified as equivalent representation and a PPR<0.8 was classified as under-representation, relative to the US population. The representation of female, Hispanic, Black, and Asian trainees decreased at each stage of the training pipeline to orthopaedic sports medicine fellowship training. In contrast, the representation of White trainees increased at each stage of the training pipeline. Over the study period, there were modest increases in female (9.9% to 12.6%) and Hispanic (1.2% to 1.7%) trainee representation in orthopaedic sports medicine. In contrast, Asian (16.6% to 5.6%) and Black (5.1% to 1.9%) trainee representation decreased. Relative to the US population, female (PPR=0.22), Black (PPR=0.30), Hispanic (PPR=0.19), Native Hawaiian/Pacific Islander (PPR=0.01), and Native American/Alaskan Native (PPR=0.00) trainees were underrepresented. In contrast, male (PPR=1.79), Asian (PPR=1.96), and White (PPR=1.36) trainees were overrepresented in orthopaedic sports medicine. There is limited diversity in the emerging orthopaedic sports medicine workforce relative to the US population. Improvements in the representation of female, Black, and Hispanic trainees in orthopaedic sports medicine has been marginal relative to trends observed at US allopathic medical schools. Promoting diversity and inclusion in the orthopaedic sports medicine workforce can create more surgical provider options for diverse patient populations in the US.

Burnout among Postgraduate Healthcare Trainees at a Tertiary Healthcare Center in Saudi Arabia.

The aim of this study was to investigate the level of burnout among postgraduate healthcare trainees at a tertiary care center in Riyadh, Saudi Arabia, and assess the need to establish a well-being program. This cross-sectional study was conducted between December 2021 and January 2022 and used two validated questionnaires: the Copenhagen Burnout Inventory (CBI) for assessing burnout among postgraduate healthcare trainees, and a questionnaire for assessing program directors' opinion on the need for a well-being program. A total of 386 trainees and 85 program directors completed the questionnaire. In both groups, the majority of the respondents were male (trainees: 53.9%; program directors: 61.2%). A total of 226 trainees (58.5%) scored above the CBI burnout cut-off score, with the median score being highest in the personal domain (62.5,IQR: 45.8-75). In the univariate analysis, the mean burnout score was higher among trainees who were married (P = 0.036), had children (P = <0.001), and were seniors (P = 0.028), whereas in the multivariate analysis, the only significant predictor of burnout was having 1-2 children (P = 0.023) or 3-4 children (P = 0.013). In the program directors survey, 90.6% agreed that improving physicians' well-being would directly rectify patients' overall well-being, but only 28.2% stated that it is currently incorporated in the curriculum. This study found that a large proportion of postgraduate healthcare trainees experience burnout, particularly in the personal domain. Although program directors supported the concept of trainees' well-being, its incorporation into the curriculum was lacking, suggesting the necessity of establishing a well-being program.

Canadian female perspectives on training in the boys club: advanced therapeutic endoscopy

Abstract Introduction Unequal female representation in the field of advanced therapeutic endoscopy (ATE) has been recently highlighted in the United States. Previous attempts to determine the barriers to entry into the career have reported a lack of mentorship, patriarchy, inflexible hours/calls and exposure to fluoroscopy. Canadian trainee exposure to ATE and differences in experience between men and women is unknown. Objectives We sought to determine the barriers to pursuing a career in ATE, specifically focussing on the perspectives of Canadian female gastroenterology fellows. Methods An online survey was developed and distributed to Canadian gastroenterology fellows enrolled in Royal College-accredited programs in 2021-2022 Results Responses were received from gastroenterology fellows at 12 of the 14 Canadian programs. The response rate was 46% (n = 42, 16 female respondents and 26 male respondents). An equal proportion of male (42%, n = 11) and female (38%, n = 6) trainees indicated interest in a career in ATE. Thirty-eight per cent (n = 6) of female trainees felt that they had inadequate mentorship opportunities/role models within ATE, in comparison to 4% (n = 1) of males (P = .004). Furthermore, 19% (n = 3) of females felt that this lack of mentorship/role models was a primary deterrent from pursuing ATE as a career, in comparison to 0% of males (P = .02). There was equal self-perceived competency surrounding ATE knowledge between both men and women. Conclusions Female gastroenterology fellows in Canada lack mentorship and role models in ATE, which seems to be a primary deterrent from pursuing it as a career when compared to their male counterparts. Recognizing and addressing the lack of female leadership and visibility is necessary to improve parity and encourage women to train in the male-dominated field of ATE.

Minimal Impact of Age on Adaptive Bone Formation in the Distal Tibia of US Army Basic Combat Trainees: The ARMI Study

ABSTRACT Introduction Although bone formation has been observed in the distal tibia of trainees during Basic Combat Training (BCT), some animal studies have demonstrated greater mechanosensitivity in the juvenile compared to the mature skeleton. How age affects skeletal adaptations to military training is unknown. The purpose of this study was to determine if skeletal adaptations to US Army BCT differ by age. Methods We enrolled 2085 trainees (1303 males, 782 females). High-resolution peripheral quantitative computed tomography was used to assess total, cortical, and trabecular bone mineral density (BMD) and the microarchitecture of the distal tibia before and after 8 wk of BCT. Generalized linear models were used to compare mean percent change (95% confidence interval (CI)) in each bone parameter by age group (&lt;20, 20–25, 26–29, and ≥30 yr) and to evaluate differences in bone parameter changes between age groups (effect estimates (95% CI)). Models were stratified by sex with multivariable adjustment. Results Male and female trainees in all age groups had increases in total BMD, trabecular BMD, and trabecular bone volume fraction from baseline (P &lt; 0.01 for all). Male and female trainees also had increases in trabecular thickness from baseline in all groups (P &lt; 0.05) except females ≥30 yr old. Female trainees 20–25 yr old had a significantly larger increase in trabecular thickness than those &lt;20 yr old (effect estimate (95% CI), 0.33% (0.02%–0.64%); P &lt; 0.05). Trabecular microarchitecture was largely not otherwise different between age groups for either sex. Male and female trainees &lt;20 yr old had greater changes in cortical BMD compared to older age groups (males, P &lt; 0.01; females, P &lt; 0.05 for all). Conclusion Trainees &lt;20 yr old experience the greatest improvements in cortical BMD at the distal tibia during US Army BCT, suggesting that adaptive bone formation in cortical bone may be attenuated with skeletal maturity. However, the mechanosensitivity of trabecular bone to exercise training remains intact regardless of age.

Gender Distribution in Paediatric Cardiology Training Programs in Canada

BackgroundDespite female medical students being the majority, there are certain medical specialities that continue to have a prevalence of male trainees, such as adult cardiology. The purpose of this study is to examine gender distribution within Canadian paediatric cardiology training programs. MethodsBoth application and successful matches to core paediatric residency programs and paediatric cardiology programs were obtained through the Canadian Resident Matching Service. Analysis was performed to determine if the association between gender of paediatric residents and paediatric cardiology applicants/fellows was significant. ResultsBetween 2016 and 2024, 12% (n = 3/26) of individuals who successfully matched into a Canadian paediatric cardiology training program identified as female and 88% (n = 23/26) identified as male. Between 2013 and 2023, 78% (n = 947/1220) of individuals who successfully matched into a Canadian paediatrics residency identified as female and 22% (n = 273/1220) identified as male. There was a statistically significant difference between the gender of paediatric residents and the gender of paediatric cardiology residents (P < 0.0001). There was no significant association between applicant gender and match outcome within paediatric cardiology training programs (P < 0.23). ConclusionsThere is a gender discrepancy within Canadian paediatric cardiology training programs with a predominance of male trainees in the recent era. It appears that female under-representation in the field is due to the low number of female applicants. Although limited by sample size, there was no clear association between applicant gender and success of admission to a paediatric cardiology training program.

Association between changes in serum bone metabolism markers and bone microarchitecture changes during basic combat training – The ARMI study

ImportanceU.S. Army Basic Combat Training (BCT) improves tibial volumetric bone mineral density (BMD) and structure in most, but not all soldiers. Few studies have investigated whether changes in serum bone biomarkers during BCT are associated with changes in tibial BMD and bone structure following BCT. ObjectiveTo characterize bone biomarker changes during BCT and to investigate the relationship between changes in bone biomarkers and changes in tibial BMD and bone structure. MethodsWe enrolled 235 trainees entering BCT in this ten-week prospective observational study. Trainees provided fasted blood samples and questionnaires weekly throughout BCT. Procollagen type 1 N-terminal propeptide (PINP) and C-terminal telopeptide of type 1 collagen (CTX) were measured by enzyme-linked immunoabsorbent assays every two weeks during BCT. We evaluated body composition and mass via dual-energy X-ray absorptiometry and bone structure, microarchitecture, and mineral density at the distal tibia via high-resolution peripheral quantitative computed tomography at baseline and post-BCT. ResultsBoth male (n = 110) and female trainees (n = 125) were young (20.9 ± 3.7 and 20.7 ± 4.3 years, respectively), with normal to overweight BMIs (25.2 ± 4.1 and 24.2 ± 3.6 kg/m2, respectively). In female trainees, PINP increased during and post-BCT compared to baseline, with the greatest increase in PINP at week four (45.4 % ± 49.6, p < 0.0001), whereas there were no changes in CTX. PINP also increased in male trainees, but only at weeks two and four (21.9 % ± 24.5, p = 0.0027 and 35.9 % ± 35.8, p < 0.0001, respectively). Unlike female trainees, in males, CTX was lower than baseline at weeks four, eight, and post-BCT. The change in PINP from baseline to week four of BCT was positively associated with changes in tibial BMD, Tb.BMD, Tb.Th, Tb.BV/TV, Ct.Th, Ct.Ar, and Ct.Po from the baseline to post-BCT. ConclusionThe bone formation marker PINP increases during U.S. Army BCT, especially during the first four weeks. Increases in PINP, but not CTX, were correlated with improved BMD and bone structure in the distal tibia.

Female interns are not choosing radiology as a career-national survey providing insights into gender imbalance.

Women are under-represented in Radiology, both globally and in Ireland. An annual review of the medical workforce in Ireland for the year 2021-2022 revealed that although the overall gender breakdown of trainees is similar, with 56% female and 44% male trainees, certain specialities have disproportionate numbers of a given gender. Females only account for 38% of Irish Radiology trainees, one of the lowest of all the specialties. The cause for this disparity is likely multifactorial, but a lack of interest inapplying for Radiology training by female doctors is a possible cause. The objectives of this study were to identify specific factors that attract or deter intern doctors from considering a career in Radiology and to identify underlying gender-specific differences. Anonymous online surveys were distributed to 50% of the intern population in Ireland between May and June 2022. The survey included questions on demographics, prior radiology exposure, and dedicated multiple-choice questions for those either considering or not considering radiology, which were subdivided into potentially influencing factors. Two-hundred-seven interns responded giving a response rate of 48.3%, which totalled almost 25% of the interns in Ireland. For those interns considering radiology, significantly more male interns (n = 24/67, 35.8%) are considering radiology compared with females (n = 26/139, 18.71%), (p < 0.009). Significantly more females were deterred by the perception of radiology as a male-based speciality (p < 0.004). Significantly fewer females are considering radiology, deterred by physics knowledge, use of technology, and, significantly, by the perception of radiology as a male-dominated speciality. This survey highlights important reasons that female interns are deterred from radiology. It will help direct future medical training and doctor recruitment policies, with a view to addressing the ongoing gender disparity in the Irish radiology workforce. Women are under-represented in the Irish and global Radiology workforce. Female interns are dissuaded from Radiology as a career by their perception of Radiology as male-dominated. This survey will shape medical training and doctor recruitment policies to improve gender diversity in radiology.

Comparing Male and Female Resident Physicians in Central Venous Catheter Insertion Self-confidence and Competency: A Retrospective Cohort Study.

Female physicians often report lower self-confidence in their procedural and clinical competency compared to male physicians. There is limited data regarding self-reported confidence of female versus male trainees and any relation to objective competency in central venous catheter insertion. To analyze differences between male and female trainees in self-confidence and skill-based outcomes in placing central venous catheters. Using data from a central venous catheter simulation training program at a large tertiary medical center, we performed linear regressions to analyze confidence difference pre- and post-training, number of restarts, and number of cannulation attempts while controlling for baseline demographic characteristics of the sample. PGY-1 physician residents in all residency specialties who insert central venous catheters in the clinical setting at a tertiary academic center with a sample size of 281 residents. Confidence difference pre- and post-training measured on a Likert scale 1-5, number of restarts (novel global assessment variable), and number of cannulation attempts during the competency evaluation. Female trainees had both lower pre-program confidence (1.35 versus 1.74 out of 5, p < 0.001) and lower post-program confidence (3.77 versus 4.12 out of 5, p = 0.0021) as compared to male trainees. There was no statistically significant difference in number of restarts (95% CI - 0.073 to 0.368, p = 0.185) or cannulation attempts (95% CI - 0.039 to 0.342, p = 0.117) between sexes in linear regressions controlled for age, specialty designation, prior central venous catheter training, prior ultrasound guided vessel cannulation training, and pre-training confidence level. Female trainees rated their confidence significantly lower than their male counterparts both before and after the training program, despite no significant difference in skill-based outcomes. We discuss potential implications for trainees acquiring procedural skills during residency and for physician educators as they design training programs and delegate procedural opportunities.

Effects of Altitude training on Ethiopian endurance athletes recovery heart rate and hematological variables

Background and Study Aim. A recent study indicates that Ethiopian middle- and long-distance athletes originate from diverse geographical regions, including areas of varying elevation. This study aimed to analyze the impact of altitude training on hematological parameters and recovery heart rates among young male endurance trainees training at sites located at different altitude levels. Material and Methods. The study employed a quasi-experimental, counterbalanced approach involving 15 male trainees. Five individuals from each training center experienced the standard training program across three distinct geographical locations and elevations. Pre- and post-test data were collected on red blood cells, hemoglobin, hematocrit, platelet count, and recovery heart rate before and after six months, from 6:00–8:00 AM. ANCOVA was utilized to analyze the data. Results. Following the intervention, the mean Red Blood Cell (RBC) count was observed to be higher in trainees from low altitude (5.18±0.33) compared to those from moderate altitude (4.48±0.14 and 5.21±0.22), with a significance level of p&lt;0.05. The mean Hemoglobin (HGB) count was found to be higher in moderate altitude trainees (17.00±0.70 and 16.31±0.65) than in low altitude trainees (15.82±1.37), although this difference was not statistically significant (p&gt;0.05). Similarly, the mean Hematocrit (HCT) count was low for both low altitude (46.04±3.49) and moderate altitude trainees (46.46±3.9 and 45.42±1.54), with no significant difference noted (p&gt;0.05). The mean Platelet (PLT) count was 226.8±75.88 for low altitude trainees and 265.8±23.18, 276±53.96 for moderate altitude trainees, with no significant difference between the groups (p&gt;0.05). As for the recovery heart rate, mean values showed no significant difference between the pre-and post-test groups. In the pretest, the mean recovery heart rate was 30.00±14.70 for low-altitude trainees and 43.20±8.90, 43.20±13.68 for moderate-altitude trainees (p&gt;0.05). In the post-test, the mean recovery heart rate was 25.20±7.82 for low-altitude trainees and 32.40±10.04, 36.00±7.35 for moderate-altitude trainees (p&gt;0.05). Conclusions. The findings indicate that training at different altitudes impacts the hematological and cardiovascular systems of endurance athletes in varied ways. This underscores the importance of developing tailored training programs to optimize performance and recovery. These results are particularly relevant for coaches and athletes seeking to enhance endurance training outcomes through altitude training strategies.

Analysis of the diversity pipeline for the orthopedic trauma surgeon workforce in the United States

IntroductionThere is a lack of research on the state of racial, ethnic, and gender diversity in the emerging orthopedic trauma workforce. The purpose of this study was to analyze the training pathway for diverse candidates in orthopedic trauma as it relates to race, ethnicity, and sex. MethodsSelf-reported demographic data were compared among allopathic medical students, orthopedic surgery residents, orthopedic trauma fellows, and the general population in the United States (2013–2022). Race categories consisted of White, Asian, Black, and Native American/Alaskan Native (NA/AN), and Native Hawaiian/Pacific Islander (NH/PI). Ethnicity categories were Hispanic/Latino or non-Hispanic/Latino. Sex categories were male and female. Representation was calculated at each stage of accredited training. Participation-to-prevalence ratios (PPRs) quantified the equitable representation of demographic groups in the emerging orthopedic trauma workforce relative to the US population. PPR thresholds were used to classify representation as overrepresented (PPR > 1.2), equitable (PPR = 0.8–1.2), and underrepresented (PPR < 0.8). ResultsRelative to medical school and orthopedic surgery residency, fewer female (48.5 % vs 16.7 % vs 18.7 %, P < 0.001), Hispanic (6.1 % vs 4.5 % vs 2.6 %, P < 0.001), Black (6.9 % vs 5.0 % vs 3.1 %, P < 0.001), and Asian (24.0 % vs 14.3 % vs 12.2 %, P < 0.001) trainees existed in orthopedic trauma fellowship training. In contrast, more male (51.5 % vs 83.3 % vs 81.3 %, P < 0.001) and White (62.8 % vs 79.1 % vs 84.0 %, P < 0.001) trainees existed in orthopedic trauma fellowship relative to earlier training stages. There were zero NA/AN or NH/PI trainees in orthopedic trauma (PPR = 0). Relative to the US population, Hispanic (PPR = 0.14), Black (PPR = 0.25), and female (PPR = 0.37) trainees were underrepresented in orthopedic trauma. In contrast, Asian (PPR = 2.04), male (PPR = 1.64), and White (PPR = 1.36) trainees were overrepresented in orthopedic trauma. ConclusionWomen, racial, and ethnic minorities are underrepresented in the emerging orthopedic trauma workforce relative to the US population, and earlier stages of training. Targeted recruitment and guided mentorship of these groups may lead to greater interest, engagement, and diversity in orthopedic trauma.

Surgeon and Surgical Trainee Experiences After Adverse Patient Events

Adverse patient events are inevitable in surgical practice. To characterize the impact of adverse patient events on surgeons and trainees, identify coping mechanisms, and assess whether current forms of support are sufficient. In this mixed-methods study, a validated survey instrument was adapted and distributed to surgical trainees from 7 programs, and qualitative interviews were conducted with faculty from 4 surgical departments in an urban academic health system. The personal impact of adverse patient events, current coping mechanisms, and desired forms of support. Of 216 invited trainees, 93 (43.1%) completed the survey (49 [52.7%] male; 60 [64.5%] in third postgraduate year or higher; 23 [24.7%] Asian or Pacific Islander, 6 [6.5%] Black, 51 [54.8%] White, and 8 [8.6%] other race; 13 [14.0%] Hispanic or Latinx ethnicity). Twenty-three of 29 (79.3%) invited faculty completed interviews (13 [56.5%] male; median [IQR] years in practice, 11.0 [7.5-20.0]). Of the trainees, 77 (82.8%) endorsed involvement in at least 1 recent adverse event. Most reported embarrassment (67 of 79 trainees [84.8%]), rumination (64 of 78 trainees [82.1%]), and fear of attempting future procedures (51 of 78 trainees [65.4%]); 28 of 78 trainees (35.9%) had considered quitting. Female trainees and trainees who identified as having a race and/or ethnicity other than non-Hispanic White consistently reported more negative consequences compared with male and White trainees. The most desired form of support was the opportunity to discuss the incident with an attending physician (76 of 78 respondents [97.4%]). Similarly, faculty described feelings of guilt and shame, loss of confidence, and distraction after adverse events. Most described the utility of confiding in peers and senior colleagues, although some expressed unwillingness to reach out. Several suggested designating a departmental point person for event debriefing. In this mixed-methods study of the personal impact of adverse events on surgeons and trainees, these events were nearly universally experienced and caused significant distress. Providing formal support mechanisms for both surgical trainees and faculty may decrease stigma and restore confidence, particularly for underrepresented groups.

Medical students and residents of both sexes have similar learning curves for laparoscopy simulator training

BackgroundSimulation-based laparoscopy training is a standard part of modern surgical education. Studies focused on optimizing training for surgical residents have often used medical students as study participants. This has been criticized as medical students might have different prerequisites for surgical skills training due to their limited knowledge and exposure to real-life laparoscopic procedures. Simulation-based training has also been criticized for favouring male trainees due to its resemblance with video games and focus on competition. This study aimed to investigate if there is any difference in skills acquisition between novice surgical residents and medical students for proficiency-based laparoscopic training. Furthermore, to examine if there was a difference between male and female participants. MethodWe did a post-hoc study combining data from 59 participants from four previously published randomized trials. We compared residents with medical students and females with male participants across studies with identical training programs. ResultsThe median time to reach proficiency in the first training program comparison was 295 (IQR: 269-357) and 318 (241-445) minutes, respectively, for the residents and medical students (p=0.87). Male trainees spent 323 (IQR: 281-371) minutes to reach proficiency compared to 318 (IQR: 241-445)minutes for females (p=0.73). In the second training program comparison, the residents and medical students spent 169 (IQR: 123-229) and 165 (IQR: 128-214) minutes (p=0.67), respectively, reaching proficiency. The times for males and females were 166 (IQR: 61-151)minutes and 169 (61-117) minutes, respectively (p=0.74). ConclusionSimilar learning curves were observed for laparoscopic skills acquisition for residents and medical students. No difference was observed between male and female participants for proficiency-based laparoscopy simulator training.

Fortifying the workforce: A national survey of hematology/oncology fellowship program directors and training fellows for community-based careers.

9028 Background: Most hematology/oncology (HO) care occurs in community settings. In a recent national survey of currently practicing community oncologists, we highlighted areas of unmet need regarding preparation for community-based (CB) careers during fellowship [Agrawal et al, JCO OP 2024]. Our study aims to explore attitudes of HO fellowship program directors (PDs) relating to CB HO training. Methods: We conducted a cross-sectional email survey of 185 HO fellowship PDs in the United States. The primary outcome was assessing PDs’ attitudes regarding inclusion of CB HO training during fellowship. Secondary outcomes included assessing whether programs currently have clinical and/or non-clinical training experiences specifically addressing skills relevant to community practice. Participants were also surveyed to assess PDs’ attitudes regarding what motivates fellows to choose careers in community practice. Demographics pertaining to program leadership and fellows were also obtained. Results: We received a total of 53 responses (29% response rate). The majority of respondents’ programs were in academic tertiary care hospitals (76%) with a plurality in the Northeast (32%), had a median of 5 trainees per class, and had roughly equal Male and Female (including transgender men and women) trainees (70%). The majority of PDs had been in clinical practice for ≥10 years (68%) and in their program leadership position for ≤10 years (83%). Almost all PDs (96%) reported having graduates who pursue careers in CB settings, with financial compensation cited most frequently in making this decision (98%). The majority of PDs (83%) agreed that training experiences in CB HO should be available for their trainees during fellowship. A multivariate regression analysis demonstrated that there were no significant factors associated with this outcome (p&gt;.05). Training experiences relevant to community practice were not uniformly available amongst programs, with 74% of programs offering clinical experiences, but only 32% offering non-clinical experiences. The most cited clinical experience was the option to rotate in a CB setting (80%), and the most common non-clinical experience was exposure to training in quality improvement/patient safety (88%). Conclusions: While most HO training programs in the U.S. are embedded within academic centers, nearly all PDs indicated their programs train fellows who pursue careers in the community. PDs believe that experiences tailored to CB HO practice should be available to their fellows. Although many respondents’ programs offer CB clinical rotations, relevant extra-clinical skill development opportunities are lacking. Goal-concordant pathways for career development during HO fellowship can be optimized, particularly as they relate to training individuals for practice in CB settings, a growing need within the HO workforce.

Revitalizing Urologists' Role in Transplantation as a Novel Strategy to Address Surgeon Shortage: Results from a Cross-Sectional Survey.

Urologists represent functional alternatives for transplant surgeons, but their involvement is minimal. Evaluating urologists' interests in transplant and identifying associated factors may help to determine whether recruitment of more urological providers is a viable strategy to address transplant surgeon shortages in the United States. We emailed a 10-question survey to individuals pursuing urology in the United States and collected demographic data, education and training backgrounds, and preferences for proposed integrated residency programs and abbreviated transplant fellowships. We stratified respondents based on transplant interest (yes/no); we made comparisons by using t-tests for continuous variables and Fisher exact tests for categorical variables. We used multivariable logistic regression to identify factors associated with interest in transplant surgery. Of 104 respondents, 98 were included in the final analysis, with 47% indicating a current or prior interest in transplantation. Male respondents were 3.7 times more likely than female respondents to be interested (odds ratio = 4.675; 95% CI, 1.411-15.495; P = .012). Participants aged <30 years were 93% less likely than older participants to be interested in transplantation (odds ratio = 0.071; 95% CI, 0.006-0.779; P = .03). International medical graduates reported higher enthusiasm for transplantation compared with US-trained counterparts (89% vs 42%), with a trend toward significance (P = .06). Nearly all (93%, 43/46) who expressed interest endorsed having an integrated training pathway. Only 70% (32/46) supported an abbreviated fellowship (<24 mo). Lifestyle concerns and insufficient exposure during residency were the most frequently cited reasons for lack of interest. Compared with male and older urology trainees, female and younger urology trainees were less inclined to pursue transplant surgery. Nonetheless, urologists represent an untapped pool of transplant surgeons. Proposing an integrated training program for urologists and increasing exposure to transplantation during urology residency represent potential strategies to decrease transplant surgeon shortages.

Outcome of Intensive Physical Exercise on the Prevalence of Iron-Deficiency Anemia in Saudi Military Trainees

Abstract: BACKGROUND: Iron deficiency (ID) is considered a common health condition among military personnel, particularly soldiers during a period of high-intensity workouts. The causes, prevention, and treatment of ID anemia (IDA) remain the subject of ongoing and extensive research in various populations. AIM: This is the first research to study the outcome of 14 weeks of intensive physical exercise on the prevalence and factors associated with ID and IDA among Saudi military male trainees. MATERIALS AND METHODS: A cross-sectional study was conducted among n = 101 trainees who completed a questionnaire on sociodemographic data, dietary habits, current or past diagnoses of medical conditions, and physical activity. Two blood samples were collected from each participant to estimate (1) C-reactive protein and iron profile and (2) complete blood counts by the CellDYN Sapphire automated blood cell counter. Hemoglobin (Hb) fractions were identified and quantified by high-performance liquid chromatography using the TOSOH G8 analyzer to exclude hemoglobinopathy and thalassemia. RESULTS: The prevalence of ID, comprising both ID erythropoiesis and IDA among trainees, was found to be 65.3%. The occurrence of IDA was 5%, while ID erythropoiesis was detected among 60.4%. The prevalence of ID was statistically significantly higher among those drinking coffee during military training (P = 0.048). CONCLUSIONS: Further studies are recommended to validate this study’s findings by incorporating a larger sample and extending the duration of the training period and examine the mechanisms that explain the increased risk of ID during vigorous military training.

The effect of gender on emotional reactions and perceptions when individuals meet themselves in immersive virtual reality

Immersive virtual reality-based training and research are becoming more and more popular and are in continuous development. For instance, it is now possible to be trained by one’s virtual self (i.e., doppelganger), meaning that a trainee can participate in a training program in which the trainer resembles the trainee. While past research involving doppelgangers showed promising results, findings revealed gender effects such that doppelganger-based training seems to be beneficial only for male trainees. In the present research, we contribute to this literature by investigating the emotional reactions and perceptions that people have when they meet a virtual human in immersive virtual reality. Specifically, we assess the extent to which the appearance of the virtual human (doppelganger vs. unknown avatar) and an individual’s gender influence these reactions and perceptions. We found that males felt more positive emotions toward their doppelganger than toward the unknown avatar and that females perceived their doppelganger as less competent and warm than the unknown avatar. Our findings have important practical implications in terms of virtual reality-based training and research design such that the use of a doppelganger (unknown avatar) might be recommended in a training program or research setting involving men (women).

Citizenship status and career self-efficacy: An intersectional study of biomedical trainees in the United States.

This study examines the intersectional role of citizenship and gender with career self-efficacy amongst 10,803 doctoral and postdoctoral trainees in US universities. These biomedical trainees completed surveys administered by 17 US institutions that participated in the National Institutes of Health Broadening Experiences in Scientific Training (NIH BEST) Programs. Findings indicate that career self-efficacy of non-citizen trainees is significantly lower than that of US citizen trainees. While lower career efficacy was observed in women compared with men, it was even lower for non-citizen female trainees. Results suggest that specific career interests may be related to career self-efficacy. Relative to US citizen trainees, both male and female non-citizen trainees showed higher interest in pursuing a career as an academic research investigator. In comparison with non-citizen female trainees and citizen trainees of all genders, non-citizen male trainees expressed the highest interest in research-intensive (and especially principal investigator) careers. The authors discuss potential causes for these results and offer recommendations for increasing trainee career self-efficacy which can be incorporated into graduate and postdoctoral training.

Occupational stress and stress management among female and male trainees

The transition from school to professional life is asignificant event for adolescents and young adults. It is not uncommon for fears or feelings of being overwhelmed to arise during this transitional period. Against this backdrop, the article examines the subjective stress experiences of trainees, with special consideration given to gender and various occupational settings. From seven Bavarian vocational schools, 1209 students were surveyed. Stress experiences, coping strategies, psychological and physical complaints, as well as occupational burdens were assessed. Relationships between demographic characteristics, professional settings, and stress experiences were investigated through bivariate and multivariate analyses. Female students report higher levels of stress and are more likely to use emotion-regulating stress coping strategies. Men more frequently attempt to compensate for stress through alcohol and drugs. Differences in stress burden between occupational groups are only evident in bivariate analysis. In multivariate analyses, the gender effect remains highly significant. Negative occupational demands and maladaptive coping strategies significantly promote the experience of stress. The results suggest that asignificant proportion of respondents perceive the training conditions as burdensome, are exposed to health risks, and respond inadequately to stress. The establishment of additional prevention programs in both the training company and in vocational school would be desirable.

Assessing supervisor versus trainee viewpoints of entrustment through cognitive and affective lenses: an artificial intelligence investigation of bias in feedback

The entrustment framework redirects assessment from considering only trainees’ competence to decision-making about their readiness to perform clinical tasks independently. Since trainees and supervisors both contribute to entrustment decisions, we examined the cognitive and affective factors that underly their negotiation of trust, and whether trainee demographic characteristics may bias them. Using a document analysis approach, we adapted large language models (LLMs) to examine feedback dialogs (N = 24,187, each with an associated entrustment rating) between medical student trainees and their clinical supervisors. We compared how trainees and supervisors differentially documented feedback dialogs about similar tasks by identifying qualitative themes and quantitatively assessing their correlation with entrustment ratings. Supervisors’ themes predominantly reflected skills related to patient presentations, while trainees’ themes were broader—including clinical performance and personal qualities. To examine affect, we trained an LLM to measure feedback sentiment. On average, trainees used more negative language (5.3% lower probability of positive sentiment, p < 0.05) compared to supervisors, while documenting higher entrustment ratings (+ 0.08 on a 1–4 scale, p < 0.05). We also found biases tied to demographic characteristics: trainees’ documentation reflected more positive sentiment in the case of male trainees (+ 1.3%, p < 0.05) and of trainees underrepresented in medicine (UIM) (+ 1.3%, p < 0.05). Entrustment ratings did not appear to reflect these biases, neither when documented by trainee nor supervisor. As such, bias appeared to influence the emotive language trainees used to document entrustment more than the degree of entrustment they experienced. Mitigating these biases is nonetheless important because they may affect trainees’ assimilation into their roles and formation of trusting relationships.