Women Trainees Research Articles

Qualitative Exploration of the #MeTooMedicine Online Discourse: "Holding Beacons of Light to Shine in the Corners They Are Hoping to Keep Dark".

The MeToo movement forced a social reckoning, spurring women in medicine to engage in the #MeTooMedicine online discourse. Given the risks of reporting sexual violence, discrimination, or harassment, it is important to understand how women in medicine use platforms like Twitter to publicly discuss their experiences. With such knowledge, the profession can use the public documentation of women in medicine for transformative change. Using reflexive thematic analysis, 7,983 tweets (posted between November 2017-January 2020) associated with #WomenInMedicine, #MeTooMedicine, and #TimesUpHC were systematically analyzed in 2020-2022, iteratively moving from describing their content, to identifying thematic patterns, to conceptualizing the purpose the tweets appeared to serve. The Twitter engagement of women in medicine was likened to "holding beacons of light to shine in the corners [harassers] are hoping to keep dark," both reinforcing the message that "gender bias is alive and well" and calling for a "complete transformation in how we approach" the problem. The tweets of women in medicine primarily seemed aimed at disrupting complacency; encouraging bystanders to become allies; challenging stereotypes about women in medicine; championing individual women leaders, peers, and trainees; and advocating for reporting mechanisms and policies to ensure safety and accountability across medical workplaces. Women in medicine appeared to use Twitter for a host of reasons: for amplification, peer support, advocacy, and seeking accountability. By sharing their experiences publicly, women in medicine seemed to make a persuasive argument that time is up, providing would-be allies with supporting evidence of sexual violence, discrimination, and harassment. Their tweets suggest a roadmap for what is needed to achieve gender equity, ensure that lack of awareness is no longer an excuse, and ask bystanders to grapple with why women's accounts continue to be overlooked, ignored, or dismissed and how they will support women moving forward.

An Analysis of the Relationship Between Female Faculty and Female Resident Representation in Neurosurgery Residency Programs

Promoting minorities within medical specialties has been postulated to be crucial to patient care and recruitment of diverse candidates. This concept has been suspected but not formally studied in the minority of women faculty and trainees in neurosurgery. We aimed to quantitatively investigate the postulated correlation relative to female representation in neurosurgery. Data obtained from accredited neurosurgery residency programs were reviewed. Data describing the percentage of female residents and 6 demographic and 14 program-specific variables were collected. All program websites were reviewed to assess percentages of female faculty and visible commitment to diversity in applicants, evident through communicated policies, statements, or initiatives. Included programs were defined as "low" or "high" percentage of female residents or faculty relative to the grouped median value for both categories; groups were assessed for significant differences. Percentages of female faculty and residents and program-communicated diversity initiatives were investigated for significant correlation. Female faculty and diversity data were available at 117 program sites; 81 programs reported female resident percentages. Analysis revealed a significant positive correlation between female faculty and female resident percentages. Programs with higher female resident percentages had higher levels of diversity in terms of race and ethnicity. No significant correlation was found between the percentage of female faculty or residents and a communicated diversity initiative. This study of current female representation in neurosurgery revealed a previously undocumented positive correlation between percentages of female faculty and female trainees. These data suggest a modifiable barrier to female entry into neurosurgical residency programs.

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>.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.

Workplace microaggressions: results of a survey of the American College of Surgeons members

BackgroundWorkplace microaggressions are a longstanding but understudied problem in the surgical specialties. Microaggressions in healthcare are linked to negative emotional and physical health outcomes and can contribute to burnout and suboptimal delivery of patient care. They also negatively impact recruitment, retention and promotion, which often results in attrition. Further attrition at the time of an impending surgical workforce shortage risks compromising delivery of health care to the diverse US population and may jeopardize the financial stability of health care organizations. To date, studies on microaggressions have consisted of small focus groups comprised of women faculty or trainees at a single institution. There are no large, multi-organizational, gender-inclusive studies on microaggressions experienced by practicing surgeons. Objective(s)To examine the demographic and occupational characteristics of surgeons who do and do not report experiencing workplace microaggressions and whether these experiences would influence a decision to pursue a career in surgery again. Study DesignWe developed and internally validated a web-based survey to assess surgeon experiences with microaggressions and associated sequelae. The survey was distributed through a convenience sample of nine American College of Surgeons (ACS) online Communities from November 2022 to January 2023. All ACS Communities comprised members who had completed residency or fellowship training and had experience in the surgical workforce. The survey contained demographic, occupational, and validated microaggression items. Analyses include descriptive and chi-squared statistics, t-tests, and bivariable and multivariable logistic regression. ResultsThe survey was completed by 377 ACS members with the following characteristics: working as a surgeon (80.9%), non-Hispanic white (71.8%), general surgeons (71.0%), age ≥ 50 years (67.4%), fellowship-trained (61.0%), and women (58.4%). A total of 254 (67.4%) respondents reported experiencing microaggressions. Younger surgeons (p=0.002), women (p<0.001) and fellowship-trained surgeons (p=0.001) were more likely to report experiencing microaggressions than their counterparts. Surgeons working in academic medical centers or healthcare systems with teaching responsibilities were more likely to experience microaggressions than those in private practice (p<0.01). Surgeons currently working as a surgeon or those who are unable to work reported more experience with microaggressions (p=0.003). There was no difference in microaggressions experienced among respondents by surgical specialties, race/ethnicity, or for surgeons with a self-reported disability. In multivariable logistic regression, women had higher odds of experiencing microaggressions than men [aOR 15.9; 95% C.I.: 7.7-32.8] and surgeons in private practice had significantly lower odds of experiencing microaggressions compared to surgeons in academic medicine (aOR 0.3; 95% C.I. 0.1-0.8) or in healthcare systems with teaching responsibilities (aOR 0.2; 95% C.I. 0.1-0.6). Among surgeons responding to an online survey, respondents reporting microaggressions were less likely to say they would choose a career in surgery again (p<0.001). ConclusionsSurgeons reporting experience with microaggressions reflect the diversification of surgical specialties and subspecialties. With continued expansion of surgeon gender and race/ethnicity representation, deliberate efforts to address and eliminate workplace microaggressions could have broad implications for improving recruitment and retention of surgeons.

Creation of a sustainable longitudinal women in Leadership Development (WILD) curriculum focused on graduate medical education trainees

BackgroundAlthough women comprise the majority of medical students, gender disparities emerge early and remain at the highest levels of academia. Most leadership courses focus on faculty or students rather than women graduate medical education (GME) trainees.AimTo promote the leadership development of women GME trainees through empowerment, community building, networking and mentorship, and concrete leadership skills development.SettingUniversity of California, San Francisco.Participants359 women residents and fellows from 41 specialties.Program descriptionA longitudinal curriculum of monthly workshops designed to support leadership development for women trainees. Sessions and learning objectives were designed via needs assessments and literature review.Program evaluationA mixed-methods evaluation was performed for 3 years of WILD programming. Quantitative surveys assessed participant satisfaction and fulfillment of learning objectives. Structured interview questions were asked in focus groups and analyzed qualitatively.Discussion23% of invited participants attended at least one session from 2018 to 2021, despite challenging trainee schedules. Surveys demonstrated acceptability and satisfaction of all sessions, and learning objectives were met at 100% of matched sessions. Focus groups highlighted positive impact in domains of community-building, leadership skills, mentorship, and empowerment. This program has demonstrated WILD’s longitudinal sustainability and impact for women trainees.

The double-edged scalpel: Experiences and perceptions of pregnancy and parenthood during Canadian surgical residency training.

Only 34% of Canadian surgeons in 2022 were female. The protracted length of surgical residency training, concerns regarding infertility, and increased rates of obstetrical complications have been shown to contribute to the disproportionate lack of females in surgical specialties. A novel online survey was sent to all surgical residents in Canada. Respondents were asked about perceptions of pregnancy and parenthood during surgical training, and parents were asked about parental leave, accommodations they received, and pregnancy complications. Chi squared tests were used to compare opinions of male and female residents. A total of 272/2,419 (11.2%) responses were obtained, with a high response from females (61.8%) and orthopaedic residents (29.0%). There were 56 women reporting 76 pregnancy events during training, 62.5% of which had complications. Notably, 27.3% of men and 86.7% of women 'agreed' or 'strongly agreed' that surgeons have higher pregnancy complication rates than the general population (p<0.001). Men were much less likely to believe that pregnant residents should be offered modified duties (74.2% of men, 90.0% of women, p = 0.003). Women were much more likely to experience significant stigma or bias due to their status as a parent (43% of women, 0% of men, p<0.001). Women reported negative comments from others at a higher rate (58.5% of women, 40.7% of men, p = 0.013). Women believe there is negative stigma attached to being pregnant during training (62.7% of women, 42.7% of men, p = 0.01). The limitations of our study include a small sample size and response bias. Challenges and negative perceptions exist around pregnancy and parenthood in surgical residency, which disproportionately affect women trainees.

"I am the doctor": gender-based bias within the clinical practice of emergency medicine in Canada-a thematic analysis of physician and trainee interview data.

While women comprise about half of current Canadian medical students and physicians, only 31% of emergency medicine physicians identify as women and women trainees are less likely to express interest in emergency medicine compared to men. Gender-based bias continues to negatively impact the career choice, progress, and well-being of women physicians/trainees. Although instances of gender-based bias are well documented within other medical specialties, there remains a gap in the literature addressing the role of gender specific to the Canadian emergency medicine clinical environment. Using a qualitative study with a thematic analytical approach, participants were purposively and snowball sampled from a cross-section of centers across Canada and included emergency medicine attending physicians and trainees. A thematic analysis using an inductive and deductive approach was undertaken. All data were double coded to improve study trustworthiness. Descriptive statistics were used to characterize the study population. Thirty-four individuals (17 woman-identifying and 17 man-identifying) from 10 different institutions across 4 provinces in Canada participated in the study. Six themes were identified: (1) women experience gender bias in the form of microaggressions; (2) women experience imposter syndrome and question their role in the clinical setting; (3) more women provide patient care to women patients and vulnerable populations; (4) gender-related challenges with family planning and home responsibilities affect work-life balance; (5) allyship and sponsorship are important for the support and development of women physicians and trainees; and (6) women value discussing shared experiences with other women to debrief situations, find mentorship, and share advice. Gender inequity in emergency medicine affects women-identifying providers at all levels of training across Canada. Described experiences support several avenues to implement change against perceived gender bias that is focused on education, policy, and supportive spaces. We encourage institutions to consider these recommendations to achieve gender-equitable conditions in emergency medicine across Canada.

Gender disparities in cardiothoracic surgery: a comparative study in India.

This study aimed to examine the prevalence of gender bias in the field of cardiothoracic vascular surgery in India and compared women surgeons and trainees in India and abroad. This was a comparative, cross-sectional analytical study using an online questionnaire. The survey included questions about demographics, career choice, training, academic and leadership opportunities, and the impact of choosing cardiothoracic-vascular surgery as a career on personal life. A total of 203 practicing surgeons and trainees participated in the study and included 121 (59.6%) men and 82 (40.3%) women. Out of the 82 women, 48 (58.5%) were from India, and 34 (41.5%) were from other countries. Satisfaction with the specialty was similar among men and women (105 (86.7%) vs. 68 (82.9%), p = 0.44 respectively). Majority (n = 30, 62.5%) of the female surgeons in India reported being discriminated against, as well as receiving favored treatment 11 (22.9%). Compared to men, women surgeons in India were more frequently advised against pursuing a career in cardiothoracic and vascular surgery (p < 0.001) and were more frequently subjected to gender-related references (p < 0.001). In addition, they had fewer presentation opportunities (p = 0.016) at national or regional meetings during their training compared to men. Additionally, 50% (24) of the women in India reported being single, in contrast to 7% (6) of men, and only 15 (31.3%) women reported having a child, compared to 57 (66.3%) of the men. The study revealed significant gender disparities within the field of cardiothoracic vascular surgery in India and highlights the urgent need to address gender disparities and bias in cardiothoracic vascular surgery.

Addressing Barriers to Entry and Retention of Women in Interventional Vascular Specialties With Proposed Solutions: A Scientific Statement From the American Heart Association.

Representation of women in interventional vascular fields (interventional cardiology, interventional radiology, and vascular surgery) lags behind that in other specialties. With women representing half of all medical school graduates, encouraging parity of women in these fields needs to start in medical school. Barriers to pursuing careers in vascular intervention include insufficient exposure during core clerkships, early mentorship, visibility of women in the field, length of training, lifestyle considerations, work culture and environment, and concerns about radiation exposure. This scientific statement highlights potential solutions for both the real and perceived barriers that women may face in pursuing careers in vascular intervention, including streamlining of training (as both interventional radiology and vascular surgery have done with a resultant increase in percentage of women trainees), standardization of institutional promotion of women in leadership, and professional and industry partnerships for the retention and advancement of women.

Can I Leave? Perspectives on Parental Leave and Parenthood in Medical Training Among Program Directors and Trainees in Oncologic Specialties.

Purpose: Peak fertility commonly occurs during medical training, and delaying parenthood can complicate pregnancies. Trainee parental leave policies are varied and lack transparency. Research on the impacts of parenthood on trainee education is limited. Methods: A Qualtrics-based survey was distributed via e-mail/social media to program directors (PDs) within oncologic specialties with a request to forward a parallel survey to trainees. Questions assessed awareness of parental leave policies, supportiveness of parenthood, and impacts on trainee education. Statistical analyses included descriptive frequencies and bivariable comparisons by key groups. Results: A total of 195 PDs and 286 trainees responded. Twelve percent and 29% of PDs were unsure of maternity/paternity leave options, respectively. PDs felt they were more supportive of trainee parenthood than trainees perceived they were. Thirty-nine percent of nonparent trainees (NPTs) would have children already if not in medicine, and >80% of women trainees were concerned about declining fertility. Perceived impacts of parenthood on trainee overall education and academic productivity were more negative for women trainees when rated by PDs and NPTs; however, men/women parents self-reported equal impacts. Leave burden was perceived as higher for women trainees. Conclusions: A significant portion of PDs lack awareness of parental leave policies, highlighting needs for increased transparency. Trainees' perception of PD support for parenthood is less than PD self-reported support. Alongside significant rates of delayed parenthood and fertility concerns, this poses a problem for trainees seeking to start a family, particularly women who are perceived more negatively. Further work is needed to create a supportive culture for trainee parenthood.

Perception and Usage of Social Media Among Women in Orthopaedics.

The use of social media for marketing, education, and networking has increased among orthopaedic surgeons. Social media has played an important role in supporting women physicians and trainees, by allowing connections to be made across stages of training and geographic borders. The purpose of this study was to determine the perceptions of female orthopaedic surgeons, fellows, residents, and medical students regarding their usage of social media. A 22-question anonymous survey regarding the perceptions of social media usage was distributed to 1,189 female members of Ruth Jackson Orthopaedic Society via e-mail in July 2022. Data collection lasted a total of 4 weeks, from July to August 2022. Data analysis was performed using descriptive statistics. A total of 207 responses were received (17% response rate). The respondents comprised 90 orthopaedic surgeons (43%), 60 medical students (29%), 49 residents (24%), and eight fellows (4%). Ninety one percent of participants (189 of 207) reported having a social media account, with 23% (43 of 189) having separate 'personal' and 'professional' accounts. Less than half of all participants reported altering (51 of 189; 27%) or deleting (20 of 189; 11%) profiles for interviews. Fifty three percent of participants (109 of 207) 'agreed' that social media is a good way to network. Twenty eight percent of participants (58 of 207) feared gaining attention to their profile when engaging with professional accounts. Forty percent of participants (62 of 207) agreed that personal life events on social media can be considered unprofessional and should be kept on a private profile. Social media can be used to network professionally within orthopaedic surgery, connecting women at different levels of training. Although concerns about professionalism of social media accounts exist, this may be mitigated by maintaining a separate private account from a public, professional profile. Future guidelines regarding social media usage and how to maintain professionalism while being active on social media may be beneficial.

Are women residents of surgical specialties at a higher risk of developing imposter syndrome?

BackgroundImposter syndrome is a chronic feeling of doubt leading to a sense of incompetence, which is common among trainees. However, little is known about the effect of gender on imposter syndrome among surgical trainees. MethodsAn online national survey was distributed to the surgical subspecialty residents between March and September 2022, including demographics, validated Clance Imposter Scale and a short questionnaire evaluating depression and anxiety. ResultsOf the participants self identified as women (264, 69.1%) and men (118, 30.9%) (response rate 36.4%), the prevalence of imposterism was higher among women trainees (97% vs. 86%; p ​< ​0.0001). Risk factors were being a gynecologist (156, 59%, p ​< ​0.0001), single (157, 59.7% p ​= ​0.007), having no dependents (233, 88.3% p ​= ​0.001), being a foreign graduate (24, 9.1%, p ​= ​0.024) and having feelings of anxiety (82, 31.1% p ​= ​0.012). When using multivariate logistic regression to adjust for these factors, the prevalence of imposter syndrome remained significantly higher among women. ConclusionWomen trainees belonging to various surgical fields are affected by Imposter syndrome. Residency programs should develop wellness programs and provide mentorship to address this condition.

Understanding Current Demographics, Practice Patterns, and Concerns of Women in Urology: Analysis From the 2022 Society of Women in Urology Census Task Force

To describe the current demographics, needs, and challenges of women in Urology throughout the United States, including active Urologists as well as urologic trainees. An electronic survey was distributed via email and social media sites to all members of the Society of Women in Urology, including residents, fellows, and female urologists practicing in the US and its territories, between February 2022 and May 2022. The survey collected information on demographics, practice type, workplace, personal, family issues, barriers, and career plans from all respondents. Of the estimated 1375 women urologists and trainees based on AUA census data, 379 responses (27.6% response rate) were received. Almost all respondents (98%) are members of the AUA. The average age was 42.9years (SD 18.6). In terms of ethnicity, most self-reported as White 71.0%, followed by 16.4% Asian or Asian American, and 6.3% African American. The majority reported practicing in urban locations (63.5%) at an academic setting (55.7%), followed by similar distribution between private practice and hospital-employed settings (17.0%and 16.7%, respectively). The vast majority, 89.6%, reported working full-time, while only 10.4% worked part-time. The average hours of work per week were 56.7 (SD 14.5). In terms of personal demographics, 81.9% were married, 17.3% were single and 1% did not answer. 68.8% of responders had children, with the majority of these children being born during or after training. Based on the findings, although female urologists have increased in numbers, certain ethnicities are under-represented. Additional surveys and engagement of current trainees and practitioners are needed to identify further areas of intervention for specific needs.

Women in surgery: trends in nine surgical specialties.

Gender disparity in surgery remains an issue worldwide. We analysed the trends in gender distribution in surgical subspecialties across Australia and New Zealand over the last 8 years. Workforce reports from the Royal Australasian College of Surgeons were reviewed from 2014 to 2021. Data relating to 4802 applicants, 1554 trainees and 6839 active surgeons across nine surgical subspecialties was analysed. Statistical analysis was performed using a difference of proportions hypothesis test. Predictions regarding time to parity were performed using a linear regression model. All nine surgical subspecialties' surgeon numbers saw a steady increase in the representation of women between 2014 and 2021. The most significant rise seen in general surgery from 14% to 21% (P ≤ 0.001). Proportions of women trainees were variable, the only significant rise was seen in orthopaedics from 9% to 19% (P ≤ 0.001). Proportions of women applicants and successful applicants have also been variable. General surgery saw the only consistent increase in women applicants over the last 6 years, from 35% in 2016 to 43% in 2021. Linear regression predictions estimate that paediatric surgery will be the first to reach gender parity in 23 years, and orthopaedics the last, in 186 years. A steady increase in women has been observed across all surgical subspecialities over the last 8 years. However, estimates based on current trends suggest that gender parity may be out of reach for the next eight generations in subspecialties such as cardiothoracic and orthopaedic surgery.

MP57-01 SEXUAL HARASSMENT IN UROLOGY: SOCIETY OF WOMEN IN UROLOGY CENSUS FINDINGS

You have accessJournal of UrologyCME1 Apr 2023MP57-01 SEXUAL HARASSMENT IN UROLOGY: SOCIETY OF WOMEN IN UROLOGY CENSUS FINDINGS Megan McMurray, Lourdes Guerrios-Rivera, Arshia Sandozi, Smita De, Akanksha Mehta, and Francesca Monn Megan McMurrayMegan McMurray More articles by this author , Lourdes Guerrios-RiveraLourdes Guerrios-Rivera More articles by this author , Arshia SandoziArshia Sandozi More articles by this author , Smita DeSmita De More articles by this author , Akanksha MehtaAkanksha Mehta More articles by this author , and Francesca MonnFrancesca Monn More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003310.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Sexual harassment and gender discrimination toward female surgeons is a longstanding, well-recognized issue. As more women pursue training in urology, we must acknowledge the distinct challenges women urologists face within our specialty. The objective of this study was to evaluate the prevalence of sexual harassment of women urologists and trainees and to understand the factors associated with this behavior. METHODS: An electronic survey census was sent to all members of the Society of Women in Urology including residents, fellows, and women urologists practicing in the United States and territories. Surveys were also distributed to urology residency programs and via social media platforms. In addition to demographic data, we solicited information about whether respondents experienced sexual harassment and allowed for free-text descriptions of these events. Results were compiled and analyzed using descriptive statistics. RESULTS: There were 379 total female respondents with an average age of 43 (SD=18.6) years old. Of these, 75.0% were urologists in practice, 15.1% residents, and 9.8% fellows. 62.5% of respondents reported experiencing sexual harassment in training or in practice. Of those who reported experiencing sexual harassment, 70.9% described patient-perpetrated harassment, 59.5% had been harassed by a physician colleague, and 33.3% had experienced harassment from both sources. Common themes included: comments about physician appearance or clothing, inappropriate sexual comments or questions, inappropriate physical touch, and sexual advances. Only 16.0% of respondents who had experienced sexual harassment chose to report it. The incidence of harassment by each group overall, including rates of reporting, are summarized in Figure 1. Common reasons for not reporting included: presumption of institutional indifference, fear of retaliation, feeling it was not worth the time or effort, and a feeling of intimidation due to a power dynamic. CONCLUSIONS: Sexual harassment of women urologists by patients and colleagues is common and grossly underreported. Creating environments in which women feel safe to report without repercussion and clinical settings in which sexual harassment is not tolerated by patients or physicians is critical as the number of women practicing urology increases. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e784 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Megan McMurray More articles by this author Lourdes Guerrios-Rivera More articles by this author Arshia Sandozi More articles by this author Smita De More articles by this author Akanksha Mehta More articles by this author Francesca Monn More articles by this author Expand All Advertisement PDF downloadLoading ...

Gender Differences in Professional Adversities and Mental Health Among Surgical and Nonsurgical Medical Trainees: An Internet-Based Survey

Physicians in training face a variety of stressors throughout their professional development and according to their gender. Among them, surgical trainees appear to be especially at risk for mental health problems. The aim of the present study was to compare demographic features, professional activities and adversities, depression, anxiety, and distress among men and women trainees of surgical and nonsurgical medical specialties. A cross-sectional, retrospective, comparative study was conducted on a total of 12,424 trainees (68.7% nonsurgical and 31.3% surgical) from Mexico through an online survey. Demographic features, variables related to professional activities and adversities, depression, anxiety, and distress were evaluated through self-administered measures. Comparative analyses using the Cochran-Mantel-Haenszel test for categorical variables and multivariate analysis of variance including medical residency program and gender as fixed factors to test their interaction effect for continuous variables were used. An important interaction between medical specialty and gender was found. Women trainees from surgical specialties report more frequent psychological and physical aggressions. Women from both specialties had higher distress, significant anxiety, and depression than men. Men from surgical specialties worked more hours per day. Gender differences are evident in trainees for medical specialties, with a larger impact in surgical fields. Mistreatment of students is a pervasive behavior that affects society as a whole, and actions to improve learning and working environments in all medical specialties, but mostly in surgical fields, are urgently needed.

Gender trends in cardiothoracic surgery authorship

ObjectiveIn recent years, the historically low proportion of women cardiothoracic surgeons and trainees has been a subject of intense focus. Publications remain a key metric of academic success and career advancement. We sought to identify trends in the gender of first and last author publications in cardiothoracic surgery. MethodsWe searched for publications between 2011 and 2020 in 2 US cardiothoracic surgery journals, identifying those with Medical Subject Heading publication types of clinical trials, observational studies, meta-analyses, commentary, reviews, and case reports. A commercially available, validated software (Gender-API) was used to associate gender with author names. Association of American Medical Colleges Physician Specialty Data Reports were used to identify concurrent changes in the proportion of active women in cardiothoracic surgery. ResultsWe identified 6934 (57.1%) pieces of commentary; 3694 (30.4%) case reports; 1030 (8.5%) reviews, systematic analyses, meta-analyses, or observational studies; and 484 (4%) clinical trials. In total, 15,189 total names were included in analysis. Over the 10-year study period, first authorship by women rose from 8.5% to 16% (0.42% per year, on average), whereas the percentage of active US women cardiothoracic physicians rose from 4.6% to 8% (0.42% per year). Last authorship was generally flat over the decade, going from 8.9% in 2011% to 7.8% in 2020 and on average, increased at just 0.06% per year (P = .79). ConclusionsOver the past decade, authorship by women has steadily increased, more so at the first author position. Author-volunteered gender identification at the time of manuscript acceptance may be useful to more accurately follow trends in publication.

Impact of gender on the formation and outcome of formal mentoring relationships in the life sciences.

Despite increasing representation in graduate training programs, a disproportionate number of women leave academic research without obtaining an independent position that enables them to train the next generation of academic researchers. To understand factors underlying this trend, we analyzed formal PhD and postdoctoral mentoring relationships in the life sciences during the years 2000 to 2020. Student and mentor gender are both associated with differences in rates of student's continuation to positions that allow formal academic mentorship. Although trainees of women mentors are less likely to take on positions as academic mentors than trainees of men mentors, this effect is reduced substantially after controlling for several measurements of mentor status. Thus, the effect of mentor gender can be explained at least partially by gender disparities in social and financial resources available to mentors. Because trainees and mentors tend to be of the same gender, this association between mentor gender and academic continuation disproportionately impacts women trainees. On average, gender homophily in graduate training is unrelated to mentor status. A notable exception to this trend is the special case of scientists having been granted an outstanding distinction, evidenced by membership in the National Academy of Sciences, being a grantee of the Howard Hughes Medical Institute, or having been awarded the Nobel Prize. This group of mentors trains men graduate students at higher rates than their most successful colleagues. These results suggest that, in addition to other factors that limit career choices for women trainees, gender inequities in mentors' access to resources and prestige contribute to women's attrition from independent research positions.

Trainee and program director perspectives of parental leave and parenthood in oncologic specialties.

11051 Background: Delays in pregnancy exacerbate infertility. Thus, trainees are forced to make complex family planning decisions while juggling all aspects of training. In addition to a lack of parental leave and financial constraints, trainees are often concerned with the perceptions of leave and parenthood. Two single specialty surveys found that most program directors (PDs) felt parenthood negatively impacted trainee performance, disproportionately for women. We aim to understand PD and trainee perspectives of parental leave and parenthood in oncologic trainees. Methods: Contact information for PDs in oncologic specialties was gathered from FRIEDA. Surveys were distributed to all eligible PDs with a request to forward a parallel survey to their trainees. Social media links for both surveys were shared on Twitter. Tests of association for descriptive analyses included Fisher's exact test, Chi-square test, or the Mantel-Haenszel Chi-Square test, as appropriate. All computations were performed using SAS version 9.4. Results: 195 PDs and 286 trainees completed the survey with 49% and 56% female and 89% and 41% parent respondents, respectively. Per PDs, 73% of programs have a maternity leave policy, 48% have a paternity leave policy, and 5% have a fertility services policy. PDs and non-parent trainees (NPTs) rated the negative impact of parenthood on overall education (p &lt; 0.001 for PDs, p &lt; 0.001 for NPTs) and academic productivity (p &lt; 0.001 for PDs, p &lt; 0.001 for NPTs) as higher for women trainees than men trainees. PDs and NPTs also rated the burden of parental leave on co-trainees as greater for women trainees as compared to men trainees (p &lt; 0.001 for PDs, p &lt; 0.001 for NPTs). Among PDs, no significant differences by gender or specialty were found in advising for or against parenthood in training, but PDs in surgical specialties reported providing less support for trainees starting a family (p &lt; 0.001) and trainees in surgical specialties reported being less supported (p &lt; 0.001). Women trainees were more likely than men trainees to indicate that they would have started a family sooner if not in medicine (p &lt; 0.001). 89% of parent trainees would choose to have children in training again, and 84% would recommend parenthood in training. Conclusions: Although many programs have parental leave policies, a substantial number continue to lack them. Concerns about negative perceptions of parenthood by trainees are valid, particularly for women who are significantly more likely to be seen as having their education and academic productivity impacted by parenthood. In addition, specialty choice impacts the support given to trainees as they start families. Despite these barriers, the vast majority of parent trainees would still choose to have children in training and recommend this path to fellow trainees. Additional initiatives to normalize and support family planning in medical training for interested trainees are warranted.

Association of Women Leaders with Women Program Director and Trainee Representation Across US Academic Internal Medicine.

BackgroundWomen are underrepresented within internal medicine (IM). Whether women leaders attract women trainees is not well explored.ObjectiveTo characterize leader and trainee gender across US academic IM and to investigate the association of leader gender with trainee gender.DesignCross-sectional study.ParticipantsLeaders (chairs, chiefs, program directors (PDs)) in 2018 and trainees (residents, fellows) in 2012–2016 at medical school-affiliated IM and seven IM fellowship programs.ExposureLeadership (chair/chief and program director; and, for resident analyses, fellow) gender.Main MeasuresOur primary outcome was percent women trainees (IM residents and, separately, subspecialty fellows). We used standard statistics to describe leadership and trainee gender. We created separate multivariable linear regressions to evaluate associations of leader gender and percent women fellows with percent women IM residents. We then created separate multivariable multilevel models (site as a random effect) to evaluate associations of leader gender with percent women subspecialty fellows.Key ResultsOur cohort consisted of 940 programs. Women were 13.4% of IM chairs and <25% of chiefs in each fellowship subspecialty (cardiology: 2.6%; gastroenterology: 6.6%; pulmonary and critical care: 10.7%; nephrology: 14.4%; endocrinology: 20.6%; hematology-oncology: 23.2%; infectious diseases: 24.3%). IM PDs were 39.7% women; fellowship PDs ranged from nearly 25% (cardiology and gastroenterology) to nearly 50% (endocrinology and infectious disease) women. Having more women fellows (but not chairs or PDs) was associated with having more women residents (0.3% (95% CI: 0.2–0.5%) increase per 1% fellow increase, p<0.001); this association remained after adjustment (0.3% (0.1%, 0.4%), p=0.001). In unadjusted analyses, having a woman PD (increase of 7.7% (4.7%, 10.6%), p<0.001) or chief (increase of 8.9% (4.6%, 13.1%), p<0.001) was associated with an increase in women fellows; after adjustment, these associations were lost.ConclusionsWomen held a minority of leadership positions in academic IM. Having women leaders was not independently associated with having more women trainees.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-022-07635-w.