Journal of Surgical Education最新文献

{"title":"Have Degree, Will Travel? Geography and Orthopaedic Surgery Residency Match","authors":"Elizabeth Cinquegrani BS ,&nbsp;Drake Giese BS ,&nbsp;Jefferson Driscoll BS ,&nbsp;Ajiel Basmayor BS ,&nbsp;Michael Perry BS ,&nbsp;Adam Thiessen MD","doi":"10.1016/j.jsurg.2024.103352","DOIUrl":"10.1016/j.jsurg.2024.103352","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>The paucity of objective data on the residency application is challenging to Orthopedic Surgery residency programs when selecting candidates to interview and to rank. Qualifying or quantifying the effect of geography on match results will help programs screen and rank candidates more effectively. The aim of this study is to describe the geographic background of current Orthopedic Surgery residents in the United States relative to their current residency program. We hypothesize there is a significant relationship between residents’ geographic background and the location of their residency programs.</div></div><div><h3>METHODS</h3><div>Geographic background information of current Orthopedic Surgery residents in the United States was obtained from public websites of Orthopedic Surgery residency programs. Information included region and city of each resident's residency program, hometown (HT), undergraduate (UG) school, and medical school (MS). The relationships between residents’ program region and city and their geographic background was analyzed. Cramer's V values were calculated to describe the strength of association between program region and HT, UG, and MS regions. Distance of program from HT, UG city, and MS city was calculated using the Haversine distance formula.</div></div><div><h3>RESULTS</h3><div>3718 US orthopedic residents were included. 47.2% of residents matched in the same region as their HT. 40.7% matched in the same region as their UG institution, and 49.6% matched in the same region as their MS. Of residents with data for HT, UG, and MS regions, 36.6% are in a program outside of the region of their HT, UG school, and MS. There was a statistically significant relationship between program region and HT, UG, and MS regions (p &lt; 0.0001) with the strongest relationship seen with medical school region.</div><div>The average distance of residency program from HT was 1175 km, from UG city was 1041 km, and from MS city was 894 km. Of residents with data for HT, UG, and MS cities, only 0.61% had all 3 in the same city as their residency program, and 13.3% had HT, UG city, and MS city within 100 km of their residency city.</div></div><div><h3>CONCLUSION</h3><div>The association between the geographic history of Orthopedic Surgery residents and their residency program location is complex. Most residents are in residency in a location with which they have some history, but many live a considerable distance from their hometowns and the cities in which they have previously studied. This information may be helpful to residency programs as they weigh the importance of geography with other factors when considering their rank lists.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103352"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leadership in General Surgery Residency: The Impact as Seen by Former Program Directors","authors":"Shelley Jain MD ,&nbsp;Christie Buonpane MD ,&nbsp;Ryan Shabahang ,&nbsp;Rahul Kashyap MD ,&nbsp;Mohsen Shabahang MD, PhD","doi":"10.1016/j.jsurg.2024.103322","DOIUrl":"10.1016/j.jsurg.2024.103322","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>The position of general surgery residency program director (GSPD) has been well defined by governing bodies as an important educational role. Its impact on the individuals themselves has not been studied extensively. We aimed to examine the individual and professional impact of the role of GSPDs as seen by former program directors of general surgery residency programs.</div></div><div><h3>DESIGN</h3><div>This Institutional Review Board (IRB) exempt study conducted semi structured virtual interviews from May– September 2023 with former GSPDs. The research team consisted of 5 members who transcribed the interviews, coded the responses, and conducted a thematic analysis in an iterative consensus process. Final themes and subthemes were generated and representative quotes were selected.</div></div><div><h3>SETTING</h3><div>This study was conducted virtually at Wellspan York Hospital in York, Pennsylvania, a level-1 trauma center and community teaching hospital.</div></div><div><h3>PARTICIPANTS</h3><div>A total of 19 former GSPDs were recruited via purposeful sampling and snowballing. All 19 participants completed the study interview.</div></div><div><h3>RESULTS</h3><div>GSPD responses were found to have 5 recurring themes and several subthemes. The themes included 1) Development as a leader, 2) Relationship building, 3) Proficiencies needed as a program director, 4) Transactional aspects, 5) Transformational aspects.</div></div><div><h3>CONCLUSION</h3><div>Leading a general surgery residency program is an extremely impactful position that develops pivotal leadership skills, requires many proficiencies, relies on relationship building, and has aspects that are transactional and transformational. Holding the position of program director creates both personal fulfillment while 1 holds the position and has a positive professional impact in the subsequent stages of their career as a surgical educator.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103322"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the Relationships Amongst Psychological Safety, the Learning Environment, and Well-Being in Surgical Faculty and Trainees","authors":"Alyssa A. Pradarelli MD ,&nbsp;Julie Evans MS ,&nbsp;Niki Matusko MS ,&nbsp;Norah N. Naughton MD ,&nbsp;Roy Phitayakorn MD, MHPE ,&nbsp;John T. Mullen MD ,&nbsp;Lily Chang MD ,&nbsp;Melissa Johnson MD ,&nbsp;Thavam Thambi-Pillai MD ,&nbsp;Jon Ryckman MD ,&nbsp;Melissa Alvarez-Downing MD ,&nbsp;Sebastiano Cassaro MD ,&nbsp;Felicia Ivascu MD ,&nbsp;David T. Hughes MD ,&nbsp;Gurjit Sandhu PhD","doi":"10.1016/j.jsurg.2024.103375","DOIUrl":"10.1016/j.jsurg.2024.103375","url":null,"abstract":"<div><h3>Objective</h3><div>Learning environments affect the well-being of surgical faculty and trainees. Psychological safety (PS) has been linked with learning behaviors and aspects of well-being within medicine; however, given the unique challenges inherent to the surgical learning environment, there is a need to more closely examine these concepts for surgical faculty and trainees. The objective of this study is to examine the relationships between learning environment and PS, as well as PS and well-being with surgery.</div></div><div><h3>Design</h3><div>Multi-institutional, cross-sectional survey study. The electronic survey included assessments of PS, professional fulfillment, and the learning environment. Exploratory and confirmatory factor analyses were performed to identify learning environment constructs. Index construct scores were generated. Multivariable multivariate regression analyses were used to examine the relationships between constructs in the learning environment and PS as well as PS and well-being.</div></div><div><h3>Setting &amp; Participants</h3><div>The electronic survey was distributed to surgical faculty, fellows, and residents at 8 institutions across the United States.</div></div><div><h3>Results</h3><div>For faculty, higher levels of professional interactions and rapport/climate within the learning environment were significantly associated with higher levels of PS (β = 0.39, p &lt; 0.01; β = 0.34, p &lt; 0.01, respectively). Higher levels of PS were significantly associated with lower levels of interpersonal disengagement (β = -0.16, p = 0.04). For trainees, higher levels of disrespect/retaliation and personal performance worry within the learning environment were significantly associated with lower levels of PS (β = -0.45, p &lt; 0.001; β = -0.11, p = 0.048, respectively). Higher levels of PS were significantly associated with higher levels of professional fulfillment (β = 0.24, p = 0.01) and lower levels of work exhaustion (β = -0.27, p &lt; 0.01) and interpersonal disengagement (β = -0.36, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>This study identified factors within the learning environment that were positively and negatively associated with psychological safety for surgical faculty and trainees. In addition, it identified a direct relationship between psychological safety and elements of well-being and burnout.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103375"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting Resident Education Priorities With an Acute Care Surgery Service Dashboard","authors":"Karen Trang MD ,&nbsp;Logan Pierce MD ,&nbsp;Elizabeth C. Wick MD ,&nbsp;Lan Vu MD ,&nbsp;Rochelle Dicker MD ,&nbsp;Marissa A. Boeck MD ,&nbsp;Kent Garber MD ,&nbsp;Kenzo Hirose MD","doi":"10.1016/j.jsurg.2024.103342","DOIUrl":"10.1016/j.jsurg.2024.103342","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To advance surgical education priorities by using electronic health record (EHR) reporting and data visualization on an Acute Care Surgery (ACS).</div></div><div><h3>DESIGN</h3><div>Operational data from the EHR for the ACS service was displayed on an ACS dashboard using Tableau software. This data included new ACS consults (reason for consult, consult note author - attending surgeon and resident) and operations generated by those consults (type of operation, primary attending surgeon, and assisting resident). All surgeons on the service were included on the dashboard. In collaboration with service and educational leaders, the dashboard was used to address two deficiencies. First, to reduce the administrative burden for residents on ACS service, the new dashboard replaced manually generated weekly consult and operative case lists. Second, as a part of a pilot program to enable faculty assessment of residents’ Entrustable Professional Activities (EPAs) regarding pre-operative evaluation of acute surgical conditions, all faculty on the ACS service had access to the dashboard and received weekly reminders at the end of their service week. To assess the impact of the dashboard on these two education outcomes, resident surveys were used to determine average time spent on weekly consult and operative lists, and the number of EPA assessments completed were compared before, during, and after the pilot program.</div></div><div><h3>SETTING</h3><div>Academic quaternary care hospital with a general surgery residency program comprising 50 clinically active residents.</div></div><div><h3>PARTICIPANTS</h3><div>Residents and faculty who rotated on the ACS service during the study period.</div></div><div><h3>RESULTS</h3><div>The dashboard was made available to all faculty on the ACS service and automatically emailed on Saturdays. The dashboard reduced weekly resident administrative work by an average of 60 (range 30-360) minutes per week by obviating the need for manual list creation. Completed perioperative/nonoperative EPA assessments increased from zero to 5.3/month during the pilot period and continued at 2.3/month in the 3 months after the pilot ended.</div></div><div><h3>CONCLUSION</h3><div>The ACS dashboard reduced resident workload and enhanced EPA assessment. More opportunities to align resident education with EHR operational tools are likely if surgical education specialists collaborate with healthcare system and/or informatics leadership. When possible, advances in healthcare system technology should also be designed to promote training and education.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103342"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Availability of Lactation Policies and Facilities for ACGME-Accredited Surgical Residency Training Programs","authors":"Marissa D. Kruk BS ,&nbsp;Megan D. Malueg BS ,&nbsp;Kenneth V. Snyder MD, PhD ,&nbsp;Renée M. Reynolds MD","doi":"10.1016/j.jsurg.2024.103398","DOIUrl":"10.1016/j.jsurg.2024.103398","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>We aimed to investigate availability of lactation policy and facility information among surgical residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME).</div></div><div><h3>DESIGN</h3><div>Between March 1, 2023 and October 31, 2023, websites of surgical residency training programs on the ACGME Accreditation System List of Programs by Specialty were reviewed for department lactation policies, links to institutional graduate medical education (GME) websites with lactation policies, lists of lactation facilities, and links to institutional GME websites listing lactation facilities. Scatter plots were generated and Pearson correlation coefficients were calculated to assess relationships of the percentages of female residents, fellows, and faculty in each surgical specialty with the percentage of residency program websites with available lactation information.</div></div><div><h3>RESULTS</h3><div>In total, 1847 websites were reviewed. Seventeen (0.9%) had lactation policies, 31 (1.7%) had lists of lactation facilities, 231 (12.5%) had links to institutional websites with lactation policies, and 295 (16.%) had links to institutional websites with lists of lactation facilities. The percentage of female residents and fellows and percentage of female faculty were positively correlated with the percentage of residency program websites with available lactation information.</div></div><div><h3>CONCLUSION</h3><div>Limited information on lactation policies and facilities is available to surgical residents.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103398"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"True Grit: The Tale of American Integrated Plastic Surgery Residency Applicants","authors":"Charalampos Siotos MD, PhD ,&nbsp;John A. Toms III BS, MS ,&nbsp;Michelle Y. Seu MD ,&nbsp;Jubril Adepoju BS ,&nbsp;Daniel Najafali BS ,&nbsp;Ethan M. Ritz MS ,&nbsp;Deana S. Shenaq MD ,&nbsp;Keith C. Hood MD ,&nbsp;David E. Kurlander MD","doi":"10.1016/j.jsurg.2024.103371","DOIUrl":"10.1016/j.jsurg.2024.103371","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Selecting candidates for plastic and reconstructive surgery (PRS) residency is complex, involving academic metrics and intrinsic personal qualities. “Grit”—perseverance and passion for long-term goals may be one of these valued qualities. This study investigates how grit scores relate to securing a PRS residency, hypothesizing that higher grit correlates with greater matching success.</div></div><div><h3>METHODS</h3><div>After match day, an email survey was distributed to all the applicants of Rush University Medical Center's integrated PRS program during the academic years 2021-2022 and 2022-2023. This survey included items regarding match results and a validated grit questionnaire. We calculated baseline differences among the study participants. Correlation between grit score, academic achievements, and match was performed with univariate analyses using the Spearman correlation for continuous variables and the Wilcoxon rank sum test.</div></div><div><h3>RESULTS</h3><div>The program received 616 applications, of which 132 (21%) responded to the grit survey. Among the responders, 97 (74%) reported matching into PRS, versus 35 (27%) who did not. After adjusting for multiple confounders, higher grit score was found to be associated with significantly lower odds of matching into PRS residency (OR 0.13, p-value 0.03). Higher Step 1 and 2 CK scores, number of publications, and female gender were associated with greater odds of matching.</div></div><div><h3>CONCLUSION</h3><div>Our study did not identify any association between higher grit and matching successfully in PRS. After adjusting for confounders, we observed significantly higher grit scores among applicants who did not match into PRS, which may be related to the psychological phenomenon of increased perseverance as people reflect on their perceived failures.</div></div><div><h3>LEVEL OF EVIDENCE</h3><div>IV (Cross-sectional study)</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103371"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biotissue Curriculum Translates to Performance in the Operating Room for Gastrojejunostomy and Hepaticojejunostomy in Robotic Pancreaticoduodenectomy","authors":"Jasmine D. Kraftician BS ,&nbsp;Kristine Kuchta MS ,&nbsp;Mazen S. Zenati MD, PhD ,&nbsp;Sarah B. Hays MD ,&nbsp;Samer AlMasri MD ,&nbsp;Hussein H. Khachfe MD ,&nbsp;Maya Maalouf MS ,&nbsp;Annissa Desilva BS ,&nbsp;Abdulrahman Y. Hammad MD ,&nbsp;Alessandro Paniccia MD ,&nbsp;Kenneth K. Lee MD ,&nbsp;Herbert J. Zeh MD ,&nbsp;Amer H. Zureikat MD ,&nbsp;Melissa E. Hogg MD","doi":"10.1016/j.jsurg.2024.103395","DOIUrl":"10.1016/j.jsurg.2024.103395","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Robotic simulation training curricula aim to aid surgeons in attaining robotic operating room proficiency, but the crossover success remains to be examined.</div></div><div><h3>DESIGN</h3><div>A retrospective cohort study grading robotic biotissue training models and intraoperative anastomotic videos. The curriculum included deliberate practice of inanimate drills of a hepaticojejunostomy (HJ) and gastrojejunostomy (GJ). Videos were blindly reviewed, and performance was evaluated by time, errors, and Objective Structured Assessment of Technical Skills (OSATS). Spearman's correlation coefficients (ρ) were calculated for prior experience, biotissue performance, and intraoperative performance.</div></div><div><h3>SETTING</h3><div>University of Pittsburgh Medical Center from 2014 to 2018.</div></div><div><h3>PARTICIPANTS</h3><div>Thirty-one surgical oncology fellows participated in the 5-step proficiency-based robotic training curriculum for robotic pancreaticoduodenectomy.</div></div><div><h3>RESULTS</h3><div>Fellows completed an average of 5.1 ± 3.7 HJ and 4.3 ± 3.3 GJ on biotissue. More practice on biotissue correlated with greater improvement on both times to complete an anastomosis (ρ = −0.51) and errors (ρ = −0.45). Average errors on biotissue GJ and longer time on the last attempt correlated with lower average intraoperative GJ OSATS (ρ = −0.64; ρ = −0.66). More errors on the last biotissue GJ correlated with longer average intraoperative GJ time (ρ = 0.58). Errors on the first and average biotissue HJ errors correlated with lower OSATS for the intraoperative HJ (ρ = −0.74; ρ = −0.80).</div></div><div><h3>CONCLUSIONS</h3><div>Performance on biotissue correlated with intraoperative performance. Results suggest the importance deliberate practice to achieve surgical proficiency.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103395"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aching for Change: Musculoskeletal Pain in the Operating Theatre Amongst Surgical Trainees","authors":"Robert Bickerton MBChB ,&nbsp;Giles Goatly MBChB ,&nbsp;Ginny Bowbrick MBBS","doi":"10.1016/j.jsurg.2024.103405","DOIUrl":"10.1016/j.jsurg.2024.103405","url":null,"abstract":"<div><h3>Objectives</h3><div>Work-related injuries are common among surgeons with up to 70 % being found to report difficulties. Given the extension expected to career longevity for current trainees, injury prevention is more important than ever. However, ergonomics education for surgical trainees in the UK is deficient. We aimed to gauge whether current trainees in Kent, Surrey and Sussex (KSS) experience pain whilst operating and what strategies, if any, they utilise.</div></div><div><h3>Design, setting and participants</h3><div>A questionnaire was distributed to trainees in the KSS School of Surgery collecting data on pain related to operating and pain management strategies. Participants discussed their experiences of operating-related pain in a focus group.</div></div><div><h3>Results</h3><div>75 trainees across the KSS region responded. Mean age was 32 years (range 26-42) and median training level was ST4. General surgery (<em>n</em> = 22), orthopaedics (<em>n</em> = 19) and urology (<em>n</em> = 13) were the most prevalent specialties. All trainees reported musculoskeletal pain attributed to operating, with 36 % (<em>n</em> = 27) experiencing pain “frequently” or “always”. 69 % (<em>n</em> = 52) found this pain “sometimes”, “frequently” or “always” distracted them whilst operating. The most common sites for pain were the lower back (73 %), neck (49.3 %), upper back (38.7 %) and shoulders (37.3 %). No participants had received formal ergonomics training and the majority (86.7 %) had not discussed pain with their supervisors. The focus group identified a culture of enduring pain without complaint and a reluctance to discuss it with mentors.</div></div><div><h3>Conclusions</h3><div>Musculoskeletal pain from operating was found to be a common issue in this cohort with the majority reporting distraction while operating. Ergonomics is not currently addressed by any formal training programmes and we have recommended a regional training initiative for trainees in KSS to address and prevent musculoskeletal injuries.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103405"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Minority Representation Among Independent Plastic Surgery Match Applicants: An Analysis of 1000 Applicants Over an 11-Year Period","authors":"Maria J. Escobar-Domingo MD,&nbsp;Benjamin Rahmani MS,&nbsp;James E. Fanning BS,&nbsp;Angelica Hernandez Alvarez MD,&nbsp;Helen Xun MD,&nbsp;Iulianna C. Taritsa BA,&nbsp;Daniela Lee BS,&nbsp;Jose Foppiani MD,&nbsp;Samuel J. Lin MD, MBA,&nbsp;Bernard T. Lee MD, MBA, MPH","doi":"10.1016/j.jsurg.2024.103388","DOIUrl":"10.1016/j.jsurg.2024.103388","url":null,"abstract":"<div><h3>Background</h3><div>Improving diversity within plastic and reconstructive surgery (PRS) trainees is a crucial step to reduce inequities at the provider level. Trends in minority representation among independent program match applicants are understudied. We analyzed gender, racial, and ethnic demographic trends among independent PRS match applicants.</div></div><div><h3>Methods</h3><div>With the approval of the American Council of Educators in Plastic Surgery, the San Francisco Match provided data for the independent PRS match from 2013 to 2023. Trends in the independent PRS match were reviewed, and a Cochran–Armitage test was conducted to evaluate the significance of match trends in minority applicants (Female, Black, Asian, Other Race, Hispanic ethnicity) over time.</div></div><div><h3>Results</h3><div>A total of 1000 applicants participated in the independent plastic surgery match during the study period, of whom 735 matched. A 31% decrease in the number of independent PRS programs was observed. The match rate decreased from 86% to 60%. Statistical analysis by race (White, Black, Asian, Other) and match outcomes revealed significant differences in racial distributions between applicants and matched participants in 2014 (p = 0.002) and 2018 (p = 0.042). The proportion of female applicants and Hispanic applicants correlated yearly to the number of matched females and Hispanics, respectively (p &gt; 0.05). Cochran–Armitage tests showed a significant increase in match trends among female participants over time (p = 0.004).</div></div><div><h3>Conclusions</h3><div>We show a significant increase in female representation in the independent PRS match in the last decade. However, representation of racial and ethnic minorities has shown minimal change over the years. Ongoing efforts are needed to identify barriers and reduce inequities.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103388"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Your Gender Impact Resident Operative Experience? A Multi- Institutional Qualitative Study","authors":"Polina Zmijewski MD, MA ,&nbsp;Carla Aleman ,&nbsp;Nicole Panzica BS ,&nbsp;Ramsha Akhund MD ,&nbsp;Brenessa Lindeman MD, MEHP ,&nbsp;Herbert Chen MD ,&nbsp;Kenneth Lynch PhD ,&nbsp;Alexander R. Cortez MD ,&nbsp;Jessica Fazendin MD","doi":"10.1016/j.jsurg.2024.103368","DOIUrl":"10.1016/j.jsurg.2024.103368","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Recent quantitative data found that female surgical residents perform on average 37 fewer cases during their training than their male counterparts, which is equivalent to 1 to 3 months of operative experience. To further understand reasons for these observations, we performed focus groups among female general surgery residents.</div></div><div><h3>METHODS</h3><div>Twenty- five participants from all PGY levels at 21 programs were recruited. Nine focus groups of 1 hour in length were held virtually and proctored by 3 facilitators. Each group had 1 to 4 female participants. Participants were asked questions on themes of disparities in operative experience, barriers, and avenues for improvement. Sessions were transcribed and coded for themes by 3 independent reviewers. Consensus with themes was reached between reviewers and a unified codebook was created.</div></div><div><h3>RESULTS</h3><div>When asked how gender influenced their operative experience, residents commonly responded with themes of “microaggressions” such as hospitals not carrying their glove size, OR staff being reluctant to answer pages, feeling pressure to have more formal rather than informal communication with attending staff, and having to balance assertiveness/ confidence with being perceived negatively by others. When asked what barriers kept them out of the OR, female residents often responded that expectations (both internal and external) to complete all floor work prior to seeking operative experience was a significant barrier. They felt that this focus on administrative/floor task completion was disproportionately shouldered by females relative to their male peers. Other barriers included perceived lack of respect from attendings and OR staff leading to shying away from experiences, and feeling a reluctance to “claim space” in the operating room. Concerns surrounding pregnancy related discrimination, lack of support for fertility treatment, and poor lactation support/ resources were also expressed. Improvements suggested by female trainees included: increased faculty diversity, increased structured mentorship, standardization of case selection/ assignment, and setting of goals and expectations for autonomy.</div></div><div><h3>CONCLUSIONS</h3><div>We conclude that deleterious gender dominant cultural norms continue to exist in surgical residency training, and affect the operative experience of female residents. Equity education, setting clear expectations to attendings and house staff, and providing structured mentorship may represent solutions to remediate disparities in residency education.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103368"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}