This study aimed to investigate the transparency of parental benefits available to US surgical residency applicants.
Medical students prioritize work-family balance in specialty selection. Those ...applying to surgical residency programs also place a significant value on parental leave policies when deciding where to train. However, little is known about the amount of information that surgical training programs publicly offer to potential applicants regarding family support policies.
Publicly available websites for 264 general surgery training programs were accessed to determine the availability of information on parental benefits. Twenty-six "items of transparency" included types of leave, contract flexibility, salary, lactation, and childcare support. Programs with fewer than the median items of transparency were contacted to inquire about additional public resources. Academic programs were stratified by their associated medical school rankings in the US News & World Report.
A total of 144 (54%) programs were academic and 214 (81.4%) had male program directors. The median number of items of transparency was 8 (29.6%). Of the 131 programs contacted, 33 (25.9%) replied, and 2 (6.1%) improved their transparency score. Academic programs associated with medical schools in the upper third of the rankings were more likely to have ≥8 items of transparency (70.8% vs. 45.6%; P =0.002). In the adjusted analysis, academic programs odds ratio (OR): 3.44, 95% confidence interval (95% CI): 1.87-6.34, those with female program directors (OR: 2.09, 95% CI: 1.01-4.33), and those located in the Western (OR: 3.13, 95% CI: 1.31-7.45) and Southern (OR: 2.45, 95% CI: 1.21-4.98) regions of the country were more likely to have ≥8 items of transparency.
There are significant deficits in publicly available information related to parental benefits for many surgical training programs, which may impact applicants' decision making. Attracting the most talented candidates requires programs to create and share policies that support the integration of professional and personal success.
Although physician health promotes retention to the profession and encourages higher-quality patient care, residents can face challenges seeking routine medical care. Erratic working hours, time ...constraints, easy access to informal health consultation, and a culture of self-reliance can deter help-seeking behavior. Despite national focus on physician burnout and efforts to promote wellness, little is known about the self-care habits of residents. The goal of this study was to evaluate the routine healthcare practices of resident physicians.
A 44-question survey with questions on medical and psychiatric health was electronically distributed to 102 program directors in 20 New England teaching hospitals. Program directors were asked to forward the survey to current trainees.
Two hundred and ninety-nine residents completed the survey. One-third of respondents reported not having a routine place for care (RPFC), and these residents had lower use of preventive health services. Thirty-eight percent of residents taking daily prescription medication did not have an RPFC. Compared with residents in family medicine, those in surgery, internal medicine, radiology, anesthesia, OB/GYN, and pediatrics were considerably more likely to lack an RPFC. Although two-thirds of respondents reported symptoms of depression, these residents were less likely to have been under the care of a mental health professional than those who did not report depression symptoms.
Despite a high prevalence of self-reported depression and prescription medication use, a significant proportion of surveyed resident physicians in New England do not seek mental health resources and lack consistent, routine healthcare. Resident health is vital to the mission of physician well-being and mitigating the escalating problem of burnout. Barriers to self-care and help-seeking behavior should be evaluated to promote sustainable behavior that will encourage a long professional career.
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Prior work shows pregnancy during surgical residency may negatively impact career satisfaction and increase risk of attrition. We sought to gain deeper insight into the experience of childbearing ...trainees.
An electronic survey with three open-ended questions was sent to surgeons who had ≥1 pregnancy during a US general surgery training program. Transcripts were analyzed using directed content analysis and the constant comparative approach.
Six themes characterized the pregnancy experience of 219 surgeons in residency. Respondents: 1)desired work modifications during the late stages of pregnancy due to health concerns; 2)regarded maternity leave as too short; 3)perceived stigma related to pregnancy; 4)expressed need for greater lactation and childcare support; 5)desired mentorship on work-family integration; 6)placed value on supportive colleagues and faculty.
Pregnancy is challenging during surgical residency. These findings may inform policy changes to improve retention and recruitment of women trainees who wish to begin families during residency.
•Rigorous rotations close to term may cause health concerns for pregnant residents.•Residents desire written program maternity leave policies.•Pregnant surgical residents are concerned about stigma related to childbearing.•Residents who go through pregnancy desire mentorship on work-life integration.•Pregnant residents place value on supportive faculty and colleagues.
Background
Long years of school/training have shown to be associated with infertility and pregnancy complications. Rates of infertility and pregnancy complications were compared among women in ...demanding professional careers to better understand career differences impacting family planning.
Methods
Inclusion criteria : English-speaking, childbearing professional women in surgery, medicine, law, and engineering. Exclusion criteria: men and women not in professional careers mentioned and non-childbearing women. Male-dominated fields identified to select non-medical female professionals. Top medical, law, and engineering schools’ female faculty were surveyed from October 2022 to December 2022. Descriptive analysis and chi-squared tests were performed.
Results
2302 surveys were distributed and 268 responses were obtained (11.6%): 121 non-surgeon physicians, 120 lawyers/other doctorate degree holders, and 27 other/unknown. Data analysis included prior study’s surgeon data. The median age (IQR = 25%, 75%) of the surgeons was 40y (36,45), non-surgeon physicians 43y (37,50), and law/other doctorates 38y (35,46). Delayed childbearing was observed in 65.0% surgeons, 66.1% non-surgeon physicians, and 57.5% law/other doctorates (P < .001). Pregnancy loss <10wks was observed in 35.3% surgeons, 33.9% non-surgeon physicians, and 30.8% law/other doctorates (P < .001). Infertility testing was performed in 43.0% non-surgeon physicians and 34.2% law/other doctorates (P < .001). Assisted reproductive technology was utilized by 24.9% surgeons, 43.0% non-surgeon physicians, and 21.7% law/other doctorates (P < .001).
Discussion
Surgeons/physicians suffer more childbearing complications than other professional women.
Background and Objectives
Skin diseases are a common reason for emergency department (ED) consultations; however, few studies have focused on pediatric patients. Diagnostic consistency between ED ...physicians and dermatologists varies from 43% to 58%, meaning many patients seeking emergency care may receive incorrect diagnoses and treatments. We aimed to determine the diagnostic concordance between ED physicians and pediatric dermatologists.
Methods
We conducted a prospective study including all pediatric patients (<18 years) who were seen for a skin condition at the ED from December 1, 2017, to June 1, 2018, and consented to participate. We classified diagnoses according to their etiology. Patients were diagnosed by ED trainees and attending physicians, followed by blinded pediatric dermatology trainees and attending physicians. We evaluated concordance using Fleiss's kappa coefficient (κ) with a 95% confidence interval. We further stratified the data by level of training.
Results
We included 185 patients. Inflammatory conditions were the most common reason for consultation, followed by infections; 10 patients required hospitalization. Concordance between diagnoses given at the ED and at the dermatology clinic was moderate (κ 0.472, 95% CI: 0.389‐0.455) with 62.7% agreement. Concordance between different diagnostic categories was lowest for autoimmune disorders and drug reactions (κ 0.392 with 95% CI: 0.248‐0.536 and κ 0.258 with 95% CI: 0.114‐0.402).
Conclusions
Diagnostic concordance between ED physicians and dermatologists was moderate and differed according to training level and diagnoses. Dermatological education for ED providers, specifically focusing on autoimmune disorders and drug reactions, may improve diagnostic accuracy and patient care.
