Because plastic surgery trainees generally spend the majority of their training in academic centers and may have minimal exposure to other practice models, it can be difficult to decide which is the ...best route to achieve satisfaction and success. Surgeons need to be aware of benefits and challenges associated with different practice models and with workplace factors in general that contribute to happiness at work. This article reviews common practice models and provide specific and practical advice for the female surgeon.
Faculty promotion is important for retention and has implications for diversity. This study provides an update on recent trends in faculty promotion in U.S. medical schools.
Using data from the ...Association of American Medical Colleges Faculty Roster, the authors examined trends in faculty promotion over 10 years. Promotion status for full-time assistant and full-time associate professors who started between 2000 and 2009 inclusive was followed from January 1, 2010 to January 1, 2019. The authors used bivariate analyses to assess associations and promotion rates by sex, race/ethnicity, department, tenure status, and degree type.
The promotion rate for assistant professors was 44.3% (2,330/5,263) in basic science departments, 37.1% (17,232/46,473) in clinical science departments, and 33.6% (131/390) in other departments. Among clinical departments, family medicine had the lowest rate of promoting assistant professors (24.4%; 484/1,982) and otolaryngology the highest rate (51.2%; 282/551). Faculty members who were male (38.9%; 11,687/30,017), White (40.0%; 12,635/31,596), tenured (58.7%; 98/167) or tenure-eligible (55.6%; 6,653/11,976), and holding MDs/PhDs (48.7%; 1,968/4,038) had higher promotion rates than, respectively, faculty who were female (36.3%; 7,975/21,998), minorities underrepresented in medicine (URM; 31.0%; 1,716/5,539), nontenured (32.5%; 12,174/37,433), and holding other/unknown degrees (20.6%; 195/948; all P < .001). These differences were less pronounced among associate professors; however, URM and nontenured faculty continued to have lower promotion rates compared with White, Asian, or tenured faculty at the associate professor level.
Promotion rates varied not only by faculty rank but also by faculty sex, race/ethnicity, department, tenure status, and degree type. The differences were more pronounced for assistant professors than associate professors. URM faculty members, particularly assistant professors, were promoted at lower rates than their White and Asian peers. More research to understand the drivers of disparities in faculty promotion seems warranted.
Black physicians remain disproportionately underrepresented in certain medical specialties, yet comprehensive assessments in radiation oncology (RO) are lacking. Our purpose was to report current and ...historical representation trends for Black physicians in the US RO workforce.
Public registries were used to assess significant differences in 2016 representation for US vs RO Black academic full-time faculty, residents, and applicants. Historical changes from 1970 to 2016 were reported descriptively. Linear regression was used to assess significant changes for Black residents and faculty from 1995 to 2016.
In 2016, Black people represented 3.2% vs 1.5% (P < .001), 5.6% vs 3.2% (P = .005), and 6.5% vs 5.4% (P = .352) of US vs RO faculty, residents, and applicants, respectively. Although RO residents nearly doubled from 374 (1974) to 720 (2016), Black residents peaked at 31 in 1984 (5.9%; 31 of 522) and fell to 23 (3.2%; 23 of 720) in 2016 across 91 accredited programs; Black US graduate medical education trainees nearly doubled over the same period: 3506 (1984) to 6905 (2016). From 1995 to 2016, Black US resident representation significantly increased by 0.03%/y, but decreased significantly in RO by -0.20%/y before 2006 and did not change significantly thereafter. Over the same period, Black US faculty representation significantly increased by 0.02%/y, whereas Black RO faculty significantly increased by 0.07%/y before 2006, then decreased significantly by -0.16%/y thereafter. The number of Black RO faculty peaked at 37 in 2006 (3.1%; 37 of 1203) and was 27 (1.5%; 27 of 1769) in 2016, despite the nearly 1.5-fold increase in the number of both RO faculty and Black US faculty overall (4169 in 2006 and 6047 in 2016) during that period.
Black physicians remain disproportionately underrepresented in RO despite an increasing available pipeline in the US physician workforce. Deliberate efforts to understand barriers to specialty training and inclusion, along with evidence-based targeted interventions to overcome them, are needed to ensure diversification of the RO physician workforce.
BACKGROUND:Academic plastic surgery has a history of underrepresentation of ethnic and racial minority groups. Recent policy shifts by national medical groups and plastic surgery societies have ...focused on reversing these inequalities. This study seeks to measure ethnic and racial representation at academic and leadership positions following recent changes.
METHODS:A cross-sectional study was conducted in June of 2018, measuring ethnic and racial diversity of U.S. academic plastic surgery faculty. Among faculty, career qualifications, years of experience, faculty positions, and leadership ethnicity were compared.
RESULTS:A total of 930 academic plastic surgeons were included in the study. Classified collectively as nonwhite, this group graduated more recently than other academic plastic surgeons (2006 versus 2001; p < 0.0001) and had greater rates of clinical fellowship attainment (OR, 1.62; 95 percent CI, 1.16 to 2.26). Nonwhite individuals were less likely to be employed in the full professor position compared with their white colleagues (OR, 0.6; 95 percent CI, 0.42 to 0.88; p = 0.0077). However, after adjustment for differences in years of postresidency experience, this disparity was no longer significant (OR, 1.06; 95 percent CI, 0.62 to 1.83; p = 0.82), indicating the importance of current cohort experience differences. Assessment of program leadership found that nonwhite chairs employed significantly more nonwhite faculty (42.5 percent versus 20.9 percent; p < 0.0001).
CONCLUSIONS:Academic plastic surgery continues to face disparities in representation of both ethnic and racial minorities. Current inequalities are most severe at senior academic positions and may be linked to cohort experience differences along with leadership and promotion biases.
Racial/ethnic diversity remains poor in academic surgery. However, no study has quantified differences in the rates of retention and promotion of underrepresented minority (URM) academic surgeons.
...The American Association of Medical Colleges Faculty Roster was used to track all first-time assistant and associate professors appointed between 1/1/2003 and 12/31/2006. Primary endpoints were percent promotion and retention at ten-year follow-up.
Initially, the majority of assistant and associate professors of surgery were White (62%; 75%). Black assistant professors had lower 10-year promotion rates across all specialties (p < 0.01). There were no race/ethnicity-based differences in promotion for associate professors. Retention rates were higher for White assistant professors than Asian or Black/Hispanic/Other minority faculty (61.3% vs 52.8% vs. 50.8% respectively; p < 0.01). There was no difference in 10-year retention rates among associate professors based on race/ethnicity.
Underrepresented minority surgeons are less likely to remain in academia and Black assistant professors have the lowest rates of promotion. These findings highlight the need to develop institutional programs to better support and develop minority faculty members in academic medicine.
•Black assistant professors had the lowest promotion rates for all specialties.•Retention rates were significantly higher for White assistant professors.•There were no differences in promotion/retention rates for associate professors.
The impact of the COVID-19 pandemic on preclerkship and clerkship learning environments, as well as the future of medical student education, is discussed. The pandemic poses practical and logistical ...challenges and concerns for patient safety in teaching hospitals. Students may potentially spread the virus when asymptomatic and may acquire the virus in the course of training.
OBJECTIVE:To assess the changing landscape in nontenured faculty, stratified by sex and underrepresented in medicine status, for obstetrician–gynecologists at all U.S. medical schools.
METHODS:In ...this retrospective observational study, we used data from the Association of American Medical Colleges Faculty Roster to identify trends in career pathways of full-time faculty at all U.S. MD-granting medical schools from 1978 to 2017. Proportions of nontenured faculty were compared with other clinical departments, according to sex and race–ethnicity. Two-sample t-testing and simple linear regression were used for statistical comparisons.
RESULTS:The number of full-time obstetrics and gynecology faculty increased from 1,688 to 6,347, with most being nontenured (from 535 to 4,951; 9.3-fold increase) rather than tenured (from 457 to 587; 1.3-fold increase) or tenure-eligible (from 397 to 514; 1.3-fold increase). The proportions of all faculty who were nontenured increased from 29.6% to 72.5% (a 2.5-fold increase; P<.010) for men and from 43.4% to 81.4% (a 1.9-fold increase; P<.01) for women. The proportion who were nontenured increased similarly for faculty who were underrepresented in medicine (from 27.4% to 83.5%; a 3.0-fold increase; P<.01) and for those who were not underrepresented in medicine (from 32.0% to 77.1%; a 2.4-fold increase; P<.01). Trends in the increased proportions of nontenured obstetrics and gynecology faculty were similar with those in other major clinical departments.
CONCLUSIONS:The substantial rise in the number of obstetrics and gynecology faculty was largely among those who were nontenured, regardless of sex or underrepresented in medicine status. This finding signals the essential need for examining career development and academic accomplishment for promoting nontenured faculty.
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