Context Impostor syndrome (IS) is increasingly recognised as a condition among physicians and physicians in training. Impostor syndrome is especially problematic because of its association with increased rates of burnout and suicide. In order to address this issue, we need to fully understand its prevalence, scope, and factors associated with IS. The purpose of this scoping review is to analyse the existing literature on IS among practising physicians and physicians in training in order to identify current trends and directions for future research. Methods The authors conducted a literature search of nine databases for any articles on IS among practising physicians or physicians in training published prior to January 2019. Two reviewers independently screened articles and identified 18 papers meeting the study inclusion criteria. Two authors independently extracted data and performed quantitative and qualitative syntheses consistent with best practice recommendations for scoping reviews. Results Most studies utilised the Clance Impostor Phenomenon Scale and cited rates of IS ranging from 22% to 60%. Studies found that gender, low self‐esteem and institutional culture were associated with higher rates of IS, whereas social support, validation of success, positive affirmation, and both personal and shared reflections were protective. Overall, IS was also associated with higher rates of burnout. Conclusions This review summarises the existing literature on IS among practising physicians and physicians in training, providing valuable insights and areas for future research.
On October 1, 2015, the United States Centers for Medicare and Medicaid Services (CMS) issued a core measure addressing the care of septic patients. These core measures are controversial among healthcare providers. This article will address that there is no gold standard definition for sepsis, severe sepsis or septic shock and the CMS-assigned definitions for severe sepsis and septic shock are premature and inconsistent with evidence-based definitions.
In April 2018, the Surviving Sepsis Campaign (SSC) released an updated sepsis bundle, which combines directives previously listed in the three-hour and six-hour bundles. The authors discussed the reasoning and evidence supporting these changes. However, there are data that suggest these recommendations may be contrary to the best available evidence. Our purpose here is to highlight the areas where evidence is only as strong as the methodological constructs of the research used. This article is a narrative review of the available, limited evidence on which the one-hour bundle was based.
Background Current rates of burnout among physicians are alarming when compared to nonphysician U.S. workers, and numerous interventions have been introduced to mitigate the issue. However, no interventions have specifically targeted the 30% burnout rate among physician program directors. The complex and demanding role of program directors necessitates building relationships, solving crises, securing jobs for residents and maintaining well-being of trainees. The aim of this study is to investigate the impact of emotional intelligence (EQ) on burnout levels among program directors. Methods A cross-sectional survey was administered from May 17 to June 30, 2021 to program directors and assistant/ associate program directors at an academic medical center in south-central Pennsylvania. A self-report questionnaire was used to collect data. The survey included an open-ended question along with the Trait Emotional Intelligence Questionnaire- Short Form (TEIQue-SF), Copenhagen Burnout Inventory (CBI), and demographic questions. All data were analyzed using SAS Version 9.4. Results Of the 109 program directors and assistant/associate program directors invited in the survey, 34 (31.20%) responded. The findings indicate that there is a moderate inverse association between EQ and burnout, suggesting EQ as a protective factor against burnout. We also found that program directors who were considering leaving their position demonstrated higher levels of burnout compared to those who did not. Results from the open-ended question suggest that perceived lack of support, micromanagement, criticism, and extra duties with less payment were among the reasons program directors and associates were considering steeping down from their position. The results showed no association between EQ skills and years of practicing. Conclusions Burnout among program directors and assistant/associate program directors is not as alarming as rates of burnout among physicians-in-training. However, despite high level of EQ skills and low burnout level, nearly 43% of program directors were considering leaving their position. Nurturing EQ skills may be useful in improving retention and reducing turnover among medical leaders.
Each year, residency programs face the daunting task of screening hundreds of applications and choosing which students to invite for an interview and how to rank them. The average number of applications received by an emergency medicine (EM) program in 2019, for example, was 909; 1 however, a programs have needed to only rank between 5.9 and 6.8 applicants per position to fill. 2 To help narrow down the field of candidates into a final list, programs may resort to easily accessible means of screening, such as medical school attended, standardized test scores, medical school grades, letters of evaluation, and impressions during interviews. It
Study Objective: Research in engineering fields has shown that using masculine or feminine coded language in job advertisements affects the proportion of men vs. women applying for those jobs, and that changing such wording alters the applicant pool in a way that improves diversity. In medicine, there are fields that are traditionally heavily male-dominated, such as surgery, and fields that attract more women, such as family practice, obstetrics, and pediatrics. We sought to determine if sex coded language in physician job advertisements reflects the sex disparities in medical and surgical fields.Methods: This was a cross sectional study of all physician job advertisements on 16 academic and non-academic medical job databases from September 2020-February 2021. Job advertisements were cut and pasted verbatim for the purposes of the study. Using a sex decoder program based on prior research by Gaucher et al on sexed wording in job advertisements, we analyzed each job to determine if the job advertisement contained any sex coded words and if the advertisement was overall highly masculine, masculine, highly feminine, feminine, or neutral. Region of the country, requirement for subspecialty training, and field (emergency medicine (EM), internal medicine (IM), surgery, pediatrics, obstetrics (OB), family practice (FP), and multiple fields) were also recorded. Data was reviewed and duplicate listings were deleted. Data were analyzed using descriptive statistics and logistic regression. The study was reviewed by the IRB and found to be exempt.Results: 509 jobs were posted to the study websites during the study period. The jobs included 193 IM jobs (37.9%), 89 surgery jobs (17.5%), 74 EM jobs (14.5%), 63 FP jobs (12.4%), 41 pediatric jobs (8.1%), 29 OB jobs (5.7%). 43.6% of job advertisements coded as masculine or strongly masculine (M), 35.4% coded as feminine or strongly feminine (F), 20.8% coded as neutral (N). Of those neutral coded jobs, only 19 advertisements (3.7%) had no sex coded language at all. Region of the country and requirement for subspecialty training were not associated with sex coding. Field of practice was predictive of sex coding, with pediatrics (29.3%M, 54.8%F) and OB (24.1%M, 41.4%F) more commonly having feminine coded language and IM (48.7%M, 31.6%F) and EM (54.8%M, 25%F) having disproportionately more masculine coded job advertisements (p¼0.001). Surgery (36%M, 39.3%F) and FP (39.7%M, 39.7%F) were more balanced. This is consistent with the sex proportion of some fields, such as OB and pediatrics, which have 59% and 64% women in practice respectively, and EM and IM, which have 72% and 61% men in practice, respectively. Surgical job advertisements are less commonly masculine coded, although the specialty is 78% male.Conclusion: Job advertisements for medical positions often contain sex coded language that may reduce the diversity of the applicant pool. For most medical fields, this sexed language is in keeping with the sex make-up of the specialty. Further studies should focus on whether modificati...
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