ObjectivesTo describe levels of burnout and impostor syndrome (IS) in medical students, and to recognize demographic differences in those experiencing burnout and IS. MethodsResearch participants included 2,612 medical students who entered Jefferson Medical College between 2002 and 2012. This sample was divided into two groups: Matriculants between 2002 and 2007 (n=1,380) and between 2008 and 2012 (n=1,232). Data for 2002-2007 matriculants were subjected to EFA (principal component factor extraction), and data for matriculants of 2008-2012 were used for CFA (structural equation modeling, and root mean square error for approximation).ResultsOne hundred and thirty-eight students completed the questionnaire. Female gender was significantly associated with IS (χ2(3)=10.6, p=0.004) with more than double the percentage of females displaying IS than their male counterparts (49.4% of females versus 23.7% of males). IS was significantly associated with the burnout components of exhaustion (χ2 (2)=5.9, p=0.045), cynicism (χ2(2)=9.4, p=0.004), emotional exhaustion (χ2(2)=8.0, p=0.018), and depersonalization (χ2 (2)=10.3, p=0.006). The fourth year of medical school was significantly associated with IS (χ2(3)=10.5, p=0.015).ConclusionsAlmost a quarter of male medical students and nearly half of female students experience IS and IS was found to be significantly associated with burnout indices. Given the high psychological morbidity of these conditions, this association cannot be ignored. It behooves us to reconsider facets of medical education (i.e. shame-based learning and overall teaching style) and optimize the medical learning environment.
Objectives A broad survey of women otolaryngologists on the current state of the field, including opportunities for advancement, support of family leave, and prevalence of harassment, has not been performed since 1998. An update on the experiences of female otolaryngologists is vital to continue to advance the specialty. Study Design Anonymous web‐based survey. Methods Survey of members of the Women in Otolaryngology (WIO) section of the American Academy of Otolaryngology–Head and Neck Surgery (all members of the AAO‐HNS that identify as female are automatically members of this section). Distributed via AAO‐HNS. Results Five hundred thirty‐five responses out of 2303 total WIO members (response rate of 23.2%). Respondents ranged in age from 25 to >65 years. Respondents reported that in the residency programs they attended, 29% of residents, 13% of faculty, and 7% of department leaders were women. Forty‐four percent disagreed that their department leaders and 39% disagreed that their male co‐residents were supportive of women starting families in training. Younger respondents were more likely to feel that their department leaders were supportive of female residents, maternity leave, etc. Harassment in the current work environment did not differ by age; 53% reported harassment‐free, 31% subtle undertones, 8% noticeable tones, 2% significant harassment. Harassment in the workplace varied by region; the greatest level of harassment was in the Midwest. Conclusions Women otolaryngologists continue to experience harassment in the workplace. It is encouraging that younger otolaryngologists feel more supported by their departments in both their careers and their personal lives. This survey highlights critical areas for continued growth within our specialty. Level of Evidence IV Laryngoscope, 131:E380–E387, 2021
Objective Describe longitudinal audiometric and otologic outcomes in patients with cleft palates. Study Design Case series with chart review. Setting Single academic medical center. Methods Charts of 564 patients with a diagnosis of cleft palate (59% syndromic etiology, 41% nonsyndromic) from 1998 to 2014 were reviewed. Patients without at least 1 audiometric follow-up were excluded from analysis. Patient demographics, surgeries, audiometric tests, and otologic data were recorded for 352 patients. Results Forty-five percent had isolated cleft palates, 34% had unilateral cleft lip and palate, and 21% had bilateral cleft lip and palate. Patients were followed for a mean of 50.3 months with a mean of 3.2 separate audiograms performed. Patients received a mean of 2.93 pressure equalization tubes. Increased number of pressure equalization tubes was not associated with incidence of cholesteatoma, which was identified in only 4 patients. Nine patients underwent eventual tympanoplasty with an 89% closure rate. Analysis of mean air-bone gap by cleft type did not reveal significant differences ( P = .08), but conductive losses and abnormal tympanometry persisted into teenage years. Conclusions Patients with cleft palates have eustachian tube dysfunction, which, in our cohort, resulted in persistent conductive hearing loss, highlighting the importance of long-term follow-up. Cholesteatoma incidence was low and not associated with number of tubes, which at our institution were placed prophylactically. Tympanoplasty was successful in those with persistent perforations.
Most patients use online resources for information on health care professionals. Physician perceptions of these sites tend to be negative. Awareness of the content and rating patterns may help physicians better manage their online reputation.
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