Gender Differences in Utilization of Duty-hour Regulations, Aspects of Burnout, and Psychological Well-being Among General Surgery Residents in the United States

Dahlke, Allison R.; Johnson, Julie K.; Greenberg, Caprice C.; Love, Remi; Kreutzer, Lindsey; Hewitt, D. Brock; Quinn, Christopher; Engelhardt, K; Bilimoria, Karl Y.

doi:10.1097/sla.0000000000002700

Cited by 108 publications

(125 citation statements)

References 30 publications

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“…Surgical fields have historically been male‐dominated professions with less gender diversity . Possible causes for gender disparities in surgery include unequal mentorship opportunities and unconscious bias which may lead to differences in psychological well‐being, burnout, and confidence levels among male and female residents …”

Section: Discussionmentioning

confidence: 99%

“…To what extent does gender disparity also exist in graduate medical education? There have been reports demonstrating gender inequality in graduate medical education, including surgical education . All residents—male and female—should have equitable educational experiences in residency to enable them to independently practice medicine upon completion of their training.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating gender parity in operative experience for otolaryngology residencies in the United States

et al. 2019

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Objectives Gender disparity exists in medicine, such as differences in pay and promotion opportunities. We hypothesize that there is also a gender difference in graduate medical education as manifested by operative case volume. This study compares surgical case volume by gender for graduating US otolaryngology residents. Study Design Cohort study. Methods With data use approval from the Accreditation Council for Graduate Medical Education, we evaluated the key indicator case log summaries of graduating otolaryngology residents from 2009–2017. Mean and standard deviation were used for all cases, and t‐tests were used to compare cases by resident gender. The Bonferroni method was used to adjust for multiple comparisons across years. Results Data from 1740 male and 804 female residents were evaluated. Across all years, the average number of key indicator cases reported was 778.8 and 813.6 by female and male residents, respectively, with an average difference of 34.8 cases per graduating year (95% confidence interval [CI] 19.4, 50.2; P < .001). When a resident self‐reported the role of resident surgeon/supervisor, the average number of key indicator cases reported was 602.6 and 643.9 by female and male residents, respectively, with an average difference of 41.3 cases per graduating year (95% CI, 28.0, 54.6; P < .001). Conclusion Gender‐based discrepancies in surgical case volume exist among graduating otolaryngology residents. This disparity is partially attributed to the self‐reported role in the surgery. This study has identified those discrepancies so that training programs can implement strategies to ensure improved gender parity. Level of Evidence 2b Laryngoscope, 130:1651–1656, 2020

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluating gender parity in operative experience for otolaryngology residencies in the United States

et al. 2019

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“…The challenges described above all contribute to physician burnout, another factor that negatively impacts physician retention. Female physicians in particular demonstrate higher levels and manifestations of burnout . Female residents face gender‐specific challenges in addition to the stress typically associated with residency.…”

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confidence: 99%

“…Similarly, female faculty receive poorer teaching evaluations from students in comparison to their male counterparts . Female faculty and residents report higher rates of sexual harassment, gender bias, and discrimination directed from both patients and colleagues and ultimately higher rates of burnout and attrition from the workforce . Recognizing these risk factors and addressing disparities can help decrease burnout of female physicians and lead to better retention.…”

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confidence: 99%

Gender Disparities in Academic Emergency Medicine: Strategies for the Recruitment, Retention, and Promotion of Women

Agrawal

Madsen

Lall

et al. 2019

AEM Education and Training

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Although women comprise half of all medical students, the number of female academic emergency medicine (EM) physicians remains at approximately 27%. In addition, despite having equivalent credentials, female EM faculty remain underrecognized and undercompensated when compared to their male counterparts. Recent studies have shown superior outcomes among patients treated by EM physicians who are women; however, disparities in advancement persist. This white paper, prepared on behalf of the Academy for Women in Academic Emergency Medicine, describes recent evidence demonstrating gender disparities in the EM workforce including content presented at the 2019 Society for Academic Emergency Medicine Annual Scientific Meeting. The authors describe strategies to address the identified problems. Specific recommendations include individual as well as institutional/systems-level approaches to creating directed programming and initiatives to recruit, support, and promote women at all aspects of the career continuum.

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“…In addition to the training environment, individual factors such as marriage [15] and childcare [16] have been reported to reduce the factors of BO. Women are more resistant [17] or liable [18] to BO.…”

Section: Maslach Et Al Analyzed the Cause Of Bo Based On Interviews mentioning

confidence: 99%

Effect of stress coping ability and working hours on burnout among residents

Kijima

Tomihara

Tagawa

2019

Preprint

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Background Burnout (BO) among residents leads to interruptions in training and even to exit from programs. Despite the implementation of working hour restrictions in the U.S. in 2013, the high rate of BO remains a serious problem. Therefore, we analyzed Japanese residents’ BO, training conditions, and associated factors, especially stress coping ability, with the aim of providing support for residents and evidence-based guidelines for working environments. Methods In total, 37 teaching hospitals were randomly selected, and all residents in the third and fifteenth months of a residency program at these hospitals were targeted for this research. We analyzed the residents’ BO rates, associated factors, and interactions using response data from a self-administered questionnaire consisting of the Japanese versions of the Maslach Burnout Inventory (MBI) and the Sense of Coherence (SOC) scale, as well as items asking about their training environments, gender, and age. Results Overall, 48 (49.5%) of 97 residents in 18 teaching hospitals (62 and 35 in the third and fifteenth months, respectively) whose average working hours were 63.3 hours per week were judged as having BO, among whom, 33 (53.2%) and 15 (42.9%) had BO in the third and fifteenth months, respectively. Logistic regression analysis indicated that working hours and 10 items on the SOC scale (SOC10) were significant factors of BO. Two-way analysis of variance revealed that working hours was a significant variable for the MBI-emotional exhaustion score and SOC10 in the third and fifteenth months, respectively. Regarding the MBI-cynicism and professional efficacy scores, the SOC10 was a significant variable in both the third and fifteenth months. In addition, the high SOC group (SOC10>45) showed higher personal efficacy under longer working hours. Conclusion About half of the Japanese residents were judged as having BO as early as the third month of training under regulations of working 40 hours per week. Individual stress coping ability and working hours were found to be significant factors for BO. Residents with high stress coping ability exhibited more personal efficacy with more working experiences, which suggests that the SOC scale could be a valuable tool to help foster a suitable training environment.

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Gender Differences in Utilization of Duty-hour Regulations, Aspects of Burnout, and Psychological Well-being Among General Surgery Residents in the United States

Abstract: Female residents report working more, experiencing certain aspects of burnout more frequently, and having poorer psychological well-being. Qualitative themes provide insights into possible cultural and programmatic shifts to address the concerns for female residents.

Cited by 108 publications

References 30 publications

Evaluating gender parity in operative experience for otolaryngology residencies in the United States

Evaluating gender parity in operative experience for otolaryngology residencies in the United States

Gender Disparities in Academic Emergency Medicine: Strategies for the Recruitment, Retention, and Promotion of Women

Effect of stress coping ability and working hours on burnout among residents

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