How to Get Ahead: Early-Career Colorectal Surgeons Reflect on Their First Few Years in Practice

Donahue, Colleen; Kuhnen, Angela H.; Kleiman, David A.; Marcello, Peter W.; Schoetz, David J.; Breen, Elizabeth; Saraidaridis, Julia T.

doi:10.1016/j.jsurg.2020.06.031

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…For example, in surveys of practicing surgeons at academic medical centers, the strongest predictors of workplace satisfaction were departmental leadership, collegiality and collaboration, and relationships with partners . Similarly, in a qualitative study of early-career colorectal surgeons, market competition and inadequate mentorship were identified as barriers to career advancement . The present study adds to the literature by describing several additional barriers on the departmental and institutional level, including the availability of OR time and support staff.…”

Section: Discussionmentioning

confidence: 62%

“…25 Similarly, in a qualitative study of early-career colorectal surgeons, market competition and inadequate mentorship were identified as barriers to career advancement. 26 The present study adds to the literature by describing several additional barriers on the departmental and institutional level, including the availability of OR time and support staff. Limitations in patient care resources may be worsening following the COVID-19 pandemic, which increased attrition across health care.…”

Section: Transparency In Referral Processmentioning

confidence: 88%

“…The barriers and facilitators described by the participants are consistent with those reported in prior studies of burnout, satisfaction, and attrition among surgeons. 25,26 For example, in surveys of practicing surgeons at academic medical centers, the strongest predictors of workplace satisfaction were departmental leadership, collegiality and collaboration, and relationships with partners. 25 Similarly, in a qualitative study of early-career colorectal surgeons, market competition and inadequate mentorship were identified as barriers to career advancement.…”

Section: Transparency In Referral Processmentioning

confidence: 99%

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Barriers and Facilitators to Clinical Practice Development in Men and Women Surgeons

Finn,

Syvyk,

Bakillah

et al. 2024

JAMA Surg

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ImportanceMany early-career surgeons struggle to develop their clinical practices, leading to high rates of burnout and attrition. Furthermore, women in surgery receive fewer, less complex, and less remunerative referrals compared with men. An enhanced understanding of the social and structural barriers to optimal growth and equity in clinical practice development is fundamental to guiding interventions to support academic surgeons.ObjectiveTo identify the barriers and facilitators to clinical practice development with attention to differences related to surgeon gender.Design, Setting, and ParticipantsA multi-institutional qualitative descriptive study was performed using semistructured interviews analyzed with a grounded theory approach. Interviews were conducted at 5 academic medical centers in the US between July 12, 2022, and January 31, 2023. Surgeons with at least 1 year of independent practice experience were selected using purposeful sampling to obtain a representative sample by gender, specialty, academic rank, and years of experience.Main Outcomes and MeasuresSurgeon perspectives on external barriers and facilitators of clinical practice development and strategies to support practice development for new academic surgeons.ResultsA total of 45 surgeons were interviewed (23 women [51%], 18 with ≤5 years of experience [40%], and 20 with ≥10 years of experience [44%]). Surgeons reported barriers and facilitators related to their colleagues, department, institution, and environment. Dominant themes for both genders were related to competition, case distribution among partners, resource allocation, and geographic market saturation. Women surgeons reported additional challenges related to gender-based discrimination (exclusion, questioning of expertise, role misidentification, salary disparities, and unequal resource allocation) and additional demands (related to appearance, self-advocacy, and nonoperative patient care). Gender concordance with patients and referring physicians was a facilitator of practice development for women. Surgeons suggested several strategies for their colleagues, department, and institution to improve practice development by amplifying facilitators and promoting objectivity and transparency in resource allocation and referrals.Conclusions and RelevanceThe findings of this qualitative study suggest that a surgeon’s external context has a substantial influence on their practice development. Academic institutions and departments of surgery may consider the influence of their structures and policies on early career surgeons to accelerate practice development and workplace equity.

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Section: Discussionmentioning

confidence: 62%

Section: Transparency In Referral Processmentioning

confidence: 88%

Section: Transparency In Referral Processmentioning

confidence: 99%

See 1 more Smart Citation

Barriers and Facilitators to Clinical Practice Development in Men and Women Surgeons

Finn,

Syvyk,

Bakillah

et al. 2024

JAMA Surg

View full text Add to dashboard Cite

show abstract

“…Similarly, many faculty members successfully transitioned into unsupervised practice when support or guidance may not have been offered, and may thus feel that residents could similarly advance with minimal guidance [14]. However, there is good evidence that residents entering unsupervised practice feel unprepared, [15] that their personal relationships and quality of life suffer, and that this lack of preparation leads some physicians to leave the profession [16][17][18]. Thus, it remains critical to improve residents' transition to unsupervised practice.…”

Section: Discussionmentioning

confidence: 99%

Transition to practice curriculum for general internal medicine physicians: scoping review and Canadian national survey

Thomson

O'Halloran

et al. 2022

BMC Med Educ

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Background There remains a paucity of evidence for curricula for the transition to practice (TTP) stage of Competence by Design internal medicine (IM) training programs. Current entrustable professional activities are based on expert consensus rather than robust subspecialty-specific needs assessment. Methods A scoping review was completed to identify studies with TTP focus. A national survey was conducted to identify transition experiences for general internal medicine physicians. Results were assessed by grounded theory analysis to identify core topics for TTP curricula. Results Neither scoping review nor national survey identified TTP topics related to the CanMEDS Medical Expert role. Scoping Review: 41 relevant studies were identified. Most (97.6%) were from North America. The most common study types were observational (survey) or curriculum (13/41 31.7% for each). Only two studies were exclusively in IM, and the most common subspecialty studied was surgical (13/41, 31.7%). The most common TTP topics were mentorship, billing and coding, practice management, negotiating contract and job, and financial aspects of practice. National Survey: There were 44 respondents, with the majority (25/44, 56.8%) having completed an IM subspecialty fellowship. Most (38/44) completed medical school in Canada, and most were from academic practice settings (33/44, 75.0%). The most common TTP topics were billing and coding, personal financial planning, practice management, work-life balance and mentorship. Grounded Theory Analysis: There were six themes that encompassed all TTP topics from the scoping review and national survey, being (i) building a career, (ii) continuing professional development, (iii) expectations of the profession, (iv) practice management, (v) Life, health and well-being and (vi) clinical skills. Curriculum competencies and resources for curriculum development were provided. Conclusions This study identifies topics critical for curricula development for IM transition to practice. Further research is required to evaluate effectiveness of curricula including topics and themes developed from this scoping review and national survey.

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Transition from trainee to educator in the operating room: A needs assessment and framework to support junior faculty

Lynch

Brown

Steinhagen

et al. 2022

The American Journal of Surgery

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How to Get Ahead: Early-Career Colorectal Surgeons Reflect on Their First Few Years in Practice

Cited by 6 publications

References 15 publications

Barriers and Facilitators to Clinical Practice Development in Men and Women Surgeons

Barriers and Facilitators to Clinical Practice Development in Men and Women Surgeons

Transition to practice curriculum for general internal medicine physicians: scoping review and Canadian national survey

Transition from trainee to educator in the operating room: A needs assessment and framework to support junior faculty

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