The debate rages on: physician-assisted suicide in an ethical light.

The British Medical Association and some Royal Colleges have recently changed their stance on physician-assisted suicide from 'opposed' to forms of 'neutral'. The Royal College of Anaesthetists will poll members soon on whether to follow suit. Elsewhere neutrality amongst professional bodies has preceded legalisation of physician-assisted suicide. We examine the arguments relevant to the anaesthesia community and its potential impact in the UK.

Gender representation at scientific congresses: focus on functional and female urology-a study from the EAU Young Academic Urologist Functional Urology Group.

PURPOSE: Female representation at scientific conferences is crucial for encouraging women pursuing an academic career. Nevertheless, gender inequity at urological conferences is common place and women are often stereotyped choosing functional urology. However, there is no evidence whether female representation is higher in functional urology. This investigations aims to analyze gender representation at functional urology sessions. METHODS: National and international urological congresses between 2019 and 2021 with a focus on functional urology and female urology sessions were evaluated. Congresses were categorized as national or international. Session type, topic, gender of chairs and speakers of the identified sessions were recorded. In addition, affiliation and medical specialty were collected for chairs. RESULTS: A total of 29 congresses were evaluated. Out of a total of 2893 chairs and speakers, 1034 (35.7%) were women and 1839 (63.6%) were men. This represents an overall gender gap of 27.9% for functional urology sessions. No significant differences in gender representation between national and international congresses could be identified (p = 0.076). When considering gender distribution of chairs, the gap was more pronounced by 35.5%. Furthermore, men were more likely to be invited to be a speaker in plenary and podiums sessions. CONCLUSIONS: Gender inequality is present in functional urology sessions. There is a need for greater efforts to achieve gender equality. An important step to remedy the situation is the inclusion of women in scientific program committees. Furthermore, support by the leadership of urological societies and academic departments is essential to herald a lasting change in gender inequality.

Where we came from: continuing professional development for the 18th century physician and surgeon, the genesis of British medical societies.

Keeping professionally up to date in 18th-century Britain was not an easy undertaking. Learning on the job was insufficient for the further development of individual medical knowledge. The century witnessed the gradual growth of medical societies to provide a better education than that offered by university institutions. The Worshipful Society of Apothecaries of London in 1815 was empowered to licence and regulate medical practitioners, today's general practitioners. Societies were established in Edinburgh but not so many as around London, where a particularly successful education body was established in 1773, the prestigious Medical Society of London. In 1805 a breakaway group from the society formed an equally highly respected learned body, the Medical and Chirurgical Society of London, that became the nidus for the amalgamation of numerous specialist societies to form, in June 1907, the extant Royal Society of Medicine. By the end of the 18th century, the medical society had fostered professionalism, education and unification within diverse medical and scientific disciplines.

The Northeastern Society of Plastic Surgeons: The First 40 Years.

ABSTRACT: The concept for creating the Northeastern Society of Plastic Surgeons originated in May 1982, at the American Association of Plastic Surgeons in Colorado Springs Colorado. The new society would supplement, not supplant, existing state and small regional societies. Two hundred fifty-seven northeastern plastic surgeons joined the charter membership. The inaugural meeting of the Northeastern Society of Plastic Surgeons was held in Philadelphia, September 1984. The following historical account highlights our society's founding principles and leadership throughout the first 40 years.

An Analysis of Gender Diversity in Hand and Upper Extremity Surgery Webinars.

PURPOSE: Some female upper extremity (UE) surgeons face unique barriers to participation at in-person academic and professional society meetings due to disparate childcare and household duties relative to male surgeons. Webinars may alleviate some of this travel burden and allow for more balanced participation. Our purpose was to evaluate gender diversity within academic webinars with a focus on UE surgery. METHODS: We queried webinars conducted by the following professional societies: American Academy of Orthopaedic Surgeons, American Society for Surgery of the Hand (ASSH), American Association for Hand Surgery, and American Shoulder and Elbow Surgeons societies. Webinars with an UE focus produced between January 2020 and June 2022 were included. Demographic characteristics, including sex and race, were recorded for webinar speakers and moderators. RESULTS: A total of 175 UE webinars were identified, with 173 of 175 (99%) having functioning video links. The 173 webinars had 706 speakers and 173 (25%) were women. Female representation in professional society webinars exceeded their overall participation in their sponsoring organizations. Although women comprise 6% and 15% of the overall American Academy of Orthopaedic Surgeons and ASSH membership, respectively, they accounted for 26% of American Academy of Orthopaedic Surgeons webinar speakers and 19% of ASSH webinar speakers. CONCLUSIONS: Between 2020 and 2022, women comprised 25% of speakers for professional society academic webinars with a focus on UE surgery, which exceeds the proportion of women in the individual sponsoring professional societies. CLINICAL RELEVANCE: Online webinars may mitigate some of the barriers that female UE surgeons face with respect to professional development and academic advancement. Although female participation in UE webinars often exceeded the current rates of female members in the individual professional societies, women remain underrepresented in UE surgery, relative to the percentage of female medical students.

Gender representation within radiology conferences in the UK in 2021.

AIM: To examine the gender representation and equality within academic meetings and society conferences within the UK radiology conferences. MATERIALS AND METHODS: UK-based subspecialty radiology meetings organised by major radiological associations and societies (online and in-person) from 1 January 2021 to 31 December 2021 were included. Speakers and chairs were documented with reference to their gender, years on General Medical Council (GMC) register, academic publications, and h-index. Data were analysed using SPSS v27 (IBM, Armonk, NY, USA). RESULTS: Of 298 sessional chairs, 105 were female (35.2%). Of 639 speakers, 212 (33.2%) were female. Three subspecialties (interventional radiology, uro-radiology, and nuclear medicine) had a higher proportion of female speakers than the percentage of female consultants with specialist interest. Of the 71 invited international speakers, 28.2% (20/71) were female. Online conferences had a significantly greater proportion of female speakers (43.2% versus 24.1%, p<0.001) and chairs (48.7% versus 20.4%, p<0.001) compared to in person. Male speakers had a higher median number of publications (31 versus 12, p<0.0001) and median h-index (11 versus 4, p<0.001). CONCLUSION: This study demonstrates that women are under-represented in radiology society meetings, particularly within certain subspecialty groups. Radiological societies should actively encourage a more balanced gender representation at conferences with online conference shown to improve female representation.

The 2021 American Association of Hip and Knee Surgeons Annual Meeting Proceedings to be Published Online; Open to All.

This year's 2021 American Association of HIp and Knee Surgeons Annual Meeting Proceeding will be published online and open access.

Full Abstract to Published Manuscript: Evaluation of the Scientific Impact of the American Society of Breast Surgeons Conference.

BACKGROUND: The scientific rigor of the abstracts presented at the American Society of Breast Surgeons (ASBrS) annual meeting has not been recently evaluated. In this study, we sought to determine the rate at which abstracts presented at the 2017 and 2018 ASBrS meetings were published in peer-reviewed journals, and compared the rates with breast abstracts presented at the 2018 Society of Surgical Oncology (SSO) meeting. METHODS: Abstracts from the 2017 and 2018 ASBrS and 2018 SSO conferences were searched in PubMed for published manuscripts using the abstract title and/or first or last author. RESULTS: In 2017, 21.6% of the 268 abstracts presented at the ASBrS conference resulted in full publication, compared with 36.6% of the 273 abstracts presented at the 2018 ASBrS conference, resulting in a significant difference in the publication rate (p < 0.001). Of the 158 abstracts published from the 2017 and 2018 meetings, 75 (47.8%) were published in Annals of Surgical Oncology (ASO). There was no correlation between impact factor and time to publication. Oral presentations and quick shots were more likely to be published than poster presentations, and oral presentations were more likely to be published in higher-impact journals. The 2018 SSO meetings resulted in 54 of 111 (48.6%) breast abstracts leading to full publication. CONCLUSION: Approximately 29.2% of the abstracts presented at the ASBrS 2017 and 2018 conferences resulted in a published manuscript. A higher publication rate in higher impact journals for oral presentations indicates that the abstract review process properly stratifies the research.

Choosing Wisely Neurology: Recommendations for the Canadian Neurological Society.

BACKGROUND: Choosing Wisely Canada (CWC) is a national branch of a global campaign advocating for fewer unnecessary tests and for optimizing patient care. Professional societies representing physicians, pharmacists, and nurses participate by generating lists of recommendations meant to reduce patient harm and resource mismanagement in healthcare. The Canadian Neurological Society (CNS) plays an important role in advocating for quality patient care demonstrated by deriving specific recommendations. This process is described. METHOD: The CNS Choosing Wisely task force adapted 10 recommendations for Canadian neurology practice. These were approved by the CNS board, and subsequently ranked by CNS members. RESULTS: Ten recommendations were brought forward and ranked in a survey completed by CNS members. Survey ranking is presented. The top five recommendations were selected and optimized, resulting in seven key recommendations. CONCLUSION: The recommendations set forth by the CNS will help with resource stewardship and patient safety in the delivery of neurological care by healthcare providers in Canada.

A New Decade for Diversity: Trends in Representation of Women at the Northeastern Society of Plastic Surgeons.

BACKGROUND: In 2018, the Northeastern Society of Plastic Surgeons first Women in Plastic Surgery was established, reflecting the national trend to address the gender gap between men and women in surgery. Conferences, such as the annual NESPS, are important opportunities to increase visibility of female role models and resources to address deterrents to surgical careers. We thus sought to examine the participation and visibility of women in the NESPS over the last decade. METHODS: Abstracts and programs from the NESPS regional conferences between 2013 and 2019 were accessed via the publicly available past meetings archives, and registration lists were provided by the NESPS. Registrants, panelists, speakers, moderators, and first author and senior author listed for each poster presentation, podium presentation was listed, sex was determined (male or female), and sex were aggregated by category of participation. Significance was set at a P value of less than 0.05. RESULTS: Registration of women for the NESPS annual conferences was constant for 5 years (2013-2017), followed by an increase in female registrants from 27.1% in 2017 to 42.3% in 2019. Female representation among poster and podium presentations also increased from 2017 to 2019 (7.7%-23.3% poster presentations and 11.1%-23.4% podium presentations). Invited positions (speakers, panelists, and moderators) had a peak of 32.2% in 2017, but otherwise, there is no clear evidence of improved representation of women. CONCLUSIONS: We found an increase in the proportion of female registrants at the annual NESPS conferences from 2013 to 2019. However, visibility of female participants fluctuated over the same period; addressing this represents one opportunity for closing the gender gap at the NESPS. As the percentage of female trainees continues to rise, we look to female faculty to continue to participate in educational events, such as the NESPS meeting, and to be present as role models for the growing new generation of female plastic surgeons.

National Awards and Female Emergency Physicians in the United States: Is the "Recognition Gap" Closing?

BACKGROUND: Gender inequities in recognition, compensation, promotion, and leadership roles exist in emergency medicine. Formal recognition in the workplace and opportunities for advancement are vulnerable to bias. OBJECTIVE: To examine the gender distribution of national awards in emergency medicine, to analyze whether there is a gap, and to highlight notable trends. METHODS: Recipients of the major award categories between 2001 and 2020 were examined for the 3 main national emergency medicine organizations. The gender distribution of award winners by year was compared with the gender distribution of female faculty in emergency medicine departments using data from the Association of American Medical Colleges and a chi-squared analysis. RESULTS: The gender gap in award winners has decreased over time, but men are still disproportionately given national awards over women. In all 3 organizations, women represented a smaller proportion of award winners than men when compared with the national proportion of women in academic emergency medicine. Advocacy awards were the one category where women were more likely to be recognized. Women were notably least likely to receive clinical and leadership awards. CONCLUSIONS: The gender gap in emergency medicine awards has narrowed in the last 20 years but still exists. This discrepancy is an example of how bias can compound over time to generate gaps in recognition, career advancement, and promotion. The pipeline to award nominations should be addressed at the individual, departmental, awards committee, and organizational levels. © 2021 Elsevier Inc.

Gender Representation in Speaking Roles at the American Association of Hip and Knee Surgeons Annual Meeting: 2012-2019.

BACKGROUND: The American Association of Hip and Knee Surgeons (AAHKS) has one of the lowest percentages of women members among orthopedic surgery subspecialty societies, having increased from 1.3% to 3.1% since 2012. Our purpose was to report the representation of women in various speaking roles at the AAHKS annual meeting over this time period. METHODS: We accessed the 2012-2019 AAHKS annual meeting programs online and reviewed all paper presenters, symposium faculty, and session moderators. We recorded instances of women speakers and their degree and specialty. We calculated the percentage of women speakers, women orthopedic surgeon speakers, women session moderators, and women symposium faculty for the overall period of 2012-2019, and for each annual meeting. RESULTS: Between 2012 and 2019, 33/877 (3.8%) of all speakers at AAHKS were women. Of these, 21 were women orthopedic surgeons, or 2.4% of all speakers. The proportion of total women speakers per year ranged from 1.7% (2017) to 6.4% (2013). Twenty-four of 492 (4.9%) paper presenters were women, and 12/492(2.4%) were women orthopedic surgeons. Four of 143 (2.8%) session moderators were women, and all were orthopedic surgeons. Five of 245 (2.0%) symposium faculty were women, and 0/245 (0%) were women orthopedic surgeons. CONCLUSION: Although the percentage of women AAHKS members has grown since 2012, the small percentage of women orthopedic surgeons speaking at AAHKS has not. There were no women orthopedic surgeons included on symposium faculty over this entire period. We appreciate and encourage efforts to improve gender diversity among speakers at AAHKS annual meetings.

Gender disparity in speakers at a major academic emergency medicine conference.

BACKGROUND: Although women make up a substantial portion of the workforce in emergency medicine, they remain under-represented in academia. METHODS: This study investigates trends in the representation of female speakers at the American College of Emergency Physicians scientific assembly-the largest academic emergency medicine conference in the world. Publication profiles, speaking duration and gender composition of speakers were collected and compared over a 3-year period. RESULTS: The authors described increased representation of female speakers at the conference from 2016 to 2018, as well as an upward trend in women's actual speaking time. CONCLUSION: This upward trend in women's representation may translate to more opportunities for female engagement in academic emergency medicine. Despite the increasing representation of women, male speakers outnumbered female speakers all 3 years, demonstrating that a speaker gender gap persists in academic emergency medicine.

Gender Representation by Specialty Track at Surgical Meetings: The American and Australasian Experiences.

BACKGROUND: We compared the representation of women panelists at two large, general interest surgical meetings: the American College of Surgeons (ACS) Clinical Congress and Royal Australasian College of Surgeons (RACS) Scientific Congress. MATERIALS AND METHODS: We performed comprehensive analyses of panels and panelists at ACS and RACS meetings (2013-2018). Manual review was conducted to determine counts and proportions of invited panelists by gender. We made within- and between-meeting comparisons regarding gender representation by specialty track. Tracks were characterized after our review of meeting programs. RESULTS: There were 4542 panelists and 1390 panels at RACS from 2013 to 2018. At ACS, there were 3363 panelists over 693 panels. The specialty tracks with the highest proportion of men-only panels were transplant (75%) and cardiothoracic (63%) at ACS and cardiothoracic (83%) and multidisciplinary (81%) at RACS. The lowest proportions of men-only panels were in breast and pediatric surgery at ACS (5% and 11%, respectively) and breast and rural surgery at RACS (24% and 36%, respectively). At ACS, the highest proportions of women panelists were on panels in breast (63%) and endocrine surgery (48%) and in breast (44%) and rural surgery (33%) at RACS, while the lowest proportion of women panelists were in transplant (10%) and cardiothoracic (14%) at ACS and multidisciplinary (8%) and cardiothoracic (7%) at RACS. CONCLUSIONS: There is a persistent difference in gender representation at surgical meetings, particularly within certain subspecialties. Program chairs and committees could increase the proportion of women by focusing on who serves as panelists overall and within specialty tracks.

An International Collaborative Study on Surgical Education for Quality Improvement (ASSURED): A Project by the 2017 International Society of Surgery (ISS/SIC) Travel Scholars International Working Group.

BACKGROUND: There is a huge difference in the standard of surgical training in different countries around the world. The disparity is more obvious in the various models of surgical training in low- and middle-income countries (LMICs) compared to high-income countries. Although the global training model of surgeons is evolving from an apprenticeship model to a competency-based model with additional training using simulation, the training of surgeons in LMICs still lacks a standard pathway of training. METHODS: This is a qualitative, descriptive, and collaborative study conducted in six LMICs across Asia, Africa, and South America. The data were collected on the status of surgical education in these countries as per the guidelines designed for the ASSURED project along with plans for quality improvement in surgical education in these countries. RESULTS: The training model in these selected LMICs appears to be a hybrid of the standard models of surgical training. The training models were tailored to the country's need, but many fail to meet international standards. There are many areas identified that can be addressed in order to improve the quality of surgical education in these countries. CONCLUSIONS: Many areas need to be improved for a better quality of surgical training in LMICs. There is a need of financial, technical, and research support for the improvement in these models of surgical education in LMICs.

Improving the Patient Protection and Affordable Care Act's Insurance Coverage Provisions: A Position Paper From the American College of Physicians.

The coverage reforms of the Patient Protection and Affordable Care Act have fundamentally changed the U.S. health care system. The law's health insurance regulations, which include protections for persons with preexisting conditions, have made health insurance more accessible. The premium tax credit and cost-sharing subsidies have made nongroup coverage more affordable. The essential health benefit package and coverage for preventive services without cost sharing have made insurance more comprehensive. Perhaps most important, the Medicaid expansion extended coverage to millions of low-income adults. Despite these gains, more needs to be done to bring the United States closer to achieving universal coverage. In this position paper, the American College of Physicians recommends action to enhance and expand eligibility for health insurance financial subsidies; stabilize health insurance marketplaces; provide sustained funding for outreach, education, and enrollment assistance activities; test and implement a mechanism to encourage enrollment; expand Medicaid in all states; and establish a public insurance option to increase competition.

The pathologist Philipp Schwartz (1894-1977) : From Nazi victim to initiator of the "Emergency Society of German Scholars Abroad".

Without a doubt, Frankfurt Pathologist Philipp Schwartz is one of the most iconic scholars in recent medical history. As the son of Jewish parents, he was forced to emigrate after Hitler seized power in 1933. Despite this repressive experience, he succeeded in founding the "Notgemeinschaft deutscher Wissenschaftler im Ausland" ("Emergency Association of German Scientists Abroad") in 1933, with which he helped hundreds of forcibly emigrated university teachers find academic positions. In addition, he had a decisive influence on the reform of the higher education system in Turkey, rendered outstanding achievements in neuropathology, and attained leading positions as a scientist in the exile countries Turkey and the USA.However, as successful as the pathologist's scientific career in exile may have been, his relationship with Germany remained problematic throughout his life. Against this background, this article focuses on the reception of Philipp Schwartz in the different political systems of Germany - from the Weimar Republic to the Third Reich, and from post-war Germany to the recent past in the Federal Republic. This study is essentially based on primary sources from the University Archive of Frankfurt.Schwartz had a promising career in the Weimar Republic. In the aftermath of Hitler's takeover (1933) he was deprived of any perspectives in Germany and fled to Switzerland in the spring of 1933. His achievements as a full professor in Istanbul and as initiator of the Notgemeinschaft are remarkable in both scientific and political regards. Still, he was denied employment at the Goethe University Frankfurt. Until well after his death (1977), Philipp Schwartz's life and work received little attention in Germany. It was only after the turn of the millennium that he received the recognition he was denied during his lifetime.

[Neurologists and neuroscientists: who was a Nazi? Changing perspectives on NS incrimination in the history of German medicine]. / Neurologen und Neurowissenschaftler: Wer war ein Nazi? Zum Umgang mit der NS-Belastung in der Geschichte der deutschen Medizin.

The German Neurological Society (DGN) instigated an investigation into potential incrimination of some of the previous leading members regarding their Nazi involvement. The persons in question include former (honorary) presidents and honorary members of the DGN (or the predecessor organizations) and the name givers of prizes awarded by the DGN. This introduction to the following biographies explains the difficulties and the broad discretionary leeway needed to establish an involvement in Nazi activities going beyond justiciable crimes against humanity on the basis of formal criteria (e.g. membership in the NSDAP and/or other NS organizations, involvement in Nazi crimes) and/or substantive indications (e.g. statements advocating the NS ideology, personal contacts to Nazi functionaries, active support of the system). A longitudinal analysis from 1945 until the present day reveals time-related variations in assessing who and why someone was considered to be a Nazi. A current overview of historical projects initiated by medical societies in Germany demonstrates that the endeavor of the DGN to deal with its Nazi involvement will be an integral part of the interdisciplinary "culture to cope with the past" of medical associations. Finally, it should be borne in mind that the fabric of history consists of a different material than clinical medicine or its natural scientific foundations. Checklists or scores for measuring NS involvement thus cannot and will not exist. Instead, balanced historical interpretations are needed as attempted by the biographical reconstructions presented in this volume.

[The "Conseil national professionnel d'anatomie et cytologie pathologiques" (CNPath): At the service of the profession]. / Le Conseil national professionnel d'anatomie et cytologie pathologiques (CNPath) : une structure au service de la profession.

The « conseils nationaux professionnels ¼ (CNP) are professional boards existing since 2010. Their missions, organization and functioning have been defined by the decree 2019-17 of January 9, 2019. CNPs represent all the members of a medical specialty (or health profession). CNPs must include all the learned societies and all the representative structures and associations of the same medical specialty. Their bodies must strictly respect the parity between public and private health sectors. The main missions of CNPs include the contribution to the elaboration of the national priority directions for continuous medical education and the definition of the individual plan for continuous professional development (DPC) recommended for the specialty. CNPs also behave as a single window for ministries, State agencies, welfare system and colleges of physicians. They are likely to be strongly involved in the process of re-certification of physicians, established in July 2019. The Conseil national professionnel d'anatomie et cytologie pathologiques, termed CNPath, has been created in 2010 and officially recognized by the Ministry of Health in August 2019. The main current actions of CNPath are: the elaboration of the individual DPC scheme for the specialty and the definition of the minimal obligations requested for its validation, the long-expected recognition of the expertal consultation in pathology, the support to the nation-wide effort for the production of structured pathological reports and the launching of a plan for implementing digital pathology. An internet site is under construction, to diffuse all the relevant information and make available the documents useful to all pathologists.

The American Society of Anesthesiologists Practice Parameter Methodology.

The methodology used during the development of American Society of Anesthesiologists evidence-based practice parameters, from conceptualization through final adoption of the documents, is described. Features of the methodology include the literature search, review and analysis, survey development and application, and consolidation of the full body of evidence used for preparing clinical practice recommendations. Anticipated risks of bias, validation of the process, and the importance of the documents for clinical use are discussed.