The impact of resident training on robotic operative times: is there a July Effect?

It is unknown whether the July Effect (a theory that medical errors and organizational inefficiencies increase during the influx of new surgical residents) exists in urologic robotic-assisted surgery. The aim of this study was to investigate the impact of urology resident training on robotic operative times at the beginning of the academic year. A retrospective chart review was conducted for urologic robotic surgeries performed at a single institution between 2008 and 2019. Univariate and multivariate mix model analyses were performed to determine the association between operative time and patient age, estimated blood loss, case complexity, robotic surgical system (Si or Xi), and time of the academic year. Differences in surgery time and non-surgery time were assessed with/without resident presence. Operative time intervals were included in the analysis. Resident presence correlated with increased surgery time (38.6 min (p < 0.001)) and decreased non-surgery time (4.6 min (p < 0.001)). Surgery time involving residents decreased by 8.7 min after 4 months into the academic year (July-October), and by an additional 5.1 min after the next 4 months (p = 0.027, < 0.001). When compared across case types stratified by complexity, surgery time for cases with residents significantly varied. Cases without residents did not demonstrate such variability. Resident presence was associated with prolonged surgery time, with the largest effect occurring in the first 4 months and shortening later in the year. However, resident presence was associated with significantly reduced non-surgery time. These results help to understand how new trainees impact operating room times.

Family planning influences and perceptions among dermatology residents from ACGME-accredited training programs: a survey-based study.

As an increasing number of women pursue careers in dermatology, the structure and culture of training must reflect the evolving needs of dermatology residents. To examine perceived barriers to and perceptions of family planning amongst dermatology residents capable of becoming pregnant, evidence-based principles were employed to develop a 40-question survey for dermatology residents in ACGME-accredited training programs. A pilot study was conducted with the Harvard Combined Dermatology Residency Training Program residents before full-scale national electronic survey distribution from April to June 2023. Information was collected regarding factors influencing attitudes towards becoming pregnant during residency, as well as information regarding residency program family leave, fertility preservation, and lactation policies. Ultimately, 95 dermatology residents capable of becoming pregnant completed the survey. The majority (77.9%) of respondents reported intentionally delaying having children because of their careers, and 73.7% believed there is a negative stigma attached to being pregnant or having children during dermatology residency. Of respondents who had not yet attempted to become pregnant, 75.3% were concerned about the possibility of future infertility. Of the 60% of respondents considering fertility preservation options, 84.6% noted concerns about these procedures being cost-prohibitive on a resident salary. Only 2% of respondents reported that cryopreservation was fully covered through their residency benefits, while 20% reported partial coverage. Reported program parental leave policies varied considerably with 54.9%, 25.4%, 1.4%, and 18.3% of residents reporting 4-6 weeks, 7-8 weeks, 9-10 weeks, and 11 + weeks of available leave, respectively. Notably, 53.5% of respondents reported that vacation or sick days must be used for parental leave. Respondents reported lactation policies and on-site childcare at 49.5% and 8.4% of residency programs, respectively. The trends noted in the survey responses signal concerning aspects of family planning and fertility for dermatology residents capable of becoming pregnant. Residency family planning policies, benefits, and resources should evolve and homogenize across programs to fully support trainees.

Factors associated with infectious diseases fellowship academic success.

BACKGROUND: A multitude of factors are considered in an infectious disease (ID) training program's meticulous selection process of ID fellows but their correlation to pre and in-fellowship academic success as well as post-fellowship academic success and short-term outcomes is poorly understood. Our goal was to investigate factors associated with subsequent academic success in fellowship as well as post-fellowship short-term outcomes. METHODS: In 2022, we retrospectively analyzed deidentified academic records from 39 graduates of the Mayo Clinic Rochester ID Fellowship Program (1 July 2013- 30 June 2022). Data abstracted included demographics, degrees, honor society membership, visa/citizenship status, medical school, residency training program, United States Medical Licensure Exam (USMLE) scores, letters of recommendation, in-training examination (ITE) scores, fellowship track, academic rank, career choice, number of honors, awards, and abstracts/publications prior to fellowship, during training, and within 2 years of graduation. RESULTS: Younger fellows had higher USMLE step 1 scores, pre and in-fellowship scholarly productivity, and higher ITE performance. Female fellows had significantly higher USMLE step 3 scores. Prior research experience translated to greater in-fellowship scholarly productivity. Higher USMLE scores were associated with higher ID ITE performance during multiple years of fellowship, but USMLE step 2 clinical knowledge and 3 scores were associated with higher pre and in-fellowship scholarly productivity and receiving an award during fellowship. The USMLE step 1 score did not correlate with fellowship performance beyond year 1 and 2 ITE scores. CONCLUSIONS: Multiple aspects of a prospective fellow's application must be considered as part of a holistic review process for fellowship selection. USMLE step 2 CK and 3 scores may predict fellowship performance across multiple domains.

Radiation Oncology Training in the Philippines: Bridging Gaps for Improved Cancer Care in Low- and Middle-Income Countries.

PURPOSE: Radiation oncology in the Philippines, a large lower- and middle-income country in Southeast Asia, is facing a critical shortage in manpower, with only 113 radiation oncologists (ROs) over 55 radiotherapy (RT) centers serving 100 million population. Paramount to workforce expansion is ensuring that training programs can produce adequately trained specialists. In this study, we describe the current state of radiation oncology training programs in the Philippines. METHODS: This is a cross-sectional observational analysis of the nine radiation oncology residency training programs in the Philippines. Data were collected from a survey of the program directors, the Philippine Radiation Oncology Society database, and a PubMed literature search. RESULTS: Eight of the nine programs are in the National Capital Region. Since program standardization in 2005, there have been 82 four-year residency graduates, with up to 18 new graduates annually. Faculty-to-trainee ratio ranges from 0.5 to 2.67. In terms of technology, all programs have intensity-modulated RT and high-dose-rate brachytherapy, but only six are equipped with computed tomography-based image guidance and stereotactic capabilities. Clinical education schemes vary per institution regarding curriculum implementation, resident activities, and methods of evaluation. Required resident case logs are not met for lung, GI, genitourinary, bone and soft tissue, and hematologic malignancies. In total, there are only 22 resident-led publications from 10 unique individuals in two training programs. CONCLUSION: Program expansions are warranted to meet the projected demand for ROs in the Philippines, but training programs must first improve key aspects of staffing, technology, clinical education, and research. Addressing training challenges related to resource limitations necessitates local and international collaborations with higher-capacity centers to bridge gaps for continued quality improvement with the aim of ultimately delivering better overall cancer care.

Assessing the Knowledge and Comfort Level of US Family Medicine Residents Regarding Consenting and Confidentiality in Adolescent Health Care.

OBJECTIVES: Organizations recommend providing confidential adolescent health care to reduce the consequences of high-risk health behaviors such as substance use, unhealthy eating patterns, and high-risk sexual behaviors. Family physicians are uniquely positioned to provide confidential counseling and care to this vulnerable population but must be trained to provide such care. This study describes the impact of formal and informal training on the knowledge of and comfort level in providing confidential adolescent healthcare among a sample of US Family Medicine residents. METHODS: Electronic surveys were distributed to all Family Medicine residents throughout the United States. We used descriptive statistics and χ2 analysis where appropriate to determine the association between resident-reported receipt of training, confidence, and frequency in providing confidential adolescent health care. RESULTS: A total of 714 Family Medicine residents completed the survey. The majority reported no formal training in residency (50.3%). The receipt of formal and informal training in both medical school and residency was associated with a greater degree of comfort in providing confidential adolescent care and a higher likelihood of providing confidential time alone. Those reporting formal training were more likely to always provide confidential care (P = 0.001). CONCLUSIONS: Training focused on confidential adolescent health care in medical school or residency was associated with a greater degree of comfort and a higher likelihood of providing confidential adolescent health care.

Effect of neurosurgical residency programs on neurosurgical patient outcomes in a single health care system: a cohort study.

BACKGROUND: The evidence on the benefits and drawbacks of involving neurosurgical residents in the care of patients who undergo neurosurgical procedures is heterogeneous. We assessed the effect of neurosurgical residency programs on the outcomes of such patients in a large single-payer public health care system. METHODS: Ten population-based cohorts of adult patients in Ontario who received neurosurgical care from 2013 to 2017 were identified on the basis of procedural codes, and the cohorts were followed in administrative health data sources. Patient outcomes by the status of the treating hospital (with or without a neurosurgical residency program) within each cohort were compared with models adjusted for a priori confounders and with adjusted multilevel models (MLMs) to also account for hospital-level factors. RESULTS: A total of 46 608 neurosurgical procedures were included. Operative time was 8%-30% longer in hospitals with neurosurgical residency programs in 9 out of 10 cohorts. Thirty-day mortality was lower in hospitals with neurosurgical residency programs for aneurysm repair (odds ratio [OR] 0.30, 95% confidence interval [CI] 0.20-0.44), cerebrospinal fluid shunting (OR 0.52, 95% CI 0.34-0.79), intracerebral hemorrhage evacuation (OR 0.66, 95% CI 0.52-0.84), and posterior lumbar decompression (OR 0.32, 95% CI 0.15-0.65) in adjusted models. The mortality rates remained significantly different only for aneurysm repair (OR 0.19, 95% CI 0.05-0.69) and cerebrospinal shunting (OR 0.42, 95% CI 0.21-0.85) in MLMs. Length of stay was mostly shorter in hospitals with neurosurgical residents, but this finding did not persist in MLMs. Thirty-day reoperation rates did not differ between hospital types in MLMs. For 30-day readmission rates, only extracerebral hematoma decompression was significant in MLMs (OR 1.41, 95% CI 1.07-1.87). CONCLUSION: Hospitals with neurosurgical residents had longer operative times with similar to better outcomes. Most, but not all, of the differences between hospitals with and without residency programs were explained by hospital-level variables rather than direct effects of residents.

Pregnancy and infertility in orthopedics: A review of the current state.

BACKGROUND: Orthopedic surgery continues to have one of the lowest rates of female trainees among all medical specialties in the United States. Barriers to pursuing a surgical residency include the challenges of family planning and work-life balance during training. METHODS: A systematic literature search of articles published between June 2012 and December 2022 in the MEDLINE, EMBASE, and Cochrane databases was performed in January 2023 according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). Studies were included if they evaluated pregnancy and peripartum experience and/or outcomes amongst orthopedic surgeons or trainees. RESULTS: Eighteen studies were included. Up to 67.3% of female orthopedic surgeons and trainees and 38.7% of their male counterparts delayed childbearing during residency. The most reported reasons for this delay included career choice as an orthopedic surgeon, residency training, and reputational concerns among faculty or co-residents. Infertility ranged from 17.0% to 30.4% in female orthopedic surgeons and up to 31.2% suffered obstetric complications. Assisted Reproductive Technology (ART) resulted in 12.4%-56.3% of successful pregnancies. Maternity and paternity leaves ranged from 1 to 11 weeks for trainees with more negative attitudes associated with maternal leave. CONCLUSIONS: Female orthopedic trainees and attending delay childbearing, experience higher rates of obstetric complications, and more stigma associated with pregnancy compared to their male colleagues. Program and institutional policies regarding maternity and paternity leave are variable across programs, and therefore, attention should be directed toward standardizing policies.

Leave of Absence and Medical Student Placement Into Graduate Medical Education by Race and Ethnicity.

This study examines the association between taking a leave of absence from medical school and placement into graduate medical education (GME) by race and ethnicity.

Outcomes of the Main Residency Match for Applicants With Disability.

This cohort study assesses match rates of US applicants with and without disability into specialty residence programs.

Residents' KABP and Social Support Statuses Under Normalized COVID-19 Pandemic Prevention and Control: A Cross-Sectional Study.

OBJECTIVES: To investigate the status quo of residents' knowledge, attitude, belief, and practice (KABP) and social support and the correlation of KABP with social support under normalized coronavirus disease (COVID-19) pandemic prevention and control. METHODS: A questionnaire was designed based on the KABP model, and an online survey was conducted among residents in September 2022. SPSS software (version 25.0) was used to analyze the data. Two independent sample t-tests, one-way analysis of variance (ANOVA), multivariate linear regression analysis, and Pearson's correlation analysis were conducted. RESULTS: In total, 326 valid questionnaires were obtained. The scoring rates of residents' KABP and social support were 68.1%, 92.2%, 89.3%, 75.3%, and 62.6%, respectively. Main factors influencing residents' knowledge included gender, nationality, education level, practice, and social support; those influencing attitude were belief and practice; those influencing belief were place of residence, attitude, and practice; those influencing practice were knowledge, attitude, belief, and social support; and those influencing social support were marital status, place of residence, knowledge, and practice. Social support was positively correlated with knowledge and practice. CONCLUSIONS: This study provides a scientific foundation for the current normalized prevention and control of COVID-19 and is conducive to health managers to better carry out prevention and control related health education for specific groups.

The Effect of the COVID-19 Pandemic on the Factors Influencing Iranian Medical Residents' Specialty Selection: A Qualitative Study.

Background: Medical students' specialty selection influences the composition of the physician workforce and the effectiveness of health systems. Therefore, the identification of factors that influence the choice of specialty is critical for an evidence-based health policy. This study aimed to investigate the effect of the Coronavirus Disease 2019 (COVID-19) pandemic on the determinants of specialty choice among Iranian medical residents. Methods: In early 2022, this qualitative study was conducted among Iranian medical residents in seven provinces, including Tehran, Isfahan, Fars, Khorasan Razavi, Kerman, Kermanshah, and Khuzestan. The participants were selected using a purposeful sampling method. Data were collected using 74 semi-structured in-depth face-to-face interviews. Finally, a thematic content analysis (conventional content analysis) method was applied for data synthesis. Results: The participant's mean age was 28.7±2.5 years, and more than 52% (N=39) were men. Following data synthesis, 10 sub-themes and four main themes were identified, including educational aspects affected by the pandemic, career-related hazards, personal and professional lifestyles affected by the disease, and experiences and beliefs regarding the pandemic. Conclusion: The COVID-19 pandemic has had a significant impact on medical students' educational, professional, and personal aspects of specialty choices. This study demonstrated how the disease affected the choice of specialty. Therefore, the findings could be used for developing national health policy and planning.

Trends in gastric surgery operative experience among general surgery residents in the United States: A nationwide retrospective analysis.

BACKGROUND: Gastric surgery is a crucial component of general surgery training. However, there is a paucity of high-quality data on operative volume and the diversity of surgical procedures that general surgery residents are exposed to. METHODS: We conducted a retrospective analysis of operative case logs of all general surgery residents graduating from the American College of Graduate Medical Education-accredited program from 2009 to 2022. Data on the mean number of gastric procedures, including the mean in each subcategory, were retrieved. A Mann-Kendall trend test was used to investigate trends in operative volume. RESULTS: Between 2009 and 2022, the mean overall logged gastric procedures rose significantly (τ = 0.722, P < .001) from 36.2 in 2009 to 49.2 in 2022 (35.9% increase). The most substantial growth was seen in laparoscopic gastric reduction for morbid obesity (mean 1.9 in 2017 to 19 in 2022; τ = 0.670, P = .009). A statistically significant increase was also seen in laparoscopic partial gastric resections, repair of gastric perforation, and "other major stomach procedures" (P < .05 for all comparisons). Open gastrostomy, open partial gastric resections, and open vagotomy all significantly decreased (P < .05 for all comparisons). There was no significant change in the volume of laparoscopic gastrectomy, total gastric resections, and non-laparoscopic gastric reductions for morbid obesity (P > .05 for all comparisons). CONCLUSION: There has been a substantial increase in the volume of gastric surgery during residency over the past 14 years, driven mainly by an increase in laparoscopic gastric reduction. However, there may still be a need for further gastric surgical training to ensure well-rounded general surgeons.

Academic and Geographic Employment Outcomes for Graduating Residents in Radiation Oncology: 2015-2022.

PURPOSE: Little is known about how the academic and geographic employment outcomes of new radiation oncology (RO) graduates have changed over time. In this study, we sought to trace the evolution of these outcomes for all RO residents who graduated between 2015 and 2022. METHODS AND MATERIALS: Using publicly available data sources, we identified the first permanent, clinical employment positions accepted by graduating members of the RO residency classes of 2015 to 2022. We additionally determined the medical school and residency program attended by each graduate. We then classified each clinical employment position by its rural-urban continuum code and core-based statistical area, and whether it was academic or nonacademic. RESULTS: Of 1478 RO graduates identified, 1396 first accepted clinical positions in the United States after residency. A majority accepted positions in the largest metropolitan areas (N = 878, 62.9%) and in nonacademic settings (N = 719, 51.5%). The proportion of graduates who accepted academic positions climbed steadily from 2015 to 2020 before dropping by 31% in 2021 and partially rebounding in 2022. Women and graduates of large-sized academic programs were more likely to have accepted academic positions. In contrast, graduates of small-sized residency programs were more likely than those of large-sized residency programs to have accepted positions in nonmetropolitan areas. At least 288 of the examined individuals (20.6%) had switched jobs at least once at the time of this analysis. CONCLUSIONS: Most new RO graduates in this study accepted clinical positions in large metropolitan areas. A slight majority accepted nonacademic positions. While the RO job market was able to absorb the vast majority of these new graduates between 2015 and 2022, there is no guarantee that this equilibrium will hold in the future. Additional studies aiming to refine projections of future RO demand are needed.

Racial disparities in the selection of chief resident: A cross-sectional analysis of a national sample of senior residents in the United States.

INTRODUCTION: Part of the difficulty in recruiting and retaining a diverse physician workforce, as well as within medical leadership, is due to racial disparities in medical education. We investigated whether self-identified race-ethnicity is associated with the likelihood of selection as chief resident (CR). MATERIALS AND METHODS: We performed a cross sectional analysis using de-identified person-level data from the GME Track, a national resident database and tracking system, from 2015 through 2018. The exposure variable, self-identified race-ethnicity, was categorized as African American or Black, American Indian or Alaskan Native, Asian, Hispanic, Latino or of Spanish Origin, Native Hawaiian or Pacific Islander, White, and Multi-racial. The primary study outcome was CR selection among respondents in their final program year. Logistic regression was used to estimate the adjusted odds ratios (aOR) and 95% confidence intervals (CI) of CR selection for each racial group, as compared to the White referent group. RESULTS: Among the study population (N=121,247), Black, Asian and Hispanic race-ethnicity was associated with a significantly decreased odds of being selected as CR in unadjusted and adjusted analyses. Black, Asian and Hispanic residents had a 26% (aOR=0.74, 95% CI 0.66-0.83), 29% (aOR=0.71, 95% CI 0.66-0.76) and 28% (aOR=0.72, 95% CI 0.66-0.94) decreased likelihood of becoming CR, respectively. Multi-racial residents also had a decreased likelihood, but to a lesser degree (aOR=0.92, 95% CI 0.89-0.95). CONCLUSIONS: In as much as CR is an honor that sets one up for future opportunity, our findings suggest that residents of color are disproportionately disadvantaged compared to their White peers.

Covid-19: fatores associados ao uso e adesão de equipamentos de proteção individual entre residentes no Brasil / Covid-19: factors associated with the use and adherence of personal protective equipment in Brazil among residents / Covid-19: factores asociados al uso y adherencia de equipos de protección personal entre los residentes en Brasil

Objetivo: analisar os fatores associados ao uso e a adesão aos equipamentos de proteção individual pelos profissionais pós-graduandos vinculados a programas de residência em saúde. Método: transversal com 227 residentes. Avaliadas variáveis relacionadas à adesão e uso adequado de equipamentos de proteção individual por meio de instrumento validado "E.P.I. covid-19 Brasil-versão adaptada para residentes". Realizou-se análise bivariada, teste qui-quadrado/exato de Fisher e cálculo da razão de prevalência. Pesquisa foi aprovada pelo Comitê de Ética em Pesquisa com Seres Humanos. Resultados: realizaram atividades de capacitação sobre EPIs (59,9%).Associação entre uso de máscara cirúrgica(p≤0,01) e idade; área de concentração do programa e uso de gorro (p≤0,01) e máscara cirúrgica (p=0,04); realização de atividades de capacitação e uso de máscara cirúrgica (p=0,02) e N95 (p≤0,01). A adesão variou de 0% a 67%. Conclusão: fatores associados ao uso adequado, idade, área de concentração do programa e realização de atividades de capacitação. Houve fragilidades na adesão. Sugere-se o fortalecimento do tema biossegurança na residência.

Objective: to analyze the factors associated with the use and adherence to personal protective equipment by graduate professionals linked to residency programs in health. Method: cross-sectional study with 227 residents. E.P.I.covid-19 Brasil-adapted version for residents". Bivariate analysis, Fisher chi-square/exact test and calculation of the prevalence ratio were performed. Research was approved by the Ethics Committee for Research with Human Beings. Results: they carried out training activities on PPE (59.9%). Association between use of surgical mask (p≤0.01) and age; program concentration area and use of cap (p≤0.01) and surgical mask (p=0.04); performance of training activities and use of surgical mask (p=0.02) and N95 (p≤0.01). Adherence to PPE ranged from 0% to 67%. Conclusion: factors associated with the proper use of personal protective equipment were age, area of program concentration, and performance of training activities. There were weaknesses in adherence. It is suggested to strengthen the theme of biosafety in the residence.

Objetivos:analizar los factores asociados al uso y la adherencia a los equipos de protección personal (EPP) por parte de profesionales graduados vinculados a programas de residencia en salud. Método: estudio transversal con 227 residentes. Se utilizó la versión adaptada para residentes del «Cuestionario sobre EPI en la atención primaria de salud (EPS-APS) en el contexto de la COVID-19 en Brasil. Se realizaron análisis bivariados, prueba chi-cuadrado de Fisher/prueba exacta y cálculo de la razón de prevalencia. La investigación fue aprobada por el Comité de Ética para la Investigación con Seres Humanos. Resultados: se realizaron actividades de capacitación sobre EPI (59,9%). Se observó asociación entre el uso de mascarilla quirúrgica (p≤0,01) y la edad; área de concentración del programa y uso de cofia (p≤0,01) y mascarilla quirúrgica (p=0,04); realización de actividades de capacitación y uso de mascarilla quirúrgica (p=0,02) y N95 (p≤0,01). La adherencia a los EPI osciló entre el 0% y el 67%. Conclusión: los factores asociados al uso correcto de los EPI fueron la edad, el área de concentración del programa y la realización de actividades de capacitación. Se observaron debilidades en la adherencia. Se sugiere fortalecer el tema de la bioseguridad en la residencia.

The Intersection of Race and Sex: A New Perspective Into Diversity Trends in Orthopaedic Surgery.

INTRODUCTION: Studies on diversity in orthopaedic surgery have exclusively examined challenges from a race or sex perspective. This study examines trends in the diversity of entering orthopaedic surgery residents from the intersection of race and sex. METHODS: The American Association of Medical Colleges was queried for individuals entering orthopaedic surgery residencies in the United States from 2001 to 2020. Deidentified data on self-reported sex and race were collected. Proportions by the intersection of sex and race were calculated for 5-year intervals. RESULTS: From 2001 to 2020, most of the new female residents identified as White (mean, 71.0%). The average proportion of White female residents was lower in 2016 to 2020 than in 2001 to 2005 (71.0% vs. 73.2%) but higher than that in 2011 to 2015 (66.8%). The 2016 to 2020 average was lower than that of 2001 to 2005 for those who identified as Asian (11.7% vs. 14.9%), Black (4.1% vs. 4.8%), Hispanic (3.0% vs. 4.4%), and American Indian/Alaska Native (0.0% vs. 1.5%). Most of the new male orthopaedic surgery residents from 2001 to 2020 identified as White (mean, 74.1%), but the average decreased across every 5-year interval from 2001 to 2005 (76.1%) to 2016 to 2020 (71.1%). The 2016 to 2020 average was lower than that of 2001 to 2005 for those who identified as Asian (12.2% vs. 13.6%), Black (3.5% vs. 4.2%), Hispanic (3.0% vs. 3.4%), American Indian/Alaska Native (0.0% vs. 0.6%), and Native Hawaiian/Other Pacific Islander (0.1% vs. 0.3%). In 2020, White male residents made up to 54.2% of new residents. White female residents were the second highest group represented (12.1%). CONCLUSION: Increases in representation were observed for some subgroups of new orthopaedic surgery residents from 2001 to 2020. Although the proportion of both White female and male residents decreased by 11.5% during the 20-year study period, these individuals still made up most of the trainees in 2020. These results underscore the need for conversations and recruitment practices to take into consideration the intersectionality of identities.

US Postgraduate Trainee Racial, Ethnic, and Gender Representation and Faculty Compensation By Specialty.

This study compares postgraduate trainee racial, ethnic, and gender representation and faculty compensation for 21 clinical specialties using 2015-2022 data.

Assessment of Demographic Changes of Workforce Diversity in Otolaryngology, 2013 to 2022.

Importance: Given the growth of minoritized groups in the US and the widening racial and ethnic health disparities, improving diversity remains a proposed solution in the field of otolaryngology. Evaluating current trends in workforce diversity may highlight potential areas for improvement. Objective: To understand the changes in gender, racial, and ethnic diversity in the otolaryngology workforce in comparison with changes in the general surgery and neurosurgery workforces from 2013 to 2022. Design, Setting, and Participants: This cross-sectional study used publicly available data from the Accreditation Council for Graduate Medical Education and the Association of American Medical Colleges for 2013 to 2022, and included medical students and trainees in all US medical residency programs and allopathic medical schools. Main Outcomes and Measures: Average percentages of women, Black, and Latino trainees during 2 intervals of 5 years (2013-2017 and 2018-2022). Pearson χ2 tests compared demographic information. Normalized ratios were calculated for each demographic group in medical school and residency. Piecewise linear regression assessed linear fit for representation across time periods and compared rates of change. Results: The study population comprised 59 865 medical residents (43 931 [73.4%] women; 6203 [10.4%] Black and 9731 [16.2%] Latino individuals; age was not reported). The comparison between the 2 study intervals showed that the proportions of women, Black, and Latino trainees increased in otolaryngology (2.9%, 0.7%, and 1.6%, respectively), and decreased for Black trainees in both general surgery and neurosurgery (-0.4% and -1.0%, respectively). In comparison with their proportions in medical school, Latino trainees were well represented in general surgery, neurosurgery, and otolaryngology (normalized ratios [NRs]: 1.25, 1.06, and 0.96, respectively); however, women and Black trainees remained underrepresented in general surgery, neurosurgery, and otolaryngology (women NRs, 0.76, 0.33, and 0.68; Black NRs, 0.63, 0.61, and 0.29, respectively). The percentage of women, Black, and Latino trainees in otolaryngology all increased from 2020 to 2022 (2.5%, 1.1%, and 1.1%, respectively). Piecewise regression showed positive trends across all 3 specialties. Conclusions and Relevance: The findings of this cross-sectional study indicate a positive direction but only a modest increase of diversity in otolaryngology, particularly in the context of national demographic data. Novel strategies should be pursued to supplement existing efforts to increase diversity in otolaryngology.

Results of the 2020 Survey of the American Alliance of Academic Chief Residents in Radiology.

RATIONALE AND OBJECTIVES: An annual survey of chief residents in accredited North American radiology programs is conducted by the American Alliance of Academic Chief Residents in Radiology (A3CR2). The purpose of this study is to summarize the 2020 A3CR2 chief resident survey. MATERIALS AND METHODS: An online survey was distributed to chief residents from 194 Accreditation Council on Graduate Medical Education-accredited radiology residencies. Questions were designed to gather information about residency program practices, benefits, fellowship or advanced interventional radiology (IR) training choices, and the integration of IR training. Subsets of questions focused on the perception of corporatization, non-physician providers (NPPs), and artificial intelligence (AI) in radiology and their relationship to the radiology job market. RESULTS: 174 individual responses from 94 programs were provided, yielding a 48 % program response rate. Extended emergency department coverage has steadily decreased over the last 5 years (2016-2020), however only 52 % of programs have independent overnight call (without attending coverage). Regarding the impact of new integrated IR residencies on training, 42 % indicated there was no appreciable impact on their DR or IR training, while 20 % indicated DR training for IR residents suffered and 19 % indicated IR training for DR residents suffered. Corporatization in radiology was perceived as the biggest potential threat to the future job market. CONCLUSIONS: Integration of IR residency did not detrimentally affect DR or IR training in most programs. Radiology resident perception of corporatization, NPPs, and AI may help residency programs shape educational content.