Gender Distribution of Faculty Is Strongly Correlated With Resident Gender at Canadian Radiology Residency Programs.

Objective: Women are underrepresented in radiology overall, in radiology subspecialties, and in radiology leadership and academic positions. It is unclear why this disparity persists despite greater gender diversification in medicine. We sought to determine if a correlation exists between the proportion of female faculty at an institution, and the proportion of female residents in the associated residency program across Canada. Methods: Faculty gender for each Canadian Diagnostic Imaging Residency Program was obtained through publicly available sources (departmental websites and provincial physician registries) in the fall of 2020. Resident gender data was obtained through a survey emailed to programs following the April 2021 CaRMS match. Data was analyzed using Pearson's correlation coefficient. Research ethics approval was obtained. Results: Faculty information was available for 15 of the 16 Canadian radiology residency programs (94%) and resident information was obtained for 16 programs (100% response rate). Overall, women accounted for 31.4% of radiologist faculty and 31.9% of radiology residents, with a wide range between institutions (19.5-47.8% for faculty and 13.3%-47.1% for residents). There was a strong positive correlation between the proportion of female faculty and the proportion of female residents within individual programs (r=0.73; R2=0.54; p=0.002). Conclusion: Approximately one third of faculty and residents at Canadian Diagnostic Radiology residency programs were female but there was a wide range across the country with a strong correlation between faculty and resident gender distribution. Further exploration is warranted to determine causes of this correlation including the possible influence of role modeling, mentoring, female-friendly culture, and bias.

Does Lymphocyte Count Impact Dosing of Anti-Thymocyte Globulin in Unrelated Donor Stem Cell Transplantation?

Anti-thymocyte globulin (ATG) is used to reduce the incidence and severity of graft-versus-host disease (GVHD) with hematopoietic cell transplantation, yet optimum dosing has yet to be determined. We have previously demonstrated that 2.5 mg/kg ATG in conditioning can reduce the incidence of GVHD in unrelated donor transplants. Recent literature has suggested that ATG dosing based on absolute lymphocyte count (ALC) could lead to more optimum exposure of the drug. We sought to determine if ALC at the time of transplant could impact clinical outcomes. We conducted a retrospective single-center study analyzing all consecutive patients at The Ottawa Hospital who received a matched unrelated donor stem cell transplant with ATG between 2009 and 2014. Patients received rabbit ATG (thymoglobulin) at 0.5 mg/kg on day -2 and 2.0 mg/kg on day -1. Univariate and multivariate analyses were used to determine if any patient- or transplant-related factors, including weight, ALC, and total ATG dose given, impacted GVHD, relapse, or mortality. In total, 111 patients met inclusion, with a median age of 50 years (range, 19 to 70). The most common diagnoses were acute myelogenous leukemia (43%), Myelodysplasia/myeloproliferative neoplasms (13%), and lymphoma (12%). The median weight at time of conditioning was 80.3 kg (range, 45 to 216). The median ALC on the first day of ATG administration was 0.1 × 109/L (range, 0 to 190). The median total dose of ATG received was 201 mg (range, 112 to 540 mg). The incidence of acute and chronic GVHD was 35.1% and 21.6%, respectively. In the multivariate model, the actual dose of ATG given to patients was not associated with GVHD (hazard ratio [HR], 1.11; 95% confidence interval [CI], 0.99 to 1.25; P = .07), relapse (HR, 1.13; 95% CI, 0.98 to 1.30; P = .1), or mortality (HR, 1.09; 95% CI, 0.92 to 1.28; P = .32). Similarly, the pretransplant ALC was not associated with GVHD (HR, 1; P = .82), relapse (HR, 1; P = .90), or mortality (HR, 1; P = .39). If patients had received ALC-based dosing according to previously published work (Admiraal et al., Lancet Haematol 2017), the mean total dose of ATG received would have been 1205 mg, more than 5 times the mean dose that was actually given based on weight. With GVHD outcomes being similar to that published by Admiraal et al. and ALC not independently associated with outcomes in our study, further studies are still needed to compare standard weight-based dosing to ALC-based dosing of ATG in matched unrelated donor stem cell transplant.