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  • Item type:Publication,
    Bias in Student Evaluations of Surgical Attendings: Role of Gender, Race, Age and Experience Open PDF 
    (Elsevier BV, 2026-06)
    Theis, Claudia
    ;
    Jacob, Anusha S.
    ;
    Kapadia, Muneera Rehana
    ;
    Pascarella, Luigi
    Introduction Student evaluations influence faculty promotion but may reflect implicit bias. We assessed whether surgeon gender, race, age, and experience were associated with differences in student evaluations at a large academic medical center. Materials and methods This retrospective cohort study included 149 surgical attendings evaluated by medical students at the University of North Carolina between 2016 and 2020. Quantitative evaluation items were rated on 5-point Likert scales and analyzed using surgeon-level summary comparisons (Wilcoxon rank-sum and Kruskal–Wallis tests), evaluation-level multivariable logistic regression, and generalized estimating equations (GEEs) to account for clustering of multiple evaluations per attending. Qualitative free-text comments were analyzed using a validated natural language processing framework and summarized on a 5-point sentiment scale. Results A total of 149 surgical attendings were evaluated, including 39 women (26.2%) and 110 men (73.8%). The racial and ethnic distribution was 102 White (68.5%), 28 Asian (18.8%), 13 Black (8.7%), and 6 Latino (4.0%). In total, 2475 quantitative evaluations were analyzed, of which 1542 (62.3%) included narrative comments. The median time in practice was 14 y (Q1-Q3: 9-22), and the median time at the University of North Carolina was 11 y (Q1-Q3: 7-19.5). Median composite quantitative evaluation scores were lower for women than for men (4.42 [4.32-4.61] versus 4.61 [4.40-4.82] on a 5-point scale; P = 0.002). In GEE models accounting for clustering of evaluations within attendings and adjusting for age, race/ethnicity, and years in practice, women remained independently associated with lower evaluation scores (β = −0.206; 95% confidence interval: −0.294 to −0.118; P < 0.001). Composite evaluation scores did not differ significantly across racial or ethnic groups (Kruskal–Wallis P = 0.40), and race was not a significant predictor in adjusted models (GEE P = 0.13). Attendings aged ≥50 y had lower unadjusted evaluation scores than younger colleagues (P = 0.03); however, age was not independently associated with evaluation scores after clustering adjustment (GEE P = 0.14). Qualitative sentiment scores were uniformly high (median 4.0 [Q1-Q3: 4.0-4.5]) and did not differ by gender, race, or age. Conclusions Women surgeons received lower quantitative scores than their male colleagues, despite similarly positive qualitative feedback. Age differences were observed in unadjusted analyses but were attenuated after accounting for clustering, whereas no significant differences were observed by race or years in practice. Although absolute score differences were modest, these findings suggest that commonly used student evaluation metrics may reflect gender-related bias and should be interpreted cautiously in academic surgical assessment.
  • Item type:Publication,
    A Gravid Situation: General Surgery Faculty Support for Pregnant Surgical Residents Open PDF 
    (2024)
    Freudenberger, Devon C.
    ;
    Riner, Andrea N.
    ;
    Herremans, Kelly M.
    ;
    Vudatha, Vignesh
    ;
    McGuire, Kandace P.
    INTRODUCTION: The perceptions of teaching faculty toward pregnant general surgery residents have been overlooked despite the daily interactions amongst these groups. METHODS: A 32-question survey designed to measure general surgery teaching faculty perceptions toward pregnant residents was distributed electronically from March 2022 to April 2022 to general surgery teaching faculty in the United States. Descriptive statistics were used to characterize responses and differences in perceptions, and qualitative analysis identified recurring themes from free-text responses. RESULTS: Among 163 respondents included in the final analysis, 58.5% were male and 41.5% were female. Despite 99.4% of surgeons feeling comfortable if a resident told them they were pregnant, 22.4% of surgeons disagreed that their institutions have supportive cultures toward pregnancy. Almost half (45.4%) have witnessed negative comments about pregnant residents and half (50.3%) believe that pregnant surgical residents are discriminated against by their coresidents. Nearly two-thirds of surgeons (64.8%) believe that someone should have a child whenever they wish during training. Given recent reports, 80.2% of surgeons recognized that female surgeons have increased risks of infertility and pregnancy complications. Recurring themes of normalizing pregnancy, improving policies, and creating a culture change were expressed. CONCLUSIONS: In this national survey, although there appears to be positive perceptions of pregnancy in surgical training amongst those surveyed, there is acknowledged necessity of further normalizing pregnancy and improving policies to better support pregnant residents. These data provide further evidence that though perceptions may be improving, changes are still needed to better support pregnancy during training.