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Language: search.filters.language.EnglishSubject: search.filters.subject.Surgical Education

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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,
    Authorship Trends and Gender Concordance in Surgical Research
    (Elsevier BV, 2025-08)
    Smith, Brandon T.
    ;
    Villela-Castrejon, Javier
    ;
    Rodriguez, Larissa
    ;
    Kalva, Prathik
    ;
    Beal, Taylor
    INTRODUCTION: Building inclusive and diverse research teams is increasingly important in the era of team science. We explored authorship trends over the last 3 decades to assess progress in academic surgery. METHODS: Two general surgical journals (Journal of the American Medical Association Surgery and Annals of Surgery) and two nonsurgical multidisciplinary scientific journals (Nature and Science) were queried at 10-y intervals from 1991 to 2021. Data collected included total number of authors per article, instances of shared authorship, authors' gender, geographic location of the authors, and number of references per article. RESULTS: A total of 741 journal articles were examined. Over the last 3 decades, the number of women authors has nearly doubled in surgical journals and tripled in nonsurgical journals. The proportion of women authors per article, women first authors, and women senior authors all increased significantly, though women remain only 26% of all authors. Intriguingly, articles with a woman senior author had a significantly greater proportion of women coauthors than articles with a man senior author (55 ± 4% versus 12 ± 6%; P < 0.05) across all 3 decades in all journals. In 2021, only 10% of articles with a man senior author had an equal or greater proportion of women coauthors. CONCLUSIONS: Though there are now more women authors, we describe a pattern of gender concordance where women senior authors may publish with other women more than men senior authors. Our findings highlight both the progress made and potential for growth in achieving gender equity in academic surgery.
  • 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.
  • Item type:Publication,
    Gender Discrepancies in Middle Author Publications in US Academic General Surgery Open PDF 
    (2023)
    Alam Khan, M.T.
    ;
    Patnaik, R.
    ;
    Laffoon, A.N.
    ;
    Krokar, L.
    ;
    Ince, S.R.
    Introduction: To explore gender discrepancies in publications at general surgery departments, we performed a cross-sectional comparing the number of women and men at each academic rank and their number of first author (FA), middle author (MA), last author (LA), and total publications. Methods: Thirty academic general surgery departments were randomly selected. For each faculty, we tabulated: first, middle, last names, gender, academic rank, educational leadership, year of medical school graduation, and additional graduate degrees. Bibliography, H-index, and citations were downloaded from the Scopus database. Results: One thousand three hundred twenty-six faculty sampled, 881 (66.4%) men and 445 (33.5%) women. Men outnumbered women at all ranks, with increasing disparity at higher ranks. Men outnumbered women in all subspecialties—largest difference in transplant surgery (84.4% versus 15.6%, P < 0.001). Men at all ranks had more MA publications: assistant professor (rate ratio 1.20; 95% confidence interval, 1.01-1.43, P = 0.024), associate professor (1.65; 1.31-2.06, P < 0.001), and professor (1.50; 1.20-1.91, P = 0.008). Men associate professors had more LA publications (1.74; 1.34-2.37, P < 0.001). No differences found in FA publications at any rank, nor LA publications at assistant professor and professor ranks. At subspecialty level, men in surgical oncology (1.95; 1.55-2.45, P < 0.001) and transplant surgery (1.70; 1.09-2.66, P = 0.02) had more MA publications. Conclusions: While FA and LA publications did not differ significantly across genders, the largest difference lies in MA publications, beginning at junior ranks and persisting with seniority. Discrepancies in MA publications may reflect gender discrepancies in collaborative opportunities, hence total publications should be used cautiously when determining academic productivity. © 2023 Elsevier Inc.