Physicians, Women

内科医生,Women
  • 文章类型: Journal Article
    性别差距是一种新词,它确定了女性与男性相比所经历的社会和职业状况之间的差异。随着学术等级的提升,差距也会增加。近年来,辩论扩大了,并计划了更多的选择来消除当前的性别差距。
    这项研究是通过检查性别差距的景观来进行的,特别是在法医学学术领域。我们的分析涉及审查2006年至2024年之间发表的论文,这些论文是通过电子数据库搜索(PubMed)确定的。使用的搜索词是:“性别差距”和“学术”和“医学”和“领导”。“总的来说,我们分析了85篇论文。此外,我们检查了法医学住院医师计划的数据。
    女性在医学中的代表性是众所周知的。尽管越来越多的女性担任医学领导职务,他们仍然远远落后于男性。这些数据突显了一种情况,可以被视为指控“学术虐待”的理由。在意大利法医居留计划中,不到20%是由女性领导的,其中,并非所有人都拥有正教授的军衔。尽管某种再平衡已经在进行中,差距仍然很大。已经有法规要求地方当局在议会中促进性别平等,公司,和其管辖下的机构。最好考虑女性参加大学竞赛的最低配额。这将是消除学术和法医领域性别差距的第一步。
    UNASSIGNED: Gender gap is a neologism that identifies the disparity between social and professional conditions experienced by females compared to males. The disparity increases as one ascends the academic hierarchy. In recent years, the debate has expanded, and more options have been planned for the elimination of the current gender gap.
    UNASSIGNED: This research was conducted by examining the landscape of the gender gap, particularly in the academic forensic medicine field. Our analysis involved reviewing papers published between 2006 and 2024, identified through electronic database searches (PubMed). The search terms used were: \"gender gap\" AND \"academic\" AND \"medicine\" AND \"leadership.\" In total, we analyzed 85 papers. Additionally, we examined data from forensic medicine residency programs.
    UNASSIGNED: The representation of women in medicine is well-known. Despite the increasing number of women in leadership positions in medicine, they still lag significantly behind men. These data highlight a situation that could be seen as grounds for an accusation of \"academic abuse\". In the Italian forensic residency programs, less than 20% are led by women, and among these, not all hold the rank of full professor. Although a certain rebalancing is already underway, the gap is still significant. There are already regulations obliging local authorities to promote gender equality in councils, companies, and institutions under their jurisdiction. It would be desirable to consider minimum quotas for female participation in university competitions. This would be a first step toward eliminating the gender gap in academic and forensic medical fields.
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  • 文章类型: Interview
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  • 文章类型: Systematic Review
    背景:关于多样性主题的出版物数量,股本,在过去的5年里,包容性激增。然而,尚未对该主题进行系统综述。
    方法:从2018年到2023年,使用搜索词“多样性”查询了六本顶级整形外科期刊。\“方法,结论,并列出了建议。
    结果:共确定了138篇出版物;68篇研究提供了适合分析的数据。所有研究均为回顾性研究。目前,超过40%的整形外科住院医师申请人是女性。综合整形外科居民中的女性比例现在为43%。在2021年和2022年,女性第一年居民的比例超过了男性。参加会议的女性演讲者比例(34%)是劳动力人数(17%)的两倍。25%的学术教师职位和22%的项目主任职位现在由女性担任。代表性不足的少数民族占综合整形外科住院医师申请人的不到10%。
    结论:黑人和西班牙裔申请人占综合整形外科住院医师的比例(6%和8%,分别)反映了黑人和西班牙裔医学生的比例(7%和6%,分别)。已经提出了许多建议,以增加整形外科计划中代表性不足的少数民族的比例。
    结论:整形手术中女性的比例急剧增加。西班牙裔和黑人的缺乏反映了一小部分申请人,而不是“泄漏的管道”。\"
    BACKGROUND: The number of publications on the subject of diversity, equity, and inclusion has surged in the last 5 years. However, a systematic review of this topic has not been published.
    METHODS: Six top plastic surgery journals were queried from 2018 to 2023 using the search term \"diversity.\" Methods, conclusions, and recommendations were tabulated.
    RESULTS: A total of 138 publications were identified; 68 studies presented data suitable for analysis. All studies were retrospective. Currently, over 40% of plastic surgery residency applicants are women. The proportion of women in integrated plastic surgery residents is now 43%. In 2021 and 2022, the percentage of female first-year residents exceeded men. The percentage of female presenters at meetings (34%) is double the number in the workforce (17%). Twenty-five percent of academic faculty positions and 22% of program director positions are now held by women. Underrepresented minorities account for fewer than 10% of applicants to integrated plastic surgery residencies.
    CONCLUSIONS: The proportion of Black and Hispanic applicants to integrated plastic surgery residencies (6% and 8%, respectively) mirrors the proportion of Black and Hispanic medical students (7% and 6%, respectively). Numerous recommendations have been made to increase the proportion of underrepresented minorities in plastic surgery programs.
    CONCLUSIONS: The representation of women in plastic surgery has increased dramatically. A lack of Hispanics and Blacks reflects a small pool of applicants, as opposed to a \"leaky pipeline.\"
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  • 文章类型: Systematic Review
    目的:学术医学晋升中的性别差距已经确立。然而,很少有研究报告根据学术生产和国家或国际声誉调整后的晋升性别差异,即,职业生涯持续时间,出版物,赠款资金,和领导职位。作者对男女在实现晋升基准方面的差异进行了系统的回顾和荟萃分析,并分析了这种差异在地理上和专业内的位置。
    方法:对学术搜索Premier的系统搜索,业务源完成,科克伦图书馆,ERIC,GenderWatch,谷歌学者,Embase,MEDLINE,PubMed,Scopus,和WebofScience从成立到2022年8月17日进行。包括所有报告医学院教职员工男女全职教授人数的研究。主要结果是与男性相比,女性晋升为正教授的调整比值比(AOR)。
    结果:240项研究符合纳入标准。女性晋升正教授的未调整OR为0.38(95%置信区间[CI],0.36、0.41)。16项研究报告了AOR。女性晋升为正教授的合并AOR为0.60(95%CI,0.46,0.77)。在手术中晋升为正教授的AOR为0.55(95%CI,0.34,0.88),在内科中晋升为0.80(95%CI,0.57,1.11)。统计异质性高(Q=66.6,I2=79.4%,P<.001)。关于元回归,77%的异质性来自美国以外的研究,报告了更多的差异(AOR,0.29;95%CI,0.22,0.38)。
    结论:大多数研究继续发现女性升职率下降。性别差异在手术和美国以外的研究中尤为明显。结果表明,晋升的差异是由于生产力和领导力的差异以及性别偏见。
    OBJECTIVE: The gender gap in promotion in academic medicine is well established. However, few studies have reported gender differences in promotion adjusted for scholarly production and national or international reputation, namely, career duration, publications, grant funding, and leadership positions. The authors performed a systematic review and meta-analysis of the differences between men and women in achieving benchmarks for promotion and analyze where such differences lie geographically and within specialties.
    METHODS: A systematic search of Academic Search Premier, Business Source Complete, Cochrane Library, ERIC, GenderWatch, Google Scholar, Embase, MEDLINE, PubMed, Scopus, and Web of Science was conducted from inception to August 17, 2022. All studies that reported the number of male and female full professors on medical school faculty were included. The primary outcome was the adjusted odds ratio (AOR) for promotion to full professor for women compared with men.
    RESULTS: Two hundred forty-four studies met the inclusion criteria. The unadjusted OR for promotion to full professor for women was 0.38 (95% confidence interval [CI], 0.36-0.41). Sixteen studies reported an AOR. The pooled AOR of promotion for women to full professor was 0.60 (95% CI, 0.46-0.77). The AOR for promotion to full professor was 0.55 (95% CI, 0.34-0.88) in surgery and 0.80 (95% CI, 0.57-1.11) in internal medicine. Statistical heterogeneity was high ( Q = 66.6, I2 = 79.4%, P < .001). On meta-regression, 77% of the heterogeneity was from studies outside the United States, where more disparity was reported (AOR, 0.29; 95% CI, 0.22-0.38).
    CONCLUSIONS: Most studies continued to find decreased promotion of women. Gender disparity was particularly notable in surgery and in studies from outside the United States. The results suggest that differences in promotion were due to differences in productivity and leadership and to gender bias.
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  • 文章类型: Review
    医师职业倦怠的患病率继续增加,并不成比例地影响女医生。乳腺成像是女性主导的亚专业,因此,女医生日益恶化的职业倦怠可能会对乳腺成像行业的未来产生重大影响.系统和组织因素已被证明是超出个人因素的最大因素。根据梅奥模型,我们回顾了有关导致医师职业倦怠的7个主要组织因素及其对女性乳腺放射科医师的潜在不成比例影响的证据.讨论的主要组织因素是工作与生活的整合,控制和灵活性,工作量和工作需求,效率和资源,在工作中找到意义,工作中的社会支持和社区,组织文化和价值观。我们还提出了机构和实践的潜在策略,以减轻女性乳腺影像学放射科医生的倦怠。这些策略中的许多也可以使男性乳腺影像学放射科医师受益,他们也有倦怠的风险。
    Physician burnout continues to increase in prevalence and disproportionately affects women physicians. Breast imaging is a woman-dominated subspeciality, and therefore, worsening burnout among women physicians may have significant repercussions on the future of the breast imaging profession. Systemic and organizational factors have been shown to be the greatest contributors to burnout beyond individual factors. Based on the Mayo Model, we review the evidence regarding the 7 major organizational contributors to physician burnout and their potential disproportionate impacts on women breast radiologists. The major organizational factors discussed are work-life integration, control and flexibility, workload and job demands, efficiency and resources, finding meaning in work, social support and community at work, and organizational culture and values. We also propose potential strategies for institutions and practices to mitigate burnout in women breast imaging radiologists. Many of these strategies could also benefit men breast imaging radiologists, who are at risk for burnout as well.
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  • 文章类型: Systematic Review
    基于性别的医学研究表明,在几乎每个职业阶段,几乎每个指标上都存在女性不平等现象;眼科也不例外。
    系统地回顾女性在高收入国家(HIC)的培训和实践中的眼科(FiO)经验。
    英语学习的系统回顾,在1990年1月至2022年5月之间发布,与HIC中的FiO有关。PubMed,MEDLINE,搜索了Embase电子数据库,以及《学术眼科杂志》,因为它没有在搜索的数据库中索引。研究是在每个职业阶段按主题组织的,从医学院开始,当人们对眼科感兴趣时,延伸到退休。
    共91项研究,87个横截面和4个队列,包括在内。在医学院,指导和招收女学生进入眼科受性别偏见的影响,与眼科医生导师认同的女性较少,性别刻板印象在男性和女性裁判撰写的推荐信中得以延续。在住院医师方面,女性有不平等的学习机会,手术病例量低于男性受训人员,女性在利润丰厚的亚专业寻求研究金的人数较少。在实践中,女性眼科医生的收入较低,学术成就较少,在领导角色中代表性较差。女性眼科医生比男性眼科医生有更大的学术影响因素,但这只是在大约30年的出版经验之后。在培训和实践的所有阶段中,患者和同事的女性都经历了更大的性骚扰。尽管存在这些差异,一些研究发现,在眼科领域,女性的总体职业满意度与男性相同,而其他人则建议更高的倦怠率。
    眼科正在接近性别均等,然而,女性在眼科中所占比例的增加并没有转化为女性在领导职位中的比例增加.性别差异在许多领域持续存在,包括招聘,培训,实践模式,学术生产力,和收入。干预措施可以改善该领域的性别平等。
    UNASSIGNED: Sex-based research in medicine has revealed inequities against females on almost every metric at almost every career stage; ophthalmology is no exception.
    UNASSIGNED: To systematically review the experiences of females in ophthalmology (FiO) from training through practice in high-income countries (HICs).
    UNASSIGNED: A systematic review of English-language studies, published between January 1990 and May 2022, relating to FiO in HICs was performed. PubMed, MEDLINE, and Embase electronic databases were searched, as well as the Journal of Academic Ophthalmology as it was not indexed in the searched databases. Studies were organized by theme at each career stage, starting in medical school when an interest in ophthalmology is expressed, and extending up to retirement.
    UNASSIGNED: A total of 91 studies, 87 cross-sectional and 4 cohort, were included. In medical school, mentorship and recruitment of female students into ophthalmology was influenced by sex bias, with fewer females identifying with ophthalmologist mentors and gender stereotypes perpetuated in reference letters written by both male and female referees. In residency, females had unequal learning opportunities, with lower surgical case volumes than male trainees and fewer females pursued fellowships in lucrative subspecialties. In practice, female ophthalmologists had lower incomes, less academic success, and poorer representation in leadership roles. Female ophthalmologists had a greater scholarly impact factor than their male counterparts, but this was only after approximately 30 years of publication experience. Pervasive throughout all stages of training and practice was the experience of greater sexual harassment among females from both patients and colleagues. Despite these disparities, some studies found that females reported equal overall career satisfaction rating with males in ophthalmology, whereas others suggested higher burnout rates.
    UNASSIGNED: Ophthalmology is approaching sex parity, however, the increase in the proportion of females in ophthalmology had not translated to an increase in female representation in leadership positions. Sex disparities persisted across many domains including recruitment, training, practice patterns, academic productivity, and income. Interventions may improve sex equity in the field.
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  • 文章类型: Journal Article
    赞助描述了一系列行动,其中有影响力的冠军(赞助商)利用他们的职位,通过帮助他们获得知名度来积极支持同事的职业生涯,认可,和/或位置。人们越来越意识到赞助对学术医学职业发展的重要性,特别是对于女性和那些历史上在医学(UIM)中代表性不足和被排除在外的女性。这份范围审查审查了目前的证据状况,和知识差距,赞助,因为它与女性和UIM教师的学术医学职业发展有关。我们在PubMed中搜索了同行评审的文献,Embase,和WebofScience(WoS)过去50年(从1973年到2023年7月)。16项研究被纳入最终审查。我们在赞助定义和职业发展价值方面达成了相对共识。研究设计的异质性限制了我们直接比较研究结果的能力。所有纳入的研究都集中在赞助方面的性别差异:四项定量研究中有两项发现男性更有可能获得赞助,一个报告没有性别差异,一个人动力不足。除了一项定性研究外,所有研究都报告了性别差异,女性不太可能获得或被确定为赞助。混合方法研究表明,赞助可能因职业阶段而异。只有两项研究分析了UIM人群的赞助。关于衡量和评估赞助的最佳方法,现有数据尚无定论,什么机构支持(例如,结构化程序,正式承认,或赞助激励措施)应该看起来像,在什么职业阶段赞助是最重要的。解决这一知识差距对于理解哪些赞助最佳实践至关重要,如果有的话,应用于促进学术医学职业发展的公平。我们主张在机构和国家层面致力于开发新的基础设施,以透明和公平地支持妇女和UIM的职业发展。
    Sponsorship describes a set of actions wherein an influential champion (sponsor) uses their position to actively support a colleague\'s career by helping them gain visibility, recognition, and/or positions. There is growing awareness of the importance of sponsorship for career advancement in academic medicine, particularly for women and those who are historically underrepresented and excluded in medicine (UIM). This scoping review examines the current landscape of evidence, and knowledge gaps, on sponsorship as it relates to career advancement in academic medicine for women and UIM faculty. We searched peer-reviewed literature in PubMed, Embase, and Web of Science (WoS) over the past 50 years (from 1973 through July 2023). Sixteen studies were included in the final review. We found relative consensus on sponsorship definition and value to career advancement. Heterogeneity in study design limited our ability to directly compare study outcomes. All included studies focused on gender differences in sponsorship: two of four quantitative studies found men were more likely to receive sponsorship, one reported no gender differences, and one was insufficiently powered. All but one of the qualitative studies reported gender differences, with women less likely to access or be identified for sponsorship. The mixed-methods studies suggested sponsorship may vary by career stage. Only two studies analyzed sponsorship for UIM populations. The existing data are inconclusive regarding best ways to measure and assess sponsorship, what institutional support (e.g., structured programs, formal recognition, or incentives for sponsorship) should look like, and at what career stage sponsorship is most important. Addressing this knowledge gap will be critically important for understanding what sponsorship best practices, if any, should be used to promote equity in career advancement in academic medicine. We advocate for commitment at the institutional and national levels to develop new infrastructure for transparently and equitably supporting women and UIM in career advancement.
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  • 文章类型: Letter
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  • 文章类型: Meta-Analysis
    背景:文献报道了女性外科医生的职业满意度。这项研究提供了全面的回顾,以了解女性外科医生的职业满意度及其影响因素。
    方法:PRISMA指南用于提取研究以进行系统评价和荟萃分析。评估的结果包括手术职业满意度,职业重新考虑,工作与生活的平衡,以及性别偏见和歧视(GBD)。比较每种结果的女性与男性,计算赔率。
    结果:这项研究表明,女性外科医生不太可能认可整体职业满意度(或,0.68;95%CI,0.55-0.85)和工作-生活平衡满意度(OR,0.61;95%CI,0.40-0.92)与男性外科医生相比。它还显示,女性外科医生更有可能报告工作场所GBD(或者,13.82;95%CI,4.37-43.65)。
    结论:未来的干预措施可能是必要的,以提高女外科医生的职业和工作生活平衡满意度,同时协调确保她们充分了解外科职业义务的需要。
    Career satisfaction among women surgeons have been well-reported in literature. This study provides a comprehensive review to understand career satisfaction and its contributory factors among female surgeons.
    PRISMA guidelines were utilized to extract studies for systematic review and meta-analysis. Outcomes assessed included surgical career satisfaction, career reconsideration, work-life balance, and gender bias and discrimination (GBD). Odds ratios were calculated comparing women to men for each outcome.
    This study demonstrated that female surgeons were less likely to endorse overall career satisfaction (OR, 0.68; 95% CI, 0.55-0.85) and work-life balance satisfaction (OR, 0.61; 95% CI, 0.40-0.92) compared to male surgeons. It also revealed that women surgeons were more likely to report workplace GBD (OR, 13.82; 95% CI, 4.37-43.65).
    Future interventions may be necessary to increase career and work-life balance satisfaction among women surgeons while reconciling the need to ensure they are adequately informed of the obligations of a surgical career.
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  • 文章类型: Review
    目标:这篇论文源于一种渴望加深我们自己的理解,即为什么当盟友和赞助者提供或创造晋升机会时,女性会“说不”。领导或认可。由此产生的男女在领导岗位上的代表性差异,学术医学中邀请的主题演讲者和出版物计数是一个顽固而邪恶的问题,需要跨多学科文献的知识综合。认识到这个主题的复杂性,我们选择了一个叙述性的批判性审查方法来探讨为什么一个男人的机会可能是一个女人在学术医学中的负担。
    方法:我们参与了一个迭代过程,回顾和解读心理学文献(认知,工业和教育),社会学,卫生职业教育和商业,对发布的背景或年份没有任何限制。知识综合和解释由我们的综合专业知识指导,生活经验,与作者团队以外的专家进行磋商,并提出以下指导性问题:(1)为什么女性获得职业发展机会的时间较少?(2)为什么女性进行研究和领导的时间较少?(3)这些差异如何维持?
    结果:拒绝机会可能是更大问题的征兆。社会期望的力量,文化和性别陈规定型观念仍然是抵制行动呼吁的力量。因此,女性不成比例地承担其他没有得到认可的任务。这种差距是通过打破根深蒂固的陈规定型观念的社会后果来维持的。
    结论:流行的策略,例如“倾向于机会”,\'伪造它直到你成功\'和\'克服你的冒名顶替综合症\'表明女人站在自己的方式。严重的,这些公理忽略了塑造这些选择和机会的强大的系统性障碍。我们提供的策略是盟友,赞助商和同行可以实施以抵消刻板印象的力量。
    This paper stems from a desire to deepen our own understanding of why women might \'say no\' when allies and sponsors offer or create opportunities for advancement, leadership or recognition. The resulting disparity between representation by men and women in leadership positions, invited keynote speakers and publication counts in academic medicine is a stubborn and wicked problem that requires a synthesis of knowledge across multidisciplinary literature. Acknowledging the complexity of this topic, we selected a narrative critical review methodology to explore reasons why one man\'s opportunity might be a woman\'s burden in academic medicine.
    We engaged with an iterative process of identifying, reviewing and interpreting literature from Psychology (cognitive, industrial and educational), Sociology, Health Professions Education and Business, placing no restrictions on context or year of publication. Knowledge synthesis and interpretation were guided by our combined expertise, lived experience, consultations with experts outside the author team and these guiding questions: (1) Why might women have less time for career advancement opportunities? (2) Why do women have less time for research and leadership? (3) How are these disparities maintained?
    Turning down an opportunity may be a symptom of a much larger issue. The power of social expectations, culture and gender stereotypes remains a resistant force against calls for action. Consequently, women disproportionately take on other tasks that are not as well recognised. This disparity is maintained through social consequences for breaking with firmly entrenched stereotypes.
    Popular strategies like \'lean into opportunities\', \'fake it till you make it\' and \'overcome your imposter syndrome\' suggest that women are standing in their own way. Critically, these axioms ignore powerful systemic barriers that shape these choices and opportunities. We offer strategies that allies, sponsors and peers can implement to offset the power of stereotypes.
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