ABSTRACT
OBJECTIVE: To identify factors influencing residency training program selection by women residents in urology and to evaluate the residents' gender-based experiences during training. Urology remains a disproportionately male-physician-dominated field. Understanding the needs and experiences of women residents is essential for developing strategies to recruit and retain more women urologists in independent practice. METHODS: An anonymous, 15-item web-based electronic survey was posted on social media and distributed via institutional email addresses between May and July 2021, targeted to all 461 current women U.S. urology residents. Both quantitative and qualitative data were collected and analyzed using descriptive statistical methods and thematic analysis, respectively. RESULTS: 147 complete responses were received. The most important factors influencing initial residency training program selection included geographic location/setting (37%) and institutional reputation (27%), compared to number of women faculty (3.4%) and women residents (0%). However, respondents cited a need for increased presence of women faculty and mentorship (36%), elimination of gender bias/harassment in the workplace (33%), and improved family support/maternity leave policies (15%) during residency to better foster clinical and academic growth of women residents. In interactions with patients, 97% reported not being recognized as a doctor, 84% reported stereotyping of women doctors, and 78% reported experiencing inappropriate treatment/harassment from male patients. CONCLUSION: Geographic setting and institutional reputation were the most important factors for residency program selection by women urology residents. Although overlooked as a priority during the initial application process, current women urology residents seek increased women faculty presence, leadership and mentorship during residency to foster clinical and academic growth. Women residents face extremely high rates of gender bias and harassment in the workplace.
ABSTRACT
Purpose: The use of integrative approaches for symptom management is highly prevalent among patients undergoing cancer treatment and among cancer survivors and is increasingly endorsed by clinical practice guidelines. However, access to and implementation of integrative oncology (IO) approaches are hindered by barriers at multiple levels, including logistic, geographic, financial, organizational, and cultural barriers. The goal of this mixed-method study was to examine oncology provider and patient knowledge, beliefs, and preferences in IO to identify facilitators, barriers, and recommendations for implementation of IO modalities. Materials and Methods: Data sources included patient surveys and provider semistructured interviews. Patients were in active treatment (n = 100) and survivors (n = 100) of heterogeneous cancer types. Patient and survivor surveys interrogated: (1) interest in types of IO approaches; and (2) preferences for delivery modality, frequency, and location. Providers (n = 18) were oncologists and nurse navigators working with diverse cancer types. Interviews queried their knowledge of and attitudes about IO, about their patients' needs for symptom management, and for recommendations for implementation of IO approaches in their clinic. We used the Consolidated Framework for Implementation Research framework to systematically analyze provider interviews. Results: The primary interests reported among actively treated patients and survivors were massage therapy, acupuncture, and wellness/exercise. Most patients expressed interest in both group and individual sessions and in telehealth or virtual reality options. Emergent themes from provider interviews identified barriers and facilitators to implementing IO approaches in both the internal and external settings, as well as for the implementation process. Conclusion: The emphasis on mind-body interventions as integrative rather than alternative highlights the importance of interventions as evidence-based, comprehensive, and integrated into health care. Gaining simultaneous perspectives from both patients and physicians generated insights for the implementation of IO care into complex clinical systems within a comprehensive cancer center.
