RESUMO
Background: The gender disparity in surgery leadership roles is well-reported. However, the effect of program type and region on mean number of men or women occupying a particular leadership role has yet to be explored. This study aims to investigate the gender disparity of leadership positions in different types of General Surgery Residency Programs (GSRPs). Methods: Leadership roles of the general surgery departments were collected from the Fellowship and Residency Electronic Interactive Database Access System (FREIDA) database. Each GSRP was categorized by region and program type using FRIEDA. Analysis of the mean number of men and women holding various leadership positions by program type and region was conducted using one-way ANOVA with post-hoc tests. Results: A total of 345 GSRPs were analyzed. The mean number of women occupying various leadership roles was significantly higher at university-based programs when compared to community-based programs. No significant difference in mean number of women leaders was observed by region. Conclusions: Women consistently occupy a lower number of GSRP leadership positions when compared to men, regardless of program type or region. University-based GSRP leadership positions have significantly greater gender inclusion compared to community-based GSRPs. Key messages: University-based general surgery residency programs had a higher mean number of women in all leadership roles compared to other program types. In comparison, region did not appear to be a significant factor impacting the leadership gender disparity. Improvement is needed in community-based general surgery residency programs to bridge the gender gap in leadership roles.
RESUMO
BACKGROUND: Studies suggest an increasing trend of plastic surgeons choosing private practice after training, with up to 90% pursuing private practice without future fellowships.1 Previous data showed that 66.7% of graduates from plastic surgery residency programs chose to pursue private practice without future fellowship, while more recent studies estimate this statistic has risen close to 90%.1,2 The literature has yet to characterize the current plastic surgery workforce and changes in its composition over time. This study aims to analyze the characteristics and training of plastic surgeons in California through a comparative study with general surgeons. METHODS: Surgeon demographics were extracted from the Centers for Medicare and Medicaid Services open database. Urban/rural classification and academic affiliation were crosslinked from the Inpatient Prospective System database and sole proprietorship status was cross-linked from the NPI Registry. Summary statistics and logistic regressions with chi-squared analysis were analyzed using STATA/MP17. RESULTS: Our analysis consisted of 3871 plastic and general surgeons in California. Compared to general surgeons, plastic surgeons were less likely to be females (P < 0.000), and more likely to be sole proprietors (P < 0.000), and affiliated with a teaching hospital (P < 0.005). There was no statistically significant difference in the percentage of rural-practicing plastic and general surgeons (P = 0.590). More recent plastic surgery graduates were more likely to be affiliated with an academic hospital (P < 0.0000). The composition of females significantly increased from the older graduated cohort to the most recent one. There was no significant difference in sole proprietorship and rural practice status between the oldest and youngest graduating cohorts. CONCLUSIONS: Although the California plastic surgery workforce is gaining female plastic surgeons and shifting to academic institutions, significant progress in serving rural communities is yet to be made. Our study suggests that there may be a shift in the trend of plastic surgeons opting for private practice, possibly driven by a desire for more stable positions in academia. Continued improvement in diversity and training of future plastic surgeons is needed to alleviate the rural care gap.
