RESUMO
Objective: To determine the distribution of female physicians throughout the rank from resident to leadership positions in German Otolaryngology-Head and Neck Surgery (OHNS) departments. Methods: This cross-sectional study collected data about the physician workforce in the German OHNS.The primary outcome was the proportion of female physicians. Data were collected from 165 departments from January 2022 to February 2022. The physician workforce was stratified based on gender and leadership. Results: We included 2089 physicians from 165 departments of OHNS in German hospitals. Female residents and specialists outnumbered male peers (484/872 [55.5%] vs. 388/872 [44.5%] and 224/363 [61.71%] vs. 139/363 [38.29%], respectively). However, the women proportion decreased gradually with elevated hierarchical rank starting at the attending physician level to reaching its lowest extreme (14/165 [7.23%]) at the head of the department level. Holding a leadership position was associated with being male (n = 282 [85.2%] vs. n = 49 [14.8%], p < .0001). This persisted even after controlling the academic rank in a multivariable regression model (OR: 5.027, 95% CI: 3.536-7.146). The gap between the two genders in favor of men regarding leadership persisted in all kinds of hospitals. However, this disparity was lowest in university hospitals, (male: n = 83 [78.3%] vs. female: n = 23, [21.7%], p < .0001). Conclusions: Even though women outnumbered men in resident and specialist positions, they are still underrepresented in leadership positions in OHNS. Continuous surveillance is needed to watch the dynamic changes in the gap between the two genders and address it with more sex equality-supporting policies. Level of Evidence: IV.
RESUMO
BACKGROUND: The German health care system has recently become an attractive destination for international medical graduates, particularly from developing countries such as Syria. However, there are no studies about the factors that influence the successful entry into the German healthcare system at trainee level. METHOD : An anonymous cross-sectional survey was distributed electronically to Syrian medical graduates who successfully entered residency training in Germany. Collected data included demographics and factors that influence entering the residency, such as proven German proficiency and clinical experience in the home country. Hypothesis testing was used to assess the difference between the variables. RESULTS: A total of 109 participants responded to the survey. Twenty-three (21.1%) subjects completed a medical residency in Syria before moving to Germany, and 46 (42.2%) had no previous clinical experience before moving to Germany. The proven German proficiency of the participants upon arrival in Germany was less than B1 in 39 (35.8%), B1 in 37 (33.9%), and B2 in 33 (30.3%) cases. None of the participants had a language level beyond B2, and 18 (16.5%) had no German knowledge. The median of months spent in Germany till residency for those with B1 or B2 certificates before moving to Germany (10.5 (6.25-16) months and 8 (5-11) months, respectively) differed significantly from those with German-language skills belowB1 ((21 (14-29) months, p < .001). Residency in the home country was not associated with a difference in the median of the months in Germany till entering residency, p = 0.84. CONCLUSION: A crucial factor influencing the successful entry to the German medical system at the trainee level is the ability to speak German, measured in levels based on the Common European Framework of Reference for languages. A high language skill level is a crucial factor associated with a decrease in time in Germany till entering residency for an international medical applicant. In contrast, previous work experience is not influencing the entry into the German labor market.
