Postdoctoral T32 training is correlated with obtaining an academic primarily research faculty position.

The mission of NIH-sponsored institutional training programs such as the T32 is to provide strong research and career training for early career scientists. One of the main avenues to pursuing health-related research is becoming research faculty at an academic institution. It is therefore important to know whether these programs are succeeding in this mission, or, if barriers exist that prevent trainees from pursuing these careers. Our institution currently trains ~ 2400 post-doctoral scholars per year, approximately 5% of whom are enrolled in one of our 33 T32 programs. In this study, we 1) compare the proximal professional career trajectories of T32 trainees with non-T32 trainees at our institution, 2) compare proximal career trajectories of trainees in a subset of cardiovascular T32 programs based on their previous training backgrounds, and 3) survey past and current T32 trainees in a subset of cardiovascular T32 programs about the barriers and enablers they experienced to pursuing research-oriented careers. We find that former T32 trainees are significantly more likely to attain appointments as primarily research faculty members, compared to other trainees. Trainees report a perceived lack of stability, the paucity of open positions, and the 'publish or perish' mentality of academia as the top barriers to pursuing careers in academia. However, they were still more likely to choose research over clinical careers after participating in a dedicated T32 program. Our results support the conclusion that structured training programs strengthen the pipeline of young scientists pursuing careers in academic research, including those from underrepresented backgrounds. However, T32 postdoctoral researchers are held back from pursuing academic careers by a perceived lack of stability and high competition for faculty positions.

Gender-based support systems influencing female students to pursue a bachelor of medicine, bachelor of surgery (MBBS) in Rwanda.

BACKGROUND: While Sub-Saharan Africa contains nearly one third of the global burden of disease, it only contains 3.5% of the healthcare workforce. Furthermore, female medical doctors are underrepresented across the continent. Studies show that increasing gender representation in medicine not only bridges this gap but may have a positive impact on patient care. This study explores the support systems influencing female students to pursue medical school in Rwanda, aiming to recommend ways to increase female participation through support systems. METHODS: This is an exploratory, interpretive study employing qualitative methods. The study was conducted at thirteen secondary schools within two provinces and three universities in Rwanda that offer a medical degree program. Participants were divided into focus groups, including female and male secondary students in science and non-science combinations; teachers of secondary students; female and male students enrolled in medical school; and parents of secondary students in science and non-science combinations. Private and public, mixed and girls-only secondary schools that met the criteria were selected in each province, and all universities offering a medical degree. Participants were selected via random stratified sampling. Thirty-four semi-structured focus group discussions were conducted (28 secondary-level and 6 university-level) and 16 interviews. Data was coded inductively, with common themes identified. RESULTS: Four main themes were identified as support systems that can either serve as facilitators or barriers to pursuing an MBBS, including teacher support, parental or familial support, financial or institutional policy support, and having access to female mentors or role models. CONCLUSION: Social support systems are enablers encouraging female students to join medical school. Integrating social support systems in schools and the community has the potential to increase female applicants to medical school in Rwanda.

The Imperative Need for Career Counselling Sessions in the Medical and Dental Fields.

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To choose or not to choose a nurse practitioner fellowship: An opinion piece on why to choose.

ABSTRACT: New graduate nurse practitioners (NPs) often face a challenging learning curve, especially in specialized fields. The quality of clinical experiences and education varies widely across NP programs, and NP Fellowships offer an extension of formal education and clinical experiences. This editorial offers a personal perspective into the NP Fellowship experience and affirms their value to improve the standard of patient care and equip novice NPs for a sustainable career.

Critères influençant le choix du premier poste après l'internat de chirurgie orale en France.

INTRODUCTION: The Specialized Diploma in Oral Surgery (Diplôme d’études spécialisées en chirurgie orale) was established in 2011. It gives its holders a unique combination of medical and surgical expertise. As a specialty, oral surgery can be pursued via both medical and dental pathways. However, the criteria guiding students’ choice of first job after residency remain largely unknown. PURPOSE OF THE RESEARCH: The primary objective was to evaluate the factors influencing students’ choice of first job after completing their oral surgery residency. RESULTS: The main geographical factors influencing job choice were the presence of family or friends, a short commute, and the location of the spouse’s place of work. Key practice conditions included access to advanced technical facilities and an operating theater offering general anesthesia. Clinical activities ranged from pre-implant grafts to general oral surgery. The likelihood of pursuing a hospital-based position in the same facility was correlated with the well-being experienced during the residency (p < 0.05) and with the oral surgeons’ medical background (p = 0.001). Significant associations exist between region of origin, internship location, and practice region (p < 0.001; p <0.001). CONCLUSIONS: The main factors influencing the choice of first position after oral surgery residency depend on family-related and technical criteria.

The career pathways of new family physicians in South Africa from 2008 to 2022.

BACKGROUND:  Family medicine has trained specialist family physicians in South Africa since 2008, but not investigated their career pathways. The study aimed to determine the career pathways of newly qualified family physicians between 2008 and 2022. METHODS:  A cross-sectional descriptive survey of all 186 family physicians via an electronic questionnaire. RESULTS:  Response rate was 44.6% (83/186). Overall, 9.6% emigrated, 10.8% were no longer practising, and 79.5% were still practising in South Africa. Of the latter, 14.5% were in the private sector, 55.4% in the public sector and 9.6% in both. Of those in the public sector, 33.7% were in specialist family physician posts, 12% in medical officer posts, 4.8% in managerial positions and 4.8% in academic positions. Issues relating to safety and security were important to those working in both sectors and relationships with colleagues in the clinical team, to those in the public sector. Overall, participants practised near or within their province of training and were not equitably distributed. CONCLUSION:  Only a third of graduates were in specialist family physician posts in the public sector. Attention needs to be given to retaining more graduates in such posts to achieve the goals of the national position paper. The proportion in the private sector was lower than expected. The reasons for no longer practising medicine should be further explored.Contribution: This is the first study on the career pathways of family physicians in South Africa since the new speciality was created. Understanding these pathways will assist with human resources for health planning.

Resident Recruitment in a New Era.

ABSTRACT: This chapter focuses on resident recruitment and recent US National Resident Matching Program changes and the impact in the evaluation and ranking of applicants within the specialty of anesthesiology. Recruitment challenges are examined as well as program strategies and potential future directions. Also discussed are DEI initiatives within the recruitment process.

Summer undergraduate biomedical research program for underrepresented minority students in a rural, low-income state.

Introduction: Diversity can enhance the agenda and quality of biomedical research, but a dearth of underrepresented minorities and women serve as biomedical researchers. The study purpose was to examine the impact of the a summer undergraduate research program on self-efficacy in research, scientific communication, and leadership as well as scientific identity, valuing objectives of the scientific community, and intent to pursue a biomedical research career. Methods: Underrepresented minority and female undergraduate students participated in a mentored research experience in a rural, low-income state. Results: Students' self-efficacy in research, scientific communication, and leadership as well as scientific identity, valuing objectives of the scientific community, and intent to pursue a biomedical research career increased post-program compared to pre-program. Conclusion: This study supports implementation of a biomedical summer undergraduate research program for URM and women in a poor, rural, settings.

A mixed-methods exploration of the nursing associate role, programme experiences and future career pathways.

This article reports on a small mixed-methods research project undertaken with trainee nursing associates (TNAs) in the south of England. AIM: The aim was to gain insight into the motivation behind undertaking the nursing associate (NA) programme, how the NA role is perceived by service users and the wider healthcare team, and the future career pathways of NAs. METHODS: Online questionnaires (n=14) and online focus groups (n=6). FINDINGS: The results suggested undertaking the NA programme increased the TNAs' confidence and ability to use evidence to support their practice; that the role of the NA is not well understood. Some TNAs perceived the NA role as a distinct professional role, whereas others saw it as a way into registered nurse training. CONCLUSION: Role confusion still exists. Research is needed to capture how professional identities in new health and social care professional groups become established.

A national virtual job search series for neonatal-perinatal medicine fellows.

BACKGROUND: A standardized approach to prepare trainees for the job search has not been described. The objective of this study was to describe and evaluate an educational series on the job search for Neonatal-Perinatal Medicine (NPM) fellows and identify participants' job search knowledge gaps. METHODS: During the 2020-2021 academic year, we created a virtual, seven-part job search series for NPM fellows that required no funding. The series has been repeated annually. We use REDCap surveys to register participants, collect baseline/demographic information, and evaluate the series' impact at the beginning and end of the job search timeline. RESULTS: In the 2021-2022 academic year, 290 individuals registered for the series, and 89% completed the baseline/demographic survey. The majority were NPM fellows (89%). Early career neonatologists, NPM hospitalists, and pediatric residents also utilized the series (11%). Less than 25% reported being "knowledgeable" or "very knowledgeable" of core job search components, including the timeline of the job search, contract negotiation, and the general roles and responsibilities of junior faculty. Of those who completed the final job search survey and underwent a job search (60%, 97 of 162), the majority (86%) felt that career planning during training was stressful and believed that job search preparation should be structured into the NPM fellowship curriculum (81%). Many felt that the Job Search Series was helpful in elucidating components of the job search. CONCLUSIONS: We identified several knowledge gaps in NPM fellows' understanding of how to find, prepare for, and negotiate their first post-training job. We strongly believe these knowledge gaps are not unique to NPM fellows and that all graduate medical education trainees would benefit from a similar, easy-to-implement, no-cost series.

Factors of pre-war educational migration: an investigation of polish medical and dental students in Ukraine.

BACKGROUND: Low admission rates at Polish medical universities led many students to study abroad. Ukraine provided an appealing option for years. The purpose of the study is to investigate the most important factors that motived Polish students enrolled at I. Horbachevsky Ternopil National Medical University in Ukraine to pursue medical and dentistry studies in lower middle-income countries, just before the outbreak of the war. It has become incredibly important to determine crucial economic and non-economic factors. METHODS: The paper draws on a quantitative survey (N = 94) conducted among medical and dental students from Poland who had studied at I. Horbachevsky Ternopil National Medical University in Ukraine using a semi-structured questionnaire. To test whether there was a relationship between the importance of the motives, Pearson's chi-square independence test was employed. RESULTS: The study found the key economic and non-economic factors for pursuing Ukrainian studies were rejection from Polish tuition-free programs, lower Ukrainian tuition and living costs compared to Poland and to other European Union countries. Determining reasons for choosing Ternopil University were recruiter and friend recommendations and its prestige among Ukrainian medical schools. Gender influenced the ranking of motives. CONCLUSION: The article examines the unique pre-war educational migration from Poland to Ukraine - occurring counter to typical flows from lower to higher a lower income country. The study showed that universities should strengthen recruiting efforts and highlight competitive tuition and living costs to attract international students, especially from relatively more developed nations.

Predicting trajectories of vocational indecision from motivational profiles in early adolescence.

BACKGROUND, OBJECTIVE AND HYPOTHESES: During emerging adulthood, vocational indecision (i.e., the inability to make coherent career choices) develops in a heterogeneous fashion, with three distinct patterns: low; decreasing (i.e., developmental or adaptative); high and stable or increasing (i.e., chronic or maladaptive). Among the determinants of vocational indecision that have been identified in past research, academic motivation is a crucial an excellent choice, since it is at school that students' vocational choices are validated or not. According to SDT, this motivation can vary both in quantity and quality, and students tend to experience more positive academic outcomes when their motivational profile is optimal (high quantity, high quality) as opposed to suboptimal (e.g., low quantity, low quality). Thus, the purpose of this longitudinal study was to verify if the patterns found with emerging adulthood students characterized vocational indecision in adolescent students, and if supported, to predict the belonging to the most problematic trajectory by using students' academic motivational profiles. We expected several distinct trajectories of vocational indecision that would differ in shape and magnitude, and several motivational profiles that vary in quality as well as in quantity. We also expected students in high-quality or quantity motivational profiles to be less likely to follow a chronic indecision trajectory. METHOD AND RESULTS: Using data from 384 students (56% female; Mage = 13.52 years; SD = .52 at Secondary 2) surveyed annually from Secondary 2 to 5, person-centered analyses enabled estimation of motivational profile in Secondary 2 and vocational indecision trajectories during the 4-year period. Results revealed four distinct patterns of vocational indecision during adolescence labelled Low and Stable, Moderate and Stable, Developmental and Chronic Intermittent. Four motivational profiles were also identified in Secondary 2, ranging from poor (Highly Amotivated) to moderate (Autonomous-Introjected) quality of self-determination level. Also, in reference to the most self-determined profile, students in the Mixed profile were at greatest risk of following Chronically-Intermittently Undecided trajectory. Finally, the most self-determined students were at greatest probability of following the Developmentally Undecided trajectory. CONCLUSION: Overall, the findings suggest that the student motivational functioning in early secondary school years could be used to identify students at risk of experiencing the negative indecision patterns across secondary school. Several theoretical and practical implications are suggested.

Perceived Barriers to Pursuing a Career in Neurosurgery in Nigeria: A Cross-Sectional Survey of Nigerian Medical Students and Unspecialized Physicians.

BACKGROUND: Nigeria has an inadequate number of neurosurgeons to meet the population's demand for neurosurgical care. Furthermore, few Nigerian neurosurgeons are female. This study sought to evaluate perceived barriers to pursuing neurosurgery among Nigerian trainees. METHODS: A 60-question survey was distributed electronically to medical students at the College of Medicine, University of Ibadan, and unspecialized intern physicians at the University College Hospital, Ibadan, Nigeria. Participation was voluntary. RESULTS: One hundred fifty-seven respondents participated in the survey. A greater proportion of males indicated an interest in neurosurgery than females (40% vs. 18%, P = 0.010). Over 75% of respondents identified decreased family and personal time, long work hours, and limited access to maternity or paternity leave as potential barriers to neurosurgery, with no differences by gender. Respondents overall saw being female and low-income as disadvantageous to pursuing neurosurgery in Nigeria. Although they universally viewed research as important in neurosurgery, 59% of respondents reported inadequate access to research opportunities; this did not vary by gender. However, 65% of female respondents reported that having a female neurosurgery mentor would increase their interest in neurosurgery (vs. 37% of males, P = 0.001). CONCLUSIONS: Nigerian medical trainees perceived the time commitment of neurosurgery as a major barrier to pursuing the specialty. Regardless of gender, they also reported low exposure to neurosurgery and inadequate access to research and mentorship opportunities. However, we found that enhanced female representation among neurosurgery mentors and improved work-life balance could increase interest in neurosurgery and help expand Nigeria's neurosurgical workforce.

Women in Nigerian Neurosurgery: A Cross-Sectional Survey.

BACKGROUND: Although women have made remarkable strides in several medical specialties in Sub-Saharan Africa, their presence and contribution to the development of neurosurgery remain limited. We sought to study the gender differences within Nigerian neurosurgery, identify challenges resulting from these differences, and recommend how African female neurosurgeons can maximize their effects in neurosurgery. METHODS: A structured online survey captured data on neurosurgical infrastructural capacity, workforce, and training from neurosurgical consultants and residents in neurosurgical centers in Nigeria. All the collected data were coded and analyzed. RESULTS: Altogether, 82 neurosurgical consultants and 67 neurosurgical residents from 50 primary medical institutions in Nigeria completed the online survey. Only 8 of the respondents (5.4%) were women, comprising 3 consultants, 2 senior residents, and 3 junior residents. Although 40.2% of the respondents did not believe that being female affected the decision of whether to specialize in neurosurgery, 46.3% believed that being female was a disadvantage. Most did not believe that being female affected admission (57.8%), completion of a neurosurgery residency (58.5%), or life working as a neurosurgeon after graduation (63.4%). The most common challenges women face while navigating through neurosurgery training and practice are erosion of family and social life, lack of female mentors, and lack of a work-life balance. CONCLUSIONS: There is a deficit of both female consultants and trainees among Nigerian neurosurgeons. Identifying female medical students with a strong interest in neurosurgery and providing early mentorship might increase the number of female neurosurgeons.

Career trajectories of MD-PhD physician scientists: The loss of women investigators.

Advances in biomedical research require a robust physician scientist workforce. Despite being equally successful at securing early career awards from the NIH as men, women MD-PhD physician scientists are less likely to serve as principal investigators on mid- and later careers awards. Here, we discuss the causes of gender disparities in academic medicine, the implications of losing highly trained women physician scientists, and the institutional and systemic changes needed to sustain this pool of talented investigators.