Evaluation of Adult Reconstruction and Arthroplasty Fellowships in the United States Based on Academic Productivity
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PROVIDER: S-EPMC11346176 | biostudies-literature | 2024 Aug
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe Hirsch index (h-index) is a measure that evaluates both research volume and quality-taking into consideration both publications and citations of a single author. No prior work has evaluated academic productivity and contributions to the literature of adult total joint replacement surgeons. This study uses h-index to benchmark the academic impact and identify characteristics associated with productivity of faculty members at joint replacement fellowships.MethodsAdult reconstruction fellowship programs were obtained via the American Association of Hip and Knee Surgeons website. Via the San Francisco match and program-specific websites, program characteristics (Accreditation Council for Graduate Medical Education approval, academic affiliation, region, number of fellows, fellow research requirement), associated faculty members, and faculty-specific characteristics (gender, academic title, formal fellowship training, years in practice) were obtained. H-index and total faculty publications served as primary outcome measures. Multivariable linear regression determined statistical significance.ResultsSixty-six adult total joint reconstruction fellowship programs were identified: 30% were Accreditation Council for Graduate Medical Education approved and 73% had an academic affiliation. At these institutions, 375 adult reconstruction surgeons were identified; 98.1% were men and 85.3% had formal arthroplasty fellowship training. Average number of publications per faculty member was 50.1 (standard deviation 76.8; range 0-588); mean h-index was 12.8 (standard deviation 13.8; range 0-67). Number of fellows, faculty academic title, years in practice, and formal fellowship training had a significant (P < .05) positive correlation with both h-index and total publications.ConclusionsThe statistical overview presented in this work can help total joint surgeons quantitatively benchmark their academic performance against that of their peers.
| S-EPMC5712019 | biostudies-literature
Project description:Background Women have historically been underrepresented in gastroenterology (GI). Currently they compose only a small percentage of practicing GI physicians in the United States. Despite the rise in women graduating medical school, the percentage of current female GI fellows has remained low in recent years. In this study, we sought to examine the trends of female representation in GI over the past 10 years, to further elucidate the disparity, and to illustrate if any major changes have occurred. The findings were compared to those for other specialties to shed light on the relationship between them. Methods This retrospective study used data on the gender of residents obtained through the Accreditation Council for Graduate Medical Education Data Resource Books from 2009-2019. Chi-square statistical testing was used to compare representation percentages across groups. Significance was determined at the P<0.05 level, while P<0.01 was also reported. Results Over a 10-year period from 2009-2019, an average of 33.6% of GI fellowship positions were filled by women, an increase of only 3.3% since 2009. Chi-square analysis of proportions across groups demonstrated a significantly lower percentage of female representation in GI in comparison to other specialties. Conclusions Despite an increase in the number of women entering and graduating from medical school within the last decade, the number of female gastroenterologists remains a poor reflection of it. GI continues to have a significantly lower female representation than other specialties over the last decade.
| S-EPMC9648528 | biostudies-literature
Project description:BackgroundFaculty productivity is essential for academic medical centers striving to achieve excellence and national recognition. The objective of this study was to evaluate whether and how academic Departments of Medicine in the United States measure faculty productivity for the purpose of salary compensation.MethodsWe surveyed the Chairs of academic Departments of Medicine in the United States in 2012. We sent a paper-based questionnaire along with a personalized invitation letter by postal mail. For non-responders, we sent reminder letters, then called them and faxed them the questionnaire. The questionnaire included 8 questions with 23 tabulated close-ended items about the types of productivity measured (clinical, research, teaching, administrative) and the measurement strategies used. We conducted descriptive analyses.ResultsChairs of 78 of 152 eligible departments responded to the survey (51% response rate). Overall, 82% of respondents reported measuring at least one type of faculty productivity for the purpose of salary compensation. Amongst those measuring faculty productivity, types measured were: clinical (98%), research (61%), teaching (62%), and administrative (64%). Percentages of respondents who reported the use of standardized measurements units (e.g., Relative Value Units (RVUs)) varied from 17% for administrative productivity to 95% for research productivity. Departments reported a wide variation of what exact activities are measured and how they are monetarily compensated. Most compensation plans take into account academic rank (77%). The majority of compensation plans are in the form of a bonus on top of a fixed salary (66%) and/or an adjustment of salary based on previous period productivity (55%).ConclusionOur survey suggests that most academic Departments of Medicine in the United States measure faculty productivity and convert it into standardized units for the purpose of salary compensation. The exact activities that are measured and how they are monetarily compensated varied substantially across departments.
| S-EPMC4189191 | biostudies-literature
Project description:BackgroundPaediatric cardiac critical care continues to become more sub-specialised, and many institutions have transitioned to dedicated cardiac ICUs. Literature regarding the effects of these changes on paediatric critical care medicine fellowship training is limited.ObjectiveTo describe the current landscape of cardiac critical care education during paediatric critical care medicine fellowship in the United States and demonstrate its variability.MethodsA review of publicly available information in 2021 was completed. A supplemental REDCap survey focusing on cardiac ICU experiences during paediatric critical care medicine fellowships was e-mailed to all United States Accreditation Council of Graduate Medical Education-accredited paediatric critical care medicine fellowship programme coordinators/directors. Results are reported using inferential statistics.ResultsData from 71 paediatric critical care medicine fellowship programme websites and 41 leadership responses were included. Median fellow complement was 8 (interquartile range: 6, 12). The majority (76%, 31/41) of programmes had a designated cardiac ICU. Median percentage of paediatric critical care medicine attending physicians with cardiac training was 25% (interquartile range: 0%, 69%). Mandatory cardiac ICU time was 16 weeks (interquartile range: 13, 20) with variability in night coverage and number of other learners present. A minority of programmes (29%, 12/41) mandated other cardiac experiences. Median CHD surgical cases per year were 215 (interquartile range: 132, 338). When considering the number of annual cases per fellow, programmes with higher case volume were not always associated with the highest case number per fellow.ConclusionsThere is a continued trend toward dedicated cardiac ICUs in the United States, with significant variability in cardiac training during paediatric critical care medicine fellowship. As the trend toward dedicated cardiac ICUs continues and practices become more standardised, so should the education.
| S-EPMC9440946 | biostudies-literature
Project description:Human astroviruses are an important cause of viral gastroenteritis globally, yet few studies have investigated the serostatus of adults to establish rates of previous infection. Here, we applied biolayer interferometry immunosorbent assay (BLI-ISA), a recently developed serosurveillance technique, to measure the presence of blood plasma IgG antibodies directed towards the human astrovirus capsid spikes from serotypes 1-8 in a cross-sectional sample of a United States adult population. The seroprevalence rates of IgG antibodies were 73% for human astrovirus serotype 1, 62% for serotype 3, 52% for serotype 4, 29% for serotype 5, 27% for serotype 8, 22% for serotype 2, 8% for serotype 6, and 8% for serotype 7. Notably, seroprevalence rates for capsid spike antigens correlate with neutralizing antibody rates determined previously. This work is the first seroprevalence study evaluating all eight classical human astrovirus serotypes.
| S-EPMC8229645 | biostudies-literature
Project description:ObjectiveAcademic detailing in partnership with the Opioid Overdose Education and Naloxone Distribution (OEND) program was implemented to increase naloxone access for the prevention of opioid overdose mortality in veterans at the U.S. Department of Veterans Affairs (VA). However, implementation was not uniform leading to varying levels of intervention exposure potentially impacting naloxone prescribing. We examined the impact of implementation strength (proportion of providers exposed to academic detailing) at each station on naloxone prescribing from September 2014 to December 2017.Study design and settingRetrospective cohort design with fixed effects models at the VA.Data collection/extraction methodsWe used VA Corporate Data Warehouse for data on pharmacy dispensing, station-, provider- and patient-level characteristics. OEND-specific academic detailing activities came from data recorded by academic detailers using Salesforce.com.Principal findingsVA stations wherein 100 percent of providers exposed to an OEND-related academic detailing educational outreach visit experienced an increased incident rate of naloxone prescribing that was 5.52 times the incident rate of stations where no providers were exposed; alternatively, this is equivalent to an average monthly increase of 2.60 naloxone prescriptions per 1000 population at risk for opioid overdose.ConclusionsOur findings highlight the importance of academic detailing's implementation strength on naloxone prescribing. Decision makers must carefully consider the implementation process to achieve the greatest effectiveness from the intervention.
| S-EPMC6736912 | biostudies-literature
Project description:Insurance coverage of postmastectomy breast reconstruction is mandated in America, regardless of reconstructive modality. Despite enhanced patient-reported outcomes, autologous reconstruction is utilized less than nonautologous reconstruction nationally. Lower reimbursement from Medicare and Medicaid may disincentivize autologous-based reconstruction. This study examines the impact of insurance and sociodemographic factors on breast reconstruction.MethodsA retrospective analysis of the Healthcare Cost and Utilization Project National Inpatient Sample Database from 2014 to 2017 was performed. International Classification of Diseases Clinical Modification and Procedure Coding System codes were used to identify patients for inclusion. De-identified sociodemographic and insurance data were analyzed using χ 2, least absolute shrinkage and selection operator regression analysis, and classification trees.ResultsIn total, 31,468 patients were identified for analysis and stratified by reconstructive modality, sociodemographics, insurance, and hospital characteristics. Most patients underwent nonautologous reconstruction (63.2%). Deep inferior epigastric perforator flaps were the most common autologous modality (46.7%). Least absolute shrinkage and selection operator regression identified Black race, urban-teaching hospitals, nonsmoking status, and obesity to be associated with autologous reconstruction. Publicly-insured patients were less likely to undergo autologous reconstruction than privately-insured patients. Within autologous reconstruction, publicly-insured patients were 1.97 (P < 0.001) times as likely to obtain pedicled flaps than free flaps. Black patients were 33% (P < 0.001) less likely to obtain free flaps than White patients.ConclusionsBreast reconstruction is influenced by insurance, hospital demographics, and sociodemographic factors. Action to mitigate this health disparity should be undertaken so that surgical decision-making is solely dependent upon medical and anatomic factors.
| S-EPMC9937099 | biostudies-literature
Project description: Not available
| S-EPMC2814828 | biostudies-literature
Project description: Not available
| S-EPMC9555290 | biostudies-literature
Project description:BackgroundThere are 16 vitreoretinal (VR) fellowships listed on the British and Eire Association of Vitreoretinal Surgeons (BEAVRS) website offering places to 23 applicants, however, this list is not exhaustive. The purpose of this survey was to evaluate surgical volume, training, and experience of VR fellows in the UK.MethodsAn anonymous survey was disseminated online to current and past VR fellows who are members of BEAVRS. Participants were asked about their surgical experience and confidence, before and during their fellowship, in performing a variety of procedures. Participants were also asked about their academic achievements and their career prospects.ResultsAll 26 respondents felt that their fellowship met their surgical needs and would recommend it to others. Upon completion, 92% felt prepared to work as a consultant. Following fellowship completion, the median (IQR) number of procedures performed were: phacoemulsification: 91 (51-131), pars-plana vitrectomy (PPV): 351 (226-451), simple-retinal detachment (RD): 176 (126-226), complex-RD: 31 (16-51), scleral buckle (SB): 16 (80-26), membrane-peels: 76 (41-88), intraocular-foreign body (IOFB) removal: 3 (3-3), indirect laser: 51 (11-91), scleral-fixated intraocular-lens (sfIOL): 3 (3-8), removal-of-dropped-nucleus (RODN): 16 (8-26), diabetic membrane delaminations: 16 (8-16); with an increase of confidence in performing all VR procedures (p < 0.001). Participants completed 2 (1-2) presentations and 2 (0-3) papers with no difference in academic performance between those with/without postgraduate qualifications (p = 0.409).ConclusionsOverall, fellowships in the UK are of a high quality and prepare the fellow adequately for progression into a consultant post. They help increase surgical confidence and provide opportunities to complete academic work. Fellowships without VR on-call commitments can be improved by incorporating on-call duties. Finally, COVID-19 impacted exposure to elective cases.
| S-EPMC9273700 | biostudies-literature