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Career Goals, Salary Expectations, and Salary Negotiation Among Male and Female General Surgery Residents.

ABSTRACT: Importance:In general surgery, women earn less money and hold fewer leadership positions compared with their male counterparts. Objective:To assess whether differences exist between the perspectives of male and female general surgery residents on future career goals, salary expectations, and salary negotiation that may contribute to disparity later in their careers. Design, Setting, and Participants:This study was based on an anonymous and voluntary survey sent to 19 US general surgery programs. A total of 606 categorical residents at general surgery programs across the United States received the survey. Data were collected from August through September 2017 and analyzed from September through December 2017. Main Outcomes and Measures:Comparison of responses between men and women to detect any differences in career goals, salary expectation, and perspectives toward salary negotiation at a resident level. Results:A total of 427 residents (70.3%) responded, and 407 responses (230 male [58.5%]; mean age, 30.0 years [95% CI, 29.8-30.4 years]) were complete. When asked about salary expectation, female residents had lower expectations compared with men in minimum starting salary ($249?502 [95% CI, $236?815-$262 190] vs $267?700 [95% CI, $258?964-$276?437]; P?=?.003) and in ideal starting salary ($334?709 [95% CI, $318?431-$350?987] vs $364?663 [95% CI, $351?612-$377?715]; P?

SUBMITTER: Gray K

PROVIDER: S-EPMC6714007 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Career Goals, Salary Expectations, and Salary Negotiation Among Male and Female General Surgery Residents.

Gray Kelsey K Neville Angela A Kaji Amy H AH Wolfe Mary M Calhoun Kristine K Amersi Farin F Donahue Timothy T Arnell Tracy T Jarman Benjamin B Inaba Kenji K Melcher Marc M Morris Jon B JB Smith Brian B Reeves Mark M Gauvin Jeffrey J Salcedo Edgardo S ES Sidwell Richard R Murayama Kenric K Damewood Richard R Poola V Prasad VP Dent Daniel D de Virgilio Christian C

JAMA surgery 20191101 11

<h4>Importance</h4>In general surgery, women earn less money and hold fewer leadership positions compared with their male counterparts.<h4>Objective</h4>To assess whether differences exist between the perspectives of male and female general surgery residents on future career goals, salary expectations, and salary negotiation that may contribute to disparity later in their careers.<h4>Design, setting, and participants</h4>This study was based on an anonymous and voluntary survey sent to 19 US gen ...[more]

PMID: 31461140

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Project description:Importance:Attrition from general surgery training is highest during internship. Whether the expectations and attitudes of new trainees affect their subsequent risk of attrition is unknown. Objective:To identify the expectations of general surgery residency associated with attrition from training. Design, Setting, and Participants:This prospective observational cohort study included categorical general surgery interns entering training in the 2007-2008 academic year. Residents were surveyed regarding their expectations of training and of life as an attending at the start of their intern year (June 1 to August 31, 2007). Expectations were grouped into factors by principal component analysis, and a multivariable model was created using these factors in addition to known demographic and program characteristics associated with attrition. Follow-up was completed on December 31, 2016. Main Outcomes and Measures:Attrition from training was determined by linkage to American Board of Surgery resident files through 2016, allowing 8 additional years of follow-up. Results:Of 1048 categorical surgery interns in the study period, 870 took the survey (83.0% response rate), and 828 had complete information available for analysis (524 men [63.3%], 303 women [36.6%], and 1 missing information [0.1%]). Most were white (569 [69.1%]) and at academic programs (500 [60.4%]). Six hundred sixty-six residents (80.4%) completed training. Principal component analysis generated 6 factors. On adjusted analysis, 2 factors were associated with attrition. Interns who choose their residency based on program reputation (factor 2) were more likely to drop out (odds ratio, 1.08; 95% CI, 1.01-1.15). Interns who expected as an attending to work more than 80 hours per week, to have a stressful life, and to be the subject of malpractice litigation (career life expectation [factor 6]) were less likely to drop out (odds ratio, 0.90; 95% CI, 0.82-0.98). Conclusions and Relevance:Interns with realistic expectations of the demands of residency and life as an attending may be more likely to complete training. Medical students and residents entering training should be given clear guidance in what to expect as a surgery resident.

Project description:ImportanceThe need for trainee sex equality within surgical training has resulted in an appraisal of the training experience in the New Zealand general surgery training program.ObjectiveTo investigate the association between trainee sex and surgical autonomy in the operating room in the New Zealand general surgery training program.Design, setting, and participantsRetrospective cohort study conducted from December 10, 2012, to December 10, 2017, examining all endoscopic, major, and minor procedures performed by all New Zealand general surgery trainees in every training hospital in New Zealand.Main outcomes and measuresThe primary outcome was the level of meaningful autonomy by each New Zealand general surgery trainee (ie, trainee as primary operator without the surgeon mentor scrubbed for the case). Outcomes were compared using multivariable analysis.ResultsThis study included 120 New Zealand general surgery trainees (42 women [35%] and 78 men [65%]) who were analyzed over 279.5 trainee-years (88.5 trainee-years for women and 191.0 trainee-years for men). Included were 119 380 general surgery procedures (17 465 endoscopic, 56 964 major, and 44 951 minor) in 18 hospitals. By the end of the 5-year training program, female trainees had a lower cumulative mean autonomous caseload than male trainees for endoscopic (284.0 [95% CI, 207.0-361.0] vs 352.2 [95% CI, 282.9-421.6], P = .03), major (139.9 [95% CI, 76.7-203.2] vs 198.1 [95% CI, 142.3-254.0], P = .02), and minor (456.3 [95% CI, 394.8-517.9] vs 519.9 [95% CI, 465.6-574.2], P = .007) procedures.Conclusions and relevanceAfter accounting for differences among trainees, hospital type, number of female and male surgeon mentors at each hospital, and trainee seniority, female trainees performed fewer cases with meaningful autonomy compared with male trainees. These findings support the need for pragmatic solutions to address this bias and further investigations on mechanisms contributing to discrepancies.

Project description:BackgroundThe global primary healthcare workforce is declining, leading to a shortage of general practitioners. Although various educational models aim to increase interest in general practice, effective interventions are limited. The reasons for this low appeal among medical graduates remain unclear.MethodsThis cross-sectional study surveyed medical students' and residents' attitudes towards general practice in Tyrol, Austria. The online questionnaire addressed professional values, general practice-related issues, personal professional intentions, and demographics. Data analysis employed chi-square tests and multivariate logistic regression to explore predictors of interest in general practice.ResultsThe study included 528 students and 103 residents. Key values identified were stable positions, assured income, and work-family reconciliation. General practice was recognised for long-term patient relationships and patient contact, with students attributing more positive work-environmental characteristics and higher reputation to it than residents. Few participants (students: 3.2%, residents: 11.7%) had opted for general practice; about half were considering it as career option. Reasons not to choose general practice were preferences for other specialties, intrinsic characteristics of general practice, workload, insufficient time for the patients, financial pressures, low reputation, and perceived mediocre training quality. Predictors of interest in general practice included perception of independent decision-making, importance of work-family balance (students), better practical experiences in general practice during medical school (students and residents), younger age, and perceiving general practice as offering a promising future (residents). Both groups felt underprepared by medical school and/or general practice training for general practice roles. The attractiveness of specialist medicine over general practice was related to clearer content boundaries, better career opportunities, and higher incomes.ConclusionsAccording to these results, measures to improve attractiveness of general practice should focus on (i) high-quality undergraduate education including practical experiences, and (ii) on ensuring professional autonomy, work-family reconciliation, and job stability. Efforts to encourage more graduates to pursue this essential healthcare sector are crucial for strengthening primary healthcare and public health services.Trial registrationThe study has not been registered as it did not include a direct medical intervention on human participants.

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Career Goals, Salary Expectations, and Salary Negotiation Among Male and Female General Surgery Residents.

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Career Goals, Salary Expectations, and Salary Negotiation Among Male and Female General Surgery Residents.

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