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Defining sources and ramifications of mistreatment among female vascular surgery trainees.

Publication ,  Journal Article
Pillado, EB; Li, RD; Eng, JS; Chia, MC; Conway, A; DiLosa, K; Gomez-Sanchez, C; Shaw, P; Sheahan, MG; Bilimoria, KY; Hu, Y-Y; Coleman, DM
Published in: J Vasc Surg
September 2023

OBJECTIVE: Mistreatment among vascular surgery trainees is a known risk factor for physician burnout. This study aims to characterize forms of and identify sources of mistreatment. METHODS: This is a cross-sectional study of United States vascular surgery trainees who voluntarily participated in an anonymous survey administered after the 2021 Vascular Surgery In-Training Examination. The primary outcome measures were self-reported mistreatment and sources of mistreatment between genders. Logistic regression was used for multivariable analysis. RESULTS: Representing all 125 vascular surgery training programs, 510 trainees (66.9% male) participated in the survey (83.6% response rate). Mistreatment was reported by 54.8% of trainees, with twice as many women reporting as men (82.3% vs 41.0%; P < .001). Women reported higher rates of being shouted at (44.1% vs 21.1%; P < .001); repeatedly reminded of errors (24.3% vs 16.1%; P = .04); ignored/treated hostilely (28.9% vs 10.5%; P < .001); subjected to crude/sexually demeaning remarks, stories, jokes (19.2% vs 2.1%; P < .001); evaluated by different standards (29.3% vs 2.1%; P < .001); and mistaken for a non-physician (75.2% vs 3.5%; P < .001). Among trainees reporting bullying, attendings were the most common source (68.5%). Patients and their families were the most common source of sexual harassment (66.7%), gender discrimination (90.4%), and racial discrimination (74.4%). Compared with men, women identified more patients and families as the source of bullying (50.0% vs 29.7%; P = .005), gender discrimination (97.2% vs 50.0%; P < .001), and sexual harassment (78.4% vs 27.3%; P = .003). Compared with men, women more frequently felt unprepared to respond to the behavior in the moment (10.4% vs 4.6%; P = .002), did not know how to report mistreatment at their institution (7.6% vs 3.2%; P = .04), and did not believe that their institution would take their mistreatment report seriously (9.0% vs 3.9%; P = .002). On multivariable analysis, female gender was an independent risk factor for both gender discrimination (odds ratio, 56.62; 95% confidence interval, 27.89-115) and sexual harassment (odds ratio, 26.2; 95% confidence interval, 3.34-14.8) when adjusting for children, training year, relationship status, and training program location. CONCLUSIONS: A majority of vascular surgery trainees experience mistreatment during training. Sources and forms of abuse are varied. Understanding the sources of mistreatment is critical to guide intervention strategies such as faculty remediation and/or sanctions; allyship training for staff, residents, and faculty; and institutional procedures for patient-initiated abuse.

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Published In

J Vasc Surg

DOI

EISSN

1097-6809

Publication Date

September 2023

Volume

78

Issue

3

Start / End Page

797 / 804

Location

United States

Related Subject Headings

  • Vascular Surgical Procedures
  • United States
  • Surveys and Questionnaires
  • Sexual Harassment
  • Sexism
  • Racism
  • Male
  • Internship and Residency
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
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Pillado, E. B., Li, R. D., Eng, J. S., Chia, M. C., Conway, A., DiLosa, K., … Coleman, D. M. (2023). Defining sources and ramifications of mistreatment among female vascular surgery trainees. J Vasc Surg, 78(3), 797–804. https://doi.org/10.1016/j.jvs.2023.03.504
Pillado, Eric B., Ruojia Debbie Li, Joshua S. Eng, Matthew C. Chia, Allan Conway, Kathryn DiLosa, Clara Gomez-Sanchez, et al. “Defining sources and ramifications of mistreatment among female vascular surgery trainees.J Vasc Surg 78, no. 3 (September 2023): 797–804. https://doi.org/10.1016/j.jvs.2023.03.504.
Pillado EB, Li RD, Eng JS, Chia MC, Conway A, DiLosa K, et al. Defining sources and ramifications of mistreatment among female vascular surgery trainees. J Vasc Surg. 2023 Sep;78(3):797–804.
Pillado, Eric B., et al. “Defining sources and ramifications of mistreatment among female vascular surgery trainees.J Vasc Surg, vol. 78, no. 3, Sept. 2023, pp. 797–804. Pubmed, doi:10.1016/j.jvs.2023.03.504.
Pillado EB, Li RD, Eng JS, Chia MC, Conway A, DiLosa K, Gomez-Sanchez C, Shaw P, Sheahan MG, Bilimoria KY, Hu Y-Y, Coleman DM. Defining sources and ramifications of mistreatment among female vascular surgery trainees. J Vasc Surg. 2023 Sep;78(3):797–804.
Journal cover image

Published In

J Vasc Surg

DOI

EISSN

1097-6809

Publication Date

September 2023

Volume

78

Issue

3

Start / End Page

797 / 804

Location

United States

Related Subject Headings

  • Vascular Surgical Procedures
  • United States
  • Surveys and Questionnaires
  • Sexual Harassment
  • Sexism
  • Racism
  • Male
  • Internship and Residency
  • Humans
  • Female