Disparities in Research during Plastic Surgery Training: How Can We Level the Playing Field?

Alexander I Murphy, Joseph A Mellia, Emma K Iaconetti, Paul A Asadourian, Fortunay Diatta, Kevin M Klifto, Martin P Morris, Robyn B Broach, John P Fischer, Paris D Butler
Author Information
  1. Alexander I Murphy: Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa.
  2. Joseph A Mellia: Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa.
  3. Emma K Iaconetti: Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa.
  4. Paul A Asadourian: Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa.
  5. Fortunay Diatta: Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa.
  6. Kevin M Klifto: Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa.
  7. Martin P Morris: Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa.
  8. Robyn B Broach: Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa.
  9. John P Fischer: Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa.
  10. Paris D Butler: Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa.

Abstract

Background: Lack of female and ethnically underrepresented in medicine (UIM) surgeons remains concerning in academic plastic surgery. One barrier to inclusion may be unequal opportunity to publish research. This study evaluates the extent of this challenge for plastic surgery trainees and identifies potential solutions.
Methods: Data were collected on academic plastic surgeons' research productivity during training. Bivariate analysis compared publication measures between genders and race/ethnicities at different training stages (pre-residency/residency/clinical fellowship). Multivariate analysis determined training experiences independently associated with increased research productivity.
Results: Overall, women had fewer total publications than men during training (8.89 versus 12.46, = 0.0394). Total publications were similar between genders before and during residency ( > 0.05 for both) but lower for women during fellowship (1.32 versus 2.48, = 0.0042). women had a similar number of first-author publications during training (3.97 versus 5.24, = 0.1030) but fewer middle-author publications (4.70 versus 6.81, = 0.0405). UIM and non-UIM individuals had similar productivity at all training stages and authorship positions ( > 0.05 for all). Research fellowship completion was associated with increased total, first-, and middle-author training publications ( < 0.001 for all).
Conclusions: Less research productivity for female plastic surgery trainees may reflect a disparity in opportunity to publish. Fewer middle-author publications could indicate challenges with network-building in a predominately male field. Despite comparable research productivity during training relative to non- UIM individuals, UIM individuals remain underrepresented in academic plastic surgery. Creating research fellowships for targeting underrepresented groups could help overcome these challenges.

References

  1. J Surg Res. 2018 Sep;229:332-336 [PMID: 29937010]
  2. Plast Reconstr Surg. 2014 Sep;134(3):570-578 [PMID: 25158713]
  3. Plast Reconstr Surg. 2019 Feb;143(2):640-645 [PMID: 30531627]
  4. Plast Reconstr Surg. 2009 May;123(5):1618-1627 [PMID: 19407636]
  5. Plast Reconstr Surg. 2003 Mar;111(3):981-4; discussion 985-6 [PMID: 12621167]
  6. Plast Reconstr Surg Glob Open. 2021 Dec 17;9(12):e4057 [PMID: 34934605]
  7. Plast Reconstr Surg. 2008 Dec;122(6):1929-1939 [PMID: 19050546]
  8. J Gen Intern Med. 2016 Jan;31(1):60-7 [PMID: 26173540]
  9. Ann Plast Surg. 2021 Jul 1;87(1s Suppl 1):S65-S69 [PMID: 34180867]
  10. J Craniofac Surg. 2017 Jul;28(5):1132-1135 [PMID: 28582291]
  11. Plast Reconstr Surg. 2020 Sep;146(3):690-697 [PMID: 32842118]
  12. Ann Surg. 2020 Dec;272(6):897-903 [PMID: 32649466]
  13. Am J Surg. 2021 Nov;222(5):933-936 [PMID: 33894978]
  14. Plast Reconstr Surg. 2020 Jan;145(1):268-277 [PMID: 31881629]
  15. BMJ Open. 2017 Jun 24;7(6):e013898 [PMID: 28647720]
  16. Plast Reconstr Surg. 2020 Sep;146(3):698-707 [PMID: 32842119]
  17. J Surg Educ. 2014 Jul-Aug;71(4):593-600 [PMID: 24776868]
  18. Am J Surg. 2020 Dec;220(6):1541-1548 [PMID: 32409010]
  19. J Plast Reconstr Aesthet Surg. 2020 Feb;73(2):383-390 [PMID: 31680026]
  20. J Craniofac Surg. 2022 Jan-Feb 01;33(1):15-18 [PMID: 34510059]
  21. Plast Reconstr Surg. 2017 Oct;140(4):842-849 [PMID: 28617740]
  22. Plast Reconstr Surg. 2021 Sep 1;148(3):667-677 [PMID: 34432703]
  23. Plast Reconstr Surg. 2014 Mar;133(3):730-736 [PMID: 24572862]
  24. Plast Reconstr Surg. 2019 Mar;143(3):940-949 [PMID: 30817668]
  25. Plast Reconstr Surg. 2020 Jul;146(1):193-201 [PMID: 32590665]
  26. Aesthet Surg J. 2017 Sep 01;37(8):961-966 [PMID: 28333194]
  27. Plast Reconstr Surg. 2021 Jun 1;147(6):1480-1485 [PMID: 34019522]
  28. Plast Reconstr Surg. 2016 Nov;138(5):925e-935e [PMID: 27783013]
  29. J Reconstr Microsurg. 2017 Mar;33(3):206-210 [PMID: 27978581]
  30. Plast Reconstr Surg. 1998 Sep;102(3):895-8 [PMID: 9727462]
  31. Arch Plast Surg. 2017 Sep;44(5):428-433 [PMID: 28946725]
  32. Plast Reconstr Surg. 2017 Jan;139(1):245-252 [PMID: 28027263]
  33. Plast Reconstr Surg. 2018 Jun;141(6):1561-1577 [PMID: 29794715]
  34. Aesthetic Plast Surg. 2021 Dec;45(6):3022-3028 [PMID: 33885940]
  35. Plast Reconstr Surg Glob Open. 2021 Oct 04;9(10):e3838 [PMID: 34616641]
  36. J Surg Educ. 2022 Mar-Apr;79(2):551-557 [PMID: 34840121]
  37. Plast Reconstr Surg. 2019 Nov;144(5):1227-1236 [PMID: 31688771]

Word Cloud

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