Blog Archives

Doctors’ Longevity Benefits Don’t Apply to Everyone

It’s well known that there are longevity advantages to higher education and income, however a recent study by Brigham and Women’s Hospital researchers Christopher M. Worsham, MD, MPH, and Anupam “Bapu” Jena, MD, PhD demonstrated that female physicians don’t reap those benefits. Neither do Black doctors. 

Black women physicians were shown to have the highest mortality rate in the profession.

A recent AAMC article reporting on the study also touches on other gender inequities, including female physicians’ excessive burnout and home responsibilities, experience of sexual harassment, likelihood to quit medicine, as well as their lower pay. 

Check out the AAMC piece with more details here.

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Which Specialties Have the Biggest Gender Gaps During Residency? You Will and Won’t be Surprised.

The AMA recently published a short piece based on 2022-23 data culled from their National Graduate Medical Education Census: They evaluated which medical specialties were most popular among male and female candidates who were entering residency. They then extrapolated as to which specialties are going to be increasingly female- versus male-dominated.

Female-dominated specialties included obstetrics and gynecology, pediatrics/psychiatry/child and adolescent psychiatry (combined), pediatrics, allergy and immunology, public health and general preventive medicine, and dermatology.

I wasn’t surprised that pediatrics or obstetrics and gynecology were female-dominated, but I found it interesting that dermatology – which is so well remunerated – has more women residents than male residents. Historically, women were relegated to lower paying fields.

Male-dominated specialties included orthopedic surgery, interventional radiology, neurological surgery, diagnostic radiology, and urology.

The AMA reports that specialties that offered a near equal balance of men and women in residency included neurology, general surgery, and psychiatry. Again, as someone who trained in the late 1990s, it’s a joy to hear that general surgery is now a well-balanced field in terms of gender. On the whole, when the AMA included specialties, subspecialties, and combined specialties, they report that women account for 48.2% of trainees.

For more details, you can check out the AMA piece here.

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A Bad Prognosis for Emergency Medicine

I read a fascinating piece by Dr. Thomas Cook in the December edition of Emergency Medicine News. In it, he cites work done by Cameron Gettel, MD who devised an interesting way to assess the attrition rate of emergency physicians (EPs): Gettel and his colleagues used data from the Centers for Medicare and Medicaid Services (CMS), noting which healthcare providers stopped billing CMS for emergency medical services. Gettel used this information to calculate the attrition rate for EPs. What he and his colleagues found is that the EP attrition rate was approximately 5% prior to the pandemic while it shot up to approximately 8% in urban spots and more than 11% in rural areas during the first year of the pandemic.

Using information from the American Board of Emergency Medicine, Gettel found – shockingly – that the median age of attrition for male EPs was 53.5 years and for female EPs was 43.7 years in 2019. This means that the median EP career was around 23 years long for men and fewer than 14 years long for women. Wow!

It’s absolutely critical that medical students who are considering a career in emergency medicine think about what their professional trajectory might be, considering the short median lifespan of the typical EP.

For more information on this interesting topic and how attrition might affect the job market, the need for physician personal finance training, and who applies to emergency medicine, see Dr. Cook’s piece here.

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Medscape National Physician Burnout Report 2020 is Out – Yikes!

The Medscape National Physician Burnout & Suicide Report 2020 has been published, and its results are as interesting as past years’.

The report’s most burned out specialty was…. drum roll please…urology. Fifty-four percent of urologists surveyed reported burnout. Next came neurology (50%) and nephrology (49%). The least burned out fields were public health and preventive medicine (29%), ophthalmology (30%), and orthopedics (34%). Note that my field of emergency medicine is not in the top 5 this year. (Congrats.) However, a whopping 43% of emergency physicians report burnout. 

This year Medscape compared burnout in Millenials (25-39 years old), Generation Xers (40-54), and Baby Boomers (55-73). According to the survey, Generation Xers are the most burned out at 48% compared to 38% for Millenials and 39% for Baby Boomers, although there may be other age-related, non-career issues that lead to burnout in the Xers like caring for children and aging parents.

Women suffer from significantly more burnout than men (48% versus 37%). 

Take a look at the Medscape National Physician Burnout & Suicide Report 2020 slide show yourself, and check out my Kevin MD piece on burnout here

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Selling Yourself

A recent, interesting article in the New York Times written by two professors – one from Harvard and one from Yale – reviewed a study they published in the British Medical Journal that finds that male-led scientific teams were up to 21 percent more likely than women-led teams to use positive adjectives to describe their research findings. Importantly, they also found that the greater use of positive language by male-led teams was linked to more citations. 

In the NYT article, the authors point out that in many realms and fields women have been found to use language that is more tentative than men. I have found this to be true when I conduct mock interviews as well. I note that, generally, women applicants are less willing to showcase their achievements, which I do believe adversely affects their candidacies. I try to counter that in practice with applicants. 

Of course, there is an alternate assessment of this issue: The “Lean Out” crowd feels that women should not have to conform to men’s patterns. While I strongly agree in theory, I have witnessed the disadvantage of being overly modest in the application process. 

This is a good discussion for your next coffee break with a friend!

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About Dr. Michelle Finkel

Dr. Michelle Finkel

Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital. She was appointed to the Assistant Residency Director position for the Harvard Affiliated Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more

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