scholarly journals Gender differences in attrition rates of hospital-based medical specialty programs: attributable to gender composition of the clinical specialty?

2020 ◽  
Author(s):  
Olivia Butterman ◽  
Victor Slenter ◽  
Lud Van der Velden ◽  
Ronald Batenburg
Keyword(s):  
Gender Differences ◽  
Training Program ◽  
Training Programs ◽  
Manpower Planning ◽  
Drop Out ◽  
Attrition Rate ◽  
Specialty Training ◽  
Dutch Hospital ◽  
Attrition Rates ◽  
The Difference

Abstract Background Since 1999 the Advisory Committee on Medical Manpower Planning (ACMMP) advises the Dutch government on the medical workforce capacity and the intake in training programs, as to achieve or maintain a balance on the labour market. One of the key parameters the ACMMP uses when calculating the required intake in training programs, is the attrition rate. Methods In total 11,579 trainees enrolled in hospital-based programs from January 1 st 2003 until 31 st of December 2012, for 26 specialisms. To explore possible explanations for the gender differences in attrition rate per specialty, additional information was gathered: the percentage of males per program, the total number of specialists in training, the duration of the training and the percentage of males currently working in that specialty. Results One training program was excluded, due to the small size of that training program (62 trainees) and the large outliers it produced. Regression analyses were done, showing significant explanations of the variation in the difference between male and female attrition rates (Y1), for the proportion of males working in the profession per 01-01-2003 (R 2 : .545, F(27,60), p<.000), the proportion of males in training per 01-01-2003 (R 2 : .417, F(16,01), p<.000) and a small effect for the relationship with the total attrition rate for each training program (R 2 : .163, F(4,46), p<.046). There was also a significant effect for the duration of the specialty training (R 2 : .299, F(9,85), p<.005). A Kruskal-Wallis test was preformed to analyse the difference in attrition by type of specialty. The difference between the types of specialisms were significant (H=6,66, p.0,036). Conclusions Attrition rates in Dutch hospital-based specialty programs differ between males and females in a way that more males tend to drop-out from training when the specialty is dominated by women and, importantly, vice versa as well. The relationships found needs to be explored, in particular as the duration and nature of the specialty training seem to interact with gender ratios in the training programs and occupations longer training programs tend to have more males on them. Furthermore, more insight is needed in the selection and identification processes among residents in specialty training.

scholarly journals Gender differences in attrition rates of hospital-based medical specialty programs: attributable to gender composition of the clinical specialty?

2020 ◽  
Author(s):  
Olivia Butterman ◽  
Victor Slenter ◽  
Lud Van der Velden ◽  
Ronald Batenburg
Keyword(s):  
Gender Differences ◽  
Training Program ◽  
Training Programs ◽  
Manpower Planning ◽  
Drop Out ◽  
Attrition Rate ◽  
Specialty Training ◽  
Dutch Hospital ◽  
Attrition Rates ◽  
The Difference

Abstract Background Since 1999 the Advisory Committee on Medical Manpower Planning (ACMMP) advises the Dutch government on the medical workforce capacity and the intake in training programs, as to achieve or maintain a balance on the labour market. One of the key parameters the ACMMP uses when calculating the required intake in training programs, is the attrition rate. Methods In total 11,579 trainees enrolled in hospital-based programs from January 1st 2003 until 31st of December 2012, for 26 specialisms. To explore possible explanations for the gender differences in attrition rate per specialty, additional information was gathered: the percentage of males per program, the total number of specialists in training, the duration of the training and the percentage of males currently working in that specialty. Results One training program was excluded, due to the small size of that training program (62 trainees) and the large outliers it produced. Regression analyses were done, showing significant explanations of the variation in the difference between male and female attrition rates (Y1), for the proportion of males working in the profession per 01-01-2003 (R2: .545, F(27,60), p < .000), the proportion of males in training per 01-01-2003 (R2: .417, F(16,01), p < .000) and a small effect for the relationship with the total attrition rate for each training program (R2: .163, F(4,46), p < .046). There was also a significant effect for the duration of the specialty training (R2: .299, F(9,85), p < .005). A Kruskal-Wallis test was preformed to analyse the difference in attrition by type of specialty. The difference between the types of specialisms were significant (H = 6,66, p. 0,036). Conclusions Attrition rates in Dutch hospital-based specialty programs differ between males and females in a way that more males tend to drop-out from training when the specialty is dominated by women and, importantly, vice versa as well. The relationships found needs to be explored, in particular as the duration and nature of the specialty training seem to interact with gender ratios in the training programs and occupations longer training programs tend to have more males on them. Furthermore, more insight is needed in the selection and identification processes among residents in specialty training.

Are SSRIs a Cost-Effective Alternative to Tricyclics?

1996 ◽  
Vol 168 (4) ◽  
pp. 404-409 ◽  
Author(s):  
Matthew Hotopf ◽  
Glyn Lewis ◽  
Charles Normand
Keyword(s):  
Cost Effectiveness ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Cost Effective ◽  
Drop Out ◽  
Attrition Rates ◽  
The Difference ◽  
Randomised Controlled ◽  
Meta Analyses ◽  
The Cost ◽  
Effectiveness Studies

BackgroundSelective serotonin reuptake inhibitors (SSRIs) are more expensive than tricyclics. Reports have suggested that SSRIs are cost-effective because they are better tolerated and safer in overdose.MethodA systematic review of all randomised controlled trials (RCTs), meta-analyses, and cost-effectiveness studies comparing SSRIs and tricyclic antidepressants (TCAs).ResultsNone of the RCTs provided an economic analysis and there were methodological problems in the majority which would preclude this approach. Meta-analyses suggest that clinical efficacy is equivalent but slightly fewer patients prescribed SSRIs drop out of RCTs. Cost-effectiveness studies have been based on crude ‘modelling’ approaches and over-estimate the difference in attrition rates and the cost of treatment failure. It appears impossible to evaluate the economic aspects of suicide because of its rarity.ConclusionsThere is no evidence to suggest that SSRIs are more cost-effective than TCAs. The debate will only be concluded when a prospective cost-effectiveness study is done in the setting of a large primary care based RCT.

Positive trends in neurosurgery enrollment and attrition: analysis of the 2000–2009 female neurosurgery resident cohort

2016 ◽  
Vol 124 (3) ◽  
pp. 834-839 ◽  
Author(s):  
Jaclyn J. Renfrow ◽  
Analiz Rodriguez ◽  
Ann Liu ◽  
Julie G. Pilitsis ◽  
Uzma Samadani ◽  
...  
Keyword(s):  
Career Paths ◽  
Primary Outcome ◽  
American Association ◽  
Training Programs ◽  
Female Gender ◽  
Attrition Rate ◽  
Attrition Rates ◽  
Residency Programs ◽  
Neurological Surgery ◽  
Attrition Analysis

OBJECT Women compose a minority of neurosurgery residents, averaging just over 10% of matched applicants per year during this decade. A recent review by Lynch et al. raises the concern that women may be at a higher risk than men for attrition, based on analysis of a cohort matched between 1990 and 1999. This manuscript aims to characterize the trends in enrollment, attrition, and postattrition careers for women who matched in neurosurgery between 2000 and 2009. METHODS Databases from the American Association of Neurological Surgeons (AANS) and the American Board of Neurological Surgery (ABNS) were analyzed for all residents who matched into neurosurgery during the years 2000–2009. Residents were sorted by female gender, matched against graduation records, and if graduation was not reported from neurosurgery residency programs, an Internet search was used to determine the residents’ alternative path. The primary outcome was to determine the number of women residents who did not complete neurosurgery training programs during 2000–2009. Secondary outcomes included the total number of women who matched into neurosurgery per year, year in training in which attrition occurred, and alternative career paths that these women chose to pursue. RESULTS Women comprised 240 of 1992 (12%) matched neurosurgery residents during 2000–2009. Among female residents there was a 17% attrition rate, compared with a 5.3% male attrition rate, with an overall attrition rate of 6.7%. The majority who left the field did so within the first 3 years of neurosurgical training and stayed in medicine—pursuing anesthesia, neurology, and radiology. CONCLUSIONS Although the percentage of women entering neurosurgical residency has continued to increase, this number is still disproportionate to the overall number of women in medicine. The female attrition rate in neurosurgery in the 2000–2009 cohort is comparable to that of the other surgical specialties, but for neurosurgery, there is disparity between the male and female attrition rates. Women who left the field tended to stay within medicine and usually pursued a neuroscience-related career. Given the need for talented women to pursue neurosurgery and the increasing numbers of women matching annually, the recruitment and retention of women in neurosurgery should be benchmarked and assessed.

scholarly journals Outlook on Student Retention in Higher Education University Reforms in Morocco

2017 ◽  
Vol 5 (2) ◽  
pp. 53
Author(s):  
Zoulal Mansouri ◽  
Mohamed El Amine Moumine
Keyword(s):  
Higher Education ◽  
Student Retention ◽  
Student Attrition ◽  
Drop Out ◽  
University Education ◽  
Attrition Rate ◽  
Education Reforms ◽  
Emergency Plan ◽  
Attrition Rates ◽  
Higher Education Reforms

High student attrition rates at university have become one of the most challenging issues in higher education worldwide in the last five decades. Moroccan universities are no exception. At-risk students drop out of studies for a plethora of reasons, and the attrition rate is increasing despite the efforts made in education reforms carried out since 1999. This article reviews the most important components of the higher education reforms that have been adopted in Moroccan higher education in their endeavor to enhance student retention in university. These components are chronologically reviewed, first in the National Charter of Education and Training (NCET) launched in 1999, second in the Emergency Plan conducted in 2009-2012, and finally in the latest Strategic Vision of Reform 2015-2030. It is concluded that more efforts are necessary to strike a balance between quantity and quality in terms of student retention in university education. 

scholarly journals Government-assisted Refugees in Toronto's LINC Classes: An Exploration of Perceived Needs an Barriers

2021 ◽  
Author(s):  
Dunja Metikos Debeljacki
Keyword(s):  
Training Program ◽  
Quantitative Data ◽  
Training Programs ◽  
Drop Out ◽  
Language Training ◽  
Official Language ◽  
Federally Funded ◽  
Perceived Needs ◽  
The City ◽  
Permanent Residents

Studies on any aspect of the resettlement of government-assisted refugees (GARs) in Canada are scarce. This lack of research is particularly prominent in the area of GARs' experience in official language-training programs. Drawing on both quantitative and qualitataive data, this paper is the first examination of the perceived needs and barriers of GARs in Language and Instruction for Newcomers to Canada (LINC), a federally-funded langauge training program for newly arrived permanent residents. The study focuses on the LINC program in the City of Toronto. Analysis of quantitative data suggests that GARs have high drop-out and low graduation rates from LINC classes compared to other immigrants. Interviews with key informants parallel the findings from the quantitative data, but also identify significant difficulties faced by GARs both inside and outside the LINC classroom. This study contributes to an enhanced understanding of the settlement needs of GARs and advocates for the development of both new and improved programs and services for GARs in Canada.

scholarly journals Government-assisted Refugees in Toronto's LINC Classes: An Exploration of Perceived Needs an Barriers

2021 ◽  
Author(s):  
Dunja Metikos Debeljacki
Keyword(s):  
Training Program ◽  
Quantitative Data ◽  
Training Programs ◽  
Drop Out ◽  
Language Training ◽  
Official Language ◽  
Federally Funded ◽  
Perceived Needs ◽  
The City ◽  
Permanent Residents

Studies on any aspect of the resettlement of government-assisted refugees (GARs) in Canada are scarce. This lack of research is particularly prominent in the area of GARs' experience in official language-training programs. Drawing on both quantitative and qualitataive data, this paper is the first examination of the perceived needs and barriers of GARs in Language and Instruction for Newcomers to Canada (LINC), a federally-funded langauge training program for newly arrived permanent residents. The study focuses on the LINC program in the City of Toronto. Analysis of quantitative data suggests that GARs have high drop-out and low graduation rates from LINC classes compared to other immigrants. Interviews with key informants parallel the findings from the quantitative data, but also identify significant difficulties faced by GARs both inside and outside the LINC classroom. This study contributes to an enhanced understanding of the settlement needs of GARs and advocates for the development of both new and improved programs and services for GARs in Canada.

70. Supporting IMG integration into residency trainings

2007 ◽  
Vol 30 (4) ◽  
pp. 67
Author(s):  
S. Glover Takahashi ◽  
M. Alameddine ◽  
D. Martin ◽  
S. Verma ◽  
S. Edwards
Keyword(s):  
Training Program ◽  
Residency Training ◽  
Training Programs ◽  
Comprehensive Evaluation ◽  
International Medical ◽  
Full Time ◽  
Design Development ◽  
Course Content ◽  
Medical Trainees ◽  
Personal Wellness

This paper is describes the design, development, implementation and evaluation of a preparatory training program for international medical trainees. The program was offered for one week full time shortly before they begin their residency training programs. First the paper reports on the survey and focus groups that guided the learning objectives and the course content. Next the paper describes the curriculum development phase and reports on the topical themes, session goals and objectives and learning materials. Three main themes emerged when developing the program: understanding the educational, health and practice systems in Canada; development of communication skills; and supporting personal success in residency training including self assessment, reflection and personal wellness. Sample lesson plans and handouts from each of the theme areas are illustrated. The comprehensive evaluation of the sessions and the overall program is then also described. The paper then summarizes the identified key issues and challenges in the design and implementation of a preparatory training program for international medical trainees before they begin their residency training programs. Allan GM, Manca D, Szafran O, Korownyk C. Workforce issues in general surgery. Am Surg. 2007 Feb; 73(2):100-8. Dauphinee, WD. The circle game: understanding physician migration patterns within Canada. Acad Med. 2006 (Dec); 81(12 Suppl):S49-54. Spike NA. International medical graduates: the Australian perspective. Academic Medicine. 2006 (Sept); 81(9):842-6.

52. Simulation based training improves resident competence in the performance of critical resuscitation procedures

2007 ◽  
Vol 30 (4) ◽  
pp. 56
Author(s):  
I. Rigby ◽  
I. Walker ◽  
T. Donnon ◽  
D. Howes ◽  
J. Lord
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Medical Education ◽  
Family Medicine ◽  
Training Program ◽  
Correlation Coefficient ◽  
Training Programs ◽  
Self Assessment ◽  
Procedural Skills ◽  
Simulation Based

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

PRACTICAL BASE OF FORMULATING RETRAINING PROGRAMS ON ETHNIC MINORITY AFFAIRS KNOWLEDGE FOR CADRES, CIVIL SERVANTS UP TO 2030

2018 ◽  
Author(s):  
Nguyen Van Dung ◽  
Giang Khac Binh
Keyword(s):  
Ethnic Minority ◽  
Training Program ◽  
Political System ◽  
Prime Minister ◽  
Training Programs ◽  
Civil Servants ◽  
The Political ◽  
Target Groups ◽  
The Core ◽  
The Past

As developing programs is the core in fostering knowledge on ethnic work for cadres and civil servants under Decision No. 402/QD-TTg dated 14/3/2016 of the Prime Minister, it is urgent to build training program on ethnic minority affairs for 04 target groups in the political system from central to local by 2020 with a vision to 2030. The article highlighted basic issues of practical basis to design training program of ethnic minority affairs in the past years; suggested solutions to build the training programs in integration and globalization period.

scholarly journals POS0208 GENDER DIFFERENCES IN RESPONSE TO BIOLOGICALS. WOMEN FARE WORSE ACROSS INFLAMMATORY ARTHRITIS DISEASES - DATA FROM THE BIOREG

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 320.1-321
Author(s):  
E. Loibner ◽  
V. Ritschl ◽  
B. Leeb ◽  
P. Spellitz ◽  
G. Eichbauer-Sturm ◽  
...  
Keyword(s):  
Gender Differences ◽  
Psoriatic Arthritis ◽  
Gender Difference ◽  
Disease Activity ◽  
Inflammatory Arthritis ◽  
Tnf Inhibitors ◽  
Significant Difference ◽  
The Difference ◽  
All Diseases

Background:Gender differences in prevalence and disease course are known in various rheumatic diseases; however, investigations of gender difference concerning therapeutical response have yielded variable results.Objectives:The aim of this retrospective study was to investigate, whether a gender difference in response rate to biological disease-modifying antirheumatic drugs (bDMARDs) and apremilast in bDMARD-naïve patients could be observed across the three most prevalent inflammatory arthritis diseases: rheumatoid arthritis (RA), spondylarthritis (SpA) and psoriatic arthritis (PsA). Additionally, a response to individual TNF blockers was investigated in this respect.Methods:Data from bDMARD-naïve RA-, SpA- and PsA-patients from Bioreg, the Austrian registry for biological DMARDs in rheumatic diseases, were used. Patients with a baseline (Visit 1=V1) and follow-up visits at 6 months (Visit 2=V2) and 12 months (Visit 3=V3) were included and response to therapy with TNF-inhibitors (TNFi), furthermore to therapy with rituximab, tocilizumab and apremilast was analyzed according to gender. The remaining bDMARDs were not analyzed due to small numbers. Key response-parameter for RA was disease activity score (DAS28), whereas for PsoA the Stockerau Activity Score for Psoriatic Arthritis (SASPA) and for SpA the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were employed; in addition, the Health assessment Questionnaire (HAQ) was used. Data were analyzed in R Statistic stratified by gender using Kruskal-Wallis and Wilcoxon tests.Results:354 women and 123 men with RA (n=477), 81 women and 69 men with PsA (n=150), 121 women and 191 men with SpA (n=312) were included. No significant differences in biometrics was seen between female and male patients at baseline in all diseases.In RA patients overall DAS28 decreased from baseline (V1) to V2 and V3 (DAS28: V1: male: 4.38 [3.66, 5.11], female: 4.30 [3.68, 5.03], p(m/f) = 0.905; V2: male: 2.66 [1.73, 3.63], female: 3.10 [2.17, 3.98], p(m/f) = 0.015; V3: male: 2.25 [1.39, 3.36], female: 3.01 [1.87, 3.87], p(m/f) = 0.002). For TNF inhibitors (n=311), there was a significant difference between genders at V2 (Fig.1a). Patients receiving Rituximab (n=41) displayed a significantly higher DAS28 at baseline in females, which diminished in the follow up: V1: (p(m/f) p=0.002; V2: p=0.019; V3: p=0.13); response to tocilizumab (n=63) did not show any gender differences.In PsA patients overall SASPA decreased from baseline (V1) to V2 and V3 (SASPA: V1: male: 4.00 [2.80, 5.20], female: 4.40 [2.80, 5.80], p(m/f) = 0.399; V2: male: 2.20 [1.20, 3.50], female: 3.40 [2.00, 5.00], p(m/f) = 0.071; V3: male: 1.80 [0.80, 2.70], female: 3.01 [2.35, 4.80], p(m/f) = 0.001). For TNF inhibitors (n=79), there was a significant difference between genders at V3 (Fig 1a). For Apremilast (n=39), there was a significant difference between genders at V2 (Fig.1c).In SpA patients overall BASDAI decreased from baseline (V1) to V2 and V3 (BASDAI: V1: male: 4.70 [2.88, 6.18], female: 4.80 [3.30, 6.20], p(m/f) = 0.463; V2: male: 3.05 [2.00, 4.60], female: 3.64 [2.62, 5.41], p(m/f) = 0.039; V3: male: 3.02 [1.67, 4.20], female: 3.65 [2.18, 5.47], p(m/f) = 0.016). In V3 a differential BASDAI in response to TNFi (n=299) was observed (Fig.1a).Possible differences of response to individual TNFi (etanercept, infliximab, other TNFi) measured by HAQ were investigated in all diseases together. The difference between male and females was significant at baseline for all 3 TNFi; whereas with the use of ETA the significant difference was carried through to V2 and V3, it was lost with the use of IFX and was variable with the other TNFi (Fig.1b)Figure 1.Conclusion:Female patients showed a statistically lower response to TNFi in all three disease entities (RA, SpA and PsoA) to a variable degree in our homogenous central european population. Interestingly, the difference was not uniform across individual TNFi when measured by HAQ. Gender differences were also seen in response to Apremilast.Disclosure of Interests:Elisabeth Loibner: None declared, Valentin Ritschl: None declared, Burkhard Leeb Speakers bureau: AbbVie, Roche, MSD, Pfizer, Actiopharm, Boehringer-Ingelheim, Kwizda, Celgene, Sandoz, Grünenthal, Eli-Lilly, Grant/research support from: TRB, Roche, Consultancies: AbbVie, Amgen, Roche, MSD, Pfizer, Celgene, Grünenthal, Kwizda, Eli-Lilly, Novartis, Sandoz;, Peter Spellitz: None declared, Gabriela Eichbauer-Sturm: None declared, Jochen Zwerina: None declared, Manfred Herold: None declared, Miriam Stetter: None declared, Rudolf Puchner Speakers bureau: AbbVie, BMS, Janssen, Kwizda, MSD, Pfizer, Celgene, Grünenthal, Eli-Lilly, Consultant of: AbbVie, Amgen, Pfizer, Celgene, Grünenthal, Eli-Lilly, Franz Singer: None declared, Ruth Fritsch-Stork: None declared

Sign in / Sign up

Export Citation Format

Share Document