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Browsing by Author "Reinoso, Maria A."
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Item Association Between Parental Leave and Ophthalmology Resident Physician Performance(American Medical Association, 2022-11-01) Huh, Dana D.; Wang , Jiangxia; Fliotsos , Michael J.; Beal , Casey J.; Boente , Charline S.; Wisely , C. Ellis; De Andrade , Lindsay M.; Lorch , Alice C.; Ramanathan , Saras; Reinoso, Maria A.; Swamy, Ramya N.; Waxman , Evan L.; Woreta, Fasika A.; Srikumaran, Divya; Ophthalmology, School of MedicineImportance Although parental leave is essential in enhancing resident wellness and fostering inclusive workplace environments, residents may often feel discouraged from using parental leave owing to perceived stigma and concerns about possible negative effects on their training. Objective To examine parental leave usage across multiple institutions and compare residency performance metrics between residents who took parental leave vs their peers who did not take leave. Design, Setting, and Participants This was a retrospective cross-sectional analysis conducted from April 1, 2020, to July 28, 2022, of educational records. Multicenter data were obtained from 10 Accreditation Council for Graduate Medical Education (ACGME)–accredited ophthalmology programs across the US. Included ophthalmology residents graduated between 2015 and 2019. Data were analyzed from August 15, 2021, to July 25, 2022. Exposures Performance metrics of residents who used parental leave during residency were compared with those of residents who did not take parental leave. Main Outcomes and Measures Measures of performance included the Ophthalmic Knowledge Assessment Program (OKAP) scores, ACGME milestones scores, board examination pass rates, research activity, and surgical volumes. Results Of the 283 ophthalmology residents (149 male [52.7%]) included in the study, 44 (15.5%) took a median (IQR) parental leave of 4.5 (2-6) weeks. There were no differences in average OKAP percentiles, research activity, average ACGME milestones scores, or surgical volume between residents who took parental leave and those who did not. Residents who pursued fellowship were less likely to have taken parental leave (odds ratio [OR], 0.43; 95% CI, 0.27-0.68; P < .001), and residents who practiced in private settings after residency were more likely to have taken parental leave (OR, 3.56; 95% CI, 1.79-7.08; P < .001). When stratified by sex, no differences were identified in performance between female residents who took parental leave compared with residents who did not take leave, except a mild surgical number difference in 1 subspecialty category of keratorefractive procedures (difference in median values, −2; 95% CI, −3.7 to −0.3; P = .03). Conclusions and Relevance In this multicenter cross-sectional study, no differences in performance metrics were identified between residents taking parental leave compared with their peers. These findings may provide reassurance to trainees and program directors regarding the unlikelihood, on average, that taking adequate parental leave will affect performance metrics adversely.Item Gender Differences in Case Volume Among Ophthalmology Residents(American Medical Association, 2019-07-18) Gong, Dan; Winn, Bryan J.; Beal, Casey J.; Blomquist, Preston H.; Chen, Royce W.; Culican, Susan M.; Dagi Glass, Lora R.; Domeracki, Gary F.; Goshe, Jeffrey M.; Jones, Jeremy K.; Khouri, Albert S.; Legault, Gary L.; Martin, Timothy J.; Mitchell, Kelly T.; Naseri, Ayman; Oetting, Thomas A.; Olson, Joshua H.; Pettey, Jeff H.; Reinoso, Maria A.; Reynolds, Andrew L.; Siatkowski, R. Michael; SooHoo, Jeffrey R.; Sun, Grace; Syed, Misha F.; Tao, Jeremiah P.; Taravati, Parisa; WuDunn, Darrell; Al-Aswad, Lama A.; Ophthalmology, School of MedicineQuestion Do differences in cataract surgery and total procedural volume exist between US male and female residents during ophthalmology residency training? Findings This analysis of the case logs of 1271 ophthalmology residents from 24 US ophthalmology residency programs estimates that female residents performed 7.8 to 22.2 fewer cataract operations and 36.0 to 80.2 fewer total procedures compared with their male counterparts from 2005 to 2017, and the gap widened during this period for total procedural volume. Meaning The current state of surgical training in ophthalmology residency programs deserves further study to ensure that male and female residents have equivalent training experiences. Go to: Abstract Importance Although almost equal numbers of male and female medical students enter into ophthalmology residency programs, whether they have similar surgical experiences during training is unclear. Objective To determine differences for cataract surgery and total procedural volume between male and female residents during ophthalmology residency. Design, Setting, Participants This retrospective, longitudinal analysis of resident case logs from 24 US ophthalmology residency programs spanned July 2005 to June 2017. A total of 1271 residents were included. Data were analyzed from August 12, 2017, through April 4, 2018. Main Outcomes and Measures Variables analyzed included mean volumes of cataract surgery and total procedures, resident gender, and maternity or paternity leave status. Results Among the 1271 residents included in the analysis (815 men [64.1%]), being female was associated with performing fewer cataract operations and total procedures. Male residents performed a mean (SD) of 176.7 (66.2) cataract operations, and female residents performed a mean (SD) of 161.7 (56.2) (mean difference, −15.0 [95% CI, −22.2 to −7.8]; P < .001); men performed a mean (SD) of 509.4 (208.6) total procedures and women performed a mean (SD) of 451.3 (158.8) (mean difference, −58.1 [95% CI, −80.2 to −36.0]; P < .001). Eighty-five of 815 male residents (10.4%) and 71 of 456 female residents (15.6%) took parental leave. Male residents who took paternity leave performed a mean of 27.5 (95% CI, 13.3 to 41.6; P < .001) more cataract operations compared with men who did not take leave, but female residents who took maternity leave performed similar numbers of operations as women who did not take leave (mean difference, −2.0 [95% CI, −18.0 to 14.0]; P = .81). From 2005 to 2017, each additional year was associated with a 5.5 (95% CI, 4.4 to 6.7; P < .001) increase in cataract volume and 24.4 (95% CI, 20.9 to 27.8; P < .001) increase in total procedural volume. This increase was not different between genders for cataract procedure volume (β = −1.6 [95% CI, −3.7 to 0.4]; P = .11) but was different for total procedural volume such that the increase in total procedural volume over time for men was greater than that for women (β = −8.0 [95% CI, −14.0 to −2.1]; P = .008). Conclusions and Relevance Female residents performed 7.8 to 22.2 fewer cataract operations and 36.0 to 80.2 fewer total procedures compared with their male counterparts from 2005 to 2017, a finding that warrants further exploration to ensure that residents have equivalent surgical training experiences during residency regardless of gender. However, this study included a limited number of programs (24 of 119 [20.2%]). Future research including all ophthalmology residency programs may minimize the selection bias issues present in this study.