Syrian women's preferences for birth attendant and birth place. (49/257)

BACKGROUND: Women's preferences for type of maternity caregiver and birth place have gained importance and have been documented in studies reported from the developed world. The purpose of our study was to identify Syrian women's preferences for birth attendant and place of delivery. METHODS: Interviews with 500 women living in Damascus and its suburbs were conducted using a pretested structured questionnaire. Women were asked about their preferences for the birth attendant and place of delivery, and an open-ended question asked them to give an explanation for their preferences. We analyzed preferences and their determinants, and also agreement between actual and preferred place of delivery and birth attendant. RESULTS: Only a small minority of women (5-10%) had no preference. Most (65.8%) preferred to give birth at the hospital, and 60.4 percent preferred to be attended by doctors compared with midwives (21.2%). More than 85 percent of women preferred the obstetrician to be a female. The actual place of delivery and type of birth attendant did not match the preferred place of delivery and type of birth attendant. Women's reasons for preferences were a perception of safety and competence, and communication style of caregiver. CONCLUSIONS: Most women preferred to be delivered by female doctors at a hospital in this population sample in Syria. The findings suggest that proper understanding of women's preferences is needed, and steps should be taken to enable women to make good choices. Policies about maternity education and services should take into account women's preferences.  (+info)

The Klumpke family--memories by Doctor Dejerine, born Augusta Klumpke. (50/257)

In this paper, we present a translation of an unpublished autobiographical document by Augusta Dejerine-Klumpke, reporting her early years before she came to Paris to study medicine, when she was able to become one of the first women in France to hold a hospital position, as an extern and an intern. This American-born girl later married Jules Dejerine, who was to become the second successor to Charcot at La Salpetriere 23 years later. The present document gives a vivid account on the preceding years, and emphasizes the extraordinary dynamism and enthusiasm of a young woman, whose efforts and contributions influenced neurology at the turn of the 20th century, and dramatically changed the role of women in medical careers.  (+info)

Characteristics of general practitioners who are high attenders at educational meetings. (51/257)

The characteristics of general practitioners in the west of Scotland who are high attenders at meetings accredited for the postgraduate education allowance were studied. One hundred and seventy one principals in general practice (9.5%) had attended more than 35 half-day sessions of accredited education between 1 April 1989 and 31 December 1990 and 34 doctors (1.9%) had attended more than 45 half-day sessions. The highest percentage of the doctors worked in Greater Glasgow and Lanarkshire. The doctors who were high attenders were relatively more likely to be women, to be members of the Royal College of General Practitioners and to work in a training practice. The majority of the doctors had been qualified for between 10 and 30 years and worked in group practices of three or more doctors. The characteristics of high attenders contrast markedly to doctors who are low attenders. That there were such a large number of high attenders at educational meetings is encouraging.  (+info)

Workplace discrimination: experiences of practicing physicians. (52/257)

BACKGROUND: In response to a growing concern regarding physician discrimination in the workplace, this study was developed to: (1) describe the types of discrimination that exist for the practicing physician and (2) determine which groups of physicians are more likely to experience the various forms of discrimination. METHODS: Surveys were mailed to 1930 practicing physicians in Massachusetts. Participants were asked if they had encountered discrimination, how significant the discrimination was against a specific group, the frequency of personal discrimination, and the type of discrimination. Factor analysis identified four types of discrimination: career advancement, punitive behaviors, practice barriers and hiring barriers. RESULTS: A total of 445 responses were received (a 24% response rate). Sixty-three percent of responding physicians had experienced some form of discrimination. Respondents were women (46%), racial/ethnic minorities (42%) and international medical graduates (IMGs) (40%). In addition, 26% of those classified as white were also IMGs. Over 60% of respondents believed discrimination against IMGs was very or somewhat significant. Almost 27% of males acknowledged that gender bias against females was very or somewhat significant. IMGs were more likely to indicate that discrimination against IMGs was significant in their current organization. Of U.S. medical graduates (USMGs) 44% reported that discrimination against IMGs in their current organization was significant. Nonwhites were more likely to report that discrimination based on race/ethnicity was significant. Nearly 29% of white respondents also believed that such discrimination was very or somewhat significant. CONCLUSIONS: Physicians practicing in academic, research, and private practice sectors experience discrimination based on gender, ethnic/racial, and IMG status.  (+info)

Female surgeons' alcohol use: a study of a national sample of norwegian doctors. (53/257)

AIMS: This study was designed to describe the alcohol use by female surgeons and the hazards of their drinking habits for them compared with the habits of female doctors from non-surgical specialities, and with those of their male colleagues in surgery, and to identify the variables associated with hazardous drinking. METHODS: The data were collected in 2000 from a representative national sample of 1120 Norwegian doctors. Alcohol use was measured using a modified version of the Alcohol Use Disorders Identification Test. A score of 9 or more was used as an indicator of hazardous drinking. RESULTS: Female surgeons compared with female non-surgeons had tendencies for more frequent moderate alcohol consumption accompanied by more frequent consumption of larger amounts of alcohol, and a significantly higher rate of hazardous drinking (18 vs 7.6%). Being a surgeon (OR = 1.7, 95% CI 1.2-2.4), male (OR = 2.7, 1.7-4.1) and aged 45 years or over (OR = 1.5, 1.1-2.2) were significant predictors of hazardous drinking. With separate gender analyses, being a surgeon was a significant predictor for both females (OR = 2.8, 1.2-6.6) and males (OR = 1.5, 1.0-2.3). CONCLUSION: Female surgeons practising in Norway drink more frequently and more hazardously than other female doctors. There are a number of possible explanations for this. Surgical culture may be an important factor.  (+info)

The role of cultural diversity climate in recruitment, promotion, and retention of faculty in academic medicine. (54/257)

BACKGROUND: Ethnic diversity among physicians may be linked to improved access and quality of care for minorities. Academic medical institutions are challenged to increase representation of ethnic minorities among health professionals. OBJECTIVES: To explore the perceptions of physician faculty regarding the following: (1) the institution's cultural diversity climate and (2) facilitators and barriers to success and professional satisfaction in academic medicine within this context. DESIGN: Qualitative study using focus groups and semi-structured interviews. PARTICIPANTS: Nontenured physicians in the tenure track at the Johns Hopkins University School of Medicine. APPROACH: Focus groups and interviews were audio-taped, transcribed verbatim, and reviewed for thematic content in a 3-stage independent review/adjudication process. RESULTS: Study participants included 29 faculty representing 9 clinical departments, 4 career tracks, and 4 ethnic groups. In defining cultural diversity, faculty noted visible (race/ethnicity, foreign-born status, gender) and invisible (religion, sexual orientation) dimensions. They believe visible dimensions provoke bias and cumulative advantages or disadvantages in the workplace. Minority and foreign-born faculty report ethnicity-based disparities in recruitment and subtle manifestations of bias in the promotion process. Minority and majority faculty agree that ethnic differences in prior educational opportunities lead to disparities in exposure to career options, and qualifications for and subsequent recruitment to training programs and faculty positions. Minority faculty also describe structural barriers (poor retention efforts, lack of mentorship) that hinder their success and professional satisfaction after recruitment. To effectively manage the diversity climate, our faculty recommended 4 strategies for improving the psychological climate and structural diversity of the institution. CONCLUSIONS: Soliciting input from faculty provides tangible ideas regarding interventions to improve an institution's diversity climate.  (+info)

The changing composition of the pediatric medical subspecialty workforce. (55/257)

OBJECTIVES: To characterize the composition of the pediatric subspecialty workforce in terms of the distribution of women and international medical graduates (IMGs) across pediatric medical subspecialties and to determine whether the proportions of board-certified pediatric subspecialists who are women or IMGs differ between graduation cohorts. STUDY DESIGN: We used board certification data from the American Board of Pediatrics. Within each pediatric subspecialty, we classified physicians into 2 groups, ie, recent graduates, defined as those who completed medical school after January 1, 1987, and nonrecent graduates, who completed medical school before that date. We calculated the percentage of female physicians for each subspecialty and computed 95% confidence intervals around those estimates to identify male-dominated subspecialties. Using Pearson chi2 tests, we compared the percentages of women between the 2 graduation cohorts for each subspecialty. Similar calculations were performed for the percentage of IMGs in each subspecialty. Sensitivity analyses were performed with data from the 2002 American Medical Association Physician Masterfile. RESULTS: For 9 of 16 pediatric medical subspecialties studied, the percentages of board-certified women were significantly greater in the recent cohort than in the nonrecent cohort. Subspecialties that remain predominantly male in the recent graduation cohort include cardiology, critical care medicine, gastroenterology, pulmonology, and sports medicine. In contrast, the percentages of board-certified IMGs were significantly lower for 6 of the 16 specialties studied; endocrinology and gastroenterology remain relatively reliant on IMGs. CONCLUSIONS: For the majority of pediatric medical subspecialties, concerns that the predominance of women in pediatric training may negatively affect the supply of subspecialists are likely unfounded; however, a small number of procedure-based specialties, as well as sports medicine, continue to rely disproportionately on men. There do not seem to be consistent differences in the role of IMGs across the pediatric medical subspecialties between recent and nonrecent graduates, which may reflect differing tendencies to become certified.  (+info)

Questionnaire survey of women aged 56-59 years: consultations in general practice, use of hormone replacement therapy (HRT) and participation in screening programmes. (56/257)

OBJECTIVES: To ascertain attitudes to consultations in general practice and the gender of the doctor. To determine whether women participate in the National Health Service (NHS) screening programmes available to them and their use of hormone replacement therapy (HRT). DESIGN: Postal questionnaire survey to women aged 56-59 years. SETTING: The Honiton Group Practice, East Devon, UK. PARTICIPANTS: Two hundred and ninety-four of the 334 eligible women returned the questionnaire (response rate 88%). MAIN OUTCOME MEASURES: Women's embarrassment on consulting general practitioners (GPs) and preference for a female doctor. Up-to-date cervical smears and mammography screening in eligible women and use of HRT. RESULTS: A large majority of women (248/294; 84.4%) were not embarrassed when consulting a GP and did not express a preference to see a woman GP for any problem (240/294; 81.6%). However 123/294 (41.8%) did express a preference to see a woman doctor for 'women's problems'. Sixty-five women had had a hysterectomy, and 218 of the remaining 229 (95.2%) had had a smear in the past 5 years. For breast screening, 267/294 (90.8%) had undergone mammography in the previous 3 years. Ninety-three women (32%) were currently on HRT, and on record searching a total of 146 (49.7%) had at some time been HRT users. CONCLUSIONS: Embarrassment does not appear to be a major problem for consultations related to female health. A well-organised general practice with motivated patients can achieve very high uptakes of both cervical and breast screening programmes. Interest in HRT has also risen, with half the women aged 56-59 years having used systemic HRT.  (+info)