Faculty Bibliography

BACKGROUND/UNASSIGNED:As part of the residency application process in the United States, many medical specialties now offer applicants the opportunity to send program signals that indicate high interest to a limited number of residency programs. To determine which residency programs to apply to, and which programs to send signals to, applicants need accurate information to determine which programs align with their future training goals. Most applicants use a program's website to review program characteristics and criteria, so describing the current state of residency program websites can inform programs of best practices. OBJECTIVE/UNASSIGNED:This study aims to characterize information available on obstetrics and gynecology residency program websites and to determine whether there are differences in information available between different types of residency programs. METHODS/UNASSIGNED:This was a cross-sectional observational study of all US obstetrics and gynecology residency program website content. The authorship group identified factors that would be useful for residency applicants around program demographics and learner trajectories; application criteria including standardized testing metrics, residency statistics, and benefits; and diversity, equity, and inclusion mission statements and values. Two authors examined all available websites from November 2011 through March 2022. Data analysis consisted of descriptive statistics and one-way ANOVA, with P<.05 considered significant. RESULTS/UNASSIGNED:Among 290 programs, 283 (97.6%) had websites; 238 (82.1%) listed medical schools of current residents; 158 (54.5%) described residency alumni trajectories; 107 (36.9%) included guidance related to the preferred United States Medical Licensing Examination Step 1 scores; 53 (18.3%) included guidance related to the Comprehensive Osteopathic Medical Licensing Examination Level 1 scores; 185 (63.8%) included international applicant guidance; 132 (45.5%) included a program-specific mission statement; 84 (29%) included a diversity, equity, and inclusion statement; and 167 (57.6%) included program-specific media or links to program social media on their websites. University-based programs were more likely to include a variety of information compared to community-based university-affiliated and community-based programs, including medical schools of current residents (113/123, 91.9%, university-based; 85/111, 76.6%, community-based university-affiliated; 40/56, 71.4%, community-based; P<.001); alumni trajectories (90/123, 73.2%, university-based; 51/111, 45.9%, community-based university-affiliated; 17/56, 30.4%, community-based; P<.001); the United States Medical Licensing Examination Step 1 score guidance (58/123, 47.2%, university-based; 36/111, 32.4%, community-based university-affiliated; 13/56, 23.2%, community-based; P=.004); and diversity, equity, and inclusion statements (57/123, 46.3%, university-based; 19/111, 17.1%, community-based university-affiliated; 8/56, 14.3%, community-based; P<.001). CONCLUSIONS/UNASSIGNED:There are opportunities to improve the quantity and quality of data on residency websites. From this work, we propose best practices for what information should be included on residency websites that will enable applicants to make informed decisions.

OBJECTIVE:To estimate the prevalence of the Vice Chair of Education (VCE) role in obstetrics and gynecology (OBGYN) departments and to describe the demographics, responsibilities, resource allocation, and challenges faced by individuals in this role. DESIGN/METHODS:A 2-part survey was developed with the Association of Professors of Gynecology and Obstetrics (APGO) Member Engagement Workgroup. SETTING/METHODS:National survey. PARTICIPANTS/METHODS:Part 1 was sent to OBGYN department chairs to identify departments with a VCE and to assess characteristics of departments without 1. Part 2 was sent directly to VCEs to assess characteristics of the department and the individual VCE, including demographics, academic appointments, leadership and educational experience, responsibilities, and institutional support. Chi-squared tests were used to compare departments with and without VCE. RESULTS:196 of 256 OBGYN chairs (76.5%) responded to part 1 of the survey, and 71 of 86 VCEs (82.5%) responded to part 2 of the survey. The prevalence of the VCE role was 43.9%. Departments with a VCE had larger numbers of faculty, residents, and medical students, and were more likely to identify as university-affiliated (all p < 0.001). A majority of VCEs identified as women (82.1%), associate professors (55.0%), and academic specialists (51%), with 62.3% serving as the inaugural VCE in their department. Approximately half of VCEs have a defined job description, and only 35.8% controlled an educational budget. Two-thirds (65.7%) of VCEs received full-time equivalent (FTE) support for the role, with 37.1% receiving 0.2 FTE. CONCLUSIONS:The VCE role remains relatively new in OBGYN. Optimizing success of individuals in this role requires increased job clarity, adequate support, and ongoing opportunities for career development.

Burnout among radiologists is increasingly prevalent, with the potential for having a substantial negative impact on physician well-being, delivery of care, and health outcomes. To evaluate this phenomenon using reliable and accurate means, validated quantitative instruments are essential. Variation in measurement can contribute to wide-ranging findings. This article evaluates radiologist burnout rates globally and dimensions of burnout as reported using different validated instruments; it also provides guidance on best practices to characterize burnout. Fifty-seven studies published between 1990 and 2023 were included in a systematic review, and 43 studies were included in a meta-analysis of burnout prevalence using random-effects models. The reported burnout prevalence ranged from 5% to 85%. With the Maslach Burnout Inventory (MBI), burnout prevalence varied significantly depending on the instrument version used. Among MBI subcategories, the pooled prevalence of emotional exhaustion was 54% (95% CI, 45-63%), depersonalization was 52% (95% CI, 41-63%), and low personal accomplishment was 36% (95% CI, 27-47%). Other validated burnout instruments showed less heterogeneous results; studies using the Stanford Professional Fulfillment Index yielded a burnout prevalence of 39% (95% CI, 34-45%), whereas the validated single-item instrument yielded a burnout prevalence of 34% (95% CI, 29-39%). Standardized instruments for assessing prevalence alongside multidimensional profiles capturing experiences may better characterize radiologist burnout, including change occurring over time.

Gender inequity persists in academic medicine. This article reviews the historical context, ongoing leadership challenges, and societal biases. The persistent barriers to gender equity in leadership roles, pay, and professional recognition are considered through the lens of obstetrics and gynecology where these issues persist despite a significant presence of women in the field. The impact of gender stereotypes, the role of intersectionality, and the need for systemic change are evident. Embracing diverse leadership styles and creating inclusive pathways to leadership will help actualize the potential benefits of a gender-diverse workforce, enhancing health care outcomes and fostering innovation.

The authors investigated the impact of antiplatelet therapy on the megakaryocyte (MK) and platelet transcriptome. RNA-sequencing was performed on MKs treated with aspirin or P2Y₁₂ inhibitor, platelets from healthy volunteers receiving aspirin or P2Y₁₂ inhibition, and platelets from patients with systemic lupus erythematosus (SLE). P2Y₁₂ inhibition reduced gene expression and inflammatory pathways in MKs and platelets. In SLE, the interferon (IFN) pathway was elevated. In vitro experiments demonstrated the role of P2Y₁₂ inhibition in reducing IFNα-induced platelet-leukocyte interactions and IFN signaling pathways. These results suggest that P2Y₁₂ inhibition may have therapeutic potential for proinflammatory and autoimmune conditions like SLE.

Platelets are key mediators of atherothrombosis, yet, limited tools exist to identify individuals with a hyperreactive platelet phenotype. In this study, we investigate the association of platelet hyperreactivity and cardiovascular events, and introduce a tool, the Platelet Reactivity ExpreSsion Score (PRESS), which integrates platelet aggregation responses and RNA sequencing. Among patients with peripheral artery disease (PAD), those with a hyperreactive platelet response (>60% aggregation) to 0.4 µM epinephrine had a higher incidence of the 30 day primary cardiovascular endpoint (37.2% vs. 15.3% in those without hyperreactivity, adjusted HR 2.76, 95% CI 1.5-5.1, p = 0.002). PRESS performs well in identifying a hyperreactive phenotype in patients with PAD (AUC [cross-validation] 0.81, 95% CI 0.68 -0.94, n = 84) and in an independent cohort of healthy participants (AUC [validation] 0.77, 95% CI 0.75 -0.79, n = 35). Following multivariable adjustment, PAD individuals with a PRESS score above the median are at higher risk for a future cardiovascular event (adjusted HR 1.90, CI 1.07-3.36; p = 0.027, n = 129, NCT02106429). This study derives and validates the ability of PRESS to discriminate platelet hyperreactivity and identify those at increased cardiovascular risk. Future studies in a larger independent cohort are warranted for further validation. The development of a platelet reactivity expression score opens the possibility for a personalized approach to antithrombotic therapy for cardiovascular risk reduction.

BACKGROUND:Teaching clinical pharmacology is often a challenge for medical schools. The benefits and popularity of active recall and spaced repetition through Anki flashcards are well-established and can offer a solution for teaching complex topics, but educators are often unfamiliar with this resource. APPROACH/METHODS:We implemented 501 faculty-generated pharmacology flashcards in five modules across the medical preclinical curriculum, available to 104 first-year students. At the end of each module, students were surveyed on the usefulness of this novel resource. The data from the cohort who had access to flashcards was compared with the previous cohort, without access, to analyse whether student use of Anki flashcards changed students' perceptions of the pharmacology curriculum and whether there were changes in pharmacology exam performance. EVALUATION/RESULTS:Seventy-five percent of the respondents rated the Anki pharmacology flashcards as 'very useful' or 'somewhat useful'. Eight hundred and seventy-five responses were analysed with a natural language processing algorithm, showing that fewer students mentioned pharmacology as a difficult topic in the cardiovascular and renal modules, compared with the cohort who did not use Anki flashcards. There was not a statistically significant difference in test scores between the cohorts. IMPLICATIONS/CONCLUSIONS:Anki flashcards were well-received by medical students, which might have impacted their perception of the curriculum, as evidenced by the decrease in mentions of pharmacology being a difficult topic, maintaining consistency in academic performance. Educators should consider providing flashcards to offer spaced repetition opportunities in the curriculum; an additional benefit could be increasing information equality in medical schools.

Cardiometabolic comorbidities, diabetes (DM), hypertension (HTN), and obesity, contribute to cardiovascular disease (CVD). Circulating biomarkers facilitate prognostication for patients with CVD. We explored the relationship between cardiometabolic comorbidity burden in patients with chronic coronary disease (CCD) and biomarkers of myocardial stretch, injury, inflammation, and platelet activity. We analyzed participants from the ISCHEMIA Trials biorepository with plasma biomarkers (NT-proBNP, hs-cTnT, hs-CRP, IL-6, sCD40L, and GDF-15) and clinical risk factors [hemoglobin A1c (HbA1c), systolic blood pressure (SBP), and body mass index (BMI)] at baseline. We defined cardiometabolic comorbidities as DM, HTN, and obesity at baseline. Comorbidity burden characterized by number and severity of comorbidities. Controlled comorbidities were defined as HbA1c <7% for those with DM, SBP <130 mmHg for those with HTN and BMI <30 kg/m². Severely uncontrolled was defined as HbA1c ≥8%, SBP ≥160 mmHg, and BMI ≥35 kg/m². We performed linear regression analyses to examine the association between comorbidity burden and log-transformed biomarker levels adjusting for age, sex, eGFR controlled for hemodialysis, and left ventricular ejection fraction. A total of 752 individuals (mean age 66, 19% female, 84% white) were included in this analysis. Self-reported Black race, current smokers, history of MI and HF had greater cardiometabolic comorbidity burden. The presence of ≥ 1 severely uncontrolled comorbidity was associated with significantly higher baseline levels of hs-cTnT, hs-CRP, IL-6, and GDF-15 compared to participants with no comorbidities. In conclusion, increasing cardiometabolic comorbidity burden in patients with CCD is associated with higher levels of circulating biomarkers of myocardial injury and inflammation.