LGBTQ+ Identity and Ophthalmologist Burnout

Chang, Ta Chen; Candelario, R.A. Calderon; Berrocal, Audina M.; Briceño, César A.; Chen, Jenny; Shoham-Hazon, Nir; Berco, Efraim; Valle, David Solá-Del; Vanner, Elizabeth A.

doi:10.1016/j.ajo.2022.10.002

Cited by 6 publications

(5 citation statements)

References 96 publications

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“…This was the first study to show an association between sexuality and suicidality among junior doctors and is congruent with the extant literature indicating higher rates of suicidal ideation and attempts among LGBTQ+ groups compared with the general population. 38,39 These findings echo those of related studies showing higher levels of burnout among ophthalmologists 40 and anaesthesiologists 39 who identify as LGBTQ+ than those who do not. The underlying factors explaining this are complex, and there is a clear need to better understand the experience of LGBTQ+ junior doctors, including the role of workplace factors and their interaction with non-work factors as antecedents to poor mental health.…”

Section: Individual Differences On Suicidal Ideationsupporting

confidence: 78%

Working conditions, psychological distress and suicidal ideation: cross-sectional survey study of UK junior doctors

Teoh,

Dunning,

Taylor

et al. 2023

BJPsych open

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Background Evidence attests a link between junior doctors’ working conditions and psychological distress. Despite increasing concerns around suicidality among junior doctors, little is known about its relationship to their working conditions. Aims To (a) establish the prevalence of suicidal ideation among junior doctors in the National Health Service; (b) examine the relationships between perceived working conditions and suicidal ideation; and (c) explore whether psychological distress (e.g. symptoms of depression and anxiety) mediates these relationships. Method Junior doctors were recruited between March 2020 and January 2021, for a cross-sectional online survey. We used the Health and Safety Executive's Management Standards Tool; Depression, Anxiety and Stress Scale 21; and Paykel Suicidality Scale to assess working conditions, psychological distress and suicidality, respectively. Results Of the 424 participants, 50.2% reported suicidal ideation, including 6.1% who had made an attempt on their own life. Participants who identified as LGBTQ+ (odds ratio 2.18, 95% CI 1.15–4.12) or reported depression symptoms (odds ratio 1.10, 95% CI 1.07–1.14) were more likely to report suicidal ideation. No direct relationships were reported between working conditions (i.e. control, support, role clarity, strained relationships, demand and change) and suicidal ideation. However, depression symptoms mediated all six relationships. Conclusions This sample of junior doctors reported alarming levels of suicidal ideation. There may be an indirect relationship between working conditions and suicidal ideation via depressive symptoms. Clearer research exploring the experience of suicidality in junior doctors is needed, including those who identify as LGBTQ+. Systematic interventions addressing working environment are needed to support junior doctors’ mental health.

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Section: Individual Differences On Suicidal Ideationsupporting

confidence: 78%

Working conditions, psychological distress and suicidal ideation: cross-sectional survey study of UK junior doctors

Teoh,

Dunning,

Taylor

et al. 2023

BJPsych open

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“…A more inclusive environment may provide an opportunity for people to self-identify more comfortably and would allow us to better identify where ophthalmology stands in terms of LGBTQ+ diversity in the future. Just as LGBTQ+ medical students report higher levels of burnout and prejudice, LGBTQ+ residents and attendings report higher levels of depression and anxiety (as well as perceived discrimination, harassment and social isolation) [1 ▪ ,20 ▪▪ ]. Such experiences may also extend to ophthalmology, restricting a trainee's capacity to build meaningful ties with colleagues.…”

Section: Increasing Workforce Diversitymentioning

confidence: 99%

“…This, in turn, may have an influence on letters of reference, interview possibilities, and, eventually, fellowship and career opportunities. In short, these experiences have significance for LGBTQ+ ophthalmologists’ recruitment, retention and accomplishment [1 ▪ ,20 ▪▪ ].…”

Section: Increasing Workforce Diversitymentioning

confidence: 99%

Diversity, equity and inclusion in ophthalmology

Aguwa

Williams

Woreta

2023

Current Opinion in Ophthalmology

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Purpose of review Diversity, equity and inclusion (DEI) initiatives in ophthalmology have received increased attention in recent years. This review will highlight disparities, barriers to workforce diversity, as well as current and future efforts to improve DEI in ophthalmology. Recent findings Racial, ethnic, socioeconomic and sex disparities exist in vision health and across many ophthalmology subspecialties. The pervasive disparities result from factors such as a lack of access to eye care. In addition, ophthalmology is one of the least diverse specialties at the resident and faculty level. The lack of diversity has also been documented in ophthalmology clinical trials, wherein participant demographics do not reflect the diversity of the U.S. population. Summary Addressing social determinants of health including racism and discrimination is necessary to promote equity in vision health. Diversifying the workforce and expanding the representation of marginalized groups in clinical research are also paramount. Supporting existing programmes and creating new ones focusing on improving workforce diversity and reducing eye care disparities are essential to ensure equity in vision health for all Americans.

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“…According to the AAMC medical student matriculant questionnaire, 15.9% identified as lesbian, gay, bisexual, transgender, queer, intersex, and asexual plus (LGBTQIA+) in 2023 . Though understudied, there is low LGBTQIA+ representation in ophthalmology, with LGBTQIA+ trainees and ophthalmologists reporting challenges secondary to burnout and discrimination . Other factors, such as parental income and education, are also predictors of entry into medicine.…”

Section: Introductionmentioning

confidence: 99%

“…6 Though understudied, there is low L GBTQIA+ representation in ophthalmolog y, w ith LGBTQIA+ trainees and ophthalmologists reporting challenges secondary to burnout and discrimination. [7][8][9] Other factors, such as parental income and education, are also predictors of entry into medicine. Only 11.4% of medical school matriculants were first-generation college graduates in 2019, with students from lower socioeconomic backgrounds facing numerous challenges in the residency application process.…”

mentioning

confidence: 99%

Bias Reduction Practices in Underrepresented Groups in Ophthalmology Resident Recruitment

Uner,

Choi,

Hwang

et al. 2024

JAMA Ophthalmol

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ImportanceBest recruitment practices for increasing diversity are well established, but the adoption and impact of these practices in ophthalmology residency recruitment are unknown.ObjectiveTo describe the adoption of bias reduction practices in groups underrepresented in ophthalmology (URiO) residency recruitment and determine which practices are effective for increasing URiO residents.Design, Setting, and ParticipantsThis cross-sectional survey study used an 18-item questionnaire included in the online survey of the Association of University Professors in Ophthalmology (AUPO) Residency Program Directors. Data collection occurred from July 2022 to December 2022. The data were initially analyzed on January 16, 2023. Participants included residency program directors (PDs) in the AUPO PD listserv database.Main Outcomes and MeasuresDescriptive analysis of resident selection committee approaches, evaluation of applicant traits, and use of bias reduction tools. Primary outcome was diversity assessed by presence of at least 1 resident in the last 5 classes who identified as URiO, including those underrepresented in medicine (URiM), lesbian, gay, bisexual, transgender, queer, intersex, and asexual plus, or another disadvantaged background (eg, low socioeconomic status). Multivariate analyses of recruitment practices were conducted to determine which practices were associated with increased URiO and URiM.ResultsAmong 106 PDs, 65 completed the survey (61.3%). Thirty-nine PDs used an interview rubric (60.0%), 28 used interview standardization (43.0%), 56 provided at least 1 bias reduction tool to their selection committee (86.2%), and 44 used postinterview metrics to assess diversity, equity, and inclusion efforts (67.7%). Application filters, interview standardization, and postinterview metrics were not associated with increased URiO. Multivariate logistic regression analysis showed larger residency class (odds ratio [OR], 1.34; 95% CI, 1.09-1.65; P = .01) and use of multiple selection committee bias reduction tools (OR, 1.47; 95% CI, 1.13-1.92; P = .01) were positively associated with increased URiO, whereas use of interview rubrics (OR, 0.72; 95% CI, 0.59-0.87; P = .001) and placing higher importance of applicant interest in a program (OR, 0.83; 95% CI, 0.75-0.92; P = .02) were negatively associated. URiM analyses showed similar associations.Conclusions and RelevanceOphthalmology residency interviews are variably standardized. In this study, providing multiple bias reduction tools to selection committees was associated with increased URiO and URiM residents. Prioritizing applicant interest in a program may reduce resident diversity. Interview rubrics, while intended to reduce bias, may inadvertently increase inequity.

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LGBTQ+ Identity and Ophthalmologist Burnout

Cited by 6 publications

References 96 publications

Working conditions, psychological distress and suicidal ideation: cross-sectional survey study of UK junior doctors

Working conditions, psychological distress and suicidal ideation: cross-sectional survey study of UK junior doctors

Diversity, equity and inclusion in ophthalmology

Bias Reduction Practices in Underrepresented Groups in Ophthalmology Resident Recruitment

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