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Background: Job competition and underemployment among surgeons emphasize the importance of equitable hiring practices. The purpose of this study was to describe some of the demographic characteristics of academic general surgeons and to evaluate the gender and visible minority (VM) status of those recently hired. Methods: Demographic information about academic general surgeons across Canada including gender, VM status, practice location and graduate degree status was collected. Location of residency was collected for recently hired general surgeons (hired between 2013 and 2020). Descriptive statistics were performed on the demographic characteristics at each institution. Pearson correlation coefficients and hypothesis testing were used to determine the correlation between various metrics and gender and VM status. Results: A total of 393 general surgeons from 30 academic hospitals affiliated with 14 universities were included. The percentage of female general surgeons ranged from 0% to 47.4% and the percentage of VM general surgeons ranged from 0% to 66.7% at the hospitals. This heterogeneity did not correlate with city population (gender: r = 0.06, p = 0.77; VM: r = 0.04, p = 0.83). The percentage of VM general surgeons at each hospital did not correlate with the percentage of VM population in the city (r = 0.13, p = 0.49). Only 34 of 120 recently hired academic general surgeons (28.3%) did not have a graduate degree. The percentage of recently hired academic general surgeons who did not have a graduate degree was approximately 1.5 times higher among male hirees than female hirees. With respect to academic promotion, the percentage of female full professors ranged from 0% to 40.0% and did not correlate with the percentage of female general surgeons at each institution (r = 0.11, p = 0.70). The percentage of VM full professors ranged from 0% to 44.4% and was moderately correlated with the percentage of VM surgeons at each institution (r = 0.40, p = 0.16). Conclusion: The academic general surgery workforce appears to be somewhat diverse. However, there was substantial heterogeneity in diversity between hospitals, leaving room for improvement. We must be willing to examine our hiring processes and be transparent about them to build an equitable surgical workforce. Contexte : Les processus d'accès aux postes et le sous-emploi en chirurgie rappellent l'importance d'adopter des pratiques d'embauche équitables. Cette étude avait pour but de décrire certaines des caractéristiques démographiques de la maind'oeuvre en chirurgie générale dans les hôpitaux universitaires et d'établir le statut à l'égard du genre et de l'appartenance à une minorité visible (MV) chez les personnes récemment embauchées. Méthodes : Des renseignements démographiques ont été recueillis auprès des personnes embauchées en chirurgie générale dans des établissements universitaires au Canada, incluant le genre, l'appartenance à une MV, le lieu de pratique et le niveau d'études. Le lieu de résidence a été noté pour les personnes récemment embauchées en chirurgie générale (entre 2013 et 2022). Des statistiques descriptives ont été compilées sur les caractéristiques démographiques dans chaque établissement. Nous avons utilisé le coefficient de corrélation de Pearson et le test d'hypothèse pour déterminer la corrélation entre divers paramètres, et le genre et l'appartenance à une MV. Résultats : En tout, 393 personnes embauchées en chirurgie générale dans 30 hôpitaux affiliés à 14 universités ont été incluses. Le pourcentage de femmes en chirurgie générale variait de 0% à 47,4%; et le pourcentage provenant d'une MV variait de 0% à 66,7% dans les hôpitaux. Cette hétérogénéité n'était pas en corrélation avec la population des villes (genre : r = 0,06, p = 0,77; MV : r = 0,04, p = 0,83). Le pourcentage appartenant à une MV dans chaque hôpital n'était pas en corrélation avec le pourcentage appartenant à une MV dans les villes (r = 0,13, p = 0,49). Seulement 34 personnes sur les 120 récemment embauchées en chirurgie générale dans ces hôpitaux universitaires n'avaient pas de diplômes d'études supérieures et leur pourcentage était environ 1,5 fois plus élevé chez les hommes que chez les femmes. En ce qui concerne les promotions au sein du corps professoral, le pourcentage de professeures titulaires variait de 0% à 40,0% et n'était pas en corrélation avec le pourcentage de femmes en chirurgie générale dans chaque établissement (r = 0,11, p = 0,70). Le pourcentage de professeures et de professeurs titulaires appartenant à une MV variait de 0% à 44,4% et était en corrélation modérée avec le pourcentage de chirurgiens et chirurgiennes appartenant à une MV dans chaque établissement (r = 0,40, p = 0,16). Conclusion : La main-d'oeuvre en chirurgie générale dans les centres hospitaliers universitaires semble assez diversifiée. Toutefois, on observe une hétérogénéité substantielle entre les hôpitaux au plan de la diversité, ce qui laisse place à l'amélioration. Nous devons accepter de revoir nos processus d'embauche et faire preuve de transparence à cet égard pour nous doter d'une main-d'oeuvre réellement égalitaire en chirurgie., The supply of Canadian graduating surgeons currently outweighs demand, resulting in a climate of underemployment and substantial credential creep in the hiring process. (1-6) The competition for employment emphasizes the [...]

The coronavirus disease 2019 (COVID-19) pandemic has had a massive impact on waits for elective operations, with tens of thousands of scheduled surgeries being cancelled or postponed across Canada. Provincial governments will likely not only reopen elective surgical capacity when it is deemed safe, but also target new funding to address the backlog of cases. There is a dearth of research on whether the provinces' approaches to managing wait lists are equitable from a patients' needs perspective or if they are associated with patients' perception of outcomes. The surgical cost models used in the past won't be useful to governments and hospital managers. New models based on hospitals' marginal costs, associated with running on weekends or off-hours and social distancing parameters, will be needed. Surgeon input, collaboration and leadership during the strategy development, implementation and management of surgical wait lists postpandemic will be imperative, as these decisions will significantly affect the health and lives of many Canadians., The coronavirus disease 2019 (COVID-19) pandemic did not cause long waits for elective surgeries--provinces have long had delayed access to nonurgent surgery. But now, with the exceptions of all but [...]

Introduction Physicians working in rural hospitals are frequently the frontline care providers for mental health in their communities. When a patient is deemed a risk to self or others, they [...]

Introduction: The current definition of 'teaching hospital' provided by Canadian Institute of Health Information (CIHI) focuses on large academic teaching hospitals. High-quality rural training experiences have been identified as a [...]

Author(s): Bharath Kumar Tirupakuzhi Vijayaraghavan [sup.1], Xavier Willaert [sup.2], Brian H. Cuthbertson [sup.3] Author Affiliations: (1) Critical Care, Apollo Hospitals and the Chennai Critical Care Consultants Group, , Chennai, India [...]

Author(s): Lisa Burry [sup.1], Louise Rose [sup.2], Bara Ricou [sup.3] Author Affiliations: (1) 0000 0001 2157 2938, grid.17063.33, Sinai Health System, University of Toronto, , Toronto, Canada (2) 0000 0000 [...]

Introduction Little is known regarding the relationship between the anatomic infection site and etiologic pathogen with the occurrence of acute kidney injury (AKI) in severe infections. We set out to determine the association between the site of infection, type of pathogen in septic shock and occurrence of AKI. Methods Using a large, international multicenter database that included data from 28 academic and community hospitals, we retrospectively analyzed adult (age >18 years) cases of septic shock occurring between January 1996 and December 2008. Early acute kidney injury (AKI) was classified by the RIFLE criteria at or within 24 h of shock diagnosis. Multivariate logistic regression was used to determine the association between the infection site/microbial pathogen and occurrence of AKI. Analyses were adjusted for demographics, illness severity, comorbidities and intensive care unit interventions (partial adjustment) ± site of infection and microbial pathogen (full adjustment). Results After exclusions, 4,493 cases from potentially eligible patients in the database were included in the analytic cohort of whom 3,298 (73.4 %) experienced AKI. Patients with AKI were older (p < 0.0001), had a higher mean Acute Physiology and Chronic Health Evaluation score (p < 0.0001), and had greater laboratory and hemodynamic abnormalities. The most common site of infection among septic shock patients with AKI was the lung (34.5 %), followed by gastrointestinal (GI) (26.2 %) and urinary (15.3 %) sources. Likewise, the most common infecting organism among septic shock patients with AKI was E. coli (23.9 %) followed by S. aureus (GI) (16.1 %) and other enterobacteriaceae (15.7 %). There was a large degree of variability in the occurrence of AKI based on the site of infection and the pathogen in unadjusted analysis (p < 0.0001), which persisted with partial (excluding infection site and microbial pathogen grouping) adjustment (p < 0.0001). Fully adjusted multivariate analysis showed significant variations in AKI only in relation to the anatomic source of infection, with non-pulmonary infections having higher risk than pulmonary infections. The pathogen group/pathogen had no significant independent impact on AKI. Conclusion This study demonstrates that the presence of septic AKI varies significantly based on the site of infection but not the type of causative organism., Author(s): Manish Sood [sup.1], Keren Mandelzweig [sup.2], Claudio Rigatto [sup.3], Navdeep Tangri [sup.3], Paul Komenda [sup.3], Gregory Martinka [sup.4], Yaseen Arabi [sup.5], Sean Keenan [sup.6], Aseem Kumar [sup.7], Anand Kumar [...]