Factors influencing the pursuit of fellowship training by women urologists
Brooke A. Harnisch, MD1, Kelly L. Stolzmann, MS2, Lori B. Lerner, MD2.
1Boston University, Boston, MA, USA, 2VA Boston Healthcare System, Boston, MA, USA.
Background: The number of women training in urology has doubled over the last decade. As a result, a larger number of women urologists are seeking fellowship training. The purpose of this study was to determine what factors, if any, influenced the decision to pursue advanced training, including demographics and mentorship. Additionally, we sought to determine if practice environments, salary and life satisfaction differed between those women that pursued fellowship training as compared to those that did not.
Methods: An Internal Review Board approved 114-item questionnaire was sent to all 365 American board certified women urologists in 2007. Data including subspecialty training, age at residency graduation, academic rank in medical school, length of urology training program, type of mentorship, practice environment, salary and life satisfaction were analyzed.
Results: Of the women surveyed, 69% responded (n=243). Forty two percent pursued fellowship training. The majority of women pursued fellowships in Female Urology (36%), Pediatrics (22%) and Oncology (12%). Age at completion of residency did not impact the pursuit of fellowship training nor did academic achievements prior to residency. Seventy one percent of all female urologists surveyed reported having a mentor during residency training, male and/or female. However, mentorship had no influence on pursuing fellowship (p=0.12). Peer reviewed grants were more likely to be obtained by fellowship versus non-fellowship trained urologists (p<0.001). Additionally, urologists practicing in the following environments were more likely to be fellowship trained: community hospitals (p<0.0001); private community (p=0.01); Veterans Affairs (p=0.01); and borderline significance with university affiliated hospital urologists (p=0.056). No difference was seen in county/public hospitals (p=0.93) or active duty military hospitals (p=0.80). There were no differences in salary or overall life satisfaction (95% of the entire cohort reported “moderately satisfied” or “very satisfied”) between women who pursued fellowships and those that did not.
Conclusions: While it would seem logical that women who had mentors during their residency training would be more likely to pursue advanced training, this did not prove to be the case. This may be because a high percentage of all women reported having mentors, but that being said, there is still room for improvement. We expected that nearly all women urologists in university affiliated hospitals, presumably with residency training programs, would be fellowship trained, which was not necessarily true. It is encouraging that the majority of women were satisfied with their career path, irrespective of fellowship training. These findings provide some insight and may aid future generations of female urologists in their career decisions.