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Article ; Online: The choice.

Weissman, Charles

BJOG : an international journal of obstetrics and gynaecology

2024 Volume 131, Issue 7, Page(s) 969

Language	English
Publishing date	2024-01-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2000931-8
ISSN	1471-0528 ; 0306-5456 ; 1470-0328
ISSN (online)	1471-0528
ISSN	0306-5456 ; 1470-0328
DOI	10.1111/1471-0528.17751
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Article ; Online: The Impact of Gender on the Postoperative Consumption of Intensive and Intermediate Care Resources

Charles Weissman

SAGE Open, Vol

2023 Volume 13

Abstract: Gender disparities when delivering healthcare are attributed to gender bias and gender-related pathophysiology. We examined the interaction of gender with the provision of postoperative intensive and intermediate care. Specifically whether for major ... ...

Abstract	Gender disparities when delivering healthcare are attributed to gender bias and gender-related pathophysiology. We examined the interaction of gender with the provision of postoperative intensive and intermediate care. Specifically whether for major surgeries, co-morbidities and lengths-of-surgery, women receive intensive and intermediate care as often as men. A two-phase prospective study performed in an Israeli university medical center explored utilization of postoperative intensive/intermediate care. Phase 1 examined gender differences in a broad range of postoperative intensive and intermediate patients. Phase 2 examined consecutive patients undergoing major abdominal and vascular surgeries to ascertain whether for similar surgeries and co-morbidities, women were as likely as men to receive intensive/intermediate care. Phase 1 ( n = 1883)—Proportionately more males were admitted to intensive/intermediate areas because they more often were trauma victims or had pre-existing ischemic heart disease. Female admissions were notable for obstetrical emergencies and post-meningioma excisions. Phase 2 ( n = 796)—The proportion of males and females receiving intensive/intermediate care did not differ after specific surgeries, for example, hepatectomy, carotid endarterectomy. However, among patients with underlying ischemic heart disease men, more often than women (15% vs. 21%, p < 0.05), received intensive care after elective surgery. Although pathophysiologic differences resulted in more men than women, receiving postoperative intensive/intermediate care, gender bias might also be operative. These observations highlight the importance of considering the influence of gender when choosing a postoperative care location to insure that gender differences in the levels of care are due to pathophysiology and not gender bias.
Keywords	History of scholarship and learning. The humanities ; AZ20-999 ; Social Sciences ; H
Subject code	610
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Be Careful and Protect Yourself, It Is in the Air.

Weissman, Charles

Critical care medicine

2021 Volume 49, Issue 7, Page(s) 1214–1217

Language	English
Publishing date	2021-04-27
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000005020
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Article ; Online: Transdisciplinary Science and Research Training in Psychiatry: A Robust Approach to Innovation.

Reynolds, Charles F / Weissman, Myrna M

JAMA psychiatry

2022 Volume 79, Issue 9, Page(s) 839–840

MeSH term(s)	Creativity ; Humans ; Interdisciplinary Communication ; Psychiatry
Language	English
Publishing date	2022-07-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701203-7
ISSN	2168-6238 ; 2168-622X
ISSN (online)	2168-6238
ISSN	2168-622X
DOI	10.1001/jamapsychiatry.2022.1788
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Article ; Online: Using Mean Anesthesia Workload to Plan Anesthesia Workforce Allocations: The "Flaw of Averages".

Ginosar, Yehuda / Wimpfheimer, Ariel / Weissman, Charles

Anesthesia and analgesia

2022 Volume 135, Issue 6, Page(s) 1138–1141

MeSH term(s)	Workload ; Anesthesiology ; Anesthesia ; Workforce
Language	English
Publishing date	2022-11-16
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000006220
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Article ; Online: Does examining job market awareness among medical students provide insight into the specialty selection process?

Zisk-Rony, Rachel Yaffa / Weissman, Charles / Avidan, Alexander

Annals of medicine

2023 Volume 55, Issue 1, Page(s) 2201012

Abstract: Background: The future composition of a country's physician workforce depends on medical students' choices of specialties. Students' familiarity with the job market (the healthcare system) they are about to enter and the influence job market conditions ... ...

Abstract	Background: The future composition of a country's physician workforce depends on medical students' choices of specialties. Students' familiarity with the job market (the healthcare system) they are about to enter and the influence job market conditions have on their choices has not been well explored. This study focuses on whether and how the healthcare system's employment landscape is taken into consideration by medical students and whether this facet adds information about the specialty selection process. Methods: Fifth-year medical students completed a questionnaire querying their knowledge and perceptions of the national healthcare system, selection criteria for choosing a specialty and a post-residency work position. Data were analyzed with two-tailed Student's t-tests and multivariable regression analysis. Results: The questionnaire was completed by 242 students (49% women). Forty per cent were interested in a specialty where it is 'easy to find work' and 64% in a specialty that 'provides job security'. Only 12% were attracted to specialties with empty positions due to a workforce shortage. A high salary was considered an important selection criterion by 45% of students, who were also not deterred by specialties with surplus workforce, especially, if accompanied by high salaries or controllable lifestyles. Only 17% thought it would be easy to find a residency in any hospital in the specialty they chose, reflecting the low rate (3%) of positive responses to the statement that 'there are sufficient residency positions in all specialties'. Conclusions: This study demonstrated the utility of querying medical students about their market awareness when investigating the specialty selection process. Students' poor rating of selection criteria, such as specialties with ease in finding jobs because they are suffering workforce shortages and have empty positions, provide insights and concerns for healthcare leaders. It should aid them in approaching the challenge of attracting students to specialties with workforce shortfalls.KEY MESSAGESThis study demonstrated the feasibility and potential value of adding queries about market awareness when investigating the medical student specialty selection process.Medical students were more interested in a specialty that provides job security than one where it is easy to find work.It could be useful for the healthcare leadership and medical educators in all countries to learn what medical students know about their national healthcare system and whether they need to add more healthcare delivery and system subjects to their curricula.
MeSH term(s)	Humans ; Female ; Male ; Students, Medical ; Career Choice ; Medicine ; Surveys and Questionnaires ; Delivery of Health Care
Language	English
Publishing date	2023-04-21
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1004226-x
ISSN	1365-2060 ; 1651-2219 ; 0785-3890 ; 1743-1387
ISSN (online)	1365-2060 ; 1651-2219
ISSN	0785-3890 ; 1743-1387
DOI	10.1080/07853890.2023.2201012
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Article ; Online: When policy meets reality: the new 18-hour on-call shift policy and the Israeli anesthesia workforce crisis.

Wimpfheimer, Ariel / Weissman, Charles / Fein, Shai / Ginosar, Yehuda

Israel journal of health policy research

2023 Volume 12, Issue 1, Page(s) 8

Abstract: Background: The Israeli physician workforce faces multiple challenges. These include planned policies reducing physician on-call from 26 to 18 h and, from 2026, allowing only graduates of Ministry of Health approved foreign medical schools to take the ... ...

Abstract	Background: The Israeli physician workforce faces multiple challenges. These include planned policies reducing physician on-call from 26 to 18 h and, from 2026, allowing only graduates of Ministry of Health approved foreign medical schools to take the Israeli licensing examination and an ongoing physician shortage (2019: Israel had 3.19 physicians/1000 persons vs. OECD average of 3.49 physicians/1000 persons). This study examines the potential impact of these planned policies on the Israeli anesthesiology workforce. Methods: Surveys conducted among 34 public and private Israeli hospital anesthesiology department chairs collected data on their department's number of weekday on-call anesthesiologists and current shortage of anesthesiologists. A subsequent survey collected data on each anesthesiologist in the workforce, including the country where they studied medicine. Results: Each weekday night there were 114 on-call anesthesiologists; 72 residents and 42 attendings. Using productive work coefficients, this translates to 104 resident and 51 attending anesthesiologists. Furthermore, 21 departments had existing anesthesia workforce shortages totaling 110 anesthesiologists. There were 873 anesthesiologists from non-OECD countries whose medical schools are not accredited by the World Federation for Medical Education, of whom 332 were residents (61.9% of residents). Only 20.1% of anesthesiology residents were Israeli medical school graduates. Conclusions: Descriptive survey data assessed the immediate and long-term consequences for the healthcare system and anesthesiology workforce of two new Health Ministry policies. Implementing the 18-h policy will immediately remove from the daytime workforce 155 anesthesiologists and who will be unavailable to staff elective surgery operating rooms. This will compound the current national shortage of 110 anesthesiologists. It is unclear how to replace this shortfall since there are no surplus Israeli physicians and very few Israeli graduates choose anesthesiology as a specialty. This situation will be exacerbated after 2026 when graduates of certain foreign medical schools will be unable to enter the medical workforce, further reducing the pool of potential anesthesiology residents. Both policies were promulgated without adequate operational and budgetary planning or fiscal or workforce resources; implementation of the 18-h on-call policy has already been postponed. Therefore, new or updated policies must be accompanied by specific operational plans, budgetary allocations and funds for additional workforce.
MeSH term(s)	Humans ; Anesthesiology ; Israel ; Anesthesia ; Physicians ; Health Policy
Language	English
Publishing date	2023-03-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2657655-7
ISSN	2045-4015 ; 2045-4015
ISSN (online)	2045-4015
ISSN	2045-4015
DOI	10.1186/s13584-023-00556-x
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Article ; Online: Does examining job market awareness among medical students provide insight into the specialty selection process?

Rachel Yaffa Zisk-Rony / Charles Weissman / Alexander Avidan

Annals of Medicine, Vol 55, Iss

2023 Volume 1

Abstract: AbstractBackground The future composition of a country’s physician workforce depends on medical students’ choices of specialties. Students’ familiarity with the job market (the healthcare system) they are about to enter and the influence job market ... ...

Abstract	AbstractBackground The future composition of a country’s physician workforce depends on medical students’ choices of specialties. Students’ familiarity with the job market (the healthcare system) they are about to enter and the influence job market conditions have on their choices has not been well explored. This study focuses on whether and how the healthcare system’s employment landscape is taken into consideration by medical students and whether this facet adds information about the specialty selection process.Methods Fifth-year medical students completed a questionnaire querying their knowledge and perceptions of the national healthcare system, selection criteria for choosing a specialty and a post-residency work position. Data were analyzed with two-tailed Student’s t-tests and multivariable regression analysis.Results The questionnaire was completed by 242 students (49% women). Forty per cent were interested in a specialty where it is ‘easy to find work’ and 64% in a specialty that ‘provides job security’. Only 12% were attracted to specialties with empty positions due to a workforce shortage. A high salary was considered an important selection criterion by 45% of students, who were also not deterred by specialties with surplus workforce, especially, if accompanied by high salaries or controllable lifestyles. Only 17% thought it would be easy to find a residency in any hospital in the specialty they chose, reflecting the low rate (3%) of positive responses to the statement that ‘there are sufficient residency positions in all specialties’.Conclusions This study demonstrated the utility of querying medical students about their market awareness when investigating the specialty selection process. Students’ poor rating of selection criteria, such as specialties with ease in finding jobs because they are suffering workforce shortages and have empty positions, provide insights and concerns for healthcare leaders. It should aid them in approaching the challenge of attracting students to specialties with workforce ...
Keywords	Medical Students ; Job Market ; Medical Specialties ; Market Awareness ; Job Security ; Choice of Medical Specialty ; Medicine ; R
Subject code	650
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Comparison of medical students' considerations in choosing a specialty: 2020 vs. 2009/10.

Schroeder, Hanna / Shacham, Alon / Amar, Shimon / Weissman, Charles / Schroeder, Josh E

Human resources for health

2024 Volume 22, Issue 1, Page(s) 5

Abstract: Background: Workforce shortage in healthcare and particularly in physicians poses a threat to healthcare delivery and its quality. In comparison to other OECD countries, Israel currently has a small number of medical graduates relative to its number of ... ...

Abstract	Background: Workforce shortage in healthcare and particularly in physicians poses a threat to healthcare delivery and its quality. In comparison to other OECD countries, Israel currently has a small number of medical graduates relative to its number of physicians, naturally emphasizing the importance of ensuring that this population chooses to remain in medicine. Understanding what is most important to medical students can help improve working conditions in residency. Such information is particularly needed to facilitate policy planning that will encourage the next generation of physicians to specialize in medical fields that are experiencing shortages. We hypothesized that between 2009/2010 and 2020, there were significant changes in medical students' preferences regarding their considerations for choosing a medical specialty. Methods: We compared cross-sectional data from questionnaire-based surveys of 5th year medical students performed in 2009-2010 and 2020 at two Israeli universities. Results: Of the 335 medical students who responded (237 and 98 in 2009/2010 and 2020, respectively) those in 2020 were 2.26 less likely vs. those in 2009/2010, to choose a residency for its high-paying potential (P < 0.05), and had significantly more interest in residencies with greater teaching opportunity (98.8% vs 82.9%, P < 0.05), increased responsibility and chances to make clinical decisions on their own (67.9% vs 51.6%, P < 0.05). Criteria important to both the 2009/2010 and 2020 students were choosing a bedside specialty (70.2%vs 67.9%, NS), and an interesting and challenging specialty (95.2%v s 91.3%, NS). Conclusions: These results partially supported our hypothesis that medical students' preferences have changed over the years, though there are fundamental factors that apparently reflect medical students' nature that do not change over time.
MeSH term(s)	Humans ; Students, Medical ; Cross-Sectional Studies ; Health Facilities ; Internship and Residency ; Israel
Language	English
Publishing date	2024-01-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2126923-3
ISSN	1478-4491 ; 1478-4491
ISSN (online)	1478-4491
ISSN	1478-4491
DOI	10.1186/s12960-023-00885-7
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Article ; Online: Contemporary outcomes of surgical aortic valve replacement in patients referred for a transcatheter approach.

Leung Wai Sang, Stephane / Weissman, Caleb / Parker, Jessica / Timek, Tomasz / Willekes, Charles / Fanning, Justin

International journal of cardiology

2024 Volume 407, Page(s) 132004

Abstract: Objectives: The purpose of this study is to examine which patients referred to our structural valve clinic for potential transcatheter aortic valve replacement (TAVR) are receiving surgical aortic valve replacement (SAVR) whether due to unsuitable ... ...

Abstract	Objectives: The purpose of this study is to examine which patients referred to our structural valve clinic for potential transcatheter aortic valve replacement (TAVR) are receiving surgical aortic valve replacement (SAVR) whether due to unsuitable anatomy for TAVR versus other reasons. Methods: Individuals referred for TAVR from January 2019 to March 2022, who ultimately underwent SAVR were examined, retrospectively. Patients were divided into 2 surgical groups: TAVR was technically unsuitable (SAVR-TU) and those in which TAVR was technically feasible (SAVR-TF). Results: 215 patients referred for TAVR underwent SAVR with 61 (28.4%) patients in the SAVR-TU group and 154 (71.6%) in the SAVR-TF group. The SAVR-TU group were more commonly female (52.5% vs 23.4%, p < 0.0001), had a higher incidence of stroke at baseline (9.8% vs 2.0%, p = 0.017) were frailer (5-m gait 5.2 s vs 4.7 s, p = 0.0035), and had a higher Society of Thoracic Surgery risk score (2.2 vs 1.7, p = 0.04). In the SAVR-TU group, unsuitability for TAVR was due to inadequate aortic root anatomy (86.9%), and poor peripheral access (6.6%). In the SAVR-TF group, the most common reasons for SAVR referral were concomitant coronary artery disease (42.9%), bicuspid aortic valve disease (16.9%), and concomitant aortic aneurysm (10.4%). Overall, in-hospital mortality was 1.4% with no difference between both groups. One-year survival was 96.7%. Conclusion: Despite a higher trend of aortic stenosis being treated with TAVR, higher risk patients unsuitable for TAVR can have SAVR with excellent outcomes. Moreover, patients with AS and concomitant other pathology should be evaluated for cardiac surgery.
MeSH term(s)	Humans ; Female ; Male ; Transcatheter Aortic Valve Replacement/methods ; Aged ; Retrospective Studies ; Aged, 80 and over ; Aortic Valve Stenosis/surgery ; Treatment Outcome ; Aortic Valve/surgery ; Referral and Consultation ; Heart Valve Prosthesis Implantation/methods ; Heart Valve Prosthesis Implantation/trends
Language	English
Publishing date	2024-03-30
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/j.ijcard.2024.132004
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