Pub Date : 2026-03-01Epub Date: 2025-10-28DOI: 10.1016/j.amjsurg.2025.116699
Gopika SenthilKumar , Umut Sarpel , Tiffany A. Glazer
Although nearly half of current surgical trainees identify as women, significant reproductive health disparities persist in our field. Female surgeons experience infertility rates nearly three times that of the general U.S. population, alongside substantially higher rates of pregnancy complications—even when compared to other demanding professions. These disparities are compounded by modifiable occupational hazards and the absence of standardized accommodations during pregnancy. In this article, we synthesize current evidence, identify the specific occupational factors contributing to these disparities, and propose practical, evidence-based workplace modification and policy recommendations. We also present a reproducible institutional model for pregnancy accommodations that can be adapted across institutions.
The surgical profession is at an inflection point; just as duty-hour limits reshaped the culture of surgical training in the name of safety, so too must we advance comprehensive, enforceable accommodations that protect reproductive health.
{"title":"Addressing the high rates of pregnancy complications and infertility among female surgeons: What should we do about it?","authors":"Gopika SenthilKumar , Umut Sarpel , Tiffany A. Glazer","doi":"10.1016/j.amjsurg.2025.116699","DOIUrl":"10.1016/j.amjsurg.2025.116699","url":null,"abstract":"<div><div>Although nearly half of current surgical trainees identify as women, significant reproductive health disparities persist in our field. Female surgeons experience infertility rates nearly three times that of the general U.S. population, alongside substantially higher rates of pregnancy complications—even when compared to other demanding professions. These disparities are compounded by modifiable occupational hazards and the absence of standardized accommodations during pregnancy. In this article, we synthesize current evidence, identify the specific occupational factors contributing to these disparities, and propose practical, evidence-based workplace modification and policy recommendations. We also present a reproducible institutional model for pregnancy accommodations that can be adapted across institutions.</div><div>The surgical profession is at an inflection point; just as duty-hour limits reshaped the culture of surgical training in the name of safety, so too must we advance comprehensive, enforceable accommodations that protect reproductive health.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116699"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-29DOI: 10.1016/j.amjsurg.2025.116815
Nicole M. Mott , Erin Kim , Faelan Jacobson-Davies , Michael J. Englesbe , Hari Nathan , Lesly A. Dossett
Background
Routine pre-operative testing before low-risk surgery remains common despite guidelines against it.
Methods
We conducted a retrospective cohort study of adults undergoing low-risk surgery (cholecystectomy, hernia repair, lumpectomy, thyroidectomy, mastectomy) in Michigan from 2015 to 2024. The primary outcome was testing performed within 30 days of surgery. Linear mixed models identified predictors of testing, and the results of a pilot quality improvement (QI) initiative to reduce testing at 31 hospitals were examined.
Results
Among 99,501 patients, testing rates declined from 44 % to 39 % from 2019 to 2024. Older age, comorbidity burden, and undergoing a pre-operative history and physical were associated with testing. Hospital testing rates varied from 13 % to 93 %. In the QI-participating hospitals, testing declined from 38 % to 33 % in the measurement period compared to the baseline period (p = 0.035).
Conclusions
Pre-operative testing remains common and variable. QI initiatives help reduce testing, but broader de-implementation strategies may promote sustained improvement.
{"title":"Statewide trends in routine pre-operative testing before low-risk surgery","authors":"Nicole M. Mott , Erin Kim , Faelan Jacobson-Davies , Michael J. Englesbe , Hari Nathan , Lesly A. Dossett","doi":"10.1016/j.amjsurg.2025.116815","DOIUrl":"10.1016/j.amjsurg.2025.116815","url":null,"abstract":"<div><h3>Background</h3><div>Routine pre-operative testing before low-risk surgery remains common despite guidelines against it.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adults undergoing low-risk surgery (cholecystectomy, hernia repair, lumpectomy, thyroidectomy, mastectomy) in Michigan from 2015 to 2024. The primary outcome was testing performed within 30 days of surgery. Linear mixed models identified predictors of testing, and the results of a pilot quality improvement (QI) initiative to reduce testing at 31 hospitals were examined.</div></div><div><h3>Results</h3><div>Among 99,501 patients, testing rates declined from 44 % to 39 % from 2019 to 2024. Older age, comorbidity burden, and undergoing a pre-operative history and physical were associated with testing. Hospital testing rates varied from 13 % to 93 %. In the QI-participating hospitals, testing declined from 38 % to 33 % in the measurement period compared to the baseline period (p = 0.035).</div></div><div><h3>Conclusions</h3><div>Pre-operative testing remains common and variable. QI initiatives help reduce testing, but broader de-implementation strategies may promote sustained improvement.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116815"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-10-10DOI: 10.1016/j.amjsurg.2025.116655
Zachary A. Koenig MD , Joshua T. Henderson MD , Iraj Hasan BS , Sebastian M. Brooke MD
{"title":"Spaced repetition in surgical education: Understanding the barriers and opportunities for broader adoption through a plastic surgery lens","authors":"Zachary A. Koenig MD , Joshua T. Henderson MD , Iraj Hasan BS , Sebastian M. Brooke MD","doi":"10.1016/j.amjsurg.2025.116655","DOIUrl":"10.1016/j.amjsurg.2025.116655","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116655"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-09-22DOI: 10.1016/j.amjsurg.2025.116624
Lisa Marie Jackson , James Petrancosta , Nina Kosciuszek , Sophia Liu , Tawny Kim , Erin E. Perrone , Claudia N. Emami , Kristen A. Calabro , Kenneth W. Gow
Background
Women have long been underrepresented in surgical fields, including pediatric general surgery (PGS), one of the most competitive subspecialties. This study examined trends in gender representation in PGS.
Methods
We identified all PGS graduates from U.S. and Canadian programs between 1919 and 2025 using validated sources. Gender was determined, and male-to-female ratios were analyzed by year. National leadership roles were reviewed for their representation of females. Chi-square tests were used to assess statistical significance (p < 0.05).
Results
Seventy-nine programs produced 2235 graduates: 1675 (75 %) men and 560 (25 %) women. Female representation increased steadily, with gender parity emerging around 2020. Although women entered leadership roles in PGS earlier than in General Surgery, they still lag behind men in overall leadership representation.
Conclusions
PGS has made significant progress toward gender equity in training, with recent parity among graduates. However, leadership remains an area for continued improvement to ensure equitable representation at all levels.
{"title":"The rise of women in pediatric surgery training: Have we reached equity?","authors":"Lisa Marie Jackson , James Petrancosta , Nina Kosciuszek , Sophia Liu , Tawny Kim , Erin E. Perrone , Claudia N. Emami , Kristen A. Calabro , Kenneth W. Gow","doi":"10.1016/j.amjsurg.2025.116624","DOIUrl":"10.1016/j.amjsurg.2025.116624","url":null,"abstract":"<div><h3>Background</h3><div>Women have long been underrepresented in surgical fields, including pediatric general surgery (PGS), one of the most competitive subspecialties. This study examined trends in gender representation in PGS.</div></div><div><h3>Methods</h3><div>We identified all PGS graduates from U.S. and Canadian programs between 1919 and 2025 using validated sources. Gender was determined, and male-to-female ratios were analyzed by year. National leadership roles were reviewed for their representation of females. Chi-square tests were used to assess statistical significance (p < 0.05).</div></div><div><h3>Results</h3><div>Seventy-nine programs produced 2235 graduates: 1675 (75 %) men and 560 (25 %) women. Female representation increased steadily, with gender parity emerging around 2020. Although women entered leadership roles in PGS earlier than in General Surgery, they still lag behind men in overall leadership representation.</div></div><div><h3>Conclusions</h3><div>PGS has made significant progress toward gender equity in training, with recent parity among graduates. However, leadership remains an area for continued improvement to ensure equitable representation at all levels.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116624"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145204927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-10-09DOI: 10.1016/j.amjsurg.2025.116654
E. Christopher Ellison MD
{"title":"Lessons for the surgeon from the early history of the Zollinger Ellison syndrome","authors":"E. Christopher Ellison MD","doi":"10.1016/j.amjsurg.2025.116654","DOIUrl":"10.1016/j.amjsurg.2025.116654","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116654"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-09-12DOI: 10.1016/j.amjsurg.2025.116611
Denzel R. Woode MD, Andre R. Campbell MD
{"title":"The long-lasting effects of redlining: Editorial to the paper “Strong laws aren't enough: Historic Redlining, state firearm laws, and urban firearm violence in the United States”","authors":"Denzel R. Woode MD, Andre R. Campbell MD","doi":"10.1016/j.amjsurg.2025.116611","DOIUrl":"10.1016/j.amjsurg.2025.116611","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116611"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-08DOI: 10.1016/j.amjsurg.2025.116770
Lyen C. Huang MD, MPH, FACS, FASCRS , Kevin D. Helling MD, FACS
{"title":"The people left behind","authors":"Lyen C. Huang MD, MPH, FACS, FASCRS , Kevin D. Helling MD, FACS","doi":"10.1016/j.amjsurg.2025.116770","DOIUrl":"10.1016/j.amjsurg.2025.116770","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116770"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-26DOI: 10.1016/j.amjsurg.2026.116892
Lauren Theiss Gleason
{"title":"Multidisciplinary prehabilitation in rectal cancer: Implications for recovery.","authors":"Lauren Theiss Gleason","doi":"10.1016/j.amjsurg.2026.116892","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2026.116892","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116892"},"PeriodicalIF":2.7,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-20DOI: 10.1016/j.amjsurg.2026.116876
Sasha A Still
{"title":"Cultural humility training in surgery-Innovation in format, not yet in outcomes.","authors":"Sasha A Still","doi":"10.1016/j.amjsurg.2026.116876","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2026.116876","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116876"},"PeriodicalIF":2.7,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}