American journal of surgery最新文献

Women surgeons encounter unique challenges in breastfeeding and lactation, influenced by early postpartum return to work, limited childcare options, and inadequate institutional supports. This qualitative study examined the infant-feeding experiences of Canadian women surgeons and trainees, with a focus on breastfeeding and pumping. Participants were recruited through social media, and semi-structured interviews explored motivations, barriers, and workplace experiences. Interviews were audio-recorded, transcribed, and analyzed using constructivist grounded theory with iterative open and focused coding to identify common themes. Sixteen participants across five surgical specialties were included. Three themes emerged: strong personal motivations to breastfeed; substantial structural and systemic barriers, including lack of protected time and private space; and pervasive feelings of guilt and judgment related to feeding choices. These findings highlight persistent obstacles to lactation in surgical environments and underscore the need for targeted institutional, policy, and cultural interventions to better support surgeon-mothers in achieving their infant-feeding goals.

Background: First-generation college and medical students (FGS) have a laborious path to medical school graduation. Without guidance, many FGS face an increased "distance traveled" to become surgeons.

Methods: During the 2021-2023 academic years, surgical subspecialty events were offered to pre-clinical students. Students were surveyed about first-generation status and their confidence in pursuing a surgical career.

Results: Across twenty-two surgical events, 235 students participated, of which 57% (134) identified as FGS with only 3% (4) having previous surgical exposure and 10% (13) reporting initial interest in surgery. Of non-FGS 42% (42) had previous exposure and 66% (66) reported interest in surgery. Following the event, 79% (37) FGS reported confidence in pursuing surgery.

Conclusions: These surgical subspecialty events offered many FGS a first exposure to surgery while increasing their confidence to pursue a surgical career. By building strong support networks, medical schools can support FGS as they contribute to the diversity of the surgical field.

Background: Large language models (LLM) can pass medical licensing and specialty board exams, but their ability to generate high-quality board-style exam questions is uncertain.

Methods: Three LLMs each generated 20 colorectal surgery board questions in accordance with American Board of Colon and Rectal Surgery guidelines. Questions from the Colon and Rectal Surgery Educational Program (CARSEP) served as comparators. Board-certified colorectal surgeons, blinded to source, graded each question on clarity, relevance, suitability, distractor quality, and adequacy of rationale, and categorized questions as "Approved for Committee," "Author to Review," or "Not Accepted."

Results: CARSEP demonstrated the highest "Approved for Committee" rate (65%), compared with ChatGPT-4o (7%), Copilot Pro (10%), and Gemini Advanced (10%). CARSEP significantly outperformed most LLMs across all evaluation domains (p < 0.001), except for question suitability, where most LLM questions received >70% very good to good ratings.

Conclusions: Although LLMs demonstrate potential, they are currently unable to consistently generate high-quality, colorectal surgery board-style questions.