Objective

The purpose of this study was to assess first-year medical students' implicit perceptions of surgeons, focusing on the roles of gender and demeanor (communal = supportive, associated with women; agentic = assertive, associated with men).

Design

Survey study. Each survey had 1 of 8 possible scenarios; all began with a short description of a surgeon who was described as accomplished and well trained, then varied by surgeon gender (male/female), surgeon demeanor (agentic/communal), and type of surgery (breast cancer/lung cancer). Using a 0 to 5 scale, respondents rated their perception of the surgeon through 5 questions. These 5 items were averaged to create a composite perception score scaled from 0 to 5.

Setting

Surveys were administered at the University of California, San Francisco, and the University of California, Los Angeles.

Participants

We administered surveys to 333 first-year medical students who could read English and voluntarily agreed to participate.

Results

A total of 238 students responded (71.5%). They preferred the communal vs agentic surgeon (4.2 ± 0.7 vs 3.9 ± 0.7, p = 0.002) and male medical students perceived surgeons more favorably than female medical students did (4.2 ± 0.6 vs 4.0 ± 0.8, p = 0.036). The preference score did not differ according to surgeon gender (female 4.12 vs male 3.98, p = 0.087). There were no significant interactions between the factors of student gender, surgeon gender, or demeanor. Students who reported an interest in surgery as a career did not perceive surgeons more favorably than the students interested in other fields (4.3 ± 0.7 vs 4.0 ± 0.7 respectively, p = 0.066).

Conclusions

Based on our findings, surgeon educators would likely find success in teaching and recruiting medical students by employing a communal demeanor in their interactions with all students, regardless of the students' gender or stated interest in surgery.

Background

In craniofacial microsomia, microtia and canal atresia pose formidable reconstructive challenges. We review our institutional experience in treating microtia and atresia to identify variables associated with 4 outcomes measures: complications, surgical revisions, aesthetic outcomes, and psychosocial function.

Methods

Craniofacial microsomia patients treated at the University of California Los Angeles Craniofacial Clinic between 2008 and 2014 greater than 13 years of age (n = 68) were reviewed for microtia and atresia treatment and outcomes.

Results

In total, 91.2% of patients diagnosed with craniofacial microsomia presented with microtia, affecting 75 ears. Both a male and right-sided predominance were observed. Fifty-six patients (90.3%) underwent autologous external ear reconstruction at an average age of 8.5 years. Age, type of incision, and size of cartilage framework did not predict total number of surgeries or complications. Severity of ear anomalies correlated with increased number of surgeries (P < 0.001) and decreased aesthetic outcomes (P < 0.001) but not complications. In total, 87.1% of patients with microtia had documented hearing loss, of which the majority were conductive and 18.5% were mixed sensorineural and conductive. Hearing deficits were addressed in 70.4% of patients with external hearing aids, bone anchored hearing aids, or canaloplasty. Of all variables, improvement of psychosocial function was correlated only to hearing loss treatment of any type (P = 0.01).

Conclusions

On evaluation of surgical and patient characteristics, severity of microtia predicted the total number of surgical revisions performed and aesthetic ratings. In addition, we found that the only factor that correlated with improved patient and parent-reported psychosocial outcomes was treatment of hearing loss.