Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Keck School of Medicine of University of Southern California, Los Angeles, California, USA.
Otolaryngol Head Neck Surg. 2023 Jun;168(6):1477-1484. doi: 10.1002/ohn.216. Epub 2023 Jan 29.
The workforce of neurotology has changed with increasing numbers of accredited programs and diverse representation among trainees over the past several decades. This study aims to describe the characteristics, density, and geographic variation of the current neurotology workforce in the United States.
Cross-sectional study.
American Board of Otolaryngology-Head and Neck Surgery portal and online search.
The study cohort included physicians certified in Neurotology by the American Board of Otolaryngology as of 2021 (n = 372). Physician characteristics including years of practice, gender, practice setting, and location were collected. Geographic variation analysis was performed by the state, county, and hospital referral region. Associations between the number of neurotologists per population and socioeconomic characteristics were assessed using multivariable regression analysis.
Among 372 neurotologists, 65% practiced in academic settings and 13% were female. The percentage of female neurotologists increased from 0% among neurotologists with ≥30 years of practice to 23% among <10 years of practice. There were no differences in a practice setting by gender. The geographical analysis demonstrated that the average number of neurotologists was 1.1 per 1 million Americans. In a multivariable model, the density of neurotologists was significantly higher within counties with the highest quartiles of college education (β = .6 [95% confidence interval, CI: 0.3-0.8]) and income (β = .3 [95% CI: 0.1-0.6]).
The number of board-certified neurotologists has gradually increased and there have been trends toward greater gender diversity. The geographical distribution of neurotology practice was concentrated in counties with higher socioeconomic status as expected given the referral-based nature of the subspecialty. There should be efforts to reach out to low socioeconomic communities to ensure equivalent access to neurotological care.
在过去几十年中，随着认证项目数量的增加以及学员群体的多样性，神经耳科学领域的劳动力结构发生了变化。本研究旨在描述美国当前神经耳科学领域劳动力的特征、密度和地域差异。
横断面研究。
美国耳鼻喉科学委员会（American Board of Otolaryngology-Head and Neck Surgery）门户和在线搜索。
研究队列包括截至 2021 年通过美国耳鼻喉科学委员会认证的神经耳科学医师（n=372）。收集了医师的特征，包括从业年限、性别、执业地点和所在地。通过州、县和医院转诊区进行地理差异分析。使用多变量回归分析评估了每人口神经耳科医生数量与社会经济特征之间的关联。
在 372 名神经耳科医生中，65%在学术环境中执业，13%为女性。从业年限≥30 年的神经耳科医生中，女性神经耳科医生的比例为 0%，而从业年限<10 年的神经耳科医生中，这一比例为 23%。性别与执业环境之间没有差异。地理分析表明，神经耳科医生的平均数量为每 100 万美国人 1.1 名。在多变量模型中，神经耳科医生的密度在大学教育程度最高的县（β=0.6[95%置信区间，CI：0.3-0.8]）和收入最高的县（β=0.3[95%CI：0.1-0.6]）中显著更高。
经委员会认证的神经耳科医生人数逐渐增加，性别多样性也呈上升趋势。神经耳科学实践的地域分布集中在社会经济地位较高的县，这与该亚专科的转诊性质相符。应该努力接触社会经济地位较低的社区，以确保他们能够获得同等的神经耳科护理。
