DEI Survey Grid

1. Name: Caron Rockman
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Peter Faries
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY:
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Norman Rich
2. Which of the following do your consider yourself primarily to be?
Retired
3. What is your primary practice setting?
Retired
4. Please indicate your career status.
Retired
5. Do you consider yourself to have a disability?
Yes
6. What is your race/ethnicity?
RACE: White
ETHNICITY:
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Caitlin Hicks
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
5 years or less with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: ALAIN TANBE
2. Which of the following do your consider yourself primarily to be?
Community Practice Surgeon
3. What is your primary practice setting?
Private Group Practice
4. Please indicate your career status.
5 years or less with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Juan Asensio
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Cuban-American
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
Prefer Not to Answer
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Thomas Maldonado
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Argentina
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Matthew Dougherty
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Private Group Practice
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Prefer Not to Answer
ETHNICITY: Prefer Not to Answer
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
Prefer Not to Answer
9. What is your sexual orientation?
Prefer Not to Answer
10. Other Comments
wokism is replacing professionalism in medicine
1. Name: Sareh Rajaee
2. Which of the following do your consider yourself primarily to be?
Community Practice Surgeon
3. What is your primary practice setting?
Private Group Practice
4. Please indicate your career status.
5 years or less with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Middle Eastern
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Luis López-Galarza
2. Which of the following do your consider yourself primarily to be?
Community Practice Surgeon
3. What is your primary practice setting?
Private Practice Solo
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE:
ETHNICITY:
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
Prefer Not to Answer
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
None
1. Name: Vincent Cuddy
2. Which of the following do your consider yourself primarily to be?
Retired
3. What is your primary practice setting?
Retired
4. Please indicate your career status.
Retired
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY:
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His, She, Her, Hers, They, Them, Theirs
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Glenn Jacobowitz
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Prefer Not to Answer
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: kambhampaty krishnasastry
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Asian Indian
ETHNICITY: Other
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
No comments
1. Name: Brajesh Lal
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic, Full Time Government (VA)
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Indian
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
None
1. Name: philip paty
2. Which of the following do your consider yourself primarily to be?
Community Practice Surgeon
3. What is your primary practice setting?
Private Group Practice
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Asian Indian
ETHNICITY:
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Keith Calligaro
2. Which of the following do your consider yourself primarily to be?
Hybrid Practice Surgeon
3. What is your primary practice setting?
Private Group Practice
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: James McKinsey
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Sunita Srivastava
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE:
ETHNICITY:
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
Prefer Not to Answer
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Jeffrey Silpe
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
5 years or less with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Luke Marone
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Other
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Thomas Evans
2. Which of the following do your consider yourself primarily to be?
Hybrid Practice Surgeon
3. What is your primary practice setting?
Private Group Practice
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY:
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His, She, Her, Hers, They, Them, Theirs
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Gregory Salzler
2. Which of the following do your consider yourself primarily to be?
Hybrid Practice Surgeon
3. What is your primary practice setting?
Full Time HMO or IRA, Full Time Academic
4. Please indicate your career status.
5 years or less with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Sheila Blumberg
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Black or African American, or African-Caribbean
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Issam Koleilat
2. Which of the following do your consider yourself primarily to be?
Hybrid Practice Surgeon
3. What is your primary practice setting?
Academic, community based, employed, full time
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Middle-eastern
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Martha Weaver
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Fellow
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Steve Woratyla
2. Which of the following do your consider yourself primarily to be?
Community Practice Surgeon
3. What is your primary practice setting?
Full Time HMO or IRA
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a), Other
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Steven Busuttil
2. Which of the following do your consider yourself primarily to be?
Hybrid Practice Surgeon
3. What is your primary practice setting?
Full Time HMO or IRA
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Maltese
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His, She, Her, Hers, They, Them, Theirs
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
Just a simple practicing Surgeon disenchanted with corporate medical care and approaching retirement.
1. Name: Satish Muluk
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Indian
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Hasan Dosluoglu
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic, Full Time Government (VA)
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY:
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Palma Shaw
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY:
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Jennifer Stableford
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Elias Fakhoury
2. Which of the following do your consider yourself primarily to be?
Hybrid Practice Surgeon
3. What is your primary practice setting?
Full Time HMO or IRA
4. Please indicate your career status.
5 years or less with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Middle eastern
ETHNICITY:
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Jennifer Stableford
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Michael Curi
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Prefer Not to Answer
ETHNICITY: Prefer Not to Answer
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Prefer Not to Answer
10. Other Comments
1. Name: kambhampaty krishnasastry
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Asian indian
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
I have been involved with Inclusion, Diversity at our school
1. Name: William Beckerman
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
5 years or less with an established vascular practice
5. Do you consider yourself to have a disability?
Prefer Not to Answer
6. What is your race/ethnicity?
RACE: Prefer Not to Answer
ETHNICITY: Prefer Not to Answer
7. With which gender identity do you most identify?
Prefer Not to Answer
If other:
8. What are your preferred pronouns?
Prefer Not to Answer
9. What is your sexual orientation?
Prefer Not to Answer
10. Other Comments
1. Name: Pallavi Manvar-Singh
2. Which of the following do your consider yourself primarily to be?
Hybrid Practice Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Asian Indian
ETHNICITY:
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Michol Cooper
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
5 years or less with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Jennifer Stableford
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Jerry Svoboda
2. Which of the following do your consider yourself primarily to be?
Community Practice Surgeon
3. What is your primary practice setting?
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY:
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
Prefer Not to Answer
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
There are 2 genders, male and female. There is just one race, the human race. Please cut all this pronoun crap!
1. Name: Linda Harris
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Elizabeth Wight-Regna
2. Which of the following do your consider yourself primarily to be?
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Robert Garvin
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY:
7. With which gender identity do you most identify?

If other:
8. What are your preferred pronouns?
9. What is your sexual orientation?
10. Other Comments
1. Name: Randy Shafritz
2. Which of the following do your consider yourself primarily to be?
Hybrid Practice Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Other
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Brajesh Lal
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Prefer Not to Answer
ETHNICITY: Prefer Not to Answer
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
Prefer Not to Answer
9. What is your sexual orientation?
Prefer Not to Answer
10. Other Comments
1. Name: paul yang
2. Which of the following do your consider yourself primarily to be?
Community Practice Surgeon
3. What is your primary practice setting?
Private Group Practice
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: chinese
ETHNICITY: Other
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Paul Haser
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Joseph Yoo
2. Which of the following do your consider yourself primarily to be?
3. What is your primary practice setting?
4. Please indicate your career status.
Incoming Fellow (Resident)
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE:
ETHNICITY:
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Kirran Bakhshi
2. Which of the following do your consider yourself primarily to be?
3. What is your primary practice setting?
4. Please indicate your career status.
Incoming Fellow (Resident)
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE:
ETHNICITY:
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Prefer Not to Answer
10. Other Comments
1. Name: Justin Robbins
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Military
4. Please indicate your career status.
Incoming Fellow (Resident)
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Panamanian
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Gay or Lesbian
10. Other Comments
1. Name: Ajay Menon
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon, Community Practice Surgeon
3. What is your primary practice setting?
Private Group Practice
4. Please indicate your career status.
Incoming Fellow (Resident)
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE:
ETHNICITY:
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Rory Seymour
2. Which of the following do your consider yourself primarily to be?
3. What is your primary practice setting?
Medical Student
4. Please indicate your career status.
5. Do you consider yourself to have a disability?
Yes
6. What is your race/ethnicity?
RACE: White
ETHNICITY:
7. With which gender identity do you most identify?
Other
If other: No
8. What are your preferred pronouns?
They, Them, Theirs
9. What is your sexual orientation?
Queer
10. Other Comments
I identify as Intersex
1. Name: Luis Rodriguez Cartagena
2. Which of the following do your consider yourself primarily to be?
Hybrid Practice Surgeon
3. What is your primary practice setting?
Resident
4. Please indicate your career status.
Incoming Fellow (Resident)
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Puerto Rican
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Ioannis Tsouknidas
2. Which of the following do your consider yourself primarily to be?
3. What is your primary practice setting?
4. Please indicate your career status.
Incoming Fellow (Resident)
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Khushi Patel
2. Which of the following do your consider yourself primarily to be?
3. What is your primary practice setting?
4. Please indicate your career status.
5. Do you consider yourself to have a disability?
6. What is your race/ethnicity?
RACE:
ETHNICITY:
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Susan Basharkhah
2. Which of the following do your consider yourself primarily to be?
Community Practice Surgeon, Hybrid Practice Surgeon
3. What is your primary practice setting?
Resident
4. Please indicate your career status.
Incoming Fellow (Resident)
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Persian
ETHNICITY: Other
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Domingo Uceda
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Incoming Fellow (Resident)
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Peruvian
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Abhishek Rao
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Incoming Fellow (Resident)
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Indian
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
I’m a PGY-1 Integrated-Vascular Surgery Resident.
1. Name: Scott Surowiec
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Andrea Lubitz
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
5 years or less with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY:
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Gina Biagetti
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Incoming Fellow (Resident)
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY:
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Omar Ramadan
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Incoming Fellow (Resident)
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Arab
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Bryan Kozak
2. Which of the following do your consider yourself primarily to be?
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Over 5 years with an established vascular practice
5. Do you consider yourself to have a disability?
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Lauren Waronker
2. Which of the following do your consider yourself primarily to be?
Community Practice Surgeon
3. What is your primary practice setting?
Private Group Practice
4. Please indicate your career status.
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY:
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Martin Tilson
2. Which of the following do your consider yourself primarily to be?
Retired
3. What is your primary practice setting?
Retired
4. Please indicate your career status.
Retired
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY:
7. With which gender identity do you most identify?
Male
If other:
8. What are your preferred pronouns?
He, Him, His
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Jayne Rice
2. Which of the following do your consider yourself primarily to be?
Academic Surgeon
3. What is your primary practice setting?
Full Time Academic
4. Please indicate your career status.
Incoming Fellow (Resident)
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: Black or African American, or African-Caribbean
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments
1. Name: Devon Fromer
2. Which of the following do your consider yourself primarily to be?
Hybrid Practice Surgeon
3. What is your primary practice setting?
Private Group Practice
4. Please indicate your career status.
5 years or less with an established vascular practice
5. Do you consider yourself to have a disability?
No
6. What is your race/ethnicity?
RACE: White
ETHNICITY: Non-Hispanic/Latino(a)
7. With which gender identity do you most identify?
Female
If other:
8. What are your preferred pronouns?
She, Her, Hers
9. What is your sexual orientation?
Straight or Heterosexual
10. Other Comments