CSA Demographic Survey

Central Surgical Association Demographic Climate Survey - 2021

All questions are required questions in the survey.
The survey responses will ALL be anonymous.

Question Title

* 1. What is your primary specialty?

Acute Care/Trauma/Burn/Critical Care

Bariatric

Breast

Cardiothoracic

Colorectal

Endocrine

Foregut

General

Hepatobiliary/Pancreas

Minimally Invasive Surgery

Oncology

Pediatric

Thoracic

Transplant

Vascular

Retired

Other (please specify)

Question Title

* 2. Which of the following do you consider yourself primarily to be?

Academic Surgeon

Community Practice Surgeon

Hybrid Practice Surgeon

Retired

Other (please specify)

Question Title

* 3. What is your primary practice setting?

Private Practice Solo

Private Group Practice

Private Practice/Part Time HMO

Full Time HMO or IRA

Full Time Academic

Full Time Government (VA)

Military

Retired

Other (please specify)

Question Title

* 4. Do you consider yourself to have a disability?

Yes

Prefer Not to Answer

Question Title

* 5. What is your race?

American Indian or Alaska Native – A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment.

Asian – A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Black or African American – A person having origins in any of the Black racial groups of Africa.

Native Hawaiian or Other Pacific Islander – A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

White or Caucasian – A person having origins in any of the original peoples of Europe, the Middle East, or North Africa

Prefer Not to Answer

Other (please specify)

Question Title

* 6. What is your ethnicity/culture?
An ethnic group or ethnicity is a named social category of people who identify with each other on the basis of shared attributes that distinguish them from other groups such as a common set of traditions, ancestry, language, history, society, culture, nation, religion, or social treatment within their residing area.

Hispanic and Latinx are often used interchangeably though they actually mean two different things. Hispanic refers to people who speak Spanish and/or are descended from Spanish-speaking populations, while Latinx refers to people who are from or descended from people from Latin America.

Hispanic and Latinx

Hispanic and Non-Latinx

Non-Hispanic and Latinx

Non-Hispanic and Non-Latinx

Prefer Not to Answer

Question Title

* 7. What is your immigration status?

US Citizen

Non-US Citizen

Prefer Not to Answer

Question Title

* 8. With what religion do you identify?

Atheists or None

Buddhism

Christianity

Folk religions

Hinduism

Islam

Judaism

Sikhism

Universalism

Unaffiliated

Prefer Not to Answer

Other (please specify)

Question Title

* 9. With which gender identity do you most identify?

Female

Male

Prefer Not to Answer

Other (please specify)

Question Title

* 10. What is your sexual orientation?

Bisexual

Lesbian or Gay

Straight

Prefer Not to Answer

Other (please specify)