Abstract
Surgical programs across the US continue to promote and invest in initiatives aimed at improving racial/ethnic diversity, but whether this translates to changes in the percentage of applicants or matriculants from racial/ethnic minority groups remains unclear. To examine trends in the percentage of applicants and matriculants to US surgical specialties who identified as part of a racial/ethnic group underrepresented in medicine from the 2010-2011 to 2018-2019 academic years. This cross-sectional study examined trends in self-reported racial/ethnic identity among applicants and matriculants to US residency programs to evaluate demographic changes among surgical programs from 2010 to 2018. Data were obtained from the Association of American Medical Colleges. The study population consisted of a total of 737 034 applicants and 265 365 matriculants to US residency programs, including 134 158 applicants and 41 347 matriculants to surgical programs. A total of 21 369 applicants (15.9%) and 5704 matriculants (13.8%) to surgical specialties identified as underrepresented in medicine. There was no statistically significant difference in the percentage of applicants underrepresented in medicine based on race/ethnicity for all surgical specialties combined in 2010 vs 2018 (15.3% [95% CI, 14.7%-15.9%] vs 17.5% [95% CI, 16.9%-18.1%]; P = .63). Thoracic surgery was the only surgical specialty in which there was a statistically significant change in the percentage of applicants (8.1% [95% CI, 4.9%-13.2%] vs 14.6% [95% CI, 10.2%-20.4%]; P = .02) or matriculants (0% [95% CI, 0%-19.4%] vs 10.0% [95% CI, 4.0%-23.1%]; P = .01) underrepresented in medicine based on race/ethnicity. Obstetrics and gynecology had the highest mean percentage of applicants (20.2%; 95% CI, 19.4%-20.8%) and matriculants (19.0%; 95% CI, 18.2%-19.8%) underrepresented in medicine among surgical specialties. Thoracic surgery had the lowest mean percentage of applicants (12.5%; 95% CI, 9.46%-15.4%) and otolaryngology the lowest mean percentage of matriculants (8.5%; 95% CI, 7.2%-9.9%) underrepresented in medicine. In this cross-sectional study, overall US surgical programs had no change in the percentage of applicants or matriculants who self-identified as underrepresented in medicine based on race/ethnicity, but the proportion remained higher than in nonsurgical specialties. Reevaluation of current strategies aimed at increasing racial/ethnic representation appear to be necessary to help close the existing gap in medicine and recruit a more racially/ethnically diverse surgical workforce.
Highlights
Thoracic surgery was the only surgical specialty in which there was a statistically significant change in the percentage of applicants (8.1% [95% CI, 4.9%-13.2%] vs 14.6% [95% CI, 10.2%-20.4%]; P = .02) or matriculants (0% [95% CI, 0%-19.4%] vs 10.0% [95% CI, 4.0%-23.1%]; P = .01) underrepresented in medicine based on race/ethnicity
In this cross-sectional study, overall US surgical programs had no change in the percentage of applicants or matriculants who self-identified as underrepresented in medicine based on race/ethnicity, but the proportion remained higher than in nonsurgical specialties
Surgical training programs across the US have engaged in initiatives aimed at increasing the number of individuals underrepresented in medicine (URM) based on the definition by the Association of American Medical Colleges (AAMC) as “those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.”[11] the impact of these efforts remains unclear.[12,13,14,15]
Summary
A diverse physician workforce would better reflect the increasingly racially/ethnically diverse population of the US and contribute toward addressing health care disparities, improving patient outcomes and satisfaction, and fostering greater innovation in medicine.[1,2,3] Despite these observations and numerous initiatives, the percentage of individuals who identify as belonging to racial/ethnic minority groups in medicine has continued to remain below that in the general US population.[4,5] For example, in 2019, the percentage of the population who identified as Black or African American, American Indian or Alaska Native, Native Hawaiian or other Pacific Islander, and Hispanic or Latino was more than 33%,6 while these same groups constituted approximately 12% of US medical school graduates in the class of 2019, without including those who identified as multiracial.[7]Multiple studies have shown that underrepresentation based on race/ethnicity is present in surgical fields both among trainees and faculty.[3,8,9,10] In response, surgical training programs across the US have engaged in initiatives aimed at increasing the number of individuals underrepresented in medicine (URM) based on the definition by the Association of American Medical Colleges (AAMC) as “those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.”[11]. The impact of these efforts remains unclear.[12,13,14,15] This study used data from the AAMC to assess trends in the race/ethnicity of applicants and matriculants to surgical specialties between 2010 and 2018
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