Racial Diversity Is Still Lacking Among Prospective and Current Students in Surgery Programs

The percentage of applicants for and students currently enrolled in the majority of U.S. surgical programs who are racially/ethnically diverse and underrepresented in medicine did not significantly change over an eight-year period, according to a study.

Previous research has found that, in surgical fields, racial/ethnic minorities are underrepresented not only as far as trainees go but faculty as well. Several initiatives have been taken to level out this disparity, but how effect these initiatives have been has not yet been analyzed.

The study authors collected data from the Association of American Medical Colleges Accreditation Council of Graduate Medical Education residency programs. They evaluated the percentage of racial/ethnic minority applicants and matriculants to U.S. surgical specialties from 2010–2011 to 2018–2019.

A total of 737,034 applicants and 265,365 matriculants to U.S. residency programs were identified, of whom 134,158 applicants and 41,347 matriculants were in surgical programs. Among the surgical group, 21,369 applicants (15.9%) and 5,704 matriculants (13.8%) were of a group underrepresented in medicine. When looking at all surgical specialties overall, the percentage of applicants who were underrepresented in medicine did not largely change from 2010 (15.3%; 95% confidence interval [CI], 14.7–15.9%) to 2018 (17.5%; 95% CI, 16.9–18.1%) (P=0.63).

Among all the surgical specialties, only thoracic surgery had a significant difference in the percentage of people underrepresented in medicine from 2010 to 2018 who were applicants (8.1% [95% CI, 4.9–13.2%] vs. 14.6% [95% CI, 10.2–20.4%]; P=0.02) or matriculants (0% [95% CI, 0.0–19.4%] vs. 10.0% [95% CI, 4.0–23.1%]; P=0.01). However, when looking at the mean percentage of applicants underrepresented in medicine, thoracic surgery had the lowest for applicants (12.5%; 95% CI, 9.46–15.4%).

From 2010 to 2018, the percentage of applicants to orthopedic surgery who were underrepresented in medicine did not significantly change (18.5% [95% CI, 17.2–20.0%] vs. 19.4% [95% CI, 18.0–20.9%]; P=0.92), but the percentage of matriculants did increase (9.0% [95% CI, 7.2–11.3%] vs. 12.4% [95% CI, 10.2–14.8%]; P=0.38).

The researchers reported that the highest mean percentage of both applicants and matriculants underreperesented in medicine was in obstetrics and gynecology (applicants, 20.2% [95% CI, 19.4–20.8%]; matriculants, 19.0% [95% CI, 18.2–19.8%]).

“These findings support the claim that underrepresentation of racial/ethnic minorities is a broader issue that extends beyond surgery, starting from entry into medical school and beyond residency. Therefore, to reach the goal of accurately representing the demographics of the US and improving patient care in surgery, further investment in innovative programs focused on increasing racial/ethnic diversity from the medical school to the surgical residency level appears to be needed,” the study authors concluded.

The study was published in JAMA Network Open.