Underrepresented Minorities in General Surgery Residency: Analysis of Interviewed Applicants, Residents, and Core Teaching Faculty - 20/06/20

Doi : 10.1016/j.jamcollsurg.2020.02.042

Benjamin T. Jarman, MD, FACS ^a,^⁎ , Andrew J. Borgert, PhD ^b, Kara J. Kallies, MS ^b, Amit R.T. Joshi, MD, FACS ^c, Douglas S. Smink, MD, MPH, FACS ^d, George A. Sarosi, MD, FACS ^e, Lily Chang, MD, FACS ^f, John M. Green, MD, FACS ^g, Jacob A. Greenberg, MD, FACS ^h, Marc L. Melcher, MD, PhD, FACS ⁱ, Valentine Nfonsam, MD, FACS ^j, James Whiting, MD, FACS ^k
^a Department of General Surgery, Gundersen Health System, La Crosse, WI
^b Department of Medical Research, Gundersen Health System, La Crosse, WI
^c Department of Surgery, Einstein Healthcare Network, Philadelphia, PA
^d Department of Surgery, Brigham & Women’s Hospital, Boston, MA
^e Department of Surgery, University of Florida, Gainesville, FL
^f Department of General Surgery, Virginia Mason Medical Center, Seattle, WA
^g Department of General Surgery, Carolinas HealthCare System, Charlotte, NC
^h Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
ⁱ Department of Surgery, Stanford University, Stanford, CA
^j Department of Surgery, University of Arizona, Tucson, AZ
^k Department of Surgery, Maine Medical Center, Portland, ME

^∗Correspondence address: Benjamin T Jarman, MD, FACS, Department of General Surgery, Gundersen Health System, 1900 South Ave C05-001, La Crosse, WI 54601.Department of General SurgeryGundersen Health System1900 South Ave C05-001La CrosseWI54601

Abstract

Background

The Accreditation Council for Graduate Medical Education (ACGME) requires diversity in residency. The self-identified race/ethnicities of general surgery applicants, residents, and core teaching faculty were assessed to evaluate underrepresented minority (URM) representation in surgery residency programs and to determine the impact of URM faculty and residents on URM applicants’ selection for interview or match.

Study Design

Data from the 2018 application cycle were collated for 10 general surgery programs. Applicants without a self-identified race/ethnicity were excluded. URMs were defined as those identifying as black/African American, Hispanic/Latino/of Spanish origin, and American Indian/Alaskan Native/Native Hawaiian/Pacific Islander-Samoan. Statistical analyses included chi-square tests and a multivariate model.

Results

Ten surgery residency programs received 9,143 applications from 3,067 unique applicants. Applications from white, Asian, Hispanic/Latino, black/African American, and American Indian applicants constituted 66%, 19%, 8%, 7% and 1%, respectively, of those applications selected to interview and 66%, 13%, 11%, 8%, and 2%, respectively, of applications resulting in a match. Among programs’ 272 core faculty and 318 current residents, 10% and 21%, respectively, were identified as URMs. As faculty diversity increased, there was no difference in selection to interview for URM (odds ratio [OR] 0.83; 95% CI 0.54 to 1.28, per 10% increase in faculty diversity) or non-URM applicants (OR 0.68; 95% CI 0.57 to 0.81). Similarly, greater URM representation among current residents did not affect the likelihood of being selected for an interview for URM (OR 1.20; 95%CI 0.90 to 1.61) vs non-URM applicants (OR 1.28; 95% CI 1.13 to 1.45). Current resident and faculty URM representation was correlated (r = 0.8; p = 0.005).

Conclusions

Programs with a greater proportion of URM core faculty or residents did not select a greater proportion of URM applicants for interview. However, core faculty and resident racial diversity were correlated. Recruitment of racially/ethnically diverse trainees and faculty will require ongoing analysis to develop effective recruitment strategies.

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