University of Washington School of Medicine, Seattle.
Department of Neurological Surgery, University of Washington, Seattle.
JAMA Netw Open. 2020 Nov 2;3(11):e2023509. doi: 10.1001/jamanetworkopen.2020.23509.
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.
DESIGN, SETTING, AND PARTICIPANTS: 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.
美国各地的外科项目继续推动并投资于旨在提高族裔多样性的举措，但这是否转化为少数民族群体申请人或被录取者的比例变化仍不清楚。
检查从 2010-2011 学年到 2018-2019 学年，美国外科专业申请人和被录取者中自认为属于医学代表性不足的种族/族裔群体的比例趋势。
设计、地点和参与者：这项横断面研究检查了美国住院医师项目申请人和被录取者自我报告的种族/族裔身份趋势，以评估 2010 年至 2018 年期间外科项目的人口统计学变化。数据来自美国医学协会。
研究人群包括总共 737034 名美国住院医师项目的申请人和 265365 名被录取者，其中包括 134158 名申请人和 41347 名被录取者入读外科项目。共有 21369 名申请人（15.9%）和 5704 名被录取者（13.8%）被认为在医学上代表性不足。在 2010 年和 2018 年，所有外科专业的医学代表性不足的申请人中，基于种族/族裔的申请人比例没有统计学上的显著差异（15.3%[95%CI，14.7%-15.9%]与 17.5%[95%CI，16.9%-18.1%]；P=0.63）。胸外科是唯一一个申请人比例（8.1%[95%CI，4.9%-13.2%]与 14.6%[95%CI，10.2%-20.4%]；P=0.02）或医学代表性不足的被录取者比例（0%[95%CI，0%-19.4%]与 10.0%[95%CI，4.0%-23.1%]；P=0.01）有统计学显著变化的外科专业。妇产科是外科专业中申请人（20.2%；95%CI，19.4%-20.8%）和被录取者（19.0%；95%CI，18.2%-19.8%）中医学代表性不足的比例最高。胸外科的申请人比例最低（12.5%；95%CI，9.46%-15.4%），耳鼻喉科的被录取者比例最低（8.5%；95%CI，7.2%-9.9%）医学代表性不足。
在这项横断面研究中，美国总体外科项目中，基于种族/族裔自我认同的医学代表性不足的申请人或被录取者比例没有变化，但这一比例仍高于非外科专业。似乎有必要重新评估目前旨在增加族裔代表性的策略，以帮助缩小医学领域的现有差距，并招募更多族裔多样化的外科劳动力。
