Department of Surgery, Methodist Richardson Medical Center, 2805 E President George Bush Hwy, Richardson, TX, 75082, USA.
Department of Surgery, Medical City Healthcare, Dallas, TX, USA.
World J Surg. 2021 Aug;45(8):2556-2566. doi: 10.1007/s00268-021-06108-1. Epub 2021 Apr 19.
Selection biases affecting candidate matches to fellowship programs directly influence diversity within the surgical community. The review of selection bias has never been distinctively investigated in the Hepatopancreatobiliary (HPB) surgery community. This study seeks to (i) evaluate factors affecting selection of candidates to HPB fellowships, (ii) examine explicit biases among program directors and faculty of HPB programs in North America, and (iii) compare the demography of the HPB faculty and recently graduated fellows to general surgery residents.
An anonymous, self-reported survey consisting of 10 sets of fictional applications was distributed to 52 faculty members, including program directors, of AHPBA-affiliated HPB fellowships in North America. The respondents had to pick a preferred candidate between two abridged, fictional HPB fellow applications and give an open-ended response as to why they picked that candidate. The applications were nearly identical with one notable characteristic of interest. Demographic information of both faculty and their recent fellows was also collected. This survey was administered and collected between February and April, 2020.
A total of 29 fully completed responses were received, comprising a 55.7% response rate. Respondents were 72.4% male, 69.0% Caucasian, and 79.3% held US medical degrees (MD). 50.0% of respondents preferred an MD candidate to a DO candidate, and 37% preferred US graduates to foreign-trained candidates. The respondents were unanimous in stating that gender, race, and family status were not a factor in their selection process. 5.0% said they would support an LGBTQ candidate when faced with otherwise similar applicants. Seventy-six HPB fellows from the past 5 years were 76.3% male, 56.6% Caucasian, and 51.3% US graduated Doctor of Medicine (US MD).
This is the first study explicitly exploring the impact of demographic factors in the HPB fellowship selection process. The respondents unanimously and explicitly stated that race and gender do not play any role in their selection process. Yet, there is stark discordance between general surgery resident demographics and HPB fellow demographics. A greater effort to promote a more diverse HPB surgery community may be needed.
影响 fellowship项目候选人匹配的选择偏差直接影响外科领域的多样性。在肝胆胰外科学（HPB）领域，从未对选择偏差进行过专门的审查。本研究旨在：（i）评估影响 HPB 奖学金候选人选择的因素；（ii）检查北美 HPB 项目主任和教师中的明确偏见；（iii）将 HPB 教师和最近毕业的研究员与普通外科住院医师的人口统计学进行比较。
向北美 AHPBA 附属 HPB 奖学金的 52 名教师成员（包括项目主任）分发了一份匿名、自我报告的调查，该调查由 10 组虚构的申请组成。受访者必须在两名简化的虚构 HPB 研究员申请中选择一名首选候选人，并对他们选择该候选人的原因给出开放式回答。这些申请几乎完全相同，只有一个引人关注的特征。还收集了教师和他们最近的研究员的人口统计学信息。这项调查于 2020 年 2 月至 4 月进行和收集。
共收到 29 份完整回复，回复率为 55.7%。受访者中 72.4%为男性，69.0%为白种人，79.3%拥有美国医学学位（MD）。50.0%的受访者更喜欢 MD 候选人而不是 DO 候选人，37%更喜欢美国毕业生而不是外国培训的候选人。受访者一致表示，性别、种族和家庭状况不是他们选择过程中的一个因素。5.0%的受访者表示，在面对其他方面相似的申请人时，他们会支持 LGBTQ 候选人。过去 5 年的 76 名 HPB 研究员中，男性占 76.3%，白种人占 56.6%，美国毕业的医学博士（US MD）占 51.3%。
这是第一项明确探讨 HPB 奖学金选择过程中人口统计学因素影响的研究。受访者一致明确表示，种族和性别在他们的选择过程中不起作用。然而，普通外科住院医师的人口统计学和 HPB 研究员的人口统计学之间存在明显的不协调。可能需要加大努力，促进更具多样性的 HPB 外科学术界。
