Olive Jacqueline K, Yost Colin C, Robinson Justin A, Brescia Alexander A, Han Jason J, Haney John C, Forbess Joseph M, Varghese Thomas K, Backhus Leah M, Cooke David T, Cornwell Lorraine D, Preventza Ourania A
Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University, Durham, North Carolina.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
Ann Thorac Surg. 2023 Mar;115(3):771-777. doi: 10.1016/j.athoracsur.2022.06.051. Epub 2022 Aug 5.
The integrated 6-year thoracic surgery (I-6) residency model was developed in part to promote early interest in cardiothoracic surgery in diverse trainees. To determine gaps in and opportunities for recruitment of women and minority groups in the pipeline for I-6 residency, we quantified rates of progression at each training level and trends over time.
We obtained 2015 to 2019 medical student, I-6 applicant, and I-6 resident gender and race/ethnicity demographic data from the American Association of Medical Colleges and Electronic Residency Application Service public databases and Accreditation Council for Graduate Medical Education Data Resource Books. We performed χ, Fisher exact, and Cochran-Armitage tests for trend to compare 2015 and 2019.
Our cross-sectional analysis found increased representation of women and all non-White races/ethnicities, except Native American, at each training level from 2015 to 2019 (P < .001 for all). The greatest trends in increases were seen in the proportions of women (28% vs 22%, P = .46) and Asian/Pacific Islander (25% vs 15%, P = .08) applicants. There was also an increase in the proportions of women (28% vs 24%, P = .024) and White (61% vs 58%, P = .007) I-6 residents, with a trend for Asian/Pacific Islanders (20% vs 17%, P = .08). The proportions of Hispanic (5%) and Black/African American (2%) I-6 residents in 2019 remained low.
I-6 residency matriculation is not representative of medical student demographics and spotlights a need to foster early interest in cardiothoracic surgery among all groups underrepresented in medicine while ensuring that we mitigate bias in residency recruitment.
六年制胸外科综合住院医师培训模式(I-6)的部分目的是激发不同学员对心胸外科的早期兴趣。为了确定I-6住院医师培训流程中女性和少数群体招募方面的差距和机会,我们对每个培训阶段的进展率以及随时间的趋势进行了量化。
我们从美国医学院协会、电子住院医师申请服务公共数据库以及毕业后医学教育认证委员会数据资源手册中获取了2015年至2019年医学生、I-6申请者以及I-6住院医师的性别和种族/族裔人口统计数据。我们进行了χ检验、Fisher精确检验以及Cochran-Armitage趋势检验,以比较2015年和2019年的数据。
我们的横断面分析发现,2015年至2019年,在每个培训阶段,女性以及除美洲原住民外的所有非白人种族/族裔的占比均有所增加(所有P值均<0.001)。女性申请者(28%对22%,P = 0.46)和亚太岛民申请者(25%对15%,P = 0.08)的占比增长趋势最为明显。女性I-6住院医师(28%对24%,P = 0.024)和白人I-6住院医师(61%对58%,P = 0.007)的占比也有所增加,亚太岛民有增长趋势(20%对17%,P = 0.08)。2019年,西班牙裔(5%)和黑人/非裔美国人(2%)I-6住院医师的占比仍然较低。
I-6住院医师录取情况并不代表医学生的人口统计学特征,这凸显出有必要在医学领域所有代表性不足的群体中培养对心胸外科的早期兴趣,同时确保我们减少住院医师招募中的偏见。