From the Department of Surgery, New York University Grossman School of Medicine, New York, NY (Escobar, Keshinro, Hambrecht, Frangos, Berman, DiMaggio, Joseph, Bukur, Klein, Ude-Welcome, Berry).
the New York University Langone Health Institute for Excellence in Health Equity, New York, NY (Joseph).
J Am Coll Surg. 2023 Jul 1;237(1):109-116. doi: 10.1097/XCS.0000000000000692. Epub 2023 Mar 22.
With each succession along the surgical career pathway, from medical school to faculty, the percentage of those who identify as underrepresented in medicine (URiM) decreases. We sought to evaluate the demographic trend of surgical fellowship applicants, matriculants, and graduates over time.
The Electronic Residency Application Service and the Graduate Medical Education Survey for general surgery fellowships in colorectal surgery, surgical oncology, pediatric surgery, thoracic surgery, and vascular surgery were retrospectively analyzed (2005 to 2020). The data were stratified by race and gender, descriptive statistics were performed, and time series were evaluated. Race/ethnicity groups included White, Asian, other, and URiM, which is defined as Black/African American, Hispanic/Latino(a), Alaskan or Hawaiian Native, and Native American.
From 2005 to 2020, there were 5,357 Electronic Residency Application Service applicants, 4,559 matriculants, and 4,178 graduates to surgery fellowships. Whites, followed by Asians, represented the highest percentage of applicants (62.7% and 22.3%, respectively), matriculants (65.4% and 23.8% respectively), and graduates (65.4% and 24.0%, respectively). For URiMs, the applicants (13.4%), matriculants (9.1%), and graduates (9.1%) remained significantly low (p < 0.001). When stratified by both race and gender, only 4.6% of the applicants, 2.7% of matriculants, and 2.4% of graduates identified as both URiM and female compared to White female applicants (20.0%), matriculants (17.9%), and graduates (16.5%, p < 0.001).
Significant disparities exist for URiMs in general surgery subspecialty fellowships. These results serve as a call to action to re-examine and improve the existing processes to increase the number of URiMs in the surgery subspecialty fellowship training pathway.
随着从医学院到教职员工的每一次手术职业道路的成功，自认为是医学领域代表性不足的人的比例（URiM）都会降低。我们试图评估外科住院医师、学员和毕业生随时间推移的申请人数的人口统计学趋势。
回顾性分析了电子住院医师申请服务和普通外科肛肠外科、外科肿瘤学、小儿外科、胸外科和血管外科研究生医学教育调查的数据（2005 年至 2020 年）。数据按种族和性别分层，进行描述性统计分析，并评估时间序列。种族/民族群体包括白人、亚洲人、其他人和 URiM，定义为黑人/非裔美国人、西班牙裔/拉丁裔（a）、阿拉斯加或夏威夷原住民和美洲原住民。
从 2005 年到 2020 年，有 5357 名电子住院医师申请服务申请人、4559 名学员和 4178 名外科住院医师。白人，其次是亚洲人，分别占申请人（62.7%和 22.3%）、学员（65.4%和 23.8%）和毕业生（65.4%和 24.0%）的比例最高。对于 URiM 来说，申请人（13.4%）、学员（9.1%）和毕业生（9.1%）仍然明显较低（p <0.001）。按种族和性别分层时，只有 4.6%的申请人、2.7%的学员和 2.4%的毕业生被认定为 URiM 和女性，而白人女性申请人（20.0%）、学员（17.9%）和毕业生（16.5%）则更多，差异具有统计学意义（p <0.001）。
在普通外科专科住院医师培训中，URiM 存在显著的差异。这些结果呼吁重新审视和改进现有流程，以增加手术专科住院医师培训途径中 URiM 的数量。
