Maru Johsias A, Carvajal Nicole D, de Alba Campomanes Alejandra G, Parikh Neeti, Ashraf Davin C, Kersten Robert C, Winn Bryan J, Vagefi M Reza, Grob Seanna R
School of Medicine, University of California, San Francisco, San Francisco, California.
Department of Ophthalmology, University of California, San Francisco, San Francisco, California.
J Acad Ophthalmol (2017). 2022 Dec 21;14(2):e271-e278. doi: 10.1055/s-0042-1758561. eCollection 2022 Jul.
Physician diversity is limited in ophthalmology and oculofacial plastic surgery. Determination of barriers within the application process for oculofacial plastic surgery may help target efforts to improve the recruitment of underrepresented groups. This study aimed to illuminate perceived barriers to increasing diversity in oculofacial plastic surgery trainees, according to the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) fellows and fellowship program directors (FPDs). During the month of February 2021, we sent surveys out to 54 current oculofacial plastic surgery fellows and 56 FPDs at 56 oculofacial plastic surgery programs recognized by the ASOPRS nationwide using a 15-question Qualtrics survey. Sixty-three individuals (57%) responded to the survey: 34 fellows (63%) and 29 FPDs (52%). Eighty-eight percent of fellows and 68% of FPDs identified as non-underrepresented in medicine (UiM). Forty-four percent of fellows and 25% of FPDs identified as men. FPDs most commonly noted, "Not enough minorities applying to our program" and "The objective data (Ophthalmic Knowledge Assessment Program score, United States Medical Licensing Examination Step scores, clinical honors, Alpha Omega Alpha status, letter of recommendation) for minority applicants often do not meet the threshold required to offer an interview or to be ranked to match" as barriers. Among fellows, the lowest-rated considerations when applying to oculofacial plastic surgery were "Racially/ethnically diverse faculty" and "Perceptions of minority candidates by fellowship programs," whereas "Likelihood of matching in program of choice" was ranked highest in considerations. Fellows identifying as men indicated greater concern for "Financial factors related to fellowship (e.g., loans, salary, cost of living, or cost of interviewing)" compared to fellows identifying as women who noted greater concern for "Program or preceptor acceptance of starting or having a family during fellowship." Responses from FPDs suggest that efforts focused on recruiting and supporting diverse students to medicine and ophthalmology, mentoring applicants interested in oculofacial plastic surgery, and restructuring the application process to decrease bias, may improve diversity within the subspecialty. The lack of UiM representation in this study, 6% fellows and 7.4% FPDs identified as UiM, shows both the stark underrepresentation and the need for further research into this topic.
眼科和眼整形手术领域的医生多样性有限。确定眼整形手术申请过程中的障碍可能有助于针对性地努力改善对代表性不足群体的招募。本研究旨在根据美国眼科整形与重建外科学会（ASOPRS）的学员和奖学金项目主任（FPD），阐明眼整形手术学员增加多样性所面临的感知障碍。2021年2月期间，我们使用一份包含15个问题的Qualtrics调查问卷，向全国56个经ASOPRS认可的眼整形手术项目的54名现任眼整形手术学员和56名FPD发送了调查问卷。63人（57%）回复了调查问卷：34名学员（63%）和29名FPD（52%）。88%的学员和68%的FPD表示在医学领域中不属于代表性不足群体（UiM）。44%的学员和25%的FPD为男性。FPD最常指出的障碍是“申请我们项目的少数族裔不足”以及 “少数族裔申请人的客观数据（眼科知识评估项目分数、美国医学执照考试步骤分数、临床荣誉、αΩα身份、推荐信）往往未达到获得面试或被排名以匹配的要求门槛”。在学员中，申请眼整形手术时评分最低的考虑因素是“种族/族裔多样化的教员”和“奖学金项目对少数族裔候选人的看法”，而“在首选项目中匹配的可能性”在考虑因素中排名最高。与女性学员相比，男性学员表示更关注“与奖学金相关的财务因素（如贷款、薪资、生活成本或面试成本）”，而女性学员则更关注“项目或导师对在奖学金期间开始或拥有家庭的接受程度”。FPD的回复表明，专注于招募和支持医学和眼科领域多样化学生、指导对眼整形手术感兴趣的申请人以及调整申请流程以减少偏见的努力，可能会改善该亚专业的多样性。本研究中UiM代表性不足，只有6%的学员和7.4%的FPD被认定为UiM，这既显示出严重的代表性不足，也表明需要对该主题进行进一步研究。
