University of California, Davis Medical Center. Department of Surgery. 4301 X St, Sacramento, California 95817, USA.
University of California, Davis Medical Center. Department of Surgery. 4301 X St, Sacramento, California 95817, USA; David Grant Medical Center. Department of Surgery. 101 Bodin Cir, Fairfield, California 94533, USA.
J Surg Educ. 2024 Jul;81(7):1004-1011. doi: 10.1016/j.jsurg.2024.04.003. Epub 2024 May 17.
As the US demographic evolves, surgical fields must adapt to ensure equitable healthcare. Healthcare disparities notably affect minority populations, with communities of color often facing physician shortages and higher rates of diseases such as coronary disease, stroke, and cancer. Research shows that minority physicians significantly improve patient satisfaction and outcomes in underserved communities, highlighting the need for increased physician diversity to enhance cultural competency and patient centered care. Data from the Association of American Medical Colleges (AAMC) reveals minimal increases in underrepresented minorities (URM) in surgical residency and academic careers over the past thirty-six years, with little change URM applicants and matriculants in the nine surgical specialties recognized by the American College of Surgeons from 2010 to 2018.
This review aims to critically evaluate the current landscape of racial and gender diversity in six out of the nine defined surgical specialties (general surgery, plastic surgery, neurosurgery, orthopedic surgery, cardiothoracic surgery, and vascular surgery) in the US.
We conducted a comprehensive literature review to assess of the state of diversity within surgical specialties in the United States. By analyzing the benefits of diversity in surgical fields, evaluating the effectiveness of various diversity programs and initiatives, examining the comparative diversity between surgical subspecialties, and assessing the impact of diversity on patient outcomes, our aim is to highlight the critical importance of enhancing diversity in surgical fields.
While nuances in representation and diversity vary across surgical specialties, all fields persistently exhibit underrepresentation of certain racial/ethnic groups and persistent gender disparities. These disparities manifest throughout various phases, including in residency, and in the recruitment and retention of URM individuals in surgery and surgical subspecialties. While interventions over the past decade have contributed to improving diversity in surgical fields, significant disparities persist. Limitations include the time required for recent interventions to show significant impacts and the inability of established interventions to eliminate disparities.
Despite the clear benefits, diversity within surgical specialties remains an uphill battle. Addressing the diversity gap in surgical fields is crucial for improving patient outcomes, healthcare access, and workplace environments, requiring strategies such as targeted recruitment, mentorship programs, and addressing systemic biases. This review highlights the undeniable imperative for change and serve a call to action.
随着美国人口结构的演变,外科领域必须进行调整,以确保公平的医疗保健。医疗保健差距尤其影响少数族裔群体,有色人种社区经常面临医生短缺和冠心病、中风和癌症等疾病发病率较高的问题。研究表明,少数族裔医生显著提高了服务不足社区的患者满意度和治疗效果,这凸显了增加医生多样性以增强文化能力和以患者为中心的护理的必要性。美国医学院协会 (AAMC) 的数据显示,过去 36 年来,代表性不足的少数族裔 (URM) 在外科住院医师和学术职业中的比例仅略有增加,而在 2010 年至 2018 年期间,美国外科医师学院认可的 9 个外科专业中,URM 申请人和入学人数几乎没有变化。
本综述旨在批判性地评估美国六个外科专业(普通外科、整形外科学、神经外科学、矫形外科学、心胸外科学和血管外科学)中种族和性别多样性的现状。
我们进行了全面的文献综述,以评估美国外科专业中多样性的状况。通过分析外科领域多样性的益处、评估各种多样性计划和举措的效果、检查外科亚专业之间的比较多样性以及评估多样性对患者结果的影响,我们旨在强调在外科领域增强多样性的至关重要性。
尽管在不同的外科专业中代表性和多样性的细微差别有所不同,但所有专业都普遍存在某些种族/族裔群体代表性不足和持续存在的性别差距。这些差异在各个阶段都存在,包括住院医师阶段,以及在外科和外科亚专业中招募和留住 URM 个体方面。尽管过去十年的干预措施有助于改善外科领域的多样性,但仍存在显著差距。局限性包括最近干预措施需要时间才能显示出显著影响,以及既定干预措施无法消除差距。
尽管存在明显的好处,但外科专业中的多样性仍然是一个艰巨的挑战。解决外科领域的多样性差距对于改善患者结果、获得医疗保健机会和工作场所环境至关重要,需要采取目标明确的招聘策略、导师计划和解决系统偏见等措施。本综述强调了变革的必要性,并呼吁采取行动。