Armstrong Misha, Dessources Kimberly, Cowan Renee, Huang James, Drebin Jeffrey, D'Angelica Michael
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Ann Surg Oncol. 2025 Mar;32(3):1575-1578. doi: 10.1245/s10434-024-16671-1. Epub 2024 Dec 10.
Racial and ethnic minorities remain underrepresented in the surgical workforce with well-documented barriers to diversity and inclusion, including financial support, lack of mentorship, and high attrition rates. Recent literature has documented race and sex discrimination in the training of surgical residents but little is known about the experience of discrimination at the surgical fellowship level. The goal of our study was to assess attitudes and perceptions of unconscious bias experienced during surgical oncology fellowship training at our institution.
All graduates in the Department of Surgery at a single institution from 2016 to 2021 were eligible to participate. Graduates were contacted via their last known email address and asked to complete an electronic survey. The survey included de novo multiple choice, Likert scale, and free response questions developed by the authors to identify sociodemographic data and experiences related to unconscious bias.
Overall, 271 graduates were contacted, with a response rate of 26% (n = 72). The majority of responders were male (60%) and self-identified as White (72%). Twenty-five percent reported witnessing someone else being unfairly treated and 10% of responders felt their race affected patient interactions. Free-text responses demonstrated clear examples of macroaggressions and microaggressions related to ethnicity, particularly among international fellows..
In our survey of recent surgical oncology fellows, diversity of graduates was limited and reported experiences of discrimination were more common among international graduates. Assessment of institutional culture and the experience of trainees is a necessary step to ensure adequate support and active strides towards equity and inclusion.
种族和少数族裔在外科医疗队伍中的代表性仍然不足，在多样性和包容性方面存在诸多有据可查的障碍，包括经济支持、缺乏导师指导以及高流失率。最近的文献记录了外科住院医师培训中的种族和性别歧视，但对于外科专科培训阶段的歧视经历知之甚少。我们研究的目的是评估在我们机构进行外科肿瘤学专科培训期间所经历的无意识偏见的态度和认知。
一所机构2016年至2021年外科系的所有毕业生均有资格参与。通过他们最后已知的电子邮件地址联系毕业生，并要求他们完成一项电子调查。该调查包括作者新开发的多项选择题、李克特量表和自由回答问题，以确定社会人口统计学数据以及与无意识偏见相关的经历。
总体而言，共联系了271名毕业生，回复率为26%（n = 72）。大多数回复者为男性（60%），自我认定为白人（72%）。25%的人报告目睹他人受到不公平对待，10%的回复者认为他们的种族影响了与患者的互动。自由文本回复展示了与种族相关的明显的宏观侵犯和微观侵犯的例子，特别是在国际学员中。
在我们对近期外科肿瘤学专科医生的调查中，毕业生的多样性有限，并且报告的歧视经历在国际毕业生中更为常见。评估机构文化和学员的经历是确保提供充分支持并积极推动公平和包容的必要步骤。
