Girma Samuel Mesfin, Hiwot Tsion, Aliye Nanati Jemal, Yimam Elham, Awad Ahmed K
School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Research Department, Association of Future African Cardiothoracic Surgeons, Yaounde, Cameroon.
BMC Surg. 2025 Apr 24;25(1):176. doi: 10.1186/s12893-025-02928-3.
Cardiothoracic surgery (CTS) remains one of the least diverse surgical specialties, marked by significant gender and racial disparities. Despite increased medical school enrollment and the inclusion of more women and underrepresented minorities in the medical workforce, the number of locally trained cardiothoracic surgeons remains disproportionately low, particularly in regions with limited access to specialized care. This lack of diversity is compounded by systemic barriers such as limited exposure to the specialty, a shortage of mentors and role models, and the persistence of gender bias and discrimination. These factors contribute to a workforce that does not adequately reflect the demographic diversity of the patient population, further hindering access to quality care. To address these challenges, this article outlines several policy recommendations aimed at improving equity in CTS training and workforce development. Key strategies include increasing awareness and exposure to CTS among medical students, expanding training opportunities, and establishing regional centers of excellence. Gender equity should be prioritized through the implementation of zero-tolerance policies for discrimination and harassment, and financial incentives should be introduced to retain cardiothoracic professionals locally. Additionally, mentorship, collaboration, and international partnerships can enhance surgical skills and knowledge sharing across regions. Public health policies focusing on improving access to cardiothoracic services, particularly in underserved communities, are critical for reducing disparities. Enhanced community awareness campaigns, improved data collection, and strengthened healthcare infrastructure are vital to ensure equitable access to care. Ultimately, achieving equity in CTS requires collaborative efforts between governments, academic institutions, healthcare providers, and international partners, aimed at building a resilient and diverse cardiothoracic workforce capable of meeting the needs of diverse populations.
心胸外科（CTS）仍然是多样性最少的外科专科之一，存在显著的性别和种族差异。尽管医学院的招生人数有所增加，医疗队伍中女性和代表性不足的少数族裔人数也有所增加，但本地培养的心胸外科医生数量仍然低得不成比例，尤其是在获得专科护理机会有限的地区。这种多样性的缺乏因系统性障碍而加剧，如对该专科的接触有限、导师和榜样的短缺，以及性别偏见和歧视的持续存在。这些因素导致医疗队伍无法充分反映患者群体的人口多样性，进一步阻碍了获得优质护理的机会。为应对这些挑战，本文概述了几项旨在提高心胸外科培训和劳动力发展公平性的政策建议。关键策略包括提高医学生对心胸外科的认识和接触机会、扩大培训机会，以及建立区域卓越中心。应通过实施对歧视和骚扰零容忍政策来优先实现性别平等，并引入财政激励措施以在本地留住心胸外科专业人员。此外，导师指导、合作和国际伙伴关系可以提高各地区的手术技能和知识共享。关注改善心胸外科服务可及性的公共卫生政策，特别是在服务不足的社区，对于减少差距至关重要。加强社区宣传活动、改进数据收集和加强医疗基础设施对于确保公平获得护理至关重要。最终，要在心胸外科实现公平，需要政府、学术机构、医疗服务提供者和国际伙伴之间的共同努力，目标是建立一支有韧性和多样性的心胸外科医疗队伍，能够满足不同人群的需求。
