Baxter Natalie B, Guetterman Timothy C, Thompson Noelle, Byrnes Mary L, Sandhu Gurjit, Hooper Rachel C
From the University of Michigan Medical School, Ann Arbor, MI.
Department of Family Medicine, University of Michigan, Ann Arbor, MI.
Plast Reconstr Surg Glob Open. 2025 Jun 25;13(6):e6915. doi: 10.1097/GOX.0000000000006915. eCollection 2025 Jun.
The plastic surgery workforce lacks racial and ethnic diversity. Traditionally, United States Medical Licensing Examination scores have been used as the initial screening tool for most residency programs; however, this can lead to interview selection bias against underrepresented in medicine (URiM) applicants. Understanding the barriers and facilitators to diversifying the specialty from the perspectives of program directors (PDs) may reveal strategies for improvement.
In this mixed methods study, we invited integrated plastic surgery PDs to participate in an online survey and one-on-one semistructured interviews to understand their perspectives on the application process, interview day, and strategies to improve recruitment and retention of URiM trainees. Descriptive statistics were used to analyze the survey data. Interviews were deidentified, transcribed, and analyzed inductively to generate themes based on patterns observed across narratives.
Of 108 PDs and assistant PDs, 29 (26.9%) responded to the survey and 8 participated in semistructured interviews. We identified 3 broad themes: (1) resident diversity is important for patient care and education, (2) lack of exposure and longitudinal mentorship are barriers to matriculation, and (3) program culture change can shift trends in the recruitment of URiM trainees.
PDs value the racial and ethnic diversity of trainees and are in favor of efforts to increase representation in the field. Improving mentorship and reducing bias in the application process are necessary strategies to increase representation in plastic surgery.
整形外科学术界缺乏种族和民族多样性。传统上，美国医师执照考试成绩一直被用作大多数住院医师项目的初始筛选工具；然而，这可能导致对医学领域代表性不足（URiM）申请者的面试选择偏见。从项目主任（PD）的角度了解该专业多元化的障碍和促进因素，可能会揭示改进策略。
在这项混合方法研究中，我们邀请了整形外科综合项目主任参加在线调查和一对一的半结构化访谈，以了解他们对申请过程、面试日以及改善URiM学员招募和留用策略的看法。描述性统计用于分析调查数据。访谈内容进行了去识别化处理、转录，并基于在叙述中观察到的模式进行归纳分析以生成主题。
108名项目主任和助理项目主任中，29名（26.9%）回复了调查，8名参加了半结构化访谈。我们确定了3个广泛的主题：（1）住院医师的多样性对患者护理和教育很重要；（2）缺乏接触和长期指导是入学的障碍；（3）项目文化变革可以改变URiM学员招募的趋势。
项目主任重视学员的种族和民族多样性，并支持增加该领域代表性的努力。改善指导并减少申请过程中的偏见是增加整形外科代表性的必要策略。
