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Observational Study
. 2020 Nov 2;3(11):e2023509.
doi: 10.1001/jamanetworkopen.2020.23509.

Trends in Race/Ethnicity Among Applicants and Matriculants to US Surgical Specialties, 2010-2018

Edwin Nieblas-Bedolla  1 , John R Williams  2 , Briana Christophers  3 , Christopher Y Kweon  4 , Estell J Williams  5 , Nathalia Jimenez  6
Affiliations
Observational Study

Trends in Race/Ethnicity Among Applicants and Matriculants to US Surgical Specialties, 2010-2018

Edwin Nieblas-Bedolla et al. JAMA Netw Open. .

Abstract

Importance: Surgical programs across the US continue to promote and invest in initiatives aimed at improving racial/ethnic diversity, but whether this translates to changes in the percentage of applicants or matriculants from racial/ethnic minority groups remains unclear.

Objective: To examine trends in the percentage of applicants and matriculants to US surgical specialties who identified as part of a racial/ethnic group underrepresented in medicine from the 2010-2011 to 2018-2019 academic years.

Design, setting, and participants: This cross-sectional study examined trends in self-reported racial/ethnic identity among applicants and matriculants to US residency programs to evaluate demographic changes among surgical programs from 2010 to 2018. Data were obtained from the Association of American Medical Colleges.

Results: The study population consisted of a total of 737 034 applicants and 265 365 matriculants to US residency programs, including 134 158 applicants and 41 347 matriculants to surgical programs. A total of 21 369 applicants (15.9%) and 5704 matriculants (13.8%) to surgical specialties identified as underrepresented in medicine. There was no statistically significant difference in the percentage of applicants underrepresented in medicine based on race/ethnicity for all surgical specialties combined in 2010 vs 2018 (15.3% [95% CI, 14.7%-15.9%] vs 17.5% [95% CI, 16.9%-18.1%]; P = .63). Thoracic surgery was the only surgical specialty in which there was a statistically significant change in the percentage of applicants (8.1% [95% CI, 4.9%-13.2%] vs 14.6% [95% CI, 10.2%-20.4%]; P = .02) or matriculants (0% [95% CI, 0%-19.4%] vs 10.0% [95% CI, 4.0%-23.1%]; P = .01) underrepresented in medicine based on race/ethnicity. Obstetrics and gynecology had the highest mean percentage of applicants (20.2%; 95% CI, 19.4%-20.8%) and matriculants (19.0%; 95% CI, 18.2%-19.8%) underrepresented in medicine among surgical specialties. Thoracic surgery had the lowest mean percentage of applicants (12.5%; 95% CI, 9.46%-15.4%) and otolaryngology the lowest mean percentage of matriculants (8.5%; 95% CI, 7.2%-9.9%) underrepresented in medicine.

Conclusions and relevance: In this cross-sectional study, overall US surgical programs had no change in the percentage of applicants or matriculants who self-identified as underrepresented in medicine based on race/ethnicity, but the proportion remained higher than in nonsurgical specialties. Reevaluation of current strategies aimed at increasing racial/ethnic representation appear to be necessary to help close the existing gap in medicine and recruit a more racially/ethnically diverse surgical workforce.

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Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.
Figure 1.. US Residency Applicant and Matriculant Sample by Specialty Type and Underrepresented in Medicine (URM) Status, 2010-2018
Not all residency programs were included in the residency applicant sample; a full list of included residencies is available in the methods. URM refers to individuals who identified as URM based on race/ethnicity as defined by the Association of American Medical Colleges.
Figure 2.
Figure 2.. Applicants and Matriculants to US Surgical and Nonsurgical Specialties Who Identified as Underrepresented in Medicine (URM) Based on Race/Ethnicity, 2010-2018
Figure 3.
Figure 3.. Matriculants to US Surgical Specialties Combined by Race/Ethnicity, 2010-2018
Total percentage may not add to 100% because, starting in 2013 to 2014, individuals were allowed to choose more than 1 racial/ethnic category. Other refers to individuals who chose 1 of the following options: other race/ethnicity, unknown race/ethnicity, non-US citizen, or non–permanent US resident.
See this image and copyright information in PMC

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