Educational Outcomes and Impact of Historically Black Colleges and Universities on the Pipeline of Minority Surgeons

Abstract

Introduction: We aim to examine the professional outcomes of graduates from a Historically Black College and University (HBCU) surgery residency program since inception.

Materials and methods: A retrospective analysis using records of 378 graduates from a single HBCU general surgery residency program was queried from 1938 to 2025. Educational outcomes were captured and trends evaluated by univariable and multivariable analyses.

Results: Overall, there were 300 (87%) Black, 78 (21%) female, 234 (62%) Black males, 293 (79.0%) male, and 12 (3.5%) Hispanic surgical graduates. Comparing early to late cohorts, we found that decreased Black graduates (122 (90%) versus 96 (80%), P = 0.029), decreased Black male graduates (100 (70%) versus 58 (47%), P < 0.001), increased female graduates (22 (16%) versus 48 (39%), P < 0.001), increased Hispanic graduates (1 (1%) versus 6 (5%), P = 0.045), increased graduates pursuing fellowships (65 (54%) versus 91 (77%), P < 0.001), increased maintenance of board certification (96 (76%) versus 113 (91%), P = 0.001), increased fellowship of the American College of Surgeons distinction (58 (46%) versus 74 (60%), P = 0.026), and increased age at graduation (33 y old versus 34 y old, P = 0.0325). On multivariable analyses, the odds of board certification (adjusted odds ratio [aOR] = 3.75, P = 0.008), fellowship (aOR = 2.00, P = 0.028), and female sex (aOR = 4.15, P < 0.001) were significantly associated with the late versus early group of graduates, whereas fellowship of the American College of Surgeons designation, pursuance of an academic position, US medical graduate, Black Race, and Hispanic Ethnicity were not.

Conclusions: Trends for surgical graduates of this HBCU program appear to mirror national trends. Such programs contribute to the diversification of surgeons, while maintaining excellent educational outcomes.

Keywords: Education outcomes; Historically Black colleges and Universities; Surgery residency; Surgical education.