TimesUpPRS: A Social Media Movement for Promoting Diversity, Equity, and Inclusion in Plastic Surgery

The Role of Diversity in Residency Program Selection: Insights From Applicants to Integrated Plastic Surgery Programs

BACKGROUND

Prior research has identified criteria valued by residency applicants when assembling their rank lists. However, with the composition of medical trainees continuously diversifying, there has been greater emphasis on creating a physician cohort reflective of the general US census. This study aimed to evaluate if faculty/resident diversity has a similar influence as established program features on residency program selection for current applicants applying to plastic surgery residency.

METHODS

A survey was administered to candidates of our institution's integrated plastic surgery residency program for the 2022-2023 and 2023-2024 application cycles to gather demographic data and rate the most impactful factors influencing rank list decisions. This was done using a Likert scale to rank program characteristics from 1 (not important) to 5 (extremely important).

RESULTS

Our survey response rate was 27% (180/673). Female and underrepresented in medicine (URiM) applicants ranked the presence of URiM faculty within a program (P = 0.002, P = 0.022), URiM faculty in administrative positions (P = 0.005, P = 0.012), residents identifying as the same race/ethnicity (P = 0.001, P < 0.001), and program participation in diversity, equity, and inclusion initiatives (P = 0.001, P = 0.003) as more important than their male and White counterparts.

CONCLUSIONS

Although quality of life and perceived fit are universal priorities, female and URiM applicants placed higher importance on diverse faculty, resident representation, and program initiatives related to diversity, equity, and inclusion. These results suggest residency programs may appeal to more applicants by considering these factors in their future recruitment strategies.

Gender, Racial, and Ethnic Diversity in Plastic Surgery: Evaluating Effective Initiatives and Identifying Areas for Improvement

ABSTRACT

Women and racial and ethnic minorities have historically been underrepresented in medicine, making up a minority of all physicians and a smaller subset of plastic surgeons. Furthermore, these groups represent an even smaller fraction of plastic surgeons in research and leadership roles. Parallel to the general recognition of the importance of increasing diversity in the medical field, there has been a surge in the literature detailing current issues and highlighting potential areas for intervention within plastic surgery. Various initiatives have been piloted to address the underrepresentation of certain demographic groups in the field. These have largely targeted the medical student level, with a focus on increasing mentorship, targeted recruitment, exposure to the field, and scholarly opportunities. With the growing body of research conducted in this realm, this review seeks to synthesize our understanding of the modern landscape of gender, racial, and ethnic diversity within plastic surgery, with an emphasis on identifying successful initiatives that have positively impacted representation and inclusivity.

The Evolving Plastic Surgery Applicant: How Far Have We Come in 30 Years?

BACKGROUND

Plastic surgery training has undergone tremendous change and transitioned through many models over the years, including independent, combined, and integrated. This study evaluates how these changes and others have affected plastic surgery applicants' demographics and academic qualifications over the last 30 years.

METHODS

Data on applicant demographics and academic qualifications were extracted from multiple sources including the National Resident Matching Program, the American Association of Medical Colleges, and cross-sectional surveys of plastic surgery applicants for the years 1992, 2005, 2011, and 2022. Data were compared using pairwise χ2 goodness of fit tests.

RESULTS

The sex distribution of plastic surgery applicants changed significantly over the last 30 years: whereas men predominated in 1992 (86% male vs 14% female), by 2011, the distribution was nearly equal (54% male vs 46% female in both 2011 and 2022, P < 0.001).The racial makeup of applicants also changed over time (P < 0.05). White applicants decreased from 73% in 1992 to 55% in 2011, and 53% in 2022. While there was an increase in Asian (7% to > 17% to > 20%) and other (13% to > 14% to > 21%) applicants over time, whereas the proportion of Black applicants remained stagnant (5% to > 6% to > 8%).Applicants with prior general surgery experience declined precipitously over the years: 96% in 1992, 64% in 2005, 37% in 2011, and 26% in 2022 (P < 0.001). When compared with 1992, Alpha Omega Alpha status increased significantly in 2011 (36% vs 12%, P < 0.05) but did not change considerably in 2005 (22%) and 2022 (23%). Research experience increased dramatically over the years, with the proportion of applicants with at least one publication going from 43% in 1992, to 75% in 2005, to 89% in 2011, and to 99% in 2022 (P < 0.001). Applicant interest in academic plastic surgery did not change considerably over the years at roughly ranging from 30% to 50% of applicants (P = ns).

CONCLUSIONS

There has been a shift in the demographics and academic qualifications of plastic surgery applicants over the last 3 decades. Understanding this evolution is critical for reviewing and evaluating the makeup of our specialty, and enacting changes to increase representation where necessary.