Underrepresented Minorities are Underrepresented Among General Surgery Applicants Selected to Interview

Area of Science:

• Medical Education
• Surgical Training
• Diversity in Medicine

Background:

• General surgery residency programs face challenges in recruiting diverse trainees.
• Accreditation requirements now mandate diversity in residency programs.
• Defining and achieving diversity in surgical training remains complex.

Purpose of the Study:

• To analyze the self-identified racial/ethnic distribution of general surgery applicants.
• To identify characteristics of underrepresented minorities (URM) in the applicant pool.
• To assess disparities in interview selection for URM applicants.

Main Methods:

• Data from the Electronic Residency Application Service (ERAS) for the 2018 cycle were analyzed.
• Ten general surgery residency programs participated, including independent and university programs.
• URM were defined as applicants identifying as Black/African American, Hispanic/Latino, American Indian/Alaskan Native, or Native Hawaiian/Pacific Islander-Samoan.

Main Results:

• URM applicants (Hispanic/Latino, Black, American Indian/Alaskan Native/Pacific Islander) constituted 21% of total applicants but only 15% of those selected for interviews.
• A higher proportion of URM applicants had United States Medical Licensing Examination (USMLE) Step 1 scores ≤220 compared to White and Asian applicants.
• Non-white self-identification was a significant predictor of lower interview selection likelihood, while USMLE Step 1 scores >220 and US medical school graduation increased selection likelihood.

Conclusions:

• URM applicants are underrepresented in interview selections for general surgery residency.
• Lower USMLE Step 1 scores among URM applicants may lead to exclusion by strict score cutoffs.
• Programs should analyze disparities and implement strategies to interview overlooked URM applicants for greater diversity.