Racial and Ethnic Diversity in American Plastic Surgery Residency

Significant efforts during the past decades have led to growing racial diversity in the field, resulting in more underrepresented minorities (URM) in training. To highlight areas for improving URM inclusion and training, we sought to pinpoint educational and achievement gaps among URMs in contrast to White and Asian trainees.

In this cross-sectional study, publicly accessible records were assessed for data on trainees' education, research, location, and race, comparing URMs (Black, Hispanic, Hawaiian, Native American) to White and Asian trainees.

Among 1092 trainees across 95 programs (950 integrated and 142 independent), Whites and Asians comprised 94.2%, while URMs (Blacks, Hispanics, and Others) made up 5.8%. Compared to U.S. medical students, there was a 21.4% increase in Whites and 1.2% in Asians, with a 3.9% and 4.3% decrease in Blacks and Hispanics, respectively. Comparable proportions graduated from medical schools with affiliated residency programs, matched at their schools, or pursued alternative pathways. URMs were all allopathic graduates, had more advanced degrees, with significantly more MBAs (p=0.024). A higher proportion of URMs trained in independent programs (p=0.003) and were distributed towards Southern and Midwestern programs (p=0.021). URMs had fewer citations (p=0.047), though publications and Hirsch index were comparable.

Our analysis identifies a remediable issue, offering avenues for improved racial representation. Early pre-match mentorship remains the key intervention to diversify the field by effectively guiding match strategies for URMs. This is evidenced by fewer citations among URM trainees albeit comparable research backgrounds higher prevenance of advanced degrees, particularly MBAs.