A Scoping Review to Assess Current Interventions and Gaps in Recruiting for an Inclusive Surgical Workforce

While the diversity of the surgical workforce has well-studied benefits for patient care, surgical subspecialties have historically been unsuccessful in recruiting diverse trainees. Although surgical programs have made substantial efforts to address this problem, to progress, we need to (1) synthesize the evidence for successful strategies for recruiting diverse surgical trainees and (2) identify the dimensions of diversity that have not been studied. This scoping review assesses strategies for the effective recruitment of diverse surgical trainees, identifies the level of evidence supporting these strategies, and examines the current gaps in the literature.

NLM PubMed, Elsevier Embase, and Clarivate Web of Science were searched on September 4, 2024. We included studies reporting original data assessing interventions to recruit diverse trainees, defined broadly, e.g., gender and sexual minorities, ethnic and racial minorities, persons with disabilities, and veterans, into graduate surgical training programs (general surgery, otolaryngology, orthopedic surgery, plastic surgery, urology, neurosurgery, vascular surgery, oral and maxillofacial surgery, and cardiothoracic surgery).

In this scoping review of 25 articles, we found the most common interventions included early exposure programs (11 of 25 included studies; 44%), efforts to reduce bias in the interview process (8 of 25; 32%), and improving programmatic structure to promote inclusion (6 out of 25; 24%). We found that the highest level of evidence achieved in the literature was level 3 (20 out of 25 included studies; 80%). Studies most commonly intervened to increase racial and ethnic minority representation (19/25; 76%) and women's representation (11/25; 44%).

This scoping review summarizes and assesses the literature on evidence-based practices for recruiting a diverse surgical workforce. This work outlines interventions institutions can develop to promote diversity within the surgical workforce. Furthermore, it provides areas for advancing the recruitment of an inclusive surgical workforce.