Exploring effective strategies in promoting diversity, equity, and inclusivity in surgery: scoping review

Diversity, equity, and inclusion is vital for improving patient care, reducing health disparities, and driving innovation in surgery. Despite this, surgical doctors who are women or from minority groups remain under-represented in surgery. Barriers including limited exposure, entrenched stereotypes, systemic biases, and lack of diverse role models persist, whereas effective strategies remain underexplored. This review evaluates existing diversity, equity, and inclusion interventions that improve recruitment, retention, and promotion in surgery.

Following PRISMA-ScR guidelines, PubMed, Embase, and the Cochrane Library were searched in November 2024 and updated in September 2025 to include all studies published up to that date. Eligible studies ranged from October 2010 to August 2025. Methodological quality was assessed using an adapted 2018 Critical Appraisal Skills Programme checklist. Data were synthesized thematically to identify recurring intervention patterns.

From 928 articles, 19 studies were included. Four overarching themes emerged: (1) pipeline programmes (workshops and scholarships) fostered early exposure, with some reporting > 70% participants from minority groups and doubled surgical entry of women; (2) holistic recruitment strategies overcoming rigid academic cut-offs increased interview offers to participants from minority groups (up to 8%) while maintaining academic standards, with some programmes reporting zero attrition; (3) mentorship from medical school to early career yielded 86% fellowship pursuit and > 50% faculty appointments among surgeons from minority groups; and (4) comprehensive institutional efforts, including diversity committees and faculty bias training, achieved up to 55% women and 33% people from minority groups among new hires. Mentorship, holistic reviews, career-stage scholarships, and institutional accountability emerged as impactful measures.

This review underscores the importance of integrated diversity, equity, and inclusion strategies providing evidence-based pathways to address systemic inequities and build a more inclusive surgical workforce.