Disparate Representations in University-Based General Surgery Programs

University-based (UB) residency programs have more research infrastructure and academic mentorship. The current study sought to determine whether disparities in representation exist in residents matriculated in UB programs.

This was a retrospective case-control study of general surgery residency matriculants from 2013 to 2020.

Among the 10,810 matriculants during this period, Black and Hispanic matriculants represented 4.3% and 4.9% of the study cohort, respectively. Women represented 43.9% of the study population. The growth of matriculants in non-UB programs outpaced the UB programs for all groups. In the multivariable analysis controlling for research output, honor society membership, and additional advanced degrees, female gender was associated with higher likelihood of matriculating into a UB program (odds ratio [OR] 1.19, 95% confidence interval [CI] 1.09-1.29, P < 0.001) while Hispanic ethnicity (OR 0.78, 95% CI 0.65-0.94, P = 0.01) and multiracial identity (OR 0.82, 95% CI 0.70-0.97, P = 0.02) were associated with lower likelihoods. Interaction analysis further confirmed that Hispanic and multiracial men were associated with lower likelihoods of matriculating into a UB program comparing to their female counterparts in all other groups.

Disparities in the representation of gender, race, and ethnicity exist among matriculants of UB programs. Inspiring more Hispanic and multirace academic surgeons at early stages and increasing their representation in UB programs could turn the tide on the stagnating progress in diversifying the academic surgical workforce.