背景:随着美国人口的发展,外科领域必须适应,以确保公平的医疗保健。医疗保健差距特别影响少数民族人口,有色人种社区经常面临医生短缺和冠心病等疾病发病率较高的问题,中风,和癌症。研究表明,少数族裔医生显着提高了服务不足社区的患者满意度和结果,强调需要增加医生的多样性,以提高文化能力和以患者为中心的护理。来自美国医学院协会(AAMC)的数据显示,在过去的三十六年中,在外科住院医师和学术生涯中,代表性不足的少数群体(URM)的增长最小。从2010年到2018年,美国外科医生学院认可的9个外科专业的URM申请人和预科生变化不大。
目的:这篇综述旨在批判性地评估九个确定的外科专业中的六个(普外科,整形手术,神经外科,骨科手术,心胸外科,和血管手术)在美国。
方法:我们进行了全面的文献综述,以评估美国外科专业的多样性状况。通过分析手术领域多样性的好处,评估各种多样性计划和举措的有效性,检查外科亚专科之间的比较多样性,并评估多样性对患者预后的影响,我们的目标是强调加强外科领域多样性的至关重要性。
结果:虽然代表性和多样性的细微差别因外科专业而异,所有领域持续表现出某些种族/族裔群体代表性不足和持续存在的性别差异。这些差异体现在各个阶段,包括居住,以及URM人员在外科和外科亚专科的招聘和保留。虽然过去十年的干预措施有助于改善外科领域的多样性,巨大的差距仍然存在。限制包括最近的干预措施显示重大影响所需的时间,以及既定的干预措施无法消除差距。
结论:尽管有明显的好处,外科专业的多样性仍然是一场艰苦的战斗。解决手术领域的多样性差距对于改善患者预后至关重要。医疗保健访问,和工作环境,需要有针对性的招聘等策略,导师计划,解决系统性偏见。这项审查强调了不可否认的变革必要性,并呼吁采取行动。
BACKGROUND: As the US demographic evolves, surgical fields must adapt to ensure equitable healthcare. Healthcare disparities notably affect minority populations, with communities of color often facing physician shortages and higher rates of diseases such as coronary disease, stroke, and cancer. Research shows that minority physicians significantly improve patient satisfaction and outcomes in underserved communities, highlighting the need for increased physician diversity to enhance cultural competency and patient centered care. Data from the Association of American Medical Colleges (AAMC) reveals minimal increases in underrepresented minorities (URM) in surgical residency and academic careers over the past thirty-six years, with little change URM applicants and matriculants in the nine surgical specialties recognized by the American College of Surgeons from 2010 to 2018.
OBJECTIVE: This review aims to critically evaluate the current landscape of racial and gender diversity in six out of the nine defined surgical specialties (general surgery, plastic surgery, neurosurgery, orthopedic surgery, cardiothoracic surgery, and vascular surgery) in the US.
METHODS: We conducted a comprehensive literature review to assess of the state of diversity within surgical specialties in the United States. By analyzing the benefits of diversity in surgical fields, evaluating the effectiveness of various diversity programs and initiatives, examining the comparative diversity between surgical subspecialties, and assessing the impact of diversity on patient outcomes, our aim is to highlight the critical importance of enhancing diversity in surgical fields.
RESULTS: While nuances in representation and diversity vary across surgical specialties, all fields persistently exhibit underrepresentation of certain racial/ethnic groups and persistent gender disparities. These disparities manifest throughout various phases, including in residency, and in the recruitment and retention of URM individuals in surgery and surgical subspecialties. While interventions over the past decade have contributed to improving diversity in surgical fields, significant disparities persist. Limitations include the time required for recent interventions to show significant impacts and the inability of established interventions to eliminate disparities.
CONCLUSIONS: Despite the clear benefits, diversity within surgical specialties remains an uphill battle. Addressing the diversity gap in surgical fields is crucial for improving patient outcomes, healthcare access, and workplace environments, requiring strategies such as targeted recruitment, mentorship programs, and addressing systemic biases. This review highlights the undeniable imperative for change and serve a call to action.