While the proportion of women entering plastic surgery residency programs has increased in recent years, numbers of black and Hispanic trainees are declining or unchanged, reports a study in the March issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons.
Even though there were increases in all of those groups among medical student graduates, black representation has actually decreased among plastic surgery trainees, and Hispanic representation has made minimal changes.
The researchers analyzed data on medical student applications to and resident enrollments in accredited U.S. plastic surgery training programs from 2010 to 2016. The study focused on trends in gender and racial/ethnic representation, as well as possible barriers to increased diversity among plastic surgery trainees.
The proportion of women in plastic surgery residency programs increased during the study period, despite a decrease in female applicants. The number of women residents increased by 2.23 percent per year in integrated plastic surgery programs (where trainees stay in the same program for both general and specialty surgical training); and by 0.7 percent per year in independent programs, where residents train in plastic surgery after general surgery training elsewhere.
The increased representation of women in plastic surgery training programs was similar to trends in other specialties, including general surgery, internal medicine, family medicine, and obstetrics and gynecology.
In contrast, the overall proportion of black plastic surgery residents decreased during the study period, despite an increase in black residents in independent programs. This mirrored the trend in other specialties, where the percentage of black applicants was higher than the number of black residents for the same year.
Hispanic representation among applicants and plastic surgery residents showed little or only marginal change during the years studied. The number of Hispanic medical students has also increased in recent years.
Past studies have shown under-representation of black, Hispanic, and female medical school graduates training to become plastic surgeons, compared to other surgical fields. The new study shows an encouraging increase among women in integrated plastic surgery programs, though there's room for future growth.
Black and Hispanic representation in plastic surgery training programs has not followed the same trajectory. The researchers believe this lack of progress may reflect barriers beginning as early as medical school, including an absence of mentors, lack of access to plastic surgery resources, or implicit bias.
While the racial barriers remain frustrating, the greater proportion of women trainees came as welcome news -- despite growing pessimism over workplace parity.
In July, digital health venture Rock Health polled 635 women across healthcare and found that roughly 55 percent of respondents believe it will take 25 years or more to achieve gender parity in the workplace -- and that's up from 45 percent last year. Only 5 percent said it will happen in the next five years, down from 8 percent in 2017.