American Council of Academic Plastic Surgeons
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Diversity & Inclusion Initiatives: What Can Plastic Surgery Learn from Our Colleagues?
Kshipra Hemal, BS1; Meera Reghunathan, MD2; Greta Davis, BS2; Megan Newsom, BS1; Amanda Gosman MD2
1Department of Plastic & Reconstructive Surgery, Wake Forest Baptist Hospital, Winston Salem, NC, USA 2Division of Plastic & Reconstructive Surgery, University of California, San Diego, CA, USA

Background: Many have demonstrated that plastic surgery trainees lack gender and racial/ethnic diversity, but little is known about the interventions that can successfully address this problem. In this review, we characterize interventions used in other surgical fields to promote matriculation of underrepresented minorities (URM) and women and consider their applicability to plastic surgery.
Methods: The PubMed/MEDLINE database was searched for studies describing interventions for diversity in surgical fields between 2000-2020 in the United States. Articles were included if they met the following criteria: (1) specific interventions for increasing URM and gender diversity, (2) within surgery, and (3) targeting all stages of learners prior to residency.
Results: Of the 791 articles screened, 15 were included. Strategies included offering a holistic review of residency applications (20%), clerkships (20%), one-time interventions (20%), awards (13%), longitudinal mentoring programs (13%), and curated websites (7%). A holistic review of applications led to a significant increase in the representation of both women and URMs ranked and matched into programs. Summer internships within a longitudinal mentoring program were also effective: the odds of applying to orthopedic surgery for women and URMs who participated were 51 and 15 times the national average, respectively. Clerkships led to high satisfaction among participating students and in one case, a significant increase in the number of women applying to orthopedic surgery, but no such trend was seen among URMs. The presence of diversity and inclusion initiatives in orthopedic residency programs was not associated with a higher proportion of URM students, but it was associated with a higher proportion of female students in otolaryngology residency programs. Awards were either open to women or all genders, and did not lead to a statistically significant increase in the proportion of women applying to residency. One-time interventions lead to positive shifts in participantsí attitudes towards surgery but no statistically significant changes in application rates.
Conclusion: Holistic review of applications and longitudinal mentoring programs are the most effective at increasing representation of women and URMs in surgical fields. These interventions should be adapted to create a more diverse cohort of future plastic surgeons.



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