American Council of Academic Plastic Surgeons
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Diversity in Microsurgery and Craniofacial Fellowship Training: Racial and Gender Disparities in the Last Decade
Michelle K Oberoi, BA BS1; Meera Reghunathan MD2; Youssef Aref BS MPH3; Jacob J Dinis BS5 Darius Balumuka MD5; Amanda Gosman MD2
1University of California, Riverside School of Medicine, Riverside, CA, USA 2Department of Surgery, Division of Plastic & Reconstructive Surgery, University of California, San Diego, San Diego, CA, USA 3California University of Science and Medicine, Colton, CA, USA 4Frank H Netter MD School of Medicine, North Haven, CT, USA 5Division of Plastic & Reconstructive Surgery, Oregon Health & Science University School of Medicine, Portland, OR, USA

Background: Racial/ethnic and gender disparities becoming more pronounced at each stage in the pipeline to academia. Female plastic surgery residents have increased to nearly 40%, yet only 11% of full professors of plastic surgery are female. The representation of underrepresented minorities severely declines between plastic surgery residents and academicians with only 1.6% of Black/African-American and 4.9% of Hispanic/Latinx full professors of plastic surgery.1 This study aims to describe the gender and racial representation of microsurgery and craniofacial fellows and how it may be affecting the pipeline from residency to academia
Methods: Names and photos of graduated fellows for the past ten years (2012-2021) were extracted from institutional websites for microsurgery and craniofacial fellowship. Using a two-person evaluation method as described in Smith et al1, race and ethnicity were primarily determined by photographic and surname and verified, when possible, through online confirmation methods (articles, social media). Racial/ethnic and gender distributions will be analyzed with ARIMA time series modeling
Results: Among 30 US microsurgery fellowships, 174 (51.0%) graduated fellows were identified, resulting in 64 (36.8%) females (Figure 1) and the following racial/ethnic distribution: 105 (60.3%) White, 51 (29.3%) Asian, 12 (6.9%) Hispanic or Latinx, and 6 (3.5%) Black or African-American. Among 31 US craniofacial fellowships, 134 (44.1%) graduated fellows were identified resulting in 39 (29.1%) females and the following racial/ethnic distribution: 74 (55.2%) White, 44 (32.8%) Asian, 7 (5.2%) Hispanic/Latinx, 8 (5.9%) Black/African-American, and 1 (0.8%) mixed race. Relative to the US population, Hispanic/Latinx (0.35-fold) and Black/African-American (0.31-fold) were underrepresented whereas Asian fellows (4.41-fold) were overrepresented
Conclusion: This study demonstrates that racial/ethnic minorities are disproportionately underrepresented among fellowships. Efforts should be made to improve the recruitment of fellows of underrepresented backgrounds and thus improve the pipeline into academic careers. References: 1. Smith, Brandon T. M.S.; Egro, Francesco M. M.B.Ch; Murphy, Carolyn P. B.A.; Stavros, Alexander G. B.S.; Nguyen, Vu T. M.D. An Evaluation of Race Disparities in Academic Plastic Surgery, Plastic and Reconstructive Surgery: January 2020 - Volume 145 - Issue 1 - p 268-277 doi: 10.1097/PRS.0000000000006376. 2. Brotherton SE, Etzel SI. Graduate Medical Education, 2019-2020. JAMA. 2020 Sep 22;324(12):1230-1250. doi: 10.1001/jama.2020.14635. PMID: 32960221.

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