Analysis of Diversity, Equity, and Inclusion Initiatives Presented Across US Academic Department of Surgery Websites in 2021

Health Disparities Curricula in General Surgery Residency Programs: A Critical Scoping Review

INTRODUCTION

In 2021, the structural determinants of health (SDOH) were added to the Accreditation Council of Graduate Medical Education common program requirements for all accredited residency programs, including general surgery. In this study, we sought to explore the current scope of, and concepts used in, health disparities curricula for general surgery residents, specifically investigating how general surgery residents learn about health disparities and the SDOH.

METHODS

We searched PubMed, EMBASE, Education Research Complete (EBSCOhost), and Web of Science Core Collection using keywords related to health disparities and the SDOH. Inclusion criteria consisted of all studies published after 2005 that discussed health disparities curricula for Accreditation Council of Graduate Medical Education-accredited general surgery residency programs. Five thousand three hundred seventeen articles were screened using a two-phase process. Data extraction and analysis was performed using critical review methods.

RESULTS

Seventeen articles were identified. Within these articles, seven unique health disparities curricula were found. All seven of the identified curricula employed cultural frameworks as methods to mitigate health disparities. Three curricula, all published after 2011, included education on the SDOH. A wide variety of educational methods were utilized; in-person didactics was the most common.

CONCLUSIONS

In the current literature, culture continues to play a large role in health disparities training for general surgery residents. Though further efforts are needed to understand the methods used in programs that have not published scholarly work, it is imperative to ensure that residents are provided with the sociopolitical perspective needed to understand the SDOH and serve all patients, including those affected by health disparities.

Advancing diversity in spine surgery: the critical role of professional societies and foundations

This manuscript examines the challenges and initiatives within organizations associated with spine surgery to enhance diversity, equity, and inclusion (DEI), focusing on the systemic barriers that hinder the representation of women and underrepresented in medicine (URiM) minorities. Highlighting the contributions of pioneering individuals who overcame racial and gender discrimination to forge paths in these fields, it stresses the importance of professional societies and foundations in promoting DEI. Despite advancements, legal challenges and recent legislation in various states threaten to undermine DEI efforts, presenting a critical moment for organizations to reassess and reinforce their strategies. By detailing the roles of specific professional societies, foundations, and initiatives like the American Society of Black Neurosurgeons and Nth Dimensions, the manuscript underscores the necessity of targeted actions to ensure the progress toward a more inclusive and equitable spine surgery community.

When I Don't see me, Am I seen? Race and student perception of the surgery clerkship

INTRODUCTION

Increasing interest in general surgery from students who are Under-Represented in Medicine (URiM) is imperative to advancing diversity, equity, and inclusion efforts. We examined medical student third year surgery clerkship evaluations quantitatively and qualitatively to understand the experiences of URiM and non-URiM learners at our institution.

METHODS

Evaluations from 235 graduated medical students between the years of 2019 and 2021 were analyzed. T-tests were used to compare numerical data. Free-text comments were qualitatively analyzed using inductive thematic analysis by two independent reviewers with conflicts resolved by a third.

RESULTS

Evaluations were completed by 214 non-URiM students (91.1 ​%) and 21 (8.9 ​%) URiM students. There were no significant differences between URiM and non-URiM students in ratings of faculty and resident teaching. When asked whether residents were positive role models for patient care, non-URiM students were more likely than URiM students to agree (3.284 vs. 2.864, p ​= ​0.040). When asked whether they considered faculty to be positive role models, non- URM students were also more likely to answer affirmatively than URiM students (3.394 vs. 2.909 p ​= ​0.013). Qualitative comments were similar between the two groups. When asked what the strengths of the clerkship were, the most commonly evoked theme was "interactions with team" with subthemes of "team integration" "feeling valued" and positive "faculty" or "resident" interactions. "Operative experience" was the second most commonly evoked strength of the clerkship. The most common criticisms of the clerkship involved "negative interactions with team" with subthemes of "not prioritized above other learners" and "ignored." Negative "academic experience" was the next most commonly evoked weakness, with an affiliated theme of "lack of teaching."

CONCLUSIONS

URiM students are less likely than non-URiM students to see surgical residents and faculty as positive role models. Integrating medical students into the team, taking time to teach, and allowing students to feel valued in their roles improves the clerkship experience for trainees and can contribute to recruitment efforts.