Trends in Racial and Gender Diversity Among Complex General Surgical Oncology Fellowship Trainees

BACKGROUND

This study examines trends in racial and gender diversity of trainees within Complex General Surgical Oncology Fellowships, and compares the racial and gender proportions of trainees across different fields to assess potential barriers to increasing diversity within surgical oncology training programs.

METHODS

Accredited Council for Graduate Medical Education (ACGME) data were queried to identify surgical trainees between 2013 and 2021. Trainees were identified based on self-reported race and gender and were stratified based on residency type and fellowship program type if applicable. Chi-square tests were used to assess differences between groups and trends.

RESULTS

A significantly lower proportion of individuals who are underrepresented in medicine (URMs) trained in surgical oncology fellowships (8.9%) compared with both the overall trainee pool (12.8%) and general surgery residency programs (13.1%) [p < 0.05]. There was no significant increase in URM representation in surgical oncology fellowships across the study period. Furthermore, there was a significantly lower proportion of females training in surgical oncology fellowships (38.6%) compared with the overall trainee pool (45.6%) [p < 0.05]. Despite a significant increase in female representation in general surgery residency and other surgical fellowships, there was no significant increase in female representation in surgical oncology fellowships across the study period.

CONCLUSIONS

This study identifies disparities in gender and racial minority representation within ACGME-accredited Complex General Surgical Oncology Fellowship training programs. While steps have been taken to expand diversity, more needs to be done to combat the systemic barriers that both racial minorities and women face during their training.

Application and Match Rates in the Complex General Surgical Oncology Match

Background

The Society of Surgical Oncology collaborates with the National Resident Matching Program (NRMP) to facilitate the Complex General Surgical Oncology (CGSO) Match.

Objective

The purpose of this study was to understand trends in CGSO Match outcomes. We hypothesized that (1) match rates would increase with time; (2) US allopathic graduates would have higher match rates than non-US allopathic graduates; and (3) most applicants would match at one of their top three ranked choices.

Methods

The NRMP provided applicant and program data from the CGSO Match (2014–2021). Chi-square tests elucidated temporal trends and match rates by applicant archetype.

Results

The annual number of applicants decreased from 103 to 90 (13% decrease), while the annual number of fellowship positions increased from 56 to 67 (20% increase) from 2014–2021. The annual percentage of applicants who did not match decreased from 46% to 26% (p < 0.05). Annual match rates increased from 54% to 74% (p < 0.05). US allopathic graduates had higher match rates than non-US allopathic graduates but this disparity narrowed over time (84% vs. 55% in 2021; p < 0.001). Approximately half of all applicants matched at one of their top three choices (first, 29%; second, 12%; third, 8%). Applicants matching at one of their top three choices increased from 36% to 50% (p < 0.05).

Conclusions

CGSO Match rates have increased over the past decade, thus primarily benefiting non-US allopathic graduates. Most applicants match at one of their top three choices. More research is needed to understand disparities in match rates by applicant and residency program characteristics.

Trainee Utilization of the SCORE Curriculum is Associated With Improved ABSITE Performance: A Multi-institutional Study

BACKGROUND

The Surgical Council on Resident Education's (SCORE) structured educational curriculum for general surgery residents uses a 2-year repeating cycle of modules and quizzes called "This Week in SCORE" (TWIS) to organize and sequence the curricular content on the SCORE portal. The purpose of this study was to evaluate the impact of using the SCORE content and TWIS curriculum on American Board of Surgery In-Training Examination (ABSITE) performance. To date, no multi-institutional studies have examined this effect.

METHODS

Eight residency programs participated, including university and community-based programs. SCORE usage overall, TWIS usage, and ABSITE percentile scores (adjusted for post-graduate year [PGY]) were analyzed for the academic years 2017 to 2020. SCORE usage was defined as number of SCORE logins annually per resident with "low usage" ≤10 times and "high usage" >10 times. TWIS usage was defined as "low usage" (no TWIS quizzes done) or "high usage" (≥1 TWIS quiz per year).

RESULTS

Four hundred and twenty-eight trainees were evaluated. Trainees with high SCORE and TWIS usage consistently achieved a higher ABSITE percentile score. This difference was maintained in subgroup analysis by PGY with the greatest impact in PGY-1 and PGY-2 levels.

CONCLUSIONS

Utilization of multiple aspects of SCORE content appears to have a significant positive impact on ABSITE performance across all levels of postgraduate training. This multi-institutional study of a large number of users is the first to demonstrate that increased usage of SCORE content appears to be a predictor of ABSITE performance success.

Colon and Rectal Surgery Residency Selection Criteria: A National Program Director Survey

OBJECTIVE

Colon and Rectal Surgery has established itself as a highly competitive specialty over recent years, with demand for residency positions growing and becoming increasingly difficult to obtain each year. However, limited information exists as to which characteristics make for a successful colorectal surgery applicant. This study aims to identify which academic benchmarks and applicant characteristics impact successful matriculation into Colon and Rectal Surgery residency.

DESIGN

Each Colon and Rectal Surgery residency program was sent a web-based survey comprised of 28 questions. Questions were designed to assess which factors were considered when evaluating an applicant prior to offering an interview and during rank determination.

SETTING

The study was conducted as an anonymous web-based survey.

PARTICIPANTS

Each Colon and Rectal Surgery residency program in the United States accredited by the Accreditation Council for Graduate Medical Education (N = 63) was included in the study. Forty-four of 63 programs completed the survey for an overall response rate of 70%.

RESULTS

Ninety-one percent of the programs reported having a prerequisite American Board of Surgery In-Training Examination score for interview, with 50% of these programs requiring scores above the 50th percentile. During the ranking process, the most important factors considered by programs were interpersonal skills and communication, letters of recommendation, and interaction with other applicants and nonclinical staff. The majority of program directors felt that interview performance was the most important factor in ranking an applicant highly.

CONCLUSIONS

Successful matriculation into Colon and Rectal Surgery requires the applicant to achieve the necessary academic benchmarks while also demonstrating a variety of desirable characteristics, which are most importantly assessed during an interview.