Supporting diversity, equity, & inclusion in surgery residencies: creating a more equitable training environment

Purpose Despite increasing awareness of the need for diversity in surgery, African, Native, and Hispanic American surgeons as well as women and LGBTQ + surgeons, among others, remain underrepresented relative to their fraction of the population at all levels of the surgical profession. The purpose of this commentary is to highlight evidence-based strategies for promoting diversity, equity, and inclusion in surgery training programs and provide practical guidance for implementing these approaches from experts in the field. Methods The Association of Surgical Education convened a panel on Diversity, Equity, and Inclusion as part of the Association’s Annual Meeting held in April 2021. The insights from this panel generated a commentary on evidence-based approaches to improving program diversity and making the field of surgery more equitable and inclusive. Results Surgical residency programs should evaluate the composition of their programs to quantify areas of inadequate representation and formulate clear goals for addressing these needs. Evidence-based recruitment strategies include formation of Diversity and Inclusion Councils, signaling diversity and inclusion through program websites and recruitment activities, and using a holistic recruitment process. To retain under-represented trainees and faculty, programs must develop processes for responding to micro-aggressions and harassment, provide mentorship, and educate trainees and staff about recognizing bias and celebrating diversity. Pipeline programs directed at school-aged children from disadvantaged or under-represented backgrounds and medical student minority groups have also been shown to shift students’ trajectories toward surgical careers. Conclusions Surgical training programs have an urgent responsibility to address disparities in representation in the surgical workforce by employing evidence-based approaches to increase the diversity, equity, and inclusion of the field.