Document text
Principal Investigator: JULIE ANN SOSA
Organization: WEILL MEDICAL COLL OF CORNELL UNIV
Fiscal Year: 2024
Award: $669,355
Funding agency: National Institute on Minority Health and Health Disparities
Abstract
Addressing Surgical Disparities at the Root: Improving Diversity in the Surgical Workforce
The recent COVID-19 pandemic, racially motivated murders, and subsequent protests underscore what we
already know--that racial disparities in medicine run far deeper than patient outcomes alone and must be
addressed at all levels. Racial and gender disparities in surgical outcomes and satisfaction are well documented.
From a pipeline perspective, surgery struggles to maintain and promote underrepresented minority (UIM) and
women residents and faculty. Efforts to improve diversity in the workforce overtime have not kept pace with the
increased diversity in our patient populations. There is evidence that improving diversity in the surgical workforce
can improve the quality and outcomes of care for UIM and women patients. The proposed study involves a team
of interdisciplinary investigators with complimentary expertise and a strong record of research in the topic area
collaborating with multiple stakeholder societies. Our objective is to reduce disparities in surgical care using a
novel, transdisciplinary, multi-institutional deviance approach to characterize disparities in the surgical workforce,
set best practice guidelines, and develop a pilot intervention. Our central hypothesis is that by using deviance
methodology we can identify best practices in retention and promotion of women and minority faculty and
trainees in surgery that can be used to help increase diversity in the work force and ultimately patient quality of
care. We will perform a secondary data analysis to measure diversity among surgical faculty across the U.S.;
identify programs with the best and worst records of promotion and retention of UIM and women faculty; and
document the range of promotion and retention among these groups at academic medical centers to identify
predictors of successful diversity efforts Using AAMC data combined with ABS data and qualifying as well as
certifying examination data, we will describe the sociodemographic profile of surgical trainees and current
attrition rates for surgical residents in the U.S., identifying those programs with the best and worst records of
graduating residents. We will utilize data on cultural competency and bias assessment surveys collected from
our target programs as well as focus groups with the National Medical Association, the Association of Women
Surgeons and the Historically Black Medical Colleges and Universities and in-depth, qualitative interviews with
program administrators, UIM and women trainees, faculty, and department and division heads at programs that
have been successful - or struggled at - retaining and promoting UIM and women faculty to study best and worst
practices and organizational characteristics. Finally, we will take predictors from our quantitative analysis,
themes from our qualitative analysis, and coordinate a Delphi panel of academic leaders and patient advocacy
groups to create a set of best practice guidelines and develop a pilot study to test at poorly performing programs.
By defining best practices for retention and promotion of residents and faculty, we can develop best practices
and test these to help improve diversity, equity, and inclusion in the academic surgical workforce.
Terms: <Academia><Academic Medical Centers><Accreditation><Active Follow-up><Address><Administrator><Ally><American><Area><Asian><Association of American Medical Colleges><Black><Black Populations><Black group><Black individual><Black people><Black race><Blacks><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Caring><Certification><Characteristics><Client satisfaction><Clinical Trials><Collaborations><Complex><Corporate Culture><Data><Data Analyses><Data Analysis><Decrease disparity><Disparities><Disparity><Drops><Enabling Factors><Enrollment><Ethnic Origin><Ethnicity><Faculty><Failure><Feedback><Female><Focus Groups><Future><Gender><General Population><General Public><Guidelines><HBCUs><Hispanic><Historically Black Colleges><Historically Black Colleges and Universities><Historically Black Institution><Historically Black University><Individual><Infrastructure><Institution><Intervention><Intervention Strategies><Interview><Investigators><Latino><Lower disparity><MD students><Measures><Medical><Medical Students><Medicine><Mentorship><Methodology><Methods><Minority><Murder><Nature><Operative Procedures><Operative Surgical Procedures><Organizational Culture><Outcome><Patient Care><Patient Care Delivery><Patient Satisfaction><Patient advocacy><Patient outcome><Patient-Centered Outcomes><Patient-Focused Outcomes><Patients><Perioperative><Physicians><Pilot Projects><Play><Population><Practice Guidelines><Process><QOC><Qualifying><Quality of Care><Race><Races><Racial Group><Records><Research><Research Personnel><Researchers><Residencies><Risk><Running><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Sex Orientation><Sexual Orientation><Societies><Specialty><Surgeon><Surgical><Surgical Interventions><Surgical Procedure><Surgical Profession><Surgical Specialties><Survey Instrument><Surveys><Testing><Training><Training Programs><Underrepresented Ethnic Minority><Underrepresented Minority><Uninsured><Universities><University Medical Centers><Woman><Work><accredited><active followup><associate faculty><associate professor><black male><black men><care for patients><care of patients><care outcomes><career><caring for patients><cohort><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><cultural competence><culturally competent><data interpretation><disparities in race><disparity due to race><disparity reduction><diversity, equity, and inclusiveness><enroll><equity, diversity, and inclusion><experience><faculty support><female faculty><female patients><follow up><follow-up><followed up><followup><full professor><gender disparity><graduate medical education><health care outcomes><healthcare outcomes><high risk><improved><improved outcome><inequality due to race><inequity due to race><interventional strategy><male><medical college><medical school students><medical schools><medical specialties><mid-career faculty><midcareer faculty><minority patient><mitigate disparity><novel><parity><patient advocacy group><patient oriented outcomes><patient population><patients being female><patients being women><patients from minority><patients of minority><patients who are female><pilot study><professor><programs><race based disparity><race based inequality><race based inequity><race disparity><race related disparity><race related inequality><race related inequity><racial><racial background><racial disparity><racial inequality><racial inequity><racial origin><racial population><racial subgroup><racially unequal><reduce disparity><reduction in disparity><satisfaction><school of medicine><senior faculty><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><socio-demographic factors><socio-demographics><sociodemographic factors><sociodemographics><statistics><success><surgery><surgery outcome><surgery specialty><surgical disparities><surgical outcome><treatment planning><under served area><under served geographic area><under served location><under served region><under-representation of minorities><under-represented minority><underrepresentation of minorities><underserved area><underserved geographic area><underserved location><underserved region><women faculty><women patients>