Progress With Shortcomings: An Examination of Demographic Representation in Integrated Plastic Surgery Residencies.

Background: This retrospective study investigates progress in representation among Black, Hispanic, American Indian/Alaska Native (AIAN) Native Hawaiian/Pacific Islander (NHPI), and female demographics in plastic surgery and other surgical residencies. Utilizing applicant and resident data, demographic trends were examined to assess the effectiveness of recent diversification efforts.

Methods: Binomial analysis of proportions applicants and residents between 2016 and 2022 was conducted. Instances where proportions of applicants surpassed that of residents indicated underrepresentation. Representation trends were assessed via linear regressions of proportions of applicants and residents with time as the explanatory variable. Binomial analysis of proportions of medical school graduates in 2020 and plastic surgery residents in 2021 was conducted. Instances where proportions of graduates surpassed that of residents indicated underrepresentation.

Results: Plastic surgery saw an increase in female applicants (14.9%) and residents (5.5%), an increase in Hispanic residents from 2020-2022 (1.3%), and a decrease in AIAN (0.4%) and NHPI residents (0.2%). Black residents remained the most underrepresented group of residents relative to applicants. Trends were similar to those seen in other specialties. All groups were underrepresented in plastic surgery relative to numbers in the US population and among medical school graduates.

Conclusions: Findings suggest that plastic surgery has made minimal progress in achieving representativeness relative to the US population. Although women and Hispanic demographics have made strides, similar progress has not been evident among Black, AIAN, and NHPI demographics. All groups continue to experience varying degrees of underrepresentation across specialties. Addressing this persistent disparity demands further investigation and targeted, strategic interventions.