Trends in workforce diversity in vascular surgery programs in the United States

Background: U.S. black and Hispanic populations are growing at a steady pace. In contrast, the medical profession lacks the same minority growth and representation. Women are also under-represented in many surgical disciplines. The purpose of this study was to assess trends in the proportion of women, blacks, and Hispanics admitted to vascular surgery (VS) and related specialties, and to compare them with each other and with a surgical specialty, orthopedic surgery (OS), with a formal diversity initiative. Methods: Data on the fellowship pool of VS, interventional radiology (IR), and interventional cardiology (IC), as well as the resident pools of general surgery (GS) and orthopedic surgery (OS), were obtained from U.S. graduate medical education reports for 1999 through 2005. Cochrane-Armitage trend tests were used to assess trends in the proportion of females, blacks, and Hispanics in relation to the total physician workforce for each subspecialty. Results: No significant trends in the proportion of females, blacks, or Hispanics accepted into VS and IC fellowship programs occurred during the study period. In contrast, IR, GS, and OS programs revealed significant trends for increasing proportions of at least one of the underrepresented study groups. In particular, OS, which has implemented a diversity awareness program, showed a positive trend in female and Hispanic trainees (P < .04 and P < .02, respectively). Blacks showed a significant increasing trend only in IR (P = .05). Conversely, a positive trend toward continued growth in the Hispanic group was seen in GS (P < .001), IR, and OS (P = .04 and P = .02, respectively). Conclusions: The racial/ethnic and gender composition of the physician trainee pool in vascular specialties, particularly VS, has not matched the increasing growth of underrepresented groups in the US population of patients with vascular disease. Formal programs to recruit qualified women and minorities appear successful in increasing workforce diversity.