Jesus G Ulloa1, Omar Viramontes, Gery Ryan, Kenneth Wells, Melinda Maggard-Gibbons, Gerardo Moreno. 1. J.G. Ulloa is a surgery resident, Department of Surgery, University of California, San Francisco, San Francisco, California. At the time of this research, he was a Robert Wood Johnson Foundation clinical scholar, University of California, Los Angeles, and Veterans Affairs, Los Angeles Health Service Research & Development Center of Innovation, Los Angeles, California. O. Viramontes is a medical student, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California. G. Ryan is assistant dean for academic affairs, RAND Health, RAND Corporation, Santa Monica, California. K. Wells is professor, Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California. M. Maggard-Gibbons is assistant professor, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, and Veterans Affairs, Los Angeles Health Service Research & Development Center of Innovation, Los Angeles, California. G. Moreno is associate professor, Department of Family Medicine, and director, PRIME Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
Abstract
PURPOSE: As racial and ethnic heterogeneity in the United States increases, it is important that the health care workforce, including surgery, mirror that diversity. Structural and perceptual barriers may contribute to an underrepresentation of African American and Latino surgeons. Understanding these barriers may translate into interventions and, in turn, improved diversification of the U.S. surgery workforce. METHOD: In 2016, the authors conducted in-depth semistructured interviews, exploring structural and perceptual barriers that African American and Latino surgeons face. The authors used conventional qualitative techniques to analyze data and identify themes. RESULTS: The authors interviewed 23 participants and observed three major themes characterizing the path to becoming a surgeon: creating a path to medicine, surgical culture, and mentorship. Subthemes provided further nuance. For creating a path to medicine, the subthemes were personal attributes, family support, community assets/barriers, and minority experience. For surgical culture, the subthemes comprised quality of life, surgeon-patient relationship, and restoring health. For mentorship, the subthemes were aspirational figures, formal programs/peer support, and professional opportunities. Experiences described by African Americans and Latinos were similar, but the experiences of participants of different self-identified childhood socioeconomic status were dissimilar. CONCLUSIONS: The path to a surgical career as experienced by African American and Latino surgeons is heavily influenced by mentors mediating their integration into surgical culture and engendering a feeling of belonging. Future surgeons from groups underrepresented in medicine would benefit from identifying aspirational figures early, a structured introduction into the rigors of the profession, and a deconstruction of negative surgical norms.
PURPOSE: As racial and ethnic heterogeneity in the United States increases, it is important that the health care workforce, including surgery, mirror that diversity. Structural and perceptual barriers may contribute to an underrepresentation of African American and Latino surgeons. Understanding these barriers may translate into interventions and, in turn, improved diversification of the U.S. surgery workforce. METHOD: In 2016, the authors conducted in-depth semistructured interviews, exploring structural and perceptual barriers that African American and Latino surgeons face. The authors used conventional qualitative techniques to analyze data and identify themes. RESULTS: The authors interviewed 23 participants and observed three major themes characterizing the path to becoming a surgeon: creating a path to medicine, surgical culture, and mentorship. Subthemes provided further nuance. For creating a path to medicine, the subthemes were personal attributes, family support, community assets/barriers, and minority experience. For surgical culture, the subthemes comprised quality of life, surgeon-patient relationship, and restoring health. For mentorship, the subthemes were aspirational figures, formal programs/peer support, and professional opportunities. Experiences described by African Americans and Latinos were similar, but the experiences of participants of different self-identified childhood socioeconomic status were dissimilar. CONCLUSIONS: The path to a surgical career as experienced by African American and Latino surgeons is heavily influenced by mentors mediating their integration into surgical culture and engendering a feeling of belonging. Future surgeons from groups underrepresented in medicine would benefit from identifying aspirational figures early, a structured introduction into the rigors of the profession, and a deconstruction of negative surgical norms.
Authors: Sara P Myers; Mohini Dasari; Joshua B Brown; Stephanie T Lumpkin; Matthew D Neal; Kaleab Z Abebe; Nicole Chaumont; Stephanie M Downs-Canner; Meghan R Flanagan; Kenneth K Lee; Matthew R Rosengart Journal: JAMA Surg Date: 2020-07-01 Impact factor: 14.766