Racial, ethnic, and gender diversity lacking in surgical leadership

Gender, ethnic, and racial diversity are lacking in leadership positions across U.S. academic surgery departments, according to a study published online Oct. 11 in JAMA Surgery.

Yoshiko Iwai, from University of North Carolina at Chapel Hill School of Medicine, and colleagues assessed how racial, ethnic, and gender diversity among U.S. academic surgery department leaders differs across roles and surgical specialties.

The authors searched publicly accessible medical school and affiliated hospital websites in the United States and Puerto Rico (154 surgical departments affiliated with 146 medical schools; Jan. 15 to July 15, 2022). In total, 2,165 faculty were in included in the analysis.

The researchers found that there were more men than women in leadership positions at all levels—chairs (85.9 versus 14.1%), vice chairs (68.4 versus 31.6t), and division chiefs (87.1 versus 12.9%). Furthermore, only 192 leaders (8.9%) were from racial or ethnic groups that are underrepresented in medicine (URiM).

Both overall and within racial and ethnic groups, women occupied more vice chair than chair or division chief positions. URiM individuals were most commonly seen as vice chairs of diversity, equity, and inclusion (51.6%) or faculty development (17.9%). URiM representation was greatest for division chief roles in transplant surgery (13.8%) and lowest in oral and maxillofacial surgery (5.0%).

Women made up <20% of division chief roles, except for breast and endocrine surgery (63.6%). Nearly half of division chiefs (46.2%) and vice chairs (44.4%) had no female URiM leaders.

"Female and URiM surgical leaders are disproportionately clustered in roles (e.g., vice chairs of diversity, equity, and inclusion or faculty development) that may not translate into future promotion to department chairs," the authors write.

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