Perceptions of Otolaryngology Residency Among Students Underrepresented in Medicine

Abstract

Objective Otolaryngology‐Head and Neck Surgery (OHNS) has historically been one of the least diverse surgical subspecialties. The objective of this study was to better understand perceptions of OHNS from underrepresented students in medicine (URiM) and identify factors affecting URiM application to the specialty. Study Design Survey via electronic questionnaire. Methods An anonymous, 22‐question electronic survey was administered nationally to URiM medical students (N = 388) regarding factors that play a role in developing an interest in applying to OHNS. Responses to questions were compared between URiMs applying to OHNS and those applying to other fields. Results Thirty‐six percent of respondents identified as African American and 26% as Latino. Students completed the survey in all years of medical school. Research opportunities (H(2) = 18.58, P < .001) and having a race‐concordant role model were the most important factors for those pursing OHNS residency. Personality fit and interactions with OHNS faculty had the greatest influence on their decision to pursue OHNS residency. Board scores (e.g., USMLE Step 1/2CK Scores), competitiveness, lifestyle during residency, the influence of application costs, and racial/ethnic and gender distributions did not reach statistical significance or were noninfluential. Conclusion URiMs applying to OHNS value race‐concordant mentorship, are involved in research, and have meaningful relationships with their respective OHNS department. We found that establishing meaningful connections with URiM mentors significantly impacts URiM students considering OHNS. While this cohort was not influenced by overemphasis of board scores within the OHNS match process, the COVID‐19 pandemic negatively impacted this aspect of their application, along with away rotations. Level of Evidence NA Laryngoscope, 132:2335–2343, 2022

Strategies to Counteract Impact of Harmful Bias in Selection of Medical Residents

“…7 Among URiM learners, additional factors play a role in specialty selection, such as level of diversity within a field, availability of mentors with similar backgrounds, and active recruitment into specific fields. 8 These candidates may not consider pursuing a specialty because they do not feel they would meet the qualifications or fit the stereotypical characteristics of a practitioner in that specialty. 9,10 Based on a survey of medical students, at the time of graduation, women were 9% more likely to choose pediatrics and 10% more likely to choose OB/GYN—fields where there is a larger female presence and increased opportunities for mentorship.…”

Factors Influencing Underrepresented Medical Students' Career Choice in Surgical Subspecialties

“…16 In students with exposure to their surgical subspecialty of interest, interest in the technology and procedures, the intellectual challenge, and research opportunities all positively influenced a surgical career choice; the challenge was exposing the students in the first place. 16,19,22,23 Mentorship. In a survey with 145 respondents applying in the 2019 otolaryngology match, the presence of female faculty and residents was rated as having a mean importance of 4.1 and 4.2, respectively, out of 5.…”

“…times more likely to be influenced by their interactions with OHNS faculty. 23 Many studies noted a lack of mentorship for some surgical specialties, which may be explained by a lack of resources like a home program. In a survey of 104 medical students across 36 US allopathic medical schools, 25% of the participants did not have an otolaryngology department at their medical school.…”

“…Research opportunities, either the presence or lack of, were cited as an influential factor in four articles, three of which demonstrated the importance of research opportunities in URiM medical students interested in otolaryngology and plastic surgery. 17,23,27,28 The presence of research opportunities was an important factor in specialty choice for students interested in a career in otolaryngology, especially among first-year medical students. However, the competitiveness of the field, as measured by the number of research publications prior to residency application, was a reason URiM students interested in otolaryngology felt deterred from applying to an OHNS residency.…”

“…17,23 Sixty percent of OHNS interested medical students reported financial earning potential as a positive influence on their decision. 23 While this was true of non-URiM students as well, URiM medical students disproportionately come from lower socioeconomic backgrounds with increased financial stress and burden. 17…”