Perceptual and Structural Facilitators and Barriers to Becoming a Surgeon: A Qualitative Study of African American and Latino Surgeons

Ulloa, Jesus G.; Viramontes, Omar; Ryan, Gery W.; Wells, Kenneth B.; Maggard-Gibbons, Melinda; Moreno, Gerardo

doi:10.1097/acm.0000000000002282

Cited by 51 publications

(40 citation statements)

References 19 publications

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“…Our findings are in keeping with current literature that demonstrates that DBSH and microaggressions in the workplace not only harm the victim but also undermine the team culture and reduce both the quality of care and patient safety 9 . Results from a United States national survey found that 31.9% reported discrimination based on gender and 16.6% reported racial discrimination.…”

Section: Discussionsupporting

confidence: 90%

“…URM doctors are more likely to serve uninsured patients and practice in regional and remote areas, leading to improved patient satisfaction and broader access to care for minorities. Additionally, patients have been shown to be more satisfied with their treatment and doctor‐patient communication when they are managed by a doctor from their own culture 8,9 …”

Section: Introductionmentioning

confidence: 99%

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“The odds were stacked against me”: a qualitative study of underrepresented minorities in surgical training

Villanueva

Cain

Greenhill

et al. 2021

ANZ Journal of Surgery

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Background The Royal Australasian College of Surgeons (RACS) is expected to provide surgical care to a diverse patient population across Australia and New Zealand (ANZ). To improve the quality‐of‐care individuals receive, the surgical workforce must reflect the population it serves. Achieving diversity within RACS will strengthen therapeutic relationships with patients and promote an inclusive culture. This study investigates the perspectives of underrepresented minority (URM) trainees to highlight barriers for the selection and completion of the RACS Surgical Education and Training (SET) program. Methods This qualitative study used online, semi‐structured, in‐depth interviews of URM trainees. Participants were recruited by self‐identification and were invited to participate based on inclusion criterion. Interviews took place between August and October 2020, were transcribed and de‐identified. Framework analysis was used to identify themes. Findings Eight participants from four surgical specialities were interviewed, six from Australia and two from New Zealand. There were six female and two male participants. The findings identified barriers that were grouped into eight broad areas: discouragement; structural racism, discrimination and unconscious bias; language barriers; policies and procedures; lack of role models; homophobia; sexual harassment and women in surgery. Conclusion The findings offer guidance to RACS and the surgical community to explore new strategies to improve the experience of URM SET trainees. While on a small scale, the study draws directly on the URMs' experiences to inform strategies addressing equity, diversity and inclusion. The aim is to produce a diverse surgical workforce that better delivers healthcare services to a diverse population.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

“The odds were stacked against me”: a qualitative study of underrepresented minorities in surgical training

Villanueva

Cain

Greenhill

et al. 2021

ANZ Journal of Surgery

View full text Add to dashboard Cite

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“…A recent study suggests that some of the facilitators to becoming a URM surgeon, such as mentorship and family, are similar to those in our findings. 20 In addition to the novelty that our study offers, it also brings to the forefront voices of URM pediatricians and can inform future works.…”

Section: Discussionmentioning

confidence: 86%

Factors That Influence the Choice of Academic Pediatrics by Underrepresented Minorities

et al. 2019

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“…‘Most participants highlighted surgical culture, explicitly describing what it means to be a surgeon and how some think surgeons fit a particular mold . One Latino participant commented: “Surgery is kind of clubby …”’ (p.1331) 21 …”

Section: Resultsmentioning

confidence: 99%

Invoking culture in medical education research: A critical review and metaphor analysis

et al. 2021

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Introduction: 'Culture' is a word frequently invoked within medical education literature to explain challenges faced by learners in practice. While social settings and practices are widely acknowledged as critical influences on medical education, there is vast variability in how the term 'culture' is employed. This may lead to confusion, resulting in assumptions and oversights.Objective: This critical literature review aims to characterise how the term 'culture' is explicitly and implicitly conceptualised in medical education research.Methods: Four leading English language journals in the medical education field were searched in a twelve-month period for research papers or reviews that mentioned culture in title or abstract in a substantive way. A content analysis was undertaken of extracted definitions. In addition, metaphor analysis was used to identify conceptual metaphors, which were subsequently clustered thematically.Results: Our search yielded 26 papers, 8 of which contained definitions, mostly from the organisational literature. We interpreted nine conceptual metaphors related to how the term culture was employed (terroir, divider, dominant force, toxic force, obstacle, microclimate, object, brand and holdall) in four categories (unchanging, powerful, can adapt around, can be used).Discussion: This critical review reveals that medical education as a field: 1) draws most explicitly from the organisational literature; 2) invokes culture in multiple means but in ways that privilege either acontextual human agency or all-powerful social forces; and 3) regards culture as a negative or neutral force but rarely a positive one.There is a notable absence around conceptualisations of 'culture' that allow educator, student and administrator agency but at the same time acknowledge the deep forces that various social settings and practices exert. Other literatures investigating learning cultures and cultural reflexivity focus on this nexus and may provide possible means to advance considerations of culture within medical education research.

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Perceptual and Structural Facilitators and Barriers to Becoming a Surgeon: A Qualitative Study of African American and Latino Surgeons

Cited by 51 publications

References 19 publications

“The odds were stacked against me”: a qualitative study of underrepresented minorities in surgical training

“The odds were stacked against me”: a qualitative study of underrepresented minorities in surgical training

Factors That Influence the Choice of Academic Pediatrics by Underrepresented Minorities

Invoking culture in medical education research: A critical review and metaphor analysis

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