Striving for Inclusive Excellence in the Recruitment of Diverse Surgical Residents During COVID-19

Abstract

The COVID-19 pandemic has dramatically altered the 2020 residency application cycle and resulted in many changes to the usual application processes. Particular attention should be placed on the obstacles faced by applicants who are underrepresented in medicine (URiM) as they may be disproportionately affected by the changes in 2020. These challenges are especially relevant in competitive surgical specialties, where racial and gender diversity already lags behind other medical specialties. Inclusive excellence is a guiding philosophy in creating equitable resident selection processes. It focuses on the multilayered processes that form the foundation of inclusive institutional culture, while recognizing that excellence and inclusivity are mutually reinforcing and not mutually exclusive. A key tenant in inclusive excellence for resident recruiting involves applying an equity lens in all decision making. An equity lens allows programs to continuously evaluate resident selection policies and processes through an intentional equity-forward approach. In addition to using an equity lens, programs should emphasize the importance of equity-focused skill building, which ensures that all individuals engaged in the resident selection process have the tools and knowledge to recognize biases. Finally, institutions should implement specific programming for URiM applicants to provide them with information about key aspects of department culture and mechanisms of support for URiM trainees. Every residency program should adopt a sustained perspective of inclusive excellence, in this application cycle and beyond. The status quo has existed for far too long, and COVID-19 offers institutions and their residency programs a unique opportunity to try new and innovative equity-forward practices.

Advocating for a New Residency Application Process: A Student Perspective

“…The cost of applying to a surgical residency has significantly increased in recent years, with most applicants spending over $4,000 on travel alone. 7 , 8 , 27 , 28 This cost disproportionately disadvantages low-income individuals, adversely impacting the diversity of interviewed applicants. Inequities persist as interviews become virtual, so programs should consider abiding by best practices to mitigate bias.…”

Impacts of COVID‐19 on orthopaedic surgery residency / spine trainee application trends

“…Compared to the estimated 31.9% of Black and Hispanic persons in the US, Black and Hispanic applicants to orthopaedic surgery residency comprise 16.77% of applicants in 2021 [17]. In order to combat this, efforts focused on promoting diversity and inclusion in orthopaedic surgery should not be forgotten during this time [18]. This study has some limitations.…”

Diversity and Inclusion on General Surgery, Integrated Thoracic Surgery, and Integrated Vascular Surgery Residency Program Websites

“…After a review of the literature on D&I efforts in residency recruitment, [7][8][9] the study authors selected program website variables for evaluation. These included the following: a department-specific D&I webpage, a statement about a commitment to D&I, D&I-related opportunities for early exposure to their specialty (ie, scholarships/stipends for housing costs during visiting student rotations or summer internship programs), a link to a non-departmentspecific D&I webpage, and visiting student rotations specifically for UiM students at non-home institutions.…”