Disparities in Diversity, Equity, and Inclusion in Surgical Residency Education: A Systematic Review

Background Increasing minority representation in surgical training is an important step toward eliminating health care disparities and access to care for vulnerable patient populations. Underrepresented minorities (URMs) face unique barriers to becoming board-certified surgeons, affecting their recruitment, retention, and overall success. This systematic review aims to consolidate existing literature on these disparities by examining trends affecting URMs across the surgical training continuum.Methods A systematic literature search was conducted using PubMed/Ovid, Google Scholar, and Elsevier Library. Search terms included "diversity, surgical education, and underrepresented minorities." Articles were screened based on selection criteria focusing on US general surgery residency training, URM recruitment, retention, and performance. Final selection of articles for review were assessed for quality and summarized according to thematic trends.Results Of 180 articles reviewed, 42 met the criteria for inclusion. Underrepresented minorities face barriers in educational pathways including lower retention rates and institutional climates that disproportionately impact their experiences and wellbeing. Both URMs and women were less likely to apply, match, and succeed in surgical residency, often due to challenges related to academic performance, lack of mentorship, and institutional support. Additionally, significant gaps were identified in surgical mentorship, leadership, and faculty diversity among these groups.Conclusions Underrepresented minority surgical trainees encounter significant barriers along the medical education continuum for successful completion of surgical training and subsequent surgical careers. Our study underscores the need to create a diverse and inclusive workforce that promotes health equity and access to care.