The Intersection of Race and Sex: An Overlooked Aspect in Diversity Recruitment
Lauren N West-Livingston1, Justine Aziz1, Ashlee Stutsrim2, Matthew P Goldman2, Kevin Chang2, Matthew S Edwards2, Julie A Freischlag2, Gabriela A Velazquez2
1Wake Forest School of Medicine, Winston-Salem, NC;2Atrium Health Wake Forest Baptist, Winston-Salem, NC
INTRODUCTION: Representation in medical specialties plays a large role in the recruitment of minority applicants to categorical residency programs and fellowships. Since vascular surgery is relatively small specialty, recruitment efforts for underrepresented minorities in medicine are paramount for diversifying the field in regards to both gender identity and race. The most recent SVS Task Force on Diversity, Equity, and Inclusion surveyed members about demographic identifiers. Of the respondents only 15.42% identified as women, 71.4% of SVS members identified as White, 6.08% Hispanic or Latino, 2.19% as Black or African American, 0.35% other. This speaks to the great void in gender and racial/ethnic diversity in the field of vascular surgery, as these figures imply representation at a lesser level than national averages. We sought to analyze existing data on demographic information for medical trainees to evaluate the pipeline to surgical training and careers, with a focus on how examining data through an intersectional lens offers more information about the trainees and surgeons these numbers represent. Our goal was to demonstrate the greater need for recruitment of diverse applicants into our specialty, insight gained by stratifying data and acknowledging the presence of 2 URM identities, and to propose possible causes and solutions for attrition of interested underrepresented minorities in medicine to surgical specialties.
METHODS: Public data on medical trainees from the Association of American Medical Colleges were analyzed and compared with data on sex/gender and race/ethnicity of practicing vascular surgeons.
RESULTS: For integrated vascular surgery residents, 63.2% of U.S. and Canadian MD and U.S. DO graduate respondents identified as men. 53.9% identified as White, 7.0% Hispanic, 5.8% Black or African American, 1.5% American Indian or Alaska Native, and 0.3% identified as Native Hawaiian or Other Pacific Islander. For vascular surgery fellows, 67.2% of U.S. and Canadian MD and U.S. DO respondents identified as men. 59.5% identified as White, 6.6% Hispanic, 3.5 Black or African American, 0.4% American Indian or Alaska Native, and 0.4% identified as Native Hawaiian or Other Pacific Islander. For general surgery gender and race/ethnicity distribution see table.
CONCLUSIONS:This analysis conveys that the number of underrepresented minorities in medicine continues to be less than the representation of these groups seen in the U.S. populace. Data are limited by training paradigm, and does not examine results with an intersectional lens that would allow us to further stratify these figures by the combination of race and gender, or the subgroups within certain racial/ethnic identities. To have a more complete idea of representation and need for recruitment, we urge collectors of data to analyze demographics through an intersectional lens that takes into account the fact that trainees and surgeons may be URMs due to both sex/gender and race/ethnicity, which presents unique barriers in representation and sense of belonging. 
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