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Minority Underrepresentation in Academia: Factors Impacting Careers of Surgery Residents.

Julien JS, Lang R, Brown TN, Aldrich MC, Deppen SA, Wu H, Feurer ID, Tarpley M, Hill G, Tarpley J, Beauchamp RD, Grogan EL. Minority Underrepresentation in Academia: Factors Impacting Careers of Surgery Residents. Journal of racial and ethnic health disparities. 2014 Dec 1; 1(4):238-246.

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BACKGROUND: Underrepresentation of minorities within academic surgery is an ever present problem with a profound impact on healthcare. The factors influencing surgery residents to pursue an academic career have yet to be formally investigated. We sought to elucidate these factors, with a focus on minority status. METHODS: A web-based questionnaire was sent to all administered to all ACGME-accredited general surgery programs in the United States. The main outcome was the decision to pursue a fully academic versus non-academic career. Multivariable logistic regression was used to identify characteristics impacting career choice. RESULTS: Of the 3,726 residents who received the survey, a total of 1,217 residents completed it - a response rate of 33%. Forty-seven percent planned to pursue non-academic careers, 35% academic careers, and 18% were undecided. There was no association between underrepresented minority status and academic career choice (Odds Ratio = 1.0, 95% Confidence Interval 0.6 - 1.6). Among all residents, research during training (OR = 4.0, 95% CI 2.7-5.9), mentorship (OR = 2.1, 95% CI 1.6-2.9), and attending a residency program requiring research (OR = 2.3, 95% CI 1.5-3.4) were factors associated with choosing an academic career. When the analysis was performed among only senior residents (i.e., 4(th) and 5(th) year residents), a debt burden > $150,000 was associated with choosing a non-academic career (OR = 0.4, 95% CI 0.1-0.9). CONCLUSIONS: Underrepresented minority status is not associated with career choice. Intentional recruitment of minorities into research-oriented training programs, increased mentorship and research support among current minority residents, and improved financial options for minorities may increase the number choosing an academic surgical career.

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