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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.
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.