Back to 2014 Annual Meeting Posters

---

A Current Assessment of Diversity in the Surgical Workforce
Judith French^*1, Colin O'Rourke², Matthew Walsh^1
1General Surgery, Cleveland Clinic, Cleveland, OH; ²Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH

Introduction
A diverse workforce has been shown to increase profitability in business and is likely an important factor in healthcare delivery. Differing life experiences can alter the way people approach problems, impact their caregiving ability, and varied perspectives can lead to innovation. The factors that contribute to workforce diversity are unclear and it is likely valuable to look beyond gender and racial diversity to include socioeconomic status as a child, sexual orientation, previous work experience, etc.
Little is known regarding the diversity of the surgical workforce specifically when diversity is considered in its broadest context. Diversity in surgery can be compared to other medical specialties, and the implications of the findings should be explored to determine the effect on the sustainability of the profession and care of a diverse patient population. The aim of this study was to broadly assess the current status of surgical workforce diversity.
Methods
A 25-item, anonymous questionnaire was created, and a cross-sectional survey was performed. The instrument consisted of demographic questions and Likert style questions which attempted to determine the participants' perceptions of the current level of diversity in their specialty and their perceived importance of particular diversity categories, which both can impact workforce recruitment and retention.
Descriptive statistics were calculated and comparisons were made between surgical and non-surgical specialties. A factor analysis was performed on the responses to the Likert questions addressing perceptions of present diversity from the survey.
Results
Over 1,000 responses were received from U.S. based physicians across all specialties and levels of training (see Table 1). A statistically significant difference existed between surgical specialties and nonsurgical specialties with regards to gender, prior work experience, and political affiliation (see Table 2). Surgical respondents also perceived their specialties as being less diverse with regards to gender and sexual orientation when compared to respondents from the non-surgical specialties.
Factor analysis suggested four main factors behind individual's perceptions of the existing diversity in their specialty to further evaluate homogeneity: 1. Personal/Background experience diversity 2. Professional experience diversity 3. Personal health diversity 4. Sexual/gender identity diversity. In the surgical workforce there is significant perceived homogeneity regarding sexual/gender identity (p=0.003) and trend for less life experience diversity (p=0.087) compared to medical specialists.
Conclusions
Surgeons and surgical trainees are less diverse than their medical colleagues, both by demographics and self-acknowledgement. The long-term impact and potential barriers to resolve this lack of diversity requires further investigation.

Table 1 Respondent demographics in percentages.

	Surgery	Non-Surgery
Age
<25	2	1
26-30	47	51
31-35	28	23
36-40	6	7
41-45	3	5
46-50	3	3
>50	10	10
Professional Level
Resident/Fellow	81	77
Assistant/Associate Professor	12	15
Full Professor	6	5
Hospital Staff	<1	2
Private Practice	1	<1
Other	0	<1
Race
American Indian or Alaskan Native	0	2
Asian	15	17
Black or African American	9	6
Hispanic or Latino	3	6
Native Hawaiian/Pacific Islander	<1	<1
White or Caucasian	70	70
Other	5	5

Table 2 Diversity categories.

Diversity Category	Surgery	Non-Surgery	p-value
Career Prior to MD/DO	17%	24%	0.05
Identify as Female	28%	54%	<0.001
Median Political Affiliation (0= Very Liberal, 100= Very Conservative)	48	28	<0.001
Sexual Orientation			0.13
Heterosexual or Straight	95%	93%
Gay or Lesbian	2%	6%
Bisexual	3%	2%
Socioeconomic Status as a Child			0.91
Poor	3%	3%
Lower Middle Class	13%	14%
Middle Class	45%	42%
Upper Middle Class	35%	36%
Upper Class	4%	5%

---

Back to 2014 Annual Meeting Posters