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Change Is Coming: An Evaluation Of Gender And Race Disparities In Academic Plastic Surgery

Brandon T. Smith, MS Francesco M. Egro, MBChB, MSc, MRCS Carolyn P. Murphy, BA Alex G. Stavros, BS Elizabeth M. Kenny, BS Vu T. Nguyen, MD
University of Pittsburgh Medical Center
2019-02-08

Presenter: Brandon Smith

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. This project represents the original work of the resident/medical student.

Director Name: Vu T. Nguyen

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction

Purpose: Gender and race disparities in academic plastic surgery are known, but recently professional societies have promoted a cultural shift. This study evaluates the effects of these changes at faculty and leadership positions.

Methods: A cross-sectional study was conducted in June 2018 to evaluate minority representation among academic plastic surgery faculty of programs accredited by the Accreditation Council for Graduate Medical Education. A search of the ACGME listings identified current accredited plastic surgery training programs (n=140). Institutions with multiple training programs were unified under a single listing (n=100). Web-based faculty directories were utilized to identify the cohort of the study. Group comparisons were made using student's t-test and Chi-squared test.

Results: Overall, women represented 19.8% of all academic plastic surgeons. Female plastic surgeons were significantly more likely to be an assistant-professor [OR:2.19,(95%CI:1.58-3.05)], and significantly less likely to be a full-professor [OR:0.20,(95%CI:0.11-0.35)] or program chair [OR:0.32,(95%CI:0.16-0.65)]. Adjusting for years of post-residency experience, only disparities at the full-professor position remained [OR:0.34,(95%CI:0.16-0.47)], highlighting the importance of cohort experience.

Non-white plastic surgeons held 25.1% of all academic positions. Non-white plastic surgeons were significantly less likely to hold the full-professor position [OR:0.60,(95%CI:0.14-0.88)], despite greater likelihood of prior fellowship training [OR:1.62,(95%CI:1.16-2.26)]. Programs with a non-white chair had a significantly greater proportion of non-white faculty (40.5% versus 20.5%;p<0.0001) and more equitable career outcomes for non-white faculty (Non-white chair=22.7% increase in non-white full-professors;p<0.0001).

Conclusion: While experience plays an important role in current disparities, unequal appointment and advancement of faculty by program leadership demonstrates issues requiring corrective action.

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