title: Racial and Ethnic Diversity of U.S. Plastic Surgery Trainees.
abstract: BACKGROUND
  Increased diversity of U.S. physicians can improve patient communication and mitigate health disparities for racial minorities. This study analyzes trends in racial and ethnic diversity of plastic surgery residents.
  
  
  METHODS
  Demographic data of surgical residents, medical students, and integrated plastic surgery residency applicants were obtained from the Association of American Medical Colleges. Data for college students and the general population were obtained from the U.S. Census for comparison with plastic surgery. Interspecialty differences and temporal trends in racial composition were analyzed with chi-square tests.
  
  
  RESULTS
  From 1995 to 2014, Asian and Hispanic plastic surgery residents increased nearly 3-fold (7.4%-21.7%, p < 0.001) and 2-fold (4.6%-7.9%, p < 0.001), respectively. African American plastic surgery residents did not increase significantly (3.0%-3.5%, p = 0.129). Relative to the U.S. population, Hispanics (range: 0.1-0.5-fold) and African Americans (range: 0.1-0.4-fold) were underrepresented, whereas Asians (range: 2.2-5.3-fold) were overrepresented in plastic surgery. A "bottleneck" existed in the pipeline of African American and Hispanic plastic surgery residents. Significant differences in racial composition existed between plastic surgery and other surgical disciplines, which varied over time. The percentage of Hispanic (10.6% vs 7.0%, p = 0.402) and African American (6.4% vs 2.1%, p < 0.001) plastic surgery residency applicants exceeded those in residency.
  
  
  CONCLUSIONS
  Hispanics and African Americans are underrepresented in plastic surgery residency relative to whites and Asians. This study underscores the need for greater initiatives to increase diversity in plastic surgery residency.
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Jason
authors.initials: J
authors.lastname: Silvestre
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Serletti
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: Benjamin.chang@uphs.upenn.edu.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Chang
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D018864:Cultural Diversity; D016208:Databases, Factual; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D020380:Needs Assessment; D044469:Racial Groups / Q000208:ethnology; D012189:Retrospective Studies; D013043:Specialties, Surgical / Q000193:education; D013518:Surgery, Plastic / Q000193:education*; D014481:United States
keywords: Practice-Based Learning and Improvement; Professionalism; Systems-Based Practice; diversity; ethnicity; race; resident; surgery; training