Enhancing Diversity in Spine Surgery: A Decadal Analysis and Strategic Recommendations

Introduction: Despite concerted efforts to improve diversity in surgical specialties, representation in spine surgery remains limited. Studies indicate that diversity in healthcare enhances patient care, especially in underrepresented communities. This study aims to assess trends in racial diversity among spine surgery applicants, residents, and faculty over the past decade and to provide recommendations for spine surgery residency programs to foster diversity and inclusion.

Methods: A two-phase mixed-methods approach was applied. Quantitatively, demographic data for medical students, spine surgery residency applicants, residents, and academic faculty from 2010-2020 were analyzed. Data from the Association of American Medical Colleges (AAMC) and the Accreditation Council for Graduate Medical Education (ACGME) was utilized to compare racial representation across two five-year periods (2010–2014 and 2015–2020) using t-tests. Qualitatively, interviews were conducted with diversity officers from leading medical schools to identify key barriers and strategies in diversity recruitment. Thematic analysis of interview responses informed actionable recommendations.

Results: Statistical analysis revealed no significant change in minority representation among spine surgery applicants or residents between the periods. Notably, the proportion of Hispanic/Latino faculty increased slightly (P < 0.05), with a corresponding decrease in White faculty. Interview themes highlighted barriers such as metric-focused selection and economic constraints impacting underrepresented minority (URM) applicants. Recommendations from diversity officers included reducing the emphasis on standardized test scores, establishing mentorship programs for URM students, and creating funded sub-internships to mitigate financial barriers.

Conclusion : While demographic trends show incremental progress in diversity at the faculty level, significant gaps persist at the applicant and resident levels in spine surgery. Implementing targeted recruitment strategies, including reduced emphasis on metrics, mentorship opportunities, and financial support for minority applicants, could enhance diversity in spine surgery. Addressing these barriers will promote a more inclusive environment, better reflecting the communities served.