Moving the Needle: Program Directors' Views on the Recruitment of Diverse Trainees to Plastic Surgery Residency

Natalie B Baxter; Timothy C Guetterman; Noelle Thompson; Mary L Byrnes; Gurjit Sandhu; Rachel C Hooper

doi:10.1097/GOX.0000000000006915

Moving the Needle: Program Directors' Views on the Recruitment of Diverse Trainees to Plastic Surgery Residency

Plast Reconstr Surg Glob Open. 2025 Jun 25;13(6):e6915. doi: 10.1097/GOX.0000000000006915. eCollection 2025 Jun.

Authors

Natalie B Baxter¹, Timothy C Guetterman², Noelle Thompson³, Mary L Byrnes^{4

5}, Gurjit Sandhu⁵, Rachel C Hooper^{4

6}

Affiliations

¹ From the University of Michigan Medical School, Ann Arbor, MI.
² Department of Family Medicine, University of Michigan, Ann Arbor, MI.
³ University of Toledo College of Medicine and Life Sciences, Toledo, OH.
⁴ Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI.
⁵ Department of Surgery, University of Michigan, Ann Arbor, MI.
⁶ Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI.

Abstract

Background: The plastic surgery workforce lacks racial and ethnic diversity. Traditionally, United States Medical Licensing Examination scores have been used as the initial screening tool for most residency programs; however, this can lead to interview selection bias against underrepresented in medicine (URiM) applicants. Understanding the barriers and facilitators to diversifying the specialty from the perspectives of program directors (PDs) may reveal strategies for improvement.

Methods: In this mixed methods study, we invited integrated plastic surgery PDs to participate in an online survey and one-on-one semistructured interviews to understand their perspectives on the application process, interview day, and strategies to improve recruitment and retention of URiM trainees. Descriptive statistics were used to analyze the survey data. Interviews were deidentified, transcribed, and analyzed inductively to generate themes based on patterns observed across narratives.

Results: Of 108 PDs and assistant PDs, 29 (26.9%) responded to the survey and 8 participated in semistructured interviews. We identified 3 broad themes: (1) resident diversity is important for patient care and education, (2) lack of exposure and longitudinal mentorship are barriers to matriculation, and (3) program culture change can shift trends in the recruitment of URiM trainees.

Conclusions: PDs value the racial and ethnic diversity of trainees and are in favor of efforts to increase representation in the field. Improving mentorship and reducing bias in the application process are necessary strategies to increase representation in plastic surgery.