Racial, ethnic, and gender diversity of applicants and matriculants to neurological surgery residency programs.

Objective: The aim of this study was to identify trends in the demographic constitution of applicants and matriculants to neurological surgery based on race, ethnicity, and gender.

Methods: The authors conducted a cross-sectional study using compiled demographic data obtained from the Association of American Medical Colleges. Trends analyzed included proportional changes in race, ethnicity, and gender of applicants and matriculants to neurosurgical residency programs from academic years 2010-2011 to 2018-2019.

Results: A total of 5100 applicants and 2104 matriculants to neurosurgical residency programs were analyzed. No significant change in the percentage of overall women applicants (+0.3%, 95% CI -0.7% to 1.3%; p = 0.77) or in the percentage of women matriculants (+0.3%, 95% CI -2.2% to 2.9%; p = 0.71) was observed. For applicants, no change over time was observed in the percentages of American Indian or Alaska Native (AI/AN) men (0.0%, 95% CI -0.3% to 0.3%; p = 0.65); Asian men (-0.1%, 95% CI -1.2% to 1.1%; p = 0.97); Black or African American men (-0.2%, 95% CI -0.7% to 0.4%; p = 0.91); Hispanic, Latino, or of Spanish Origin men (+0.4%, 95% CI -0.8% to 1.7%; p = 0.26); White men (+0.5%, 95% CI -2.1% to 3.0%; p = 0.27); Asian women (+0.1,% 95% CI -0.9% to 1.1%; p = 0.73); Black or African American women (0.0%, 95% CI -0.6% to 0.5%; p = 0.30); Hispanic, Latino, or of Spanish Origin women (0.0%, 95% CI -0.4% to 0.4%; p = 0.71); and White women (+0.3%, 95% CI -1.1% to 1.7%; p = 0.34). For matriculants, no change over time was observed in the percentages of AI/AN men (0.0%, 95% CI -0.6% to 0.6%; p = 0.56); Asian men (0.0%, 95% CI -2.7% to 2.7%; p = 0.45); Black or African American men (-0.3%, 95% CI -1.4% to 0.8%; p = 0.52); Hispanic, Latino, or of Spanish Origin men (+0.6%, 95% CI -0.8 to 2.0%; p = 0.12); White men (-1.0%, 95% CI -5.3% to 3.3%; p = 0.92); Asian women (+0.1%, 95% CI -1.3% to 1.5%; p = 0.85); Black or African American women (0.0%, 95% CI -0.6% to 0.7%; p = 0.38); Hispanic, Latino, or of Spanish Origin women (-0.1%, 95% CI -0.7% to 0.5%; p = 0.46); and White women (+0.3%, 95% CI -2.4% to 3.0%; p = 0.70).

Conclusions: Despite efforts to diversify the demographic constitution of incoming neurosurgical trainees, few significant advances have been made in recent years. This study suggests that improved strategies for recruitment and cultivating early interest in neurological surgery are required to further increase the diversification of future cohorts of neurosurgical trainees.