Black medical students have little interest in cardiothoracic surgery
Black medical students have little interest in pursuing a career in cardiothoracic surgery (CTS), according to new data published in The Annals of Thoracic Surgery.[1]
“Despite increased interest in CTS amongst medical students broadly, the number of Black and Hispanic trainees in CTS has not seen significant growth over the past decade,” wrote first author Ibraheem Hamzat, BS, a researcher with the University of Chicago Pritzker School of Medicine, and colleagues. “Barriers to entry into the field have been described for female medical students, but no studies have explored this question for minoritized medical students.”
Hamzat et al. sent a 23-question survey to medical students from 40 different U.S. medical schools. They received nearly 400 responses from Black medical students.
Surgical subspecialties were popular among survey respondents. However, that interest did not carry over specifically to CTS. In fact, 42% of respondents said they were “not at all” interested in CTS, and just 25% of respondents indicated “some level of positive interest” in the specialty.
Men were significantly more interested in CTS than women, the group added, highlighting the fact that Black women in particular are unlikely to pursue a career in this field.
One of the survey’s key takeaways was the fact that medical students are not being exposed to CTS on a consistent basis. Even though 56% of respondents said they may be interested in shadowing a cardiothoracic surgeon, for example, just 16% of them had actually done it before. Making things even worse, 7% of respondents said they had attempted to shadow a CT surgeon in the past, but the attempt was unsuccessful. There is also a perception that “it is difficult to find a mentor in the field of CTS,” the authors noted, further highlighting the reason so many respondents may not be specifically interested in becoming a cardiothoracic surgeon in the first place.
“Streamlining the pathway to the CTS operating room and clinic presents an opportunity for intervention to enhance exposure to the field,” the authors wrote. “The perception—and data-backed reality—of a lack of minority role models in CTS is particularly concerning … While students of all demographics likely benefit from aspirational figures, this need is especially pronounced for Black students. White and Asian students are more likely to see surgeons who reflect their backgrounds, making it easier for them to find such figures. In contrast, Black medical students have significantly fewer opportunities to encounter aspirational figures who resemble them in the surgical field.”
Hamzat and colleagues also noted that CTS is seen as a “racially/ethnically biased specialty” by 73% of respondents. Women appeared to agree with this even more than men.
“Across a multitude of surgical specialties and within medical school, bias against Black trainees has been well-documented in the literature,” the group wrote. “Black medical students face disparities in subjective clinical grades, Black surgery residents perceive high rates of racial discrimination, and Black residents perceive harsher punishment for similar transgressions made by their white counterparts. These biases, whether implicit or explicit, extend to cardiac surgery and are evident in practice trends and in public remarks.”
Reviewing a 2023 incident
The study’s authors then looked back at an incident in 2023, when the outgoing president of the Society of Thoracic Surgeons (STS) made a series of comments that came under fire for appearing to be against the very idea of diversity. John Calhoon, MD, attacked the concept of affirmative action, for example, and said “inclusion is not the same as diversity.”
Thomas MacGillivray, MD, had just been named the organization’s new president as the controversy was staring to spread. He shared a statement at the time distancing STS from the statements—but Hamzat et al. wrote that the comments remained “symbolic of anti-diversity sentiments held by a subset of surgeons,” even after MacGillivray’s clarification.
Looking forward
The authors concluded their analysis by looking at ways to potentially improve this situation going forward.
“Increased exposure to CTS, highlighting opportunities to address healthcare disparities within the field, and direct engagement with CTS mentors may increase the interest of Black medical students in the field of CTS,” the group wrote.
Click here to read the full study.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.