Demographics of Current and Aspiring Integrated Six-year Cardiothoracic Surgery Trainees

Background: The integrated 6-year thoracic surgery (I-6) residency model was developed in part to promote early interest in cardiothoracic surgery in diverse trainees. To determine gaps in and opportunities for recruitment of women and minority groups in the pipeline for I-6 residency, we quantified rates of progression at each training level and trends over time. Methods: We obtained 2015 to 2019 medical student, I-6 applicant, and I-6 resident gender and race/ethnicity demographic data from the American Association of Medical Colleges and Electronic Residency Application Service public databases and Accreditation Council for Graduate Medical Education Data Resource Books. We performed χ², Fisher exact, and Cochran-Armitage tests for trend to compare 2015 and 2019. Results: Our cross-sectional analysis found increased representation of women and all non-White races/ethnicities, except Native American, at each training level from 2015 to 2019 (P <.001 for all). The greatest trends in increases were seen in the proportions of women (28% vs 22%, P =.46) and Asian/Pacific Islander (25% vs 15%, P =.08) applicants. There was also an increase in the proportions of women (28% vs 24%, P =.024) and White (61% vs 58%, P =.007) I-6 residents, with a trend for Asian/Pacific Islanders (20% vs 17%, P =.08). The proportions of Hispanic (5%) and Black/African American (2%) I-6 residents in 2019 remained low. Conclusions: I-6 residency matriculation is not representative of medical student demographics and spotlights a need to foster early interest in cardiothoracic surgery among all groups underrepresented in medicine while ensuring that we mitigate bias in residency recruitment.