Article 1
The climb to break the glass ceiling in surgery: trends in women progressing from medical school to surgical training and academic leadership from 1995 to 2015. Abelson JS, Chartrand G, Moo TA, Moore M, Yeo H. The American Journal of Surgery. 2016 Oct;212(4):566-572.
Since 2005, the number of women entering medical school has been almost equal to the number of men. However, the numbers of women in surgical training and academic leadership positions has remained consistently low. Reasons often cited for these disparities include gender discrimination, lack of visible role models, lack of support / mentorship, difference in salary and lifestyle concerns. This paper provided an update on the involvement of women in the surgical profession at every level. Only surgical subspecialties that are accessible through the general surgery track were examined: colorectal, pediatric, critical care, thoracic, and vascular (prior to the integrated residency programs). Statistical trend tests were performed using t-test and chi squared whenever appropriate, and linear regression was performed of the proportion of women medical school graduates, surgical trainees, and surgical faculty over each year of the period analyzed (1994 – 2015) to obtain the average percent change per year, with statistical significance set at P= <.05 for all tests.
The total number of medical students increased by 17.8%, with the number of women graduating increasing by 43.0%. The proportion of women graduating increased on average .5% per year over the study period. The number of general surgery trainees decreased (2.1%) over the study period, although the number of women trainees in general surgery more than doubled, with increases in the absolute number and proportion of women trainees in critical care (1.4%), colorectal (1.3%) and pediatric surgery (1.3%), although the increases were lowest in vascular (1.1%) and thoracic (0.9%) subspecialties. The number of women who are Assistant Professors of Surgery has increased over the study period by 271.9%, they still only represented 25% of all Assistant Professors of Surgery. Similar trends were seen when looking at Associate Professors of Surgery (overall increase of 295.3%, representing only 19.2% of all Associate Professors). The number of women Surgery Full Professors increased the most (366.2%) over the study period, however, if the rates of increase hold steady, it would take 49, 57, and 121 years, respectively, for women to comprise half of all Assistant, Associate, and Full Professors of Surgery. The authors also found that while there has been an increase in the number and proportions of women on the tenure track (174.8% increase, although women only represent 22.1% of all surgery faculty on tenure track over the study period).
The authors conclude that while women have made impressive strides from 1994 to 2015 in climbing the ladder to become leaders in academic surgery, the overall proportion of women at the higher rungs remains quite low. Women are on track to represent half of all general surgery trainees by approximately 2026 to 2028, however, they found that the estimated year when women will represent half of all Full Professors of Surgery has been pushed further into the future, from 2096 to 2136. Three main reasons often cited as a reason for gender disparities are gender discrimination, lack of role models and mentors, and lifestyle concerns. They cite a study which found that women in academic surgery are 10 times more likely to have experienced gender discrimination as men. They also discuss how the tenured tracks that women tend to hold, such as Clinician-educator, lag behind traditional tenure tracks in terms of promotion. The authors also discuss that there should be a national effort to address the gender differences in salary, and to enhance flexibility in training and promotion by endorsing policies that promote family-friendly policies such as appropriate parental leave, as well as increasing the strength and visibility of existing mentorship programs, which can be found through the Association of Women Surgeons, and the American College of Surgeons Women in Surgery Committee.
Article 2
Faculty Characteristics and Surgery Trainee Attrition. Harris H, Tan IM, Qiu Y, Brouwer J, Sosa JA, Yeo H. JAMA Surg. 2025 May 1;160(5):597-599.
Background:
Research demonstrates higher attrition rates among surgery trainees who are female and underrepresented in medicine (UIM). As mentorship is critical for resident retention, this study aimed to examine correlations between UIM and female faculty representation, retention, and promotion and general surgery resident attrition at a national level.
Methods:
Secondary analyses were performed using 17 years of data from the Association of American Medical Colleges (AAMC) faculty and resident rosters, which contain self-reported race, ethnicity, and sex. UIM status was classified by AAMC race and ethnicity categories. The researchers calculated adjusted odds ratios for trainee attrition with every 10–percentage point increase in institutional faculty characteristics. Institutional faculty characteristics at years of attrition/completion included percentage of UIM and female faculty, 10-year retention rate, and 10-year promotion rate.
Results:
26755 general surgery residents (33% female;19% UIM) from136 institutions were included;1911 residents left before completing training. For every 10–percentage point increase of female faculty and 10-year UIM faculty promotion rates, odds of UIM trainee attrition decreased by 16% and 12%, respectively. For every 10–percentage point increase of female faculty and UIM faculty, odds of female trainee attrition decreased by 14% and 13%, respectively. Increased percentage of female faculty correlated with reduced attrition for all groups, with greater reductions for female and UIM trainees.
Discussion:
This study found that higher percentages of female faculty and higher UIM faculty promotion rates significantly correlated with reduced UIM trainee attrition, and higher percentage of female and UIM faculty significantly correlated with reduced female trainee attrition. As research continues to demonstrate that gender and ethnic diversity within teams and organizations improves patient outcomes and boosts performance in medicine and beyond, it is imperative that we devote effort to improving retention among female and UIM surgical trainees. The authors note some limitations, including small sample size-driven results, inability to stratify by intersectional groups, and institution-level factors such as public/private which could affect resources available for retention efforts. The authors describe next steps as understanding how faculty demographics protect against attrition.
Article 3
Advancing Inclusive Excellence in Pediatric Surgery: A National Longitudinal Mentorship Program.
Mallampalli G, Gavulic AE, Campwala I, Ibrahim Y, Castellanos S, Stallion A, Siddiqui S, Arca MJ, Singleterry M, Nwomeh BN, Moreno N, Berman L, Tsao K, Downard C, Newman EA, Gadepalli SK. J Pediatr Surg. 2025 Aug;60(8):162383.
The authors note that despite an increasingly diverse patient population, pediatric surgery remains disproportionately homogenous, particularly in leadership roles. They emphasize that inclusive excellence requires both diversifying the pipeline and creating an environment where underrepresented faculty and trainees thrive. A group of pediatric surgery faculty, residents, and medical students created the Alliance of Pediatric Surgeons Growing and Advancing Representation (APGAR) which aims to increase mentorship, sponsorship, and education in pediatric surgery. This article evaluates the impact of APGAR over its initial year of programming.
Pediatric Surgery attendings were assigned to lead 17 pods of fellows, residents, and students that were recruited across social media and other venues. The pods met virtually at least every 3 months over a year, and larger group meetings were organized to address topics such as career building, networking, and imposter syndrome. Surveys were administered at the beginning and at the end of the year. The authors describe the diverse demographics of the pods as well as survey responses. Qualitative data on interest in pediatric surgery, experience with pediatric surgery, factors influencing career selection, qualities in a mentor, and other things were investigated.
The paper recognizes that pipeline initiatives are necessary but insufficient without simultaneous structural reforms. Importantly, the article frames inclusion not as an optional initiative but as a driver of innovation, patient trust, and improved outcomes in pediatric surgery. While not an empirical study, the paper synthesizes existing literature and professional consensus, offering recommendations for how pediatric surgery programs can advance both representation and inclusivity. In addition, the APGAR mentorship program which will be ongoing, with plans to strengthen and broaden its impact.
Article 4
Medical School Faculty Diversity and the Liaison Committee on Medical Education's Diversity Standards.
Nguyen M, Fancher TL, Chaudhry SI, Dardik A, Castillo-Page L, Ogedegbe G, Butler P, Desai MM, Venkataraman S, Campa OM, Sage A, Boatright D. JAMA Netw Open. 2025 May 1;8(5):e2512096.
Nguyen et al. investigated trends in medical school faculty diversity following the Liaison Committee on Medical Education (LCME)’s 2009 diversity accreditation standards. Using national Association of American Medical Colleges (AAMC) data from 2002–2019, the authors conducted an interrupted time series analysis across pre-implementation, implementation, and post-implementation periods. While student diversity increased after the standards, faculty diversity gains were modest and uneven.
The study found small increases in Black faculty, particularly Black women, and some gains for Hispanic women. However, Indigenous faculty representation declined, and Asian faculty growth slowed. White faculty proportions decreased overall, though White female faculty increased slightly. These findings suggest that while the LCME standards may have supported faculty diversity indirectly, medical schools had more leverage over admissions than faculty hiring. Structural barriers such as slow turnover, limited pipelines, and systemic biases continue to constrain progress.
The authors caution that the upcoming 2025 removal of faculty diversity requirements from LCME standards may further slow progress. They emphasize that faculty diversity is critical not only for equity but also for mentorship and role modeling, particularly for students from underrepresented backgrounds. The study highlights the need for intentional institutional strategies that will sustain and expand diversity among medical school faculty.
Article 5
Ambulance deserts and inequities in access to emergency medical services care: Are injured patients at risk for delayed care injured patients at risk for delayed care in the prehospital system? Berry C, Escobar N, Mann NC, DiMaggio C, Pfaff A, Duncan DT, Frangos S, Sairamesh J, Ogedegbe G, Wei R. J Trauma Netw Open. 2025 May 1;8(5):e2512096.
Berry et al. evaluated geographic and socioeconomic inequities in access to emergency medical services (EMS) across the United States. Using national geospatial databases and the Area Deprivation Index (ADI), the study defined “ambulance deserts” as census block groups with centers located more than 25 minutes from the nearest EMS station. Of over 333 million people in the U.S., 2.6% live in ambulance deserts, with a much higher proportion in rural (8.9%) versus urban (0.3%) settings. Populations in these areas had significantly higher ADI scores, reflecting socioeconomic disadvantage, and EMS station availability was negatively correlated with ADI.
The findings highlight how geography and socioeconomic status combine to shape trauma outcomes. Residents in rural and deprived areas are disproportionately affected, with delayed EMS responses linked to increased mortality from time-sensitive conditions. The authors frame this as an issue of “spatial justice,” where equitable distribution of EMS resources is essential to health equity. They recommend enhancing EMS operations through technology, cross-jurisdictional collaboration, and federal investment. Although this is a retrospective study with a focus on ground EMS only, it provides the first nationwide evidence linking ambulance deserts to socioeconomic deprivation, calling attention to systemic inequities in prehospital care.
