American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Clinical Updates

FDA Expands Emergency Use for Pfizer COVID-19 Vaccine to 12 to 15 Year Olds

The U.S. Food and Drug Administration (FDA) May 10 expanded the emergency use authorization of the Pfizer COVID-19 vaccine in adolescents age 12 to 15 years of age. With the recent increase in the number of adolescents who are diagnosed with COVID-19, the expanded age range is an important step forward in reducing the rate of infection in the U.S. 

According to acting FDA Commissioner Janet Woodcock, MD, the May 10 action “allows for a younger population to be protected from COVID-19, bringing us closer to returning to a sense of normalcy and to ending the pandemic. Parents and guardians can rest assured that the agency undertook a rigorous and thorough review of all available data, as we have with all of our COVID-19 vaccine emergency use authorizations.”

Read the FDA press release for more information on the agency’s decision, as well as its evaluation of available safety and effectiveness data.

From the Board of Governors Diversity Pillar: Disparities in the Surgical Workforce

by Cherisse Berry, MD, FACS, ACS Governor, Manhattan Council Chapter; Member, Board of Governors Diversity Pillar

The face of the U.S. reflects a racially and ethnically diverse nation of people, and this diversity is predicted to expand over the next several decades. Yet the diversity of our nation’s population is not reflected in the surgical workforce. In looking at the surgical workforce pipeline, racial/ethnic disparities and inequities exist at every level. 

Let us look first at our medical school graduates. Caucasians represent approximately 60 percent of the population and 55 percent of medical school graduates. Asian Americans represent 5.9 percent of the population and 21.5 percent of medical school graduates. Hispanic/Latinx Americans represent about 18.5 percent of the population but only 5.3 percent of medical school graduates. African Americans represent about 13 percent of the population but only 6 percent of medical graduates. These data make clear the need for the term “under-represented minorities in medicine” (URiM), which includes those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population. According to the Pew Research Center, by 2050, the U.S. will be 47 percent Caucasian, 29 percent Hispanic/Latinx, 13 percent African American and 9 percent Asian, with the remaining identifying as multiracial. How can we get our surgical profession to be reflective of these predictive numbers?

As we move along the pipeline and evaluate the demographic trends of our general surgery residency graduates from 2005 to 2018, out of the nearly 25,000 graduates of general surgery residency programs, 10 percent were underrepresented minorities, although 19 percent were Asian.1 

We see similar racial/ethnic disparities in our department of surgery medical school faculty. Minorities remain grossly underrepresented in academic surgery. According to the 2017 Association of American Medical College faculty roster, out of 15,671 department of surgery medical school faculty, 9,973 (64 percent) were Caucasian, 2,168 (13.8 percent) were Asian, 401 (2.6 percent) were Hispanic/Latinx and 426 (2.7 percent) were African American.2 The statistics are similar when the medical school faculty are stratified by academic rank. Hispanic/Latinx Americans and African Americans represent 2 percent and 2.3 percent, respectively, of our nation’s professors of surgery. Finally, of the 337 chairs of departments, 288 (85 percent) are Caucasians. To date, an African-American woman surgeon has never ascended to the role of surgical department chair.

The reasons for these disparities and inequities are multifactorial: implicit and explicit bias and discrimination, systemic racism and intersectionality. We are just beginning to shine a very important light not only on the importance of diversity, equity, inclusion and social justice, but more importantly on strategies to achieve such goals. Our surgical workforce and surgical leadership should reflect the diversity of the population we serve. As described by the Association of American Medical Colleges, “Diversity has been widely recognized as key to excellence in academic medicine. Practicing conscious inclusion and equity-mindedness to achieve inclusion excellence—an environment where diversity is a strategic imperative, inclusivity is intentional, and exclusionary practices have been identified, critically deconstructed, and eliminated—will enable the bonuses of diversity to be revealed, actualized, and leveraged. Then and only then will a diverse workforce be empowered to attain its full potential—and academic medical centers be able to truly attain excellence.”3

References

  1. Keshinro A, Frangos, Berman, et al. Underrepresented minorities in surgical residencies: Where are they? A call to action to increase the pipeline. Ann Surg. 2020;272(3):512-520.
  2. Berry C, Khabele D, Johnson-Mann C, et al. A call to action: Black/African American surgeon scientists, where are they? Ann Surg. 2020;272(1):24-29.
  3. Acosta DA. Achieving excellence through equity, diversity, and inclusion. January 14, 2020. Available at: www.aamc.org/news-insights/achieving-excellence-through-equity-diversity-and-inclusion. Accessed May 6, 2021.