Where is the leak in the surgeon pipeline?

In order to care for an increasingly diverse population, the surgical workforce must improve in gender, racial, and ethnic diversity. We aim to identify deficiencies in the surgical pipeline. Data from the United States Census, Bureau of Labor Statistics, and Association of American Medical Colleges were collected from 2004 to 2018, and evaluated for changing population over time. Women comprise 51% of the population, 32% of surgeons, and representation is increasing at a rate of 0.4% per year. 13% of the population and 6% of surgeons are black, and representation is decreasing at a rate of −0.1% per year. Hispanics represent 18% of the population, 6% of surgeons, and representation is increasing at a rate of 0.04% per year. While the proportion of women and Hispanic surgeons is slowly increasing, the proportion of black surgeons is decreasing. Recruitment methods need to be focused to improve surgical workforce diversity. •The current surgical workforce does not represent the overall population.•There has been little improvement in diversity over a 15-year period.•Recruitment methods should be tailored based on pipeline deficiencies.