Effect of online public domain representation in neurosurgical resident recruitment and decision-making

OBJECTIVEOver the past 20 years, female representation in neurosurgical residency programs has steadily increased. Still, the number of Black women and Black neurosurgical residents overall has remained stagnant. The authors aimed to understand the factors that led to this stagnation and how online public domain representation informs current and upcoming resident recruitment and decision-making.METHODSThe authors performed a retrospective study using the following public domain sources: Doximity, neurosurgical residency program websites, and LinkedIn. The authors collected data from all neurosurgery residents who matriculated into a US neurosurgical residency program from 2015 to 2022. Variables, including name, race, gender, year of matriculation, medical school, and undergraduate institution, were recorded.RESULTSThe authors analyzed resident data from 110/113 (97.3%) US neurological surgery residency programs. Of these programs, 106 (96.4%) matriculated and retained ≥ 1 female resident over the study period. There were 408 (22.6%) female neurosurgical residents, with 37 (33.6%) programs accounting for 57.8% of all female neurosurgical residents. For those states with a female resident, the lowest percentage of female residents by state was in Iowa (6.25%) and the highest was in New Hampshire (50%). Of all programs, 60 (54.5%) matriculated and retained ≥ 1 Black resident over the study period. There were 88 (4.9%) Black neurosurgical residents, with 19 (17.3%) programs accounting for 55.7% of all Black neurosurgical residents. For those states with a Black resident, the lowest percentage of Black residents by state was in Maryland (2.0%) and the highest was in Arkansas (23.1%).CONCLUSIONSRecruiting and retaining female and Black residents has increasingly become a focus of neurosurgical programs across the country. The authors' data show that female and Black residents overwhelmingly choose to apply to and matriculate into programs that demonstrate a commitment to diversity via their online presence. Programs wishing to recruit more diverse residents should make efforts to relay their dedication to diversity, inclusion, and performance through their online presence.