Hiring Practices of US Academic Surgery Departments-Challenges and Opportunities for More Inclusive Hiring

Background: To increase workforce diversity among academic medical centers, the Association of American Medical Colleges recommends multiple inclusive strategies for evaluating and hiring candidates. Our objective was to determine (1) usual and inclusive hiring practices used among academic surgery departments and (2) the barriers to utilization of inclusive hiring practices. Materials and methods: We used a qualitative design and conducted semistructured interviews with academic surgery department chairs (n 1/4 19). Participants were interviewed by phone between March 2018 and June 2018 until thematic saturation was reached. Interviews were audiotaped and transcribed verbatim. Coding for major themes was conducted independently by two investigators and discussed to consensus iteratively using thematic analysis. Results: Rather than broad and publicly available postings, many chairs reported soliciting a small number of applications from trusted networks. Although chairs report making efforts to include women or underrepresented minority candidates in interview pools, these efforts are not typically formalized. Chairs often reported an inability to secure diverse applicant pools, given the narrow specialty or clinical niche for which applications were being solicited. A major emergent theme was an assessment of a "candidate's fit" for the department. For this reason, recruiting current or former trainees was considered a safe opportunity for the department, given a perception of loyalty and trust in the internal training program for surgical preparation. Conclusions: Many chairs rely heavily on internal hires or trusted networks, which may limit both demographic and cognitive diversity. These findings highlight gaps between best inclusive hiring practices described in other industries and usual strategies for recruitment in US academic surgery. (c) 2020 Elsevier Inc. All rights reserved.