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OVERLOOKED BARRIERS FACED BY UNDERREPRESENTED STUDENTS PURSUING PLASTIC SURGERY: AN URBAN BIOETHICS PERSPECTIVE

Gebreyesus, Maria Tsegaye
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Thesis/Dissertation
Date
2025-05
Advisor
Tuohy, Brian
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Urban Bioethics
Subject
Medical ethics
 Urban bioethics
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https://scholarshare.temple.edu/handle/20.500.12613/11078
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Gebreyesus_temple_0225M_16105.pdf
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https://doi.org/10.34944/xjtf-5z95
Abstract
Despite increasing efforts to diversify the medical profession, the field of plastic surgery remains one of the least racially representative specialties. This study investigates the persistent underrepresentation of students who are underrepresented in medicine (URM)—specifically Black, Hispanic/Latinx, American Indian/Alaskan Native, and Pacific Islander populations—within plastic surgery. Using an urban bioethics lens, this work explores the structural, financial, and social barriers that limit URM students’ access to this competitive specialty. We conducted a systematic review of the literature following PRISMA guidelines and a nationwide survey of medical students, yielding 496 valid responses. Key findings reveal alarming disparities: only 3.5% of students identified plastic surgery as their top career choice, and 0% of Black students had access to a plastic surgery mentor. Just 16.7% of respondents overall reported having a mentor in the field, with only 30.4% sharing the same racial background. Financial instability was also a major concern, disproportionately affecting Hispanic (19.4%) and “Other” (25.4%) racial groups. Competitiveness and concerns about USMLE scores further deterred students, particularly those from Asian and White backgrounds, while URM students were more impacted by mentorship and financial barriers. Through stratified analysis, our results underscore how race and socioeconomic status significantly shape access to mentorship, professional exposure, and specialty choice. These disparities are not simply educational gaps—they reflect systemic ethical failures in the recruitment and retention of diverse talent in surgical subspecialties. We argue that meaningful diversity in plastic surgery cannot be achieved without systemic reform. Recommendations include expanding structured mentorship and longitudinal exposure programs, increasing financial support for away rotations and conferences, implementing holistic admissions practices, and mandating implicit bias training for residency selection committees. Applying an urban bioethics framework, we assert that diversifying plastic surgery is not just a matter of fairness—it is a public health and social justice imperative.
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