Moving the needle: exploring the impact of pipeline programs within surgery

Abstract Purpose A notable disparity exists in representation of women and those Underrepresented in Medicine (URiM) in surgery across the United States. Pipeline Programs (PPs) in surgery have been developed to potentially combat this disparity. However, overall outcomes and best practices remain unknown. This systemic review and meta-analysis aimed to evaluate the outcomes of pre-medical pipeline programs in surgical departments. Methods Adhering to the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive literature search of the databases: PubMed, Embase, Web of Science, Scopus, and ERIC from inception to 2022. Studies in English reporting on PPs for high school and college students within surgery departments were included. Programs were included if they introduced students to the field of surgery through workshops, shadowing, research, etc. Abstract screening, full article review, and data extraction was conducted by three independent reviewers. The primary outcome was reported medical school matriculation for participants. Results Of the 941 studies screened, 13 were included in the systematic review, from which 10 were included in the meta-analysis. Most (60%) of studies reported on surgical PPs geared towards high school students and 40% towards undergraduates. Of the 847 students in these programs, a majority of the participants were female (n = 697, 87%) and 36% participants were from URiM backgrounds. The duration of the programs ranged from 1 day (50%), 8–10 weeks (40%), and 1 year (10%). A majority (80%) of studies reported on the number of students (n = 233, 28%) interested in pursuing a career in healthcare after attending the PPs, however, no study reported whether students successfully pursued a career in healthcare. Ten studies (77%) reported on the programs’ curriculum and design, and 4 studies evaluated and reported on the improvement of participant’s surgical skills after hands-on sessions. Conclusion Premedical PPs have been implemented in order to increase the diversity in the surgical field. Our systemic review found that while studies reported an increase in interest of students in pursuing career in healthcare, data on medical school matriculation and career choices was lacking, which are required to understand and improve best practices.