Discontinuation of affirmative action: Consequences for black educational equity, neurosurgical residency, and medical diversity, with consideration of potential adversity as a new path forward

Background: The underrepresentation of the Black community in neurosurgery is concerning, especially given projections that racial minorities will become the majority in the U.S. by 2044. Yet, despite these forecasts, Black candidates make up less than 4% of those in neurosurgical training programs....

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Main Authors: Albert Alan, Michelle Ennabe, Abdulmuizz Sulaiman, Martin Weinand
Format: Article
Language:English
Published: Elsevier 2024-07-01
Series:World Neurosurgery: X
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S259013972400070X
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author Albert Alan
Michelle Ennabe
Abdulmuizz Sulaiman
Martin Weinand
author_facet Albert Alan
Michelle Ennabe
Abdulmuizz Sulaiman
Martin Weinand
author_sort Albert Alan
collection DOAJ
description Background: The underrepresentation of the Black community in neurosurgery is concerning, especially given projections that racial minorities will become the majority in the U.S. by 2044. Yet, despite these forecasts, Black candidates make up less than 4% of those in neurosurgical training programs. The recent Supreme Court decision to end Affirmative Action underscores the urgency of addressing this disparity. This research delves into the implications of eliminating Affirmative Action on neurosurgery admissions and residencies. Methods: A comprehensive literature search was performed using PubMed, OVID Embase, and OVID Medline, employing the keywords “Black”, “Neurosurgery”, and “Residency”. The Maslow Adversity Index (MAI) was created to integrate adversity as a factor in neurosurgery residency evaluation. Results: After Affirmative Action, Black college enrollment increased, peaking at 36% by 2020. However, Black medical students remain underrepresented in neurosurgery residencies. ALDC (Athletes, Legacies, Dean’s List, Children of faculty/staff) admissions criteria favor White students. Furthermore, studies have highlighted the beneficial impacts of racial concordance on patient outcomes. The end of Affirmative Action necessitates new diversity strategies in admissions. A points-based assessment, inspired by Maslow's hierarchy, recognizes adversities faced by underrepresented applicants which could help residency programs enhance diversity, inclusivity, and equity in selection. Conclusion: Despite the growth in Black college attendance, disparities persist in specialized medical fields like neurosurgery. The end to Affirmative Action policies might exacerbate these disparities. Embracing holistic admission approaches, rooted in Maslow's hierarchy. This consideration is key for inclusive representation, impacting education, professions, and health outcomes.
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spelling doaj.art-51c6479f701645fd81db61e57294e6ed2024-07-21T05:26:17ZengElsevierWorld Neurosurgery: X2590-13972024-07-0123100339Discontinuation of affirmative action: Consequences for black educational equity, neurosurgical residency, and medical diversity, with consideration of potential adversity as a new path forwardAlbert Alan0Michelle Ennabe1Abdulmuizz Sulaiman2Martin Weinand3Department of Neurosurgery, University of Arizona, Tucson, AZ, USA; University of Arizona College of Medicine, Tucson, AZ, USA; Global Neurosurgical Alliance, Tucson, AZ, USA; Corresponding author. PO Box 245070 1501 N Campbell Avenue, Room, 4303, Tucson, AZ, USA.Global Neurosurgical Alliance, Tucson, AZ, USA; University of Arizona College of Medicine, Phoenix, AZ, USAGlobal Neurosurgical Alliance, Tucson, AZ, USA; College of Health Sciences, University of Ilorin, Kwara State, NigeriaDepartment of Neurosurgery, University of Arizona, Tucson, AZ, USA; University of Arizona College of Medicine, Tucson, AZ, USABackground: The underrepresentation of the Black community in neurosurgery is concerning, especially given projections that racial minorities will become the majority in the U.S. by 2044. Yet, despite these forecasts, Black candidates make up less than 4% of those in neurosurgical training programs. The recent Supreme Court decision to end Affirmative Action underscores the urgency of addressing this disparity. This research delves into the implications of eliminating Affirmative Action on neurosurgery admissions and residencies. Methods: A comprehensive literature search was performed using PubMed, OVID Embase, and OVID Medline, employing the keywords “Black”, “Neurosurgery”, and “Residency”. The Maslow Adversity Index (MAI) was created to integrate adversity as a factor in neurosurgery residency evaluation. Results: After Affirmative Action, Black college enrollment increased, peaking at 36% by 2020. However, Black medical students remain underrepresented in neurosurgery residencies. ALDC (Athletes, Legacies, Dean’s List, Children of faculty/staff) admissions criteria favor White students. Furthermore, studies have highlighted the beneficial impacts of racial concordance on patient outcomes. The end of Affirmative Action necessitates new diversity strategies in admissions. A points-based assessment, inspired by Maslow's hierarchy, recognizes adversities faced by underrepresented applicants which could help residency programs enhance diversity, inclusivity, and equity in selection. Conclusion: Despite the growth in Black college attendance, disparities persist in specialized medical fields like neurosurgery. The end to Affirmative Action policies might exacerbate these disparities. Embracing holistic admission approaches, rooted in Maslow's hierarchy. This consideration is key for inclusive representation, impacting education, professions, and health outcomes.http://www.sciencedirect.com/science/article/pii/S259013972400070XUnderrepresentationAffirmative actionNeurosurgery admissionsRacial concordanceALDC admissions criteriaHolistic admission approaches
spellingShingle Albert Alan
Michelle Ennabe
Abdulmuizz Sulaiman
Martin Weinand
Discontinuation of affirmative action: Consequences for black educational equity, neurosurgical residency, and medical diversity, with consideration of potential adversity as a new path forward
World Neurosurgery: X
Underrepresentation
Affirmative action
Neurosurgery admissions
Racial concordance
ALDC admissions criteria
Holistic admission approaches
title Discontinuation of affirmative action: Consequences for black educational equity, neurosurgical residency, and medical diversity, with consideration of potential adversity as a new path forward
title_full Discontinuation of affirmative action: Consequences for black educational equity, neurosurgical residency, and medical diversity, with consideration of potential adversity as a new path forward
title_fullStr Discontinuation of affirmative action: Consequences for black educational equity, neurosurgical residency, and medical diversity, with consideration of potential adversity as a new path forward
title_full_unstemmed Discontinuation of affirmative action: Consequences for black educational equity, neurosurgical residency, and medical diversity, with consideration of potential adversity as a new path forward
title_short Discontinuation of affirmative action: Consequences for black educational equity, neurosurgical residency, and medical diversity, with consideration of potential adversity as a new path forward
title_sort discontinuation of affirmative action consequences for black educational equity neurosurgical residency and medical diversity with consideration of potential adversity as a new path forward
topic Underrepresentation
Affirmative action
Neurosurgery admissions
Racial concordance
ALDC admissions criteria
Holistic admission approaches
url http://www.sciencedirect.com/science/article/pii/S259013972400070X
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