Third Trial - Overview

Trial to Harness Inclusion and foster Resilient Departments of Surgery (THIRD)

Poor well-being threatens the health, productivity, and longevity of the surgeon workforce. For minoritized surgeons, well-being lives in tandem with experiences of identity-based mistreatment and lack of inclusion. We believe lack of inclusion drives the persistent lack of diversity in US departments of surgery. Ample evidence indicates that by increasing physician diversity, we can reduce disparities in the patient care we deliver.

Over the past 5 years, the SECOND Trial, a national prospective, pragmatic cluster-randomized trial of general surgery residency programs, has sought to generate data on and improve resident well-being. Programs randomized to receive the intervention were able to reduce resident burnout below that of control programs, reflecting the power of a large collaborative of surgical educators armed with benchmarked, department-specific data and tools.

However, over the course of the study, we have recognized that our ability to address resident well-being was limited by our inability to assess or intervene on faculty well-being. Furthermore, in observing many institutions acknowledge and attempt to remediate their lack of physician diversity over the past few years, we have noticed a need for a theoretically driven, empirically based, systematic approach to advancing departmental inclusion. Structured as another prospective, pragmatic cluster-randomized trial, the THIRD Trial aims to address both departmental inclusion and surgeon well-being. All departments of surgery with an ACGME-accredited general surgery residency program will be eligible for enrollment in the THIRD Trial.