Diversity in medicine across the U.S is not equal with population changes – while women see improvements in representation, minority groups continue to go underrepresented
Industries and workplaces across the United States are becoming more racially and ethnically diverse, as well as improving gender equality by hiring more women – but those changes have not been seen in diversity in medicine across the makeup of clinical faculty and leadership of medical schools.
Among few positive trends, such as improvement in women’s leadership, the overall trend highlights that U.S. academic medical programs need to recruit more underrepresented clinical faculty candidates – as well as support them throughout the academic pipeline to build diversity at leadership levels in medicine.
This study highlights the urgency for action to improve diversity in medicine, as patients often have better health outcomes when cared for by physicians of similar backgrounds who can identify with their life experiences.
Sophia Kamran, MD, a radiation oncologist at Mass General Cancer Centre, said: “I didn’t have many mentors, teachers, or role models in clinical medicine from a similar background as mine to help guide me. We wanted to see where we’ve come from, where we are, and where we need to go.”
The proportion of female deans rose from zero to 18.3%
Published in the New England Journal of Medicine, researchers analysed data compiled by the Association of American Medical Colleges (AAMC) for full-time faculty members in 18 clinical academic departments from 1977 to 2019, representing clinical faculty, full professors, department chairs and deans.
Faculty members were categorised according to sex as well as race and ethnicity, as well as stratifying faculty members who were underrepresented in medicine (URM), which the AAMC defines as people who identify as Black, Hispanic, non-Hispanic Native Hawaiian or other Pacific Islander, or non-Hispanic American Indian or Alaska Native.
Across the trends examined over the 42 years representation of women increased greatly, where female clinical faculty rose from 14.8% in 1977 to 43.3% in 2019. The proportion of female deans rose from zero to 18.3%.
Yet despite this upward trend seen with women, diversity in medicine seemed to only rise significantly in this demographic, and diversity for minority groups fell behind.
While the proportion of URMs in academic medicine also rose over the study period, those increases were far smaller – as a result, Black and Hispanic women and men, and other minority groups, still represent a small part of total clinical faculty.
The data indicated growth and representation of Black men in academic medicine actually stagnated or decreased, particularly among clinical faculty and department chairs, a trend that began about a decade ago. Additionally, some URMs barely registered in the databases.
At all faculty levels, minority groups like non-Hispanic Native Hawaiian/other Pacific Islander and non-Hispanic American Indian/Alaska Native accounted for less than 1%.
Mirroring population sizes to improve diversity in medicine
The most notable success of the NEJM report, when compared with AAMC’s numbers with U.S. Census data and found that the proportion of women in academic medicine today has risen sufficiently over the past four decades to more closely mirror that of the population of women in the U.S.
Yet while U.S Census data also show that the country is rapidly increasing diversity in medicine, it is still not keeping pace with population change: URM representation at all levels in academic medicine is further away from reflecting the U.S. population today than it was in 2000.
Kamran said: “The U.S. population is going to continue getting more diverse as time goes on. We’re sounding the alarm because we are clearly falling behind.”
Kamran is encouraged that institutions appear to be responding to these disparities, but says it’s not enough for medical schools to set diversity quotas, saying: “We have to also focus on retention and development. We need evidence-based initiatives that create inclusive environments that can support cultural change.”
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