Physical Medicine and Rehabilitation Faculty Diversity Trends by Sex, Race, and Ethnicity, 2007 to 2018 in the United States

Gender and race in radiology: An intersectional analysis of the American Association of Medical Colleges (AAMC) database from 1966 to 2021

PURPOSE

To describe trends in gender and racial representation within academic radiology in the United States over a 55-year period from 1966 to 2021.

METHODS

A retrospective analysis of the American Association of Medical Colleges database of radiology faculty members from 1966 to 2021 was conducted. Trends in academic rank and tenure status for five different ethnoracial groups (White, Asian, Black, Hispanic, and Native American) each subdivided into two gender identities (men and women) were analyzed. The proportional change over time of each demographic group per outcome was analyzed with linear regression models.

RESULTS

Between 1966 and 2021, White men comprised the largest demographic in academic radiology each year. A significant decrease in both White individuals (-0.51 % per year) and men (-0.30 % per year) were observed over the study period. Additionally, the only demographic groups with meaningful changes in representation were White women (+0.20 % per year) and Asian men (+0.23 % per year), followed by Asian women in later years. Underrepresented minority groups (Black, Hispanic and Native American) collectively comprised less than 5 % of all academic radiologists. Finally, within each demographic group, the representation of women consistently lagged behind men. Despite these relative increases, in 2021, the majority of US academic radiologists were White (59.1 %) and male (70.1 %).

CONCLUSION

Historically underrepresented minorities, especially women within these groups, continue to face discrimination and are consistently the least represented in radiology. Initiatives that incorporate the intersectionality framework are imperative to break this cycle.

End of Affirmative Action-Who Is Impacted Most? Analysis of Race and Sex Among US Internal Medicine Faculty

BACKGROUND

For over 50 years, the United States (US) used affirmative action as one strategy to increase diversity in higher education including medical programs, citing benefits including training future public and private sector leaders. However, the recent US Supreme Court ending affirmative action in college admissions threatens advancements in the diversity of medical college faculty.

OBJECTIVE

Our study evaluated the demographic trends in Internal Medicine (IM) faculty in the US by assessing sex and race/ethnicity diversity to investigate who is likely to be impacted most with the end of affirmative action.

DESIGN

Longitudinal retrospective analysis SUBJECTS: IM faculty from the Association of American Medical Colleges faculty roster from 1966 to 2021 who self-reported sex and ethnicity MAIN OUTCOMES: The primary study measurement was the annual proportion of women and racial/ethnic groups among IM faculty based on academic rank and department chairs.

RESULTS

Although racial/ethnic diversity increased throughout the era of affirmative action, African American, Hispanic, and American Indian populations remain underrepresented. White physicians occupied > 50% of faculty positions across academic ranks and department chairs. Among the non-White professors, Asian faculty had the most significant increase in proportion from 1966 to 2021 (0.6 to 16.6%). The percentage of women increased in the ranks of professor, associate professor, assistant professor, and instructor by 19.5%, 27.8%, 25.6%, and 26.9%, respectively. However, the proportion of women and racial/ethnic minority faculty decreased as academic rank increased.

CONCLUSION

Despite an increase in the representation of women and racial/ethnic minority IM faculty, there continues to be a predominance of White and men physicians in higher academic ranks. With the end of affirmative action, this trend has the danger of being perpetuated, resulting in decreasing diversity among IM faculty, potentially impacting patient access and health outcomes.

Examining Diversity Recruitment Efforts in US-Based Physical Medicine and Rehabilitation Residencies: A Survey of Program Directors on Gender, Ethnic and Racial Diversity, and Implications for Recruitment Efforts

As the population of the United States continues to grow and diversify, it is critical that the medical profession follows. This study aimed to evaluate aspects of the current landscape of diversity within physical medicine and rehabilitation by surveying program directors of US-based physical medicine and rehabilitation residencies. The secondary aim was to identify program characteristics that correlate with more diverse residency classes. An online, cross-sectional 17-question survey was distributed to program directors of all US-based physical medicine and rehabilitation residencies with known contact information (95/100), with a completed survey response rate of 53% (50/95). Race and ethnicity categories of the survey were based on those used by the US Census. The percentages of individuals identifying as women or those underrepresented in medicine in this survey were below those of the general US population, a trend also seen within the field of physical medicine and rehabilitation overall. Linear regression revealed no statistically significant association between the percentage of underrepresented in medicine residents and commonly used diversity recruitment initiatives. There was a significant association between the presence of a departmental role for diversity, equity and inclusion and the percentage of women residents (odds ratio, 1.13; P = 0.017). Continued research is required to identify additional strategies with demonstrated efficacy in recruiting diverse residency applicants.

Advancing Diversity in Microbiology: A 55-Year Retrospective Analysis

Background For over 50 years, affirmative action helped advance equity, diversity and inclusion (EDI) in educational institutions in the United States (U.S.). However, the recent U.S. Supreme Court decision to end affirmative action in college admissions threatens the progress toward EDI. Objective This study aimed to assess the progress in promoting gender and racial diversity within the discipline of microbiology over a 55-year period. We sought to analyze the representation of women and minority groups in faculty ranks, tenure positions, and leadership to identify disparities and trends and determine who will likely be impacted most with the end of affirmative action. Materials and methods This longitudinal retrospective study utilized publicly available and non-identifiable Association of American Medical Colleges (AAMC) data on full-time microbiology faculty from 1967 to 2021. Faculty members were categorized based on academic ranks and tenure status, while gender and racial data were also considered. Results The analysis revealed a consistent dominance of white faculty, with over 60% representation across all academic ranks throughout the study period. The Asian and female faculty representation decreased in senior academic ranks. We observed a positive trend in the annual increase of women in faculty positions, academic ranks, chairs, and tenure positions. Furthermore, Asian faculty demonstrated the most robust surge in representation. However, disparities persisted for black, Hispanic, and Native American faculty members, reflecting broader challenges in their representation. Discussion Although efforts to enhance diversity within microbiology have yielded positive results, underrepresented minority groups still face obstacles in attaining leadership positions and senior academic ranks. The diminishing proportion of women at higher academic ranks raises concerns about potential attrition or lack of promotion opportunities. The end of affirmative action poses a risk of perpetuating this trend, leading to a decline in diversity among microbiology faculty.

Trends in gender, race, and ethnic diversity among prospective physical medicine and rehabilitation physicians

BACKGROUND

As the proportion of women and individuals who are underrepresented in medicine slowly rises, disparities persist in numerous arenas and specialties. In physical medicine and rehabilitation (PM&R), there is a continued need to focus on diversity among trainees. This study aims to evaluate diversity among PM&R applicants and residents over the past 6 years.

OBJECTIVE

To describe the demographic trends in PM&R over the last 6 years and compare those findings with trends in other specialties.

DESIGN

Surveillance.

SETTING

Analyses of national databases from self-reported questionnaires.

PARTICIPANTS

The study consists of 126,833 medical school matriculants, 374,185 resident applicants, and 326,134 resident trainees over the last 6 years.

MAIN OUTCOME MEASURES

Self-reported demographic data from the Association of American Medical Colleges and the Accreditation Council for Graduate Medical Education were analyzed for medical school matriculants, PM&R applicants, and current residents for the cycles of 2014-2015 to 2019-2020. The data were then comparatively reviewed between PM&R and other medical specialties.

RESULTS

In the 6 cycles evaluated, women accounted for 36%-39% of PM&R residents, but 47%-48% in non-PM&R specialties. Women applicants to the PM&R specialty averaged 34.4% over the 6 years analyzed, which was the fourth lowest of the 11 specialties examined. Black or African American and Hispanic, Latino, or of Spanish Origin populations each accounted for only 6% of PM&R residents. PM&R demonstrated a noticeably higher proportion of White (62.1% vs. 60.3%) and an observably lower proportion of Black or African American (6.0% vs. 7.1%) and Hispanic, Latino, or of Spanish Origin (6.3% vs. 7.9%) residents compared with non-PM&R specialties.

CONCLUSION

There is underrepresentation of women and multiple racial and ethnic minority groups in the field of PM&R from applicants to trainees demonstrating a need to improve recruitment efforts.

Training Characteristics, Academic Accomplishments, and Motivation of Current Program Directors in Physical Medicine and Rehabilitation

ABSTRACT

This study aimed to report the training characteristics, academic accomplishments, and motivation of current US academic physical medicine and rehabilitation program directors.A 22-question survey was developed and disseminated via email in May 2020 to 91 current residency program directors who are members of the Association of Academic Physiatrists Residency Fellowship Program Director Committee. Follow-up emails were sent 2 and 4 wks after initial distribution, and the survey was closed after 6 wks in June 2020. Data collected were deidentified. Descriptive analysis was performed.Response rate was 49.5% (45/91); 64.4% of program directors were men, and 35.6% were women. Of the respondents, 75.4% were White/Caucasian, 6.7% were Hispanic/Latinx, 15.6% were Asian, and 2.2% were Black/African American. Moreover, 56% (9/16) of female program directors vs. 0% (0/29) of male program directors reported experiencing sex discrimination in the workplace.Four percent of program directors were full professors in physical medicine and rehabilitation when first appointed, 17% were associate professors, and 72% were assistant professors. Thirty-four percent of program directors had at least six peer-reviewed publications when first appointed.This survey provides insight to the training characteristics, accomplishments, and motivation of current program directors for physiatrists aspiring to enter these ranks and highlights the underrepresentation of women/minorities among leadership positions in physical medicine and rehabilitation.

Analysis of physician recipients of recognition awards from the American Academy of Physical Medicine and Rehabilitation by Race and Ethnicity

BACKGROUND

Medical society recognition awards are important resources for physicians in advancing their careers. There is a need to better understand the representation of physician recipients by race and ethnicity, especially in women with intersectional identities.

OBJECTIVE

To assess the proportions of American Academy of Physical Medicine and Rehabilitation (AAPM&R) award recipients by race and ethnicity and the intersection of gender.

DESIGN

Cross-sectional and retrospective study.

SETTING AND METHODS

One hundred seven (n = 107) published online physician award recipients from 2011 to 2020 were categorized by race, ethnicity, and gender by two independent researchers. There was 100% interrater agreement on race and gender and 95% on ethnicity. Data were analyzed with descriptive analysis and multilinear regression.

MAIN OUTCOME MEASUREMENTS

Awards given to physicians coded by race (White/Caucasian, Asian, and Black/African American), ethnicity (Hispanic/Latino), and the intersection of gender with race and ethnicity were analyzed. The primary comparator was proportions by race, ethnicity, and gender of academic physicians in physical medicine and rehabilitation (PM&R) using Association of American Medical Colleges (AAMC) data. A secondary aim was recipients' proportions compared to AAMC benchmarks for all practicing physiatrists.

RESULTS

There were no significant differences in representation of award recipients by race or ethnicity compared to the primary comparator of their percentages in academic PM&R. Notably, 96.3% of awards were given to physicians identified as being in or having been in academic medicine. Secondary analysis of award recipients to all practicing physiatrists revealed significant underrepresentation of recipients who were coded as (1) White/Caucasian women, Asian men and women, Black/African American men and women (p = .016), and (2) Hispanic/Latino men and women (p = .028).

CONCLUSIONS

This is a novel study assessing race and ethnicity in physician recognition awards presented by a medical society. No significant disparities were found among recipients as compared to representation in academic PM&R. However, there were significant disparities when compared to all practicing physiatrists. These findings deserve further investigation and consideration as medical societies strive to equitably support all members.

Challenges and Opportunities in Academic Physiatry: An Environmental Scan

ABSTRACT

Environmental scans determine trends in an organization's or field's internal and external environment. The results can help shape goals, inform strategic decision making, and direct future actions. The Association of Academic Physiatrists convened a strategic planning group in 2020, composed of physiatrists representing a diversity of professional roles, career stages, race and ethnicity, gender, disability status, and geographic areas of practice. This strategic planning group performed an environmental scan to assess the forces, trends, challenges, and opportunities affecting both the Association of Academic Physiatrists and the entire field of academic physiatry (also known as physical medicine and rehabilitation, physical and rehabilitation medicine, and rehabilitation medicine). This article presents aspects of the environmental scan thought to be most pertinent to the field of academic physiatry organized within the following five themes: (1) Macro/Societal Trends, (2) Technological Advancements, (3) Diversity and Global Outreach, (4) Economy, and (5) Education/Learning Environment. The challenges and opportunities presented here can provide a roadmap for the field to thrive within the complex and evolving healthcare systems in the United States and globally.

Trends in Racial and Gender Profiles of United States Academic Emergency Medicine Faculty: Cross-Sectional Survey From 2007 to 2018

BACKGROUND

Numerous studies have reported existing disparities in academic medicine. The purpose of this study was to assess racial and gender disparity in academic emergency medicine (EM) faculty positions across the United States from 2007 to 2018.

OBJECTIVE

The primary objective was to identify the racial and ethnic and gender distributions across academic ranks in EM. The secondary objective was to describe the racial and gender proportions across different tenure tracks and degrees.

METHODS

We conducted a retrospective analysis using data from the Association of American Medical Colleges. Simple descriptive statistics and time series analysis were employed to assess the trends and relationship between race and gender across academic rank, type of degree, and tenure status.

RESULTS

When averaged, 75% of all faculty members were White physicians and 67.5% were male. Asian faculty members showed an increased representation in the lower academic ranks and underrepresented minority groups demonstrated a small increase. Asian faculty members demonstrated a significantly increasing trend at the level of instructor (t = 0.02; p = 0.034; 95% CI 0.05-1.03). Female faculty members showed a significantly decreasing trend over the study period (t = -0.01; p < 0.001; 95% CI 0.68-0.75). White academic physicians and male faculty members made up most of all degree types and tenure categories.

CONCLUSIONS

Despite an increase in proportional representation, the underrepresentation of female faculty members and those from minority groups persists in emergency medicine. Further studies are needed to identify and address the root causes of these differences.

Training Characteristics, Academic Accomplishments, and Motivation of Current Chairs in Physical Medicine and Rehabilitation

OBJECTIVE

The aim of the study was to report the training characteristics, academic accomplishments, and motivation of current United States academic physical medicine and rehabilitation chairs.

DESIGN

The authors developed a 23-question survey that was disseminated via e-mail to 86 current chairs who were members of the Chairs Council from the Association of Academic Physiatrists in May 2020. Follow-up e-mails were sent 2 and 4 wks after the initial distribution, and the survey closed after 6 wks in June 2020. The data collected were deidentified. Descriptive analysis was performed.

RESULTS

Forty-nine chair responses were received, which had a response rate of 60%. A total of 69.4% of the chairs (32 of 49) were men and 30.6% (17 of 49) were women. A total of 75.5% (37 of 49) were White/Caucasian, 12.2% (6 of 49) Hispanic/Latinx, 10.2% (5 of 49) Asian, and 2% (1 of 49) were Black/African American. A total of 8.2% of the chairs (4 of 49) reported having a disability. Sixty-seven percent of the female chairs (10 of 15) reported experiencing gender discrimination in the workplace versus 3% of male chairs (1 of 34). Twenty-nine percent of the chairs were full professors in physical medicine and rehabilitation when first appointed, 57.1% associate professors, and 6% assistant professors. A total of 73.5% of the chairs had served as a reviewer for a peer-reviewed publication. Fifty-two percent of the chairs had a leadership role in a national physical medicine and rehabilitation organization. Fifty-eight percent of the chairs had at least 16 peer-reviewed publications when first appointed.

CONCLUSIONS

This survey provides insight to the training characteristics, accomplishments, and motivation of current chairs for physiatrists aspiring to enter these ranks. It also highlights the underrepresentation of women and minorities among leadership positions in physical medicine and rehabilitation.

Diversity and Inclusion in Internal Medicine Training Programs: An Unfulfilled Dream

Background

Promoting a diversified healthcare force fosters more culturally centered care, expands the approach to high-quality healthcare for poorly served populations, improves patient contentment, and broadens research agendas, all components essential to minimize healthcare imbalances. Our study reviews the trends of gender and racial disparity in Internal Medicine residency programs.

Methodology

In this retrospective analysis, we extracted data from the Accreditation Council for Graduate Medical Education’s annual Data Resource Books from 2007 to 2019. Gender was reported as males and females. Race/ethnicity was cataloged as White/non-Hispanic, Black/non-Hispanic, Hispanic, Asian or Pacific Islander, Native American/Alaskan, others, and unknown.

Results

The representation of women increased progressively, with a relative increase of 4.7% from 2007 to 2019. For race/ethnicity, the study period started from the year 2011. When averaged across the eight-year study period, 27% of the study sample were White (non-Hispanic), followed by Asian/Pacific Islanders at 21%. The representation of other races was even lower. For 36.2% of the residents, the racial data were not known and categorized as unknown racial distribution.

Conclusions

Our study reports that gender and racial/ethnic imbalance persists within the training programs of Internal Medicine. Effectual strategies should be implemented to improve access to care to the underrepresented communities, address physician shortages in different areas of the country, and strengthen our ability to address long-established disparities in healthcare and outcomes.

Gender and Racial Trends Among Vascular Neurology Fellowship Programs: By Design or By Default

Introduction Benefits of increasing diversity in teams include the addition of different perspectives leading to increased innovation and creativity, faster problem solving, improved workforce morale, and reduced burnout leading to improved patient outcomes. This article reviewed the trend of gender and racial disparity in vascular neurology fellowship programs. Methods We retrospectively analyzed the data extracted from the Accreditation Council for Graduate Medical Education (ACGME)'s annual Data Resource Books from 2007 to 2019. ACGME cataloged gender as men and women and race/ethnicity was categorized as White/Non-Hispanic, Asian or Pacific Island, Hispanic, Black/Non-Hispanic, Native American/Alaskan, others, and unknown. Counts, proportions, relative, and absolute percentage changes were calculated to highlight trends in resident appointments over time and across the specialty of vascular neurology. Results The representation of females increased steadily; with a relative increase of 11.78% from the year 2007 to 2019. Race/ethnicity was reported starting from the year 2011. When averaged across the nine-year study period, 35% of the study sample was White (Non-Hispanic), followed by Asian/Pacific Islanders at 25%. The representation of Hispanics was 4.8%, Black/African Americans were 3%, Native Americans/ Alaskans were 0.23% and Others were 13% of the total study population. For 17.7% of the fellows, racial data were not known and was categorized as Unknown racial distribution. Conclusion Our study concludes that gender and racial disparity persists within the fellowship programs of vascular neurology. Effective strategies at individual, administrative, and national levels are needed to engage women and under-represented minorities in vascular neurology as a career choice.