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Grand Rounds

Has Representation of Women and Minority Groups Among Medical Faculty Improved?

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BACKGROUND AND PURPOSE:

  • Increasing the number of women and other underrepresented groups in medicine (URMs) is a critical public health need, as increasing representation at the medical faculty level improves health care access, quality and research for women and URMs
  • Yoo et al. (JAMA Network Open, 2022) quantified the representation of women and URMs among US medical schools

METHODS:

  • Retrospective cross-sectional study
    • US allopathic medical schools participating in the Association of American Medical Colleges (AAMC) Faculty Administrative Management Online User System
    • 1990 to 2019
  • Study design
    • URMs assessed included including American Indian and Alaska Native, Black, Hispanic, and Native Hawaiian or other Pacific Islander
    • Data based on self-identification
  • Primary outcome
    • Trends and variability in representation quotient (RQ)
      • Defined as representation of a group (i.e., proportion of total faculty) within an institution’s faculty compared to its respective US county

RESULTS:

  • 1990: 121 AAMC member institutions (72,076 faculty) | 2019: 144 institutions (184,577 faculty)
  • Median RQ of women faculty increased by 1.4% per year
    • 1990: RQ 0.42 (IQR, 0.37 to 0.46)
    • 2019: RQ 0.80 (IQR, 0.74 to 0.89)
    • Slope +1.4% per year | P<0.001
  • The median RQ of Black faculty increased by 0.5% per year, but remained low in 2019
    • 1990: RQ 0.10 (IQR, 0.06 to 0.22)
    • 2019: RQ 0.22 (IQR, 0.14 to 0.41)
    • Slope +0.5% per year | P<0.001
  • The median RQ of Hispanic faculty decreased
    • 1990: RQ 0.44 (IQR, 0.19 to 1.22)
    • 2019: RQ 0.34 (IQR, 0.23 to 0.62)
    • Slope −1.7% per year | P<0.001
  • Absolute total change in RQ of URM showed an increase, but the 30-year slope did not differ from zero
    • Slope +0.1% per year | P=0.052
  • The RQ of women faculty increased for most institutions: 88.2%
  • Trends in RQ for URM faculty showed more variation across institutions
    • Increased RQ: 39.6% of institutions
    • Decreased RQ: 6.9% of institutions
  • Nearly one-quarter of institutions shifted from the top to bottom 50th percentile institutional ranking by URM RQ when shifting from a national to a county-based comparison

CONCLUSION:

  • Representation of women among US medical faculty has broadly improved since 1990, although representation of URMs has improved only modestly with a decrease among the Hispanic population
  • The authors state

The findings of this cross-sectional study suggest that little progress has been made in URM representation among medical school faculty when contextualized with matched regional demographics 

Learn More – Primary Sources:

Institutional Variability in Representation of Women and Racial and Ethnic Minority Groups Among Medical School Faculty

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