Representation of Women and Underrepresented Groups in US Academic Medicine by Specialty.
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ABSTRACT:
SUBMITTER: Yoo A
PROVIDER: S-EPMC8406079 | biostudies-literature | 2021 Aug
REPOSITORIES: biostudies-literature
Publications
Representation of Women and Underrepresented Groups in US Academic Medicine by Specialty.
Yoo Alexander A George Benjamin P BP Auinger Peggy P Strawderman Emma E Paul David A DA
JAMA network open 20210802 8
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Project description:BackgroundWomen are underrepresented within internal medicine (IM). Whether women leaders attract women trainees is not well explored.ObjectiveTo characterize leader and trainee gender across US academic IM and to investigate the association of leader gender with trainee gender.DesignCross-sectional study.ParticipantsLeaders (chairs, chiefs, program directors (PDs)) in 2018 and trainees (residents, fellows) in 2012-2016 at medical school-affiliated IM and seven IM fellowship programs.ExposureLeadership (chair/chief and program director; and, for resident analyses, fellow) gender.Main measuresOur primary outcome was percent women trainees (IM residents and, separately, subspecialty fellows). We used standard statistics to describe leadership and trainee gender. We created separate multivariable linear regressions to evaluate associations of leader gender and percent women fellows with percent women IM residents. We then created separate multivariable multilevel models (site as a random effect) to evaluate associations of leader gender with percent women subspecialty fellows.Key resultsOur cohort consisted of 940 programs. Women were 13.4% of IM chairs and <25% of chiefs in each fellowship subspecialty (cardiology: 2.6%; gastroenterology: 6.6%; pulmonary and critical care: 10.7%; nephrology: 14.4%; endocrinology: 20.6%; hematology-oncology: 23.2%; infectious diseases: 24.3%). IM PDs were 39.7% women; fellowship PDs ranged from nearly 25% (cardiology and gastroenterology) to nearly 50% (endocrinology and infectious disease) women. Having more women fellows (but not chairs or PDs) was associated with having more women residents (0.3% (95% CI: 0.2-0.5%) increase per 1% fellow increase, p<0.001); this association remained after adjustment (0.3% (0.1%, 0.4%), p=0.001). In unadjusted analyses, having a woman PD (increase of 7.7% (4.7%, 10.6%), p<0.001) or chief (increase of 8.9% (4.6%, 13.1%), p<0.001) was associated with an increase in women fellows; after adjustment, these associations were lost.ConclusionsWomen held a minority of leadership positions in academic IM. Having women leaders was not independently associated with having more women trainees.
| S-EPMC9126637 | biostudies-literature
Project description:BackgroundThough the USA is becoming increasingly diverse, the physician workforce contains a disproportionately low number of physicians from racial and ethnic groups that are described as underrepresented in medicine (URiM). Mentorship has been proposed as one way to improve the retention and experiences of URiM physicians and trainees. The objective of this systematic review was to identify and describe mentoring programs for URiM physicians in academic medicine and to describe important themes from existing literature that can aid in the development of URiM mentorship programs.MethodsThe authors searched PubMed, PsycINFO, ERIC, and Cochrane databases, and included original publications that described a US mentorship program involving academic medical doctors at the faculty or trainee level and were created for physicians who are URiM or provided results stratified by race/ethnicity.ResultsOur search yielded 4,548 unique citations and 31 publications met our inclusion criteria. Frequently cited objectives of these programs were to improve research skills, to diversify representation in specific fields, and to recruit and retain URiM participants. Subjective outcomes were primarily participant satisfaction with the program and/or work climate. The dyad model of mentoring was the most common, though several novel models were also described. Program evaluations were primarily subjective and reported high satisfaction, although some reported objective outcomes including publications, retention, and promotion. All showed satisfactory outcomes for the mentorship programs.DiscussionThis review describes a range of successful mentoring programs for URiM physicians. Our recommendations based on our review include the importance of institutional support for diversity, tailoring programs to local needs and resources, training mentors, and utilizing URiM and non-URiM mentors.
| S-EPMC7852467 | biostudies-literature
Project description:ImportanceAsian American individuals are not underrepresented in medicine; however, aggregation in prior workforce analyses may mask underlying disparities.ObjectiveTo assess representation by Asian race and disaggregated subgroups in the US allopathic medical school workforce.Design, setting, and participantsThis cross-sectional study used Association of American Medical Colleges (AAMC) special reports, generated using the AAMC Applicant-Matriculant Data File, Student Records System, Graduate Medical Education Track Survey, and faculty roster. Participants included medical school applicants, matriculants, graduates, residents, and faculty enrolled or employed at US allopathic medical schools between 2013 and 2021. Data were analyzed between March and May 2024.ExposureAsian race or ethnic subgroup as per AAMC and US Census Bureau Office of Management and Budget criteria, including Bangladeshi American, Cambodian American, Chinese American, Filipino American, Indian American, Indonesian American, Japanese American, Korean American, Pakistani American, Taiwanese American, and Vietnamese American.Main outcomes and measuresRepresentation quotients (RQ) were used to indicate representation that was equivalent (RQ of 1), higher (RQ greater than 1), or lower (RQ less than 1) than expected representation based on US population estimates. One-way analysis of variance and linear regression models assessed mean RQ differences by career stage and over time, with Bonferroni correction for multiple comparisons.ResultsIn this study, Asian American individuals accounted for 94 934 of 385 775 applicants (23%), 39 849 of 158 468 matriculants (24%), 37 579 of 152 453 graduates (24%), 229 899 of 1 035 512 residents (22%), and 297 413 of 1 351 187 faculty members (26%). The mean (SD) RQ was significantly greater among Asian American residents (3.44 [0.15]) and faculty (3.54 [0.03]) compared with Asian applicants (3.3 [0.04]), matriculants (3.37 [0.03]), or graduates (3.31 [0.06]). Upon disaggregation, RQ was significantly lower among residents and faculty in 10 of 12 subgroups. Although subgroups, such as Taiwanese American, Indian American, and Chinese American, had RQs greater than 1 (eg, Chinese American graduates: mean [SD], RQ, 3.90 [0.21]), the RQs were less than 1 for Laotian, Cambodian, and Filipino American subgroups (eg, Filipino American graduates: mean [SD], RQ, 0.93 [0.06]) at almost every career stage. No significant RQ changes were observed over time for Laotian American and Cambodian American trainees, with a resident RQ of 0 in 8 of 25 and 4 of 25 specialties, respectively. Faculty RQ increased in 9 of 12 subgroups, but Cambodian American, Filipino American, Indonesian American, Laotian American, and Vietnamese American faculty (eg, Vietnamese American faculty: mean [SD], RQ, 0.59 [0.08]) had RQs less than 1.Conclusions and relevanceIn this cross-sectional study of Asian representation in US allopathic medical schools, Laotian American, Cambodian American, and Filipino American individuals were underrepresented at each stage of the physician workforce pathway. Efforts to promote diversity in medicine should account for these disparities to avoid perpetuating inequities.
| S-EPMC11577148 | biostudies-literature
Project description:BackgroundThe Training in Research for Academic Neurologists to Sustain Careers and Enhance the Numbers of Diverse Scholars (TRANSCENDS) program is a career advancement opportunity for individuals underrepresented in biomedical research, funded by the National Institute and Neurological Disorders and Stroke; and American Academy of Neurology (AAN).ObjectiveTo report on qualitative and quantitative outcomes in TRANSCENDS.DesignEarly career individuals (neurology fellows and junior faculty) from groups underrepresented in medicine were competitively selected from a national pool of applicants (2016-2019). TRANSCENDS activities comprised an online Clinical Research degree program, monthly webinars, AAN meeting activities, and mentoring. Participants were surveyed during and after completion of TRANSCENDS to evaluate program components.OutcomesOf 23 accepted scholars (comprising four successive cohorts), 56% were women; 61% Hispanic/Latinx, 30% Black/African American, 30% assistant professors. To date, 48% have graduated the TRANSCENDS program and participants have published 180 peer-reviewed articles. Mentees' feedback noted that professional skills development (i.e., manuscript and grant writing), networking opportunities, and mentoring were the most beneficial elements of the program. Stated opportunities for improvement included: incorporating a mentor-the-mentor workshop, providing more transitional support for mentees in the next stage of their careers, and requiring mentees to provide quarterly reports.ConclusionsTRANSCENDS is a feasible program for supporting underrepresented in medicine neurologists towards careers in research and faculty academic appointments attained thus far have been sustained. While longer term outcomes and process enhancements are warranted, programs like this may help increase the numbers of diverse academic neurologists, and further drive neurological innovation.
| S-EPMC8302150 | biostudies-literature
Project description:ObjectiveDetermine representation by gender for individual recognition awards presented to physicians by the Association of Academic Physiatrists (AAP).DesignCross-sectional survey was used. Lists of individual recognition award recipients for the 27-yr history of the AAP awards (1990-2016) were analyzed. The primary outcome measures were the total numbers of men versus women physician award recipients overall and for the past decade (2007-2016).ResultsNo awards were given to women physicians for the past 4 yrs (2013-2016) or in half of the award categories for the past decade (2007-2016). No woman received the outstanding resident/fellow award since its inception (2010-2016). There was a decrease in the proportion of awards given to women in the past decade (2007-2016, 7 of 39 awards, 17.9%) as compared with the first 17 yrs (1990-2006, 10 of 46 awards, 21.7%). Furthermore, compared with their proportional membership within the specialty, women physicians were underrepresented for the entire 27-yr history of the AAP awards (1990-2016, 17 of 85 awards, 20%). According to the Association of American Medical Colleges, the proportion of full-time female physical medicine and rehabilitation faculty members was 38% in 1992 and 41% in 2013.ConclusionsWomen physicians have been underrepresented by the AAP in recognition awards. Although the reasons are not clear, these findings should be further investigated.
| S-EPMC5757674 | biostudies-literature
Project description:PurposeAcademic medicine faces difficulty recruiting and retaining a diverse workforce. The proportion of medical students who are underrepresented in medicine (URiM) is smaller than the proportion of URiM's in the general population, and these numbers worsen with each step up the academic medicine ladder. Previously known as the "leaky pipeline," this phenomenon may be better understood as disparate "pathways with potholes," which acknowledges the different structural barriers that URiM trainees and faculty face in academic medicine. This critical scoping review analyzed current literature to determine what variables contribute to the inequitable "pathways and potholes" URiM physicians experience in academic medicine.MethodThe authors combined scoping review methodology with a critical lens. The comprehensive search strategy used terms about academic medicine, underrepresented groups, and leaving academic medical careers. One reviewer conducted screening, full text review, and data extraction while in consultation with members of the research team. Data extraction focused on themes related to pathways and potholes, such as attrition, recruitment, and retention in academic medicine. Themes were iteratively merged, and quality of contribution to the field and literature gaps were noted.ResultsIncluded papers clustered into attrition, recruitment, and retention. Those pertaining to attrition noted that URiM faculty are less likely to get promoted even when controlling for scholarly output, and a hostile work environment may exacerbate attrition. Recruitment and retention strategies were most effective when multi-pronged approaches changed every step of the recruitment and promotion processes.ConclusionsThese studies provide examples of various "potholes" that can affect representation in academic medicine of URiM trainees and faculty. However, only a few studies examined the link between isolating and hostile work environments, the so-called "chilly climate," and attrition from academic medicine. Understanding these concepts is key to producing the most effective interventions to improve diversity in medicine.
| S-EPMC10834859 | biostudies-literature
Project description:IntroductionUrinary incontinence (UI) in women is a global public health issue. However, there is a limited understanding of the experience of women from underrepresented groups suffering from UI. The purpose of this systematic review was to examine current evidence regarding the experience of women with UI from these groups.MethodologyA systematic search was undertaken to retrieve research studies that answered the research question. Four qualitative research studies were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review.ResultsFour themes emerged from this review: the perceived origin of UI, the physical, psychological, and social impact of UI, the impact of culture and religion on UI, and vice versa, and the interaction of women with health services.DiscussionSocial determinants of health, such as religion and culture, need to be considered by professionals providing care if women from underrepresented groups experiencing UI are to receive optimal care.
| S-EPMC10265309 | biostudies-literature
Project description: Not available
| S-EPMC9577044 | biostudies-literature
Project description:BackgroundGender stereotypes in science impede supportive environments for women. Research suggests that women's perceptions of these environments are influenced by stereotype threat (ST): anxiety faced in situations where one may be evaluated using negative stereotypes. This study developed and tested ST metrics for first time use with junior faculty in academic medicine.MethodsUnder a 2012 National Institutes of Health Pathfinder Award, Stanford School of Medicine's Office of Diversity and Leadership, working with experienced clinicians, social scientists, and epidemiologists, developed and administered ST measures to a representative group of junior faculty.Results174 School of Medicine junior faculty were recruited (62% women, 38% men; 75% assistant professors, 25% instructors; 50% white, 40% Asian, 10% underrepresented minority). Women reported greater susceptibility to ST than did men across all items including ST vulnerability (p < 0.001); rejection sensitivity (p = 0.001); gender identification (p < 0.001); perceptions of relative potential (p = 0.048); and, sense of belonging (p = 0.049). Results of career-related consequences of ST were more nuanced. Compared with men, women reported lower beliefs in advancement (p = 0.021); however, they had similar career interest and identification, felt just as connected to colleagues, and were equally likely to pursue careers outside academia (all p > 0.42).ConclusionsInnovative ST metrics can provide a more complete picture of academic medical center environments. While junior women faculty are susceptible to ST, they may not yet experience all of its consequences in their early careers. As such, ST metrics offer a tool for evaluating institutional initiatives to increase supportive environments for women in academic medicine.
| S-EPMC4790213 | biostudies-literature
Project description:BackgroundMentorship and research experiences are crucial for STEMM career entry and advancement. However, systemic barriers have excluded people from historically underrepresented groups.MethodsIn 2021, a virtual "matchmaking event" was held to connect NIH-funded research mentors with historically underrepresented trainees and initiate mentored research experiences. Survey data collected over 12 months was analyzed to evaluate the program's success considering the number of mentor-trainee connections, mentor-trainee research experience matches, and NIH diversity supplement application status. Statistical tests, including student's t-test, ANCOVAs, and chi-square tests, evaluated differences between attendee groups and survey time points.ResultsOut of 314 mentors contacted and 99 registered trainees, 113 mentors and 92 trainees participated. Among mentors (n = 73), 53% identified as women, 56% as non-Hispanic white, and a majority (81%) reported being the first in their family to attend college. Among trainees (n = 79), about two-thirds (67%) identified as women, 47% identified as Hispanic/Latinx, and 15% identified as Black/African American. Both mentors and trainees were extremely satisfied with the overall event (57% and 69%, respectively) and would recommend it to others (74% and 90%, respectively). Most mentor participants established at least one mentor-trainee connection after the event (n = 64, 57%), a mentor-trainee research experience match (n = 40, 35%), and planned to submit an NIH diversity supplement (n = 31, 27%). Many trainees obtained paid positions through the mentor-trainee research experience. One year after the event, 11 trainees secured NIH diversity supplement funding with their mentors.ConclusionsThe matchmaking event began bridging a much-needed gap in the research pathway by creating opportunities for trainees to connect with mentors and obtain funded research opportunities.
| S-EPMC11744948 | biostudies-literature