2 weeks Ago
Despite growing awareness, systemic barriers continue to limit the career progression of women and underrepresented minorities in academic medicine, underscoring the urgent need for equitable policies in healthcare education and leadership. Study: Race and Ethnicity, Gender, and Promotion of Physicians in Academic Medicine . Image Credit: Lordn / Shutterstock.
com A recent study published in JAMA Network Open examines the relationship between race, ethnicity, and gender and academic career progression among physicians in the United States. Data from medical graduates were obtained to investigate disparities in faculty appointments and promotions in an effort to understand and address inequities, particularly those impacting women and racial or ethnic minorities in medicine. Diversity in medicine Social research indicates that the medical academic workforce in the U.
S. is not reflective of the diversity of the general population. Underrepresentation of racial and ethnic minorities, such as Black, Hispanic, and Indigenous groups, remains evident in medical schools and faculty roles.
Furthermore, women, especially those from minority backgrounds, face significant barriers to promotion as compared to their male colleagues. Despite increasing awareness, these disparities persist and may be influenced by systemic biases and unequal opportunities. Diversity among healthcare professionals is linked to improved patient outcomes and satisfaction, particularly when care providers share similar backgrounds with patients.
Gaps in career advancement opportunities in academic medicine for underrepresented groups have prevented the fostering of equitable healthcare. Although some studies have explored factors influencing faculty diversity, few have examined how intersectional identities, such as race and gender, jointly affect career progression. About the study The present cohort study analyzed data from U.
S. medical school graduates between 1979 and 2019 provided by the Association of American Medical Colleges, as well as faculty appointment records between 2000 and 2021. Academic appointments and promotions were evaluated across career stages from instructor to department chair, covering the positions of assistant, associate, and full professor.
Self-reported data on gender and race/ethnicity were used to characterize the study participants into distinct categories, including White, Black, Asian, Hispanic, and other racial minorities. To investigate disparities, the Cox proportional hazards model, a statistical method designed to analyze time-to-event data like career promotions, was used. This approach also accounted for differences in observation periods and excluded data for individuals who had not been promoted or left academia.
Interactions between demographic factors such as gender, ethnicity, and race, as well as graduation cohorts, were explored and separated into pre-and post-2000 groups. Individuals without full-time faculty roles or sufficient follow-up data were excluded from the analysis. Appointments to the positions of instructor or assistant professor after graduation were considered entry-level roles, whereas promotions to higher ranks were defined as advancements within academia.
Department chair appointments were assessed as distinct leadership roles, often occurring outside of conventional promotion pathways. The researchers used a robust dataset and survival analysis techniques to identify patterns of inequality in career advancement. While adjustments for factors such as academic productivity were not available, the methodology ensured a detailed examination of demographic influences on promotion outcomes across multiple career stages.
Racial disparities persist in medical opportunities Significant disparities in career progression were observed within academic medicine in the U.S., with women and racial/ethnic minority groups often at a disadvantage.
Women of all racial groups and men from underrepresented minorities generally had lower promotion rates as compared to White men. Among faculty members, White men were consistently more likely to advance to higher ranks, including full professor and department chair positions. Before 2000, the likelihood of Black women being promoted to associate professor reaching full professorship was 55% and 41% lower, respectively, as compared to White men.
Similarly, Hispanic women and men also had reduced promotion rates. Asian men were an exception, often matching or exceeding White men in certain promotional categories, particularly after 2000. Some diversity improvements were observed in entry-level academic positions.
For example, Asian, Black, and White women were more likely than White men to be appointed to assistant professor roles; however, higher-rank promotions remained elusive for most minorities. Nevertheless, Black men were consistently more likely to become department chairs than White men, especially after 2000. Conclusions The study findings highlight the persistent inequities in academic medicine related to race and gender.
Promotion trends remained essentially unchanged over the study period, thus suggesting that systemic barriers in academic medicine prevail despite growing awareness of the need for equity. Addressing these inequities requires systemic changes to recruitment, evaluation, and promotion processes in academia. Enhancing diversity at all levels can also improve academic inclusivity and strengthen the healthcare workforce to better serve a diverse population.
Clark, L., Shergina, E., Machado, N.
, et al. (2024). Race and Ethnicity, Gender, and Promotion of Physicians in Academic Medicine.
JAMA Network Open 7 (11); e2446018–e2446018. doi:10.1001/jamanetworkopen.
2024.46018.
