Gender and Racial Representation Trends Among Internal Medicine Department Chairs from 2010-2020

Faculty diversity trends in physical medicine and rehabilitation by gender, race, and ethnicity in the United States, 1977-2021

BACKGROUND

This study describes the gender and racial/ethnic trends in academic physical medicine and rehabilitation (PM&R) and the shifts that have taken place in more than 4 decades.

OBJECTIVE

To gauge the diversity in gender and race/ethnicity across academic degrees, academic ranks, chair positions, and tenure status in the academic workforce of PM&R.

DESIGN

Surveillance study.

SETTING AND METHODS

The data for academic PM&R faculty were self-reported and obtained from the annual Faculty Roster report of the Association of American Medical Colleges from 1977 to 2021.

MAIN OUTCOME MEASURES

To compare the distribution of academic degree, rank, chair position, and tenure status over time, the percentage composition for each category was calculated for a period of 45 years. The temporal trends were depicted by plotting the counts and proportion changes, and the progress in terms of racial representation was illustrated by graphing the absolute changes in the percentage composition.

RESULTS

Despite an overall increase in the representation of women, women remained underrepresented in the full professor rank in 2021, at only 32.1% of full professors. The instructor category was the only category in which the proportion of women faculty was higher in 2021 (62.8%) than in 1977 (58.5%). Asian faculty had the greatest increase in representation at all ranks, with the proportion of Asian full professors increasing from 1.8% to 11.4%, associate professors increasing from 7.4% to 14.4%, and assistant professors increasing from 11.2% to 20.2%. Women's representation as department chairs increased from 12.5% to 23.7% and Asians from 2.5% to 15.3%.

CONCLUSION

Overall, although there was an increase in the number of women and underrepresented minority faculty in academic PM&R over the study period, disparities based on gender and ethnicity/race persisted, particularly in higher academic ranks and leadership positions.

Exploring Underrepresentation: The Role of Diversity Statements in Ophthalmology Residency Programs

INTRODUCTION

The underrepresentation of underrepresented minorities (URMs) in the medical field, particularly in ophthalmology, poses a critical challenge to achieving diversity and equity. While URMs constitute 19% of medical school attendees, their presence is markedly lower in ophthalmology residency programs and among practicing ophthalmologists. This study seeks to investigate the prevalence of diversity statements on ophthalmology residency program websites and their role in the underrepresentation of URMs within the field.

METHODS

This observational, cross-sectional study analyzed the websites of 126 ophthalmology residency programs listed on the San Francisco (SF) Match website. Diversity statements were categorized based on their inclusion of specific underrepresented groups (race or ethnicity, gender, sexual orientation, and disability) and analyzed for correlation with program characteristics. Descriptive statistics and Chi-squared tests were utilized to assess the prevalence of diversity statements and their association with program size, ranking, geographical location, and institutional nature.

RESULTS

Of the 126 programs analyzed, 21 (16.7%) had diversity statements specific to the ophthalmology residency program, and 115 (91.3%) featured institutional-level diversity statements. Race or ethnicity was the most commonly addressed category in diversity statements (75.3%), followed by gender (65.9%), sexual orientation (61.1%), and disability (53.2%). Statistical analyses revealed no significant correlation between program size and the presence of diversity statements. However, higher-ranked programs were more likely to mention sexual orientation and disability. Significant differences were observed at the institutional level, with public institutions more likely to include specific diversity categories.

CONCLUSION

The study highlights a significant disparity in the presence and focus of diversity statements across ophthalmology residency programs. Despite a high prevalence of institutional-level diversity statements, program-specific initiatives are lacking, particularly in addressing disability inclusion. The findings suggest a need for a more comprehensive and targeted effort to address underrepresentation in ophthalmology.

Leadership and Impostor Syndrome in Surgery

BACKGROUND

Impostor syndrome is an internalized sense of incompetence and not belonging. We examined associations between impostor syndrome and holding leadership positions in medicine.

STUDY DESIGN

A cross-sectional survey was distributed to US physicians from June 2021 to December 2021 through medical schools and professional organizations. Differences were tested with the chi-square test and t -test for categorical and continuous variables, respectively. Logistic regression was used to identify factors associated with holding leadership positions and experiencing impostor syndrome.

RESULTS

A total of 2,183 attending and retired physicians were included in the analytic cohort; 1,471 (67.4%) were in leadership roles and 712 (32.6%) were not. After adjustment, male physicians were more likely than women to hold leadership positions (odds ratio 1.4; 95% CI 1.16 to 1.69; p < 0.001). Non-US citizens (permanent resident or visa holder) were less likely to hold leadership positions than US citizens (odds ratio 0.3; 95% CI 0.16 to 0.55; p < 0.001). Having a leadership position was associated with lower odds of impostor syndrome (odds ratio 0.54; 95% CI 0.43 to 0.68; p < 0.001). Female surgeons were more likely to report impostor syndrome compared to male surgeons (90.0% vs 67.7%; p < 0.001), an association that persisted even when female surgeons held leadership roles. Similar trends were appreciated for female and male nonsurgeons. Impostor syndrome rates did not differ by race and ethnicity, including among those underrepresented in medicine, even after adjustment for gender and leadership role.

CONCLUSIONS

Female physicians were more likely to experience impostor syndrome than men, regardless of specialty or leadership role. Although several identity-based gaps persist in leadership, impostor syndrome among racially minoritized groups may not be a significant contributor.