Representation of women among medical school faculty improves, but work still needed
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Representation of women in medical school faculty improved between 1990 and 2019, according to study results published in JAMA Network Open.
However, only modest increases occurred for representation of Black faculty, and representation of Hispanic faculty decreased, researchers noted.
“My colleagues and I conducted an earlier study first looking at representation across different medical school departments and saw an increasing trend among underrepresented groups, such as Black and Hispanic faculty,” Alexander Yoo, MD, neurologist in the department of neurology and the division of sleep medicine at Center for Sleep and Circadian Neurobiology at the University of Pennsylvania Perelman School of Medicine, told Healio. “We observed substantial variation between departments, and it occurred to us that there was likely significant variability across institutions. We haven’t come far in understanding what resources and strategies are most important in recruiting and retaining underrepresented faculty. We thought that an important first step would be to identify the range of success across medical schools and show what factors seemed to be associated with that success.”
Faculty assessment
Yoo and colleagues pooled data on sex, race and ethnicity from faculty rosters across U.S. allopathic medical schools that participated in the Association of American Medical Colleges (AAMC) Faculty Administrative Management Online User System between 1990 and 2019.
Researchers used decennial census data for years 1990, 2000 and 2010, and intercensal estimates for all other years between 1990 and 2019.
Trends and variability in representation quotient served as main outcomes.
Representation quotients
Results showed that the number of AAMC member institutions increased from 121 (72,076 faculty) in 1990 to 144 (184,577 faculty) in 2019, and median representation quotient of women faculty increased from 0.42 (interquartile range [IQR], 0.37-0.46) to 0.8 (IQR, 0.74-0.89).
Researchers observed a widening of institutional distribution for the proportion of women faculty between 1990 (IQR, 18.7-23.9) and 2019 (IQR, 38.3-45). They observed the same for underrepresented minorities in 1990 (IQR, 2.8-5.6) and 2019 (IQR, 6.4-11.1).
Further, only 14.9% of 121 institutions exceeded the representation quotient for women of 0.5 in 1990 compared with all institutions that exceeded this by 2019.
Yet, only 7.6% of institutions achieved representation quotients of 1 or greater for women faculty. Median absolute change in representation quotient for women faculty was 0.37 (IQR, 0.29-0.43).
Results also showed associations between high county-based representation quotient for women in 2019 and urban campus setting (0.82; IQR, 0.75-0.9; P = .04), west U.S. region (0.88; IQR, 0.81-0.98; P = .005) and high representation quotient for women in 1990 (0.85; IQR, 0.74-0.96; P = .01).
“There was little difference in the metrics for women, which makes sense, as the proportion of women residents within a given county is far more likely to be stable and have much less intercounty variation compared with underrepresented groups,” Yoo said.
Researchers also observed a slight increase in median representation quotient of Black faculty from 0.1 (IQR, 0.06-0.22) to 0.22 (IQR, 0.14-0.41), and a median decrease in representation quotient of Hispanic faculty from 0.44 (IQR, 0.19-1.22) to 0.34 (IQR, 0.23-0.62) between 1990 and 2019.
“We tried to get a sense of what institutional characteristics might be associated with high or low representation quotient. What stood out was that institutions with a better U.S. News & World Report ranking appeared associated with a low representation quotient,” Yoo said. “This was counterintuitive because these institutions tend to have larger faculty rosters, such as more faculty mentors, and greater funding. When we looked into it a bit more, we found that the confounding variable was county diversity.”
These medical schools tended to be in highly diverse cities and may have had low representation quotients because changes in county demographics were far outpacing changes on a faculty level, Yoo continued.
“This emphasizes that institutions may face unique challenges in achieving their representational goals and may need to develop recruitment and retention strategies with these factors in mind,” he said.
Looking ahead
There remains much work to be done, Yoo told Healio.
“Equitable representation in the physician workforce as a whole is a critical piece to the health inequities problem. Prioritizing this goal in academic medicine may expedite our understanding of the problem and therefore facilitate the formation of holistic strategies to address the issue,” he said.
As far as next steps are concerned, elaboration of the ‘why’ and ‘when’ are needed, Yoo continued.
“For example, it would be helpful to identify the major times in training and early career when women and individuals of underrepresented groups are diverted away from pursuing a career in academic medicine,” he said. “[These] data could provide strategic insights for academic leadership, which according to our findings, are needed.”
For more information:
Alexander Yoo, MD, can be reached at yooal@pennmedicine.upenn.edu.
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