Female minority medical graduates experience high rates of gender discrimination
Key takeaways:
- Most female minority medical graduates reported gender discrimination during medical training or practice in the U.S.
- Researchers recommend diverse gender and racial representation in every tier of leadership.
Female immigrant and Puerto Rican minority medical graduates experienced racial/ethnic and gender discrimination in the U.S. at higher rates than their male counterparts, according to study results presented at ASCO Annual Meeting.
The findings indicate a need for diversity in selection committees to overcome gender inequities and achieve gender equity pay transparency, researchers concluded.
“Large organizations, such as ASCO, have been working to promote equity and inclusion not only for gender, but also for racial and ethnic minorities by including representation on committees and in different leadership positions. Still, there’s much more work to be done, and it is not a ‘one size fits all’ to get there,” Coral Olazagasti, MD, assistant professor of medical oncology at Sylvester Comprehensive Cancer Center at University of Miami Miller School of Medicine, told Healio.
“There have been significant movements and improvements, but we have not come to a point yet where we have found exclusive equity across the field,” she said. “It is important to continue to have conversations and shed light on the challenges that we’re still facing as minorities and as women in order to keep making strides in this movement.”
Undercompensated and underpromoted
Women in medicine remain undercompensated and underpromoted, and not much is fully understood about the experiences of non-U.S. female physicians’ experience in the U.S., according to study background.
For this reason, Olazagasti and colleagues sought to examine gender disparities among immigrant medical graduates and Puerto Rican medical graduates in oncology in the U.S. Investigators distributed an anonymous online survey via Survey Monkey between September and December 2023 to all eligible non-U.S. immigrant medical graduates and Puerto Rican medical graduates who underwent training and/or practiced medicine independently in the U.S. They performed bivariate association analyses and used two-sample Wilcoxon test for ordered categorical variables, and used Fisher’s exact test for nominal categorical variables.
Gender, racial discrimination
The study included 97 immigrant and Puerto Rican medical graduates (49% women; 48% men).
According to study results, women reported a higher likelihood to move to the U.S. for family compared with men (22.4% vs. 6.2%; P = .04). Conversely, more men reported moving to the U.S. for financial gain (20.8% vs. 6.1%; P = .04), culture/tradition (65.3% vs. 43.8%; P = .042) and dress code (44.9% vs. 20.8%; P = .017).
Researchers found that women experienced higher rates of gender discrimination during training (53.2% vs. 4.5%; P < .001) and independent practice compared with men (57.6% vs. 3.6%; P < .001). Women also experienced higher rates of ethnic/racial discrimination during training (69.6% vs. 38.1%; P = .005).
“I was surprised to see the higher rates of gender and racial discrimination among women vs. men during both training and in independent practice,” Olazagasti said. “It was also surprising to find that the majority of participants, even those who experienced discrimination, reported an excellent experience during medical training.”
Overall, men reported an excellent experience with independent practice and women reported a good experience, she said.
“This shows how resilient we international medical graduates are as a community. Even though we face challenges, and have to change the way that we dress, speak or how we conduct ourselves, we still step up to the plate and enjoy our experience and do our work,” Olazagasti said. “That is something, too, that I didn’t take lightly from this study.”
Researchers also found that more women reported no plans to return to their home country (68.8% vs. 38.3%) whereas more men reported plans to return home at some point (38.3% vs. 16.7%). Of note, 18.8% of men and no women reported leadership opportunities as the reason for wanting to return to their home country (P = .001).
Changing the culture
Olazagasti recommended specific actions needed to change the culture and truly implement gender equity in medicine.
“For one, women deserve more opportunities in leadership positions,” she said. “Leadership positions are many times taken by older men who have been in the same position for 25 years or more. It’s important to implement a maximum limit of years that one can be in a leadership position so that others can have a chance to come in with fresh ideas. It is important to fill that gap in leadership with women and minorities.”
Work is also needed in the area of equal pay and pay transparency, according to Olazagasti.
“When men are paid more than women, this puts a message out into society that men are more valuable and more highly valued,” she said. “Unfortunately, to this day, issues with pay disparities still exist because there isn’t a system of transparency in terms of pay rates and salaries.
“There also remains a need to better amplify, sponsor and offer career opportunities to minority women, especially junior minority women, who are just starting out in their careers, as a way to promote their career development,” Olazagasti added.
“We need gender and racial representation in every tier of leadership because a diverse workforce will attract a diverse patient population, and that is going to positively impact not only the workforce, but also the outcomes of patients in general,” she said. “We also need men to be a part of the ‘He for She’ movement. We don’t need bystanders anymore, it’s time for men to become ‘action standers.’ We all need to come together to ensure gender equity. The time is now.”
Despite these challenges, Olazagasti said the culture in medicine is changing.
“The situation is getting better and there will be further improvement in the years to come,” she said. “My recommendation to the incoming generation is to keep going — do not get discouraged. Find your mentors, whether that’s in your institution or outside of your institution, who have similar career goals as you and who might look and speak like you so that you feel that you fit in the environment where you want to grow as a physician.”
Collapse
Olazagasti C, et al. Abstract 9011. Presented at: ASCO Annual Meeting; May 31-June 4, 2024; Chicago.