Study: Academic leadership appears to be more diverse in PC vs. surgical specialties
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Key takeaways:
- Academic leadership was more diverse in primary care than surgical specialties.
- More members of underrepresented populations in academic medicine leadership selection committees could help reduce disparities.
Those in academic medical leadership positions tended to be more diverse in primary care compared with surgical subspecialties, according to the results of research published in JAMA Network Open.
“Discussions surrounding the lack of diversity within medicine began in 1977 when the [Association of American Medical Colleges (AAMC)] put forth a report, 'Black Underrepresentation in U.S. Medical Schools.' However, now, over 45 years later, the growth of a diverse and culturally representative health care workforce continues to be less than ideal,” Charles S. Day, MD, MBA, system medical director of value-based specialty care at Henry Ford Health and a professor of orthopedic surgery at Michigan State University College of Human Medicine and Wayne State University School of Medicine, told Healio.
Day noted that in other industries, diversity in leadership translates to diversity in the broader workforce. He and his colleagues conducted a cross-sectional study "to see what the current diversity makeup is of leadership in academic medicine across eight different subspecialties."
The researchers collected demographic data from specialized reports from the AAMC, covering four surgical specialties (general surgery, otolaryngology, neurologic surgery and orthopedic surgery) and four primary care specialties (family medicine, internal medicine, OB/GYN and pediatrics). The analysis included 186,210 physicians in various academic leadership roles — chairpersons, faculty and program directors — in 2007, 2019 and 2020.
When comparing chairperson diversity from 2007 to 2019, Day and colleagues found that only general surgery and internal medicine saw significant increases in the representation of those from historically underrepresented racial populations. Specifically, the percentage of chairpersons who self-identified as anything other than non-Hispanic white increased from 13.5% to 26.5% in general surgery (a 96% increase) and 13% to 24.7% in internal medicine (a 90% increase).
However, during this period, several specialties saw significant increases in female representation:
- OB/GYN by 53.2%;
- pediatrics by 83.1%;
- family medicine by 107.4%;
- general surgery by 226.9%; and
- orthopedic surgery by +4.1 percentage points.
Day said that, in general, they “found that surgical specialty program directors were less diverse than nonsurgical specialties with regard to ethnicity, race and sex.”
“In order to reduce these disparities, one potential step toward a solution could involve the incorporation of a representative proportion of African American, Hispanic, Asian and female members into academic medicine leadership selection committees,” Day said. “Additionally, having the highest-level leaders in academic health care systems actively promote the importance of recruiting for leadership diversity. Lastly, having greater transparency in the selection process for all faculty to understand could aid in combating these disparities.”
Perspective
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This study is an important reminder that the higher up in a leadership role, the less likely there is to be diversity, both in terms of ethnicity and gender. Intentional effort should be made to address this and bridge the gaps currently highlighted. Transparency is one key component, and the concept of top-down diversification may also address these diversity gaps. Furthermore, the researchers' suggestion to encourage leaders of health care systems to actively promote leadership diversity is both realistic and promising — the question will be how exactly they can take steps to do so.
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