In the past several years, the goal for better diversification of the physician workforce in the United States has become increasingly important. Despite this need, few assessments overall have examined diversity in graduate medical education (GME) and across specialties. To address this research gap, Curtiland Deville, MD, and colleagues had a research letter published in JAMA Internal Medicine that assessed differences in representation by female and historically underrepresented minority groups in medicine.
A Closer Look
For the investigation, the authors assessed GME diversity by race, ethnicity, and sex in using publicly reported 2012 data for the total GME pool. “This data was compared with the U.S. population, practicing physicians in the U.S., medical school graduates, and 20 of the largest residency training specialties,” says Dr. Deville.
The study team evaluated race, Hispanic ethnicity, and sex, which was defined by the U.S. Census. American Indians, Alaska Natives, Native Hawaiians, and Pacific Islanders were grouped together. Underrepresented minority groups in medicine included blacks, Hispanics, and the collective group of American Indians, Alaska Natives, Native Hawaiians, and Pacific Islanders.
According to the results, about 48% of medical school graduates were female, and approximately 15% were of underrepresented minority groups in medicine, including about 7% who were Hispanic and 7% who were black. Findings were similar for the more than 115,000 trainees in GME that were assessed in the study. Of the more than 688,000 practicing physicians involved in the analysis, about 30% were female and 9% were underrepresented minority groups in medicine.
“With the exception of Hispanic medical school graduates, who were similarly represented to Hispanic GME trainees, these groups were all underrepresented as trainees when they were compared with the U.S. population and medical school graduates,” says Dr. Deville.
The study also revealed that the percentage of female trainees was lowest for orthopedics and highest for pediatrics and obstetrics and gynecology. “Women also accounted for more than 50% of GME trainees in five other specialties, including dermatology, internal medicine/pediatrics, family medicine, pathology, and psychiatry,” Dr. Deville says. “The percentage of black trainees was lowest for otolaryngology and highest for family medicine and obstetrics and gynecology. For Hispanic trainees, percentages were lowest for ophthalmology and highest for psychiatry, family medicine, obstetrics and gynecology, and pediatrics.”
Continued Efforts Needed
Findings of the study indicate that there continues to be wide variation in diversity with regard to GME training and specialties. “We need to make greater efforts to increase the diversity of the physician workforce in the U.S.,” Dr. Deville says. “Our research can be used to help launch future investigations on the driving factors that lead women and underrepresented minority groups to be more or less likely to go into some fields rather than others.”
Deville C, Hwang WT, Burgos R, Chapman CH, Both S, Thomas Jr CR. Diversity in graduate medical education in the United States by race, ethnicity, and sex, 2012. JAMA Intern Med. 2015;175:1706-1708. Available at: http://archinte.jamanetwork.com/article.aspx?articleid=2429534.
Marrast LM, Zallman L, Woolhandler S, Bor DH, McCormick D. Minority physicians’ role in the care of underserved patients: diversifying the physician workforce may be key in addressing health disparities. JAMA Intern Med. 2014;174:289-291.
Iglehart JK. Diversity dynamics: challenges to a representative U.S. medical workforce. N Engl J Med. 2014;371:1471-1474.