Underrepresentation of underrepresented minorities in academic medicine: the need to enhance the pipeline and the pipe.

The number of underrepresented minorities (URMs; black or African American, Hispanic or Latino, American Indian or Alaska Native, Native Hawaiian or other Pacific Islander) among US medical school faculty is markedly low when compared with their respective percent representation of the US population. Women URMs are doubly underrepresented, particularly as the academic rank advances from the instructor to the professor level, and gender discrepancies occur more prominently among white female faculty. Although the percent of white faculty has decreased over the past 5 years, the low percentage of black and Hispanic faculty has not changed proportionately. Furthermore, the 2008-2009 pipeline of URM trainees is unlikely to reverse the current trends. Several measures are suggested for consideration by medical schools and the National Institutes of Health, and recommendations that URM faculty and students may wish to consider are also discussed. The major issues to address include increasing the pipeline of predoctoral URMs, promoting the success and retention of junior URM faculty, enhancing the support of senior URM faculty to serve as needed mentors, and building a pool of URM and non-URM mentors for URM trainees. Therefore, issues pertaining to both the pipeline and the pipe need to be overcome.