Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia.
JAMA Netw Open. 2019 Sep 4;2(9):e1910490. doi: 10.1001/jamanetworkopen.2019.10490.
With increasing efforts to create a diverse physician workforce that is reflective of the demographic characteristics of the US population, it remains unclear whether progress has been made since 2009, when the Liaison Committee on Medical Education set forth new diversity accreditation guidelines.
To examine demographic trends of medical school applicants and matriculants relative to the overall age-adjusted US population.
DESIGN, SETTING, AND PARTICIPANTS: Repeated cross-sectional study of Association of American Medical Colleges data on self-reported race/ethnicity and sex of medical school applicants and matriculants compared with population distribution of the medical school-aged population (20-34 years). Data from US allopathic medical school applicants and matriculants from 2002 to 2017 were analyzed.
Trends were measured using the representation quotient, the ratio of the proportion of a racial/ethnic group in the medical student body to the general age-matched US population. Linear regression estimates were used to evaluate the trend over time for Asian, black, white, Hispanic, American Indian or Alaska Native (AIAN), and Native Hawaiian or Other Pacific Islander medical school matriculants by sex.
The number of medical school applicants increased 53%, from 33 625 to 51 658, and the number of matriculants increased 29.3%, from 16 488 to 21 326, between 2002 and 2017. During that time, proportions of black, Hispanic, Asian, and Native Hawaiian or Other Pacific Islander male and female individuals aged 20 to 34 years in the United States increased, while proportions of white male and female individuals decreased and proportions of AIAN male and female individuals were stable. From 2002 to 2017, black, Hispanic, and AIAN applicants and matriculants of both sexes were underrepresented, with a significant trend toward decreased representation for black female applicants from 2002 to 2012 (representation quotient slope, -0.011; 95% CI, -0.015 to -0.007; P < .001).
Black, Hispanic, and AIAN students remain underrepresented among medical school matriculants compared with the US population. This underrepresentation has not changed significantly since the institution of the Liaison Committee of Medical Education diversity accreditation guidelines in 2009. This study's findings suggest a need for both the development and the evaluation of more robust policies and programs to create a physician workforce that is demographically representative of the US population.
随着越来越多的努力来创造一个多样化的医生队伍，以反映美国人口的人口特征，目前尚不清楚自 2009 年联络医学教育委员会提出新的多样性认证指南以来是否取得了进展。
检查医学院申请人和入学人数相对于总体年龄调整后的美国人口的人口趋势。
设计、地点和参与者：对美国医学院协会数据的重复横断面研究，该数据涉及医学院申请人和入学人数的自报种族/族裔和性别，以及医学院年龄人口（20-34 岁）的人口分布。对 2002 年至 2017 年期间的美国全医学学校申请人和入学人数进行了分析。
使用表示数量的比例来衡量趋势，该比例是医学院学生群体中某一族裔群体的比例与一般年龄匹配的美国人口的比例。线性回归估计用于评估 2002 年至 2017 年间按性别划分的亚裔、黑人、白人、西班牙裔、美国印第安人或阿拉斯加原住民（AIAN）和夏威夷原住民或其他太平洋岛民医学院入学人数的趋势。
医学院申请人的数量增加了 53%，从 33625 人增加到 51658 人，入学人数增加了 29.3%，从 16488 人增加到 21326 人，2002 年至 2017 年期间。在此期间，美国 20 至 34 岁的黑人、西班牙裔、亚裔和夏威夷原住民或其他太平洋岛民男性和女性个体的比例增加，而白人男性和女性个体的比例下降，AIAN 男性和女性个体的比例保持稳定。从 2002 年至 2017 年，黑人和西班牙裔以及 AIAN 的男女申请人和入学人数都存在代表性不足的情况，黑人女性申请人的代表性明显呈下降趋势，从 2002 年至 2012 年下降了 0.011（表示数量斜率，-0.011；95%置信区间，-0.015 至-0.007；P<.001）。
与美国人口相比，黑人和西班牙裔以及 AIAN 学生在医学院入学人数中仍然代表性不足。自 2009 年联络医学教育委员会制定多样性认证指南以来，这种代表性不足的情况并没有显著改变。本研究的结果表明，需要制定和评估更有力的政策和方案，以创建一个在人口统计学上代表美国人口的医生队伍。
