Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Johns Hopkins Center for Health Equity, Baltimore, Maryland.
JAMA Netw Open. 2020 Sep 1;3(9):e2015205. doi: 10.1001/jamanetworkopen.2020.15205.
Increasing diversity in the physician workforce is a fulcrum for reducing health disparities. Efforts to increase the diversity in the internal medicine (IM) workforce may improve health equity among an increasingly diverse population with increasing prevalence of chronic disease.
To assess diversity trends in the academic IM workforce and evaluate how well these trends reflected medical student diversity and the changing demographic composition of the general population.
DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis of a cross-sectional study analyzed data from January 1, 1980, to December 31, 2018, from the Association of American Medical Colleges Faculty Roster and Applicant Matriculant File, which capture full-time US medical school faculty and matriculants, respectively, and population data through 2017 from the US Census Bureau.
The study calculated the proportions of women and individuals from racial/ethnic groups that are traditionally underrepresented in medicine (URM) among IM faculty and faculty in all other clinical departments. These data were compared with the proportions of female and URM matriculants in US medical schools and the proportions of women and individuals from underrepresented racial/ethnic groups in the population. The analysis was stratified by sex, race/ethnicity, and intersections of sex and race/ethnicity.
From 1980 to 2018, the absolute number of full-time IM faculty increased from 10 964 to 42 547. Although IM was the department classification with the most women faculty, in 2018 it continued to have a lower proportion of women (n = 17 165 [40.3%]) compared with all other clinical departments (n = 48 936 [43.2%]). Among IM faculty, the percentage of URM faculty members more than doubled during the study period (from 4.1% to 9.7%) but still made up only a small portion of faculty members. The percentage of female matriculants among medical school matriculants increased steadily (from 28.7% in 1980 to 51.6% in 2018) and was nearly identical to their population representation in 2017 (50.7% compared with 50.8%). Although the percentage of URM matriculants had nearly doubled since 1980 (from 11.3% to 18.1%), it still lagged far behind the proportion of individuals in the US population who are members of underrepresented racial/ethnic groups (18.1% vs 31.5% in 2017).
This cross-sectional study found that progress has been made in diversifying academic IM faculty; however, it does not yet reflect the diversity of medical students or the US population. Continued efforts to increase the diversity of the academic IM workforce are needed.
增加医生队伍的多样性是减少健康差距的关键。增加内科医生(IM)劳动力的多样性的努力可能会改善越来越多的患有慢性疾病的多样化人群的健康公平。
评估学术内科劳动力的多样性趋势,并评估这些趋势在多大程度上反映了医学生的多样性以及普通人群的人口结构变化。
设计、地点和参与者:这是对一项横断面研究的二次分析,该研究分析了 1980 年 1 月 1 日至 2018 年 12 月 31 日期间美国医学学院教师名册和申请人注册文件的数据,分别记录了全职美国医学院教师和注册学生,以及美国人口普查局截至 2017 年的人口数据。
该研究计算了 IM 教师中和所有其他临床科室教师中女性和传统医学中代表性不足的种族/族裔群体(URM)成员的比例。将这些数据与美国医学院的女性和 URM 注册学生的比例以及人口中代表性不足的种族/族裔群体的女性和个人的比例进行了比较。分析按性别、种族/族裔以及性别和种族/族裔的交叉点进行分层。
从 1980 年到 2018 年,全职 IM 教师的绝对人数从 10964 人增加到 42547 人。尽管 IM 是女性教职员工比例最高的科室,但 2018 年其女性教职员工比例(n=17165[40.3%])仍低于所有其他临床科室(n=48936[43.2%])。在 IM 教师中,URM 教师的比例在研究期间翻了一番多(从 4.1%增至 9.7%),但仍只占教师的一小部分。医学院注册学生中女性注册学生的比例稳步上升(从 1980 年的 28.7%上升到 2018 年的 51.6%),与 2017 年的人口代表性几乎相同(50.7%与 50.8%)。尽管自 1980 年以来 URM 注册学生的比例几乎翻了一番(从 11.3%增至 18.1%),但仍远远落后于美国人口中属于代表性不足的种族/族裔群体的个人比例(18.1%与 2017 年的 31.5%)。
这项横断面研究发现,在使内科学术教师多样化方面已经取得了进展;然而,这并没有反映医学生或美国人口的多样性。需要继续努力增加内科医生学术队伍的多样性。