Gil Tommee Carolina, Nalleballe Krishna, Dandu Vasuki, Thombre Vaishali, Kapoor Nidhi, Doppalapudi Lalasa, Sheng Sen, Kovvuru Sukanthi, Lotia Mitesh, Veerapaneni Karthika Durga
Neurology, University of Arkansas for Medical Sciences, Little Rock, USA.
Neurology/Stroke, University of Arkansas for Medical Sciences, Little Rock, USA.
Cureus. 2021 Sep 6;13(9):e17754. doi: 10.7759/cureus.17754. eCollection 2021 Sep.
Background The lack of an adequate number of neurologists is a worldwide problem. As populations age, the prevalence of neurological disorders will likely increase, thereby increasing the demand for neurologists. In addition to the growing demand, inadequate diversity in the neurology healthcare workforce still exists. The purpose of this study is to examine the demographic characteristics of neurology residents and fellows. Methodology This cross-sectional study used data from the following publicly available databases: Accreditation Council for Graduate Medical Education, Association of American Medical Colleges, and the United States Census Bureau. Trends (from 2007 to 2018) in demographic characteristics were assessed using the slope and the associated p-value of a simple linear regression model, with the year as the independent variable. All p-values of <0.05 were considered significant. Results From 2007 through 2018, the percentage of US medical school graduates in neurology residency decreased from 58% to 55% (slope = -0.25; p = 0.0004), while the percentage of international medical graduates (IMGs) decreased from 36% to 32% (slope = -0.29; p = 0.0141) and doctor of osteopathy (DO) graduates increased from 6% to 13% (slope = 0.58; p < 0.0001). Although the percentage of female neurology residents increased from 39.5% in 2007 to 43.1% in 2018 (slope = 0.03; p = 0.8659), female physicians were underrepresented in vascular neurology fellowship (34% in 2018). Collectively, the percentage of underrepresented minorities in neurology residencies was low and increased only slightly over time (from 8% in 2011 to 9% in 2018; slope = 0.17; p = 0.0788). In 2018, the proportion of underrepresented minorities was smaller in neurology fellowships (5.5% neurophysiology, 12.5% epilepsy, 10.4% neuromuscular, and 12.4% vascular) compared to the population as a whole (31.3%). Conclusions IMGs still play an important role in filling a significant portion of the neurology residencies and fellowships. DO graduates have slowly increased in neurology residencies and fellowships. Members of several racial/ethnic minority groups and women are underrepresented in neurology house staff and efforts need to be taken to increase diversity.
神经科医生数量不足是一个全球性问题。随着人口老龄化，神经系统疾病的患病率可能会上升，从而增加对神经科医生的需求。除了需求不断增长外，神经科医疗人员队伍的多样性仍然不足。本研究的目的是调查神经科住院医师和研究员的人口统计学特征。
这项横断面研究使用了以下公开可用数据库的数据：研究生医学教育认证委员会、美国医学院协会和美国人口普查局。以年份为自变量，使用简单线性回归模型的斜率和相关p值评估人口统计学特征的趋势（2007年至2018年）。所有p值<0.05被认为具有统计学意义。
从2007年到2018年，美国医学院毕业的神经科住院医师比例从58%降至55%（斜率=-0.25；p=0.0004），而国际医学毕业生（IMGs）的比例从36%降至32%（斜率=-0.29；p=0.0141），整骨疗法医生（DO）毕业生的比例从6%升至13%（斜率=0.58；p<0.0001）。尽管神经科住院医师中女性的比例从2007年的39.5%升至2018年的43.1%（斜率=0.03；p=0.8659），但女性医生在血管神经科研究员中的比例较低（2018年为34%）。总体而言，神经科住院医师中代表性不足的少数族裔比例较低，且随时间仅略有增加（从2011年的8%升至2018年的9%；斜率=0.17；p=0.0788）。2018年，与总体人群（31.3%）相比，神经科研究员中代表性不足的少数族裔比例在神经生理学（5.5%）、癫痫（12.5%）、神经肌肉（10.4%）和血管（12.4%）方面较小。
国际医学毕业生在填补神经科住院医师和研究员的很大一部分职位方面仍发挥着重要作用。整骨疗法医生毕业生在神经科住院医师和研究员中的比例逐渐增加。几个种族/族裔少数群体的成员和女性在神经科住院医师中代表性不足，需要采取措施增加多样性。
