Pastores Stephen M, Kostelecky Natalie, Zhang Hao
All authors: Critical Care Center, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
Crit Care Explor. 2023 Aug 2;5(8):e0952. doi: 10.1097/CCE.0000000000000952. eCollection 2023 Aug.
A diverse and inclusive critical care workforce is vital to the provision of culturally appropriate and effective care to critically ill patients of all backgrounds.
The purpose of this study is to determine the trends in gender, race, and ethnicity of U.S. critical care fellowships over the past 6 years (2016-2021).
Data on gender, race, and ethnicity of critical care fellows in five Accreditation Council on Graduate Medical Education-accredited training programs (internal medicine, pulmonary and critical care, anesthesiology, surgery, and pediatrics) from 2015 to 2016 to 2020-2021 were obtained from the joint reports of the American Medical Association (AMA) and Association of American Medical Colleges published annually in the Journal of the AMA.
From 2016 to 2021, the number of U.S. critical care fellows increased annually, up 23.8%, with the largest number of fellows in pulmonary critical care medicine (60.1%). The percentage of female critical care fellows slightly increased from 38.7% to 39.4% ( = 0.57). White fellows significantly decreased from 57.4% to 49.3% ( = 0.0001); similarly, Asian fellows significantly decreased from 30.8% to 27.5% ( = 0.004). The percentage of Black or African American fellows was not statistically significantly different (4.9% vs 4.4%; = 0.44). The number of fellows who self-identified as multiracial significantly increased from 52 (1.9%) to 91 (2.7%) ( = 0.043). The percentage of fellows who identified as Hispanic was not significantly different (6.7% vs 7.5%; = 0.23).
The percentage of women and racially and ethnically minoritized fellows (Black and Hispanic) remain underrepresented in critical care fellowship programs. Additional research is needed to better understand these demographic trends in our emerging critical care physician workforce and enhance diversity.
多元化和包容性的重症监护医护人员队伍对于为所有背景的重症患者提供符合文化背景且有效的护理至关重要。
本研究的目的是确定过去6年（2016 - 2021年）美国重症监护专科培训项目中性别、种族和民族的趋势。
从美国医学协会（AMA）和美国医学院协会每年发表在《美国医学协会杂志》上的联合报告中获取了2015 - 2016年至2020 - 2021年五个经研究生医学教育认证委员会认证的培训项目（内科、肺与重症医学、麻醉学、外科和儿科学）中重症监护专科培训学员的性别、种族和民族数据。
2016年至2021年，美国重症监护专科培训学员人数逐年增加，增长了23.8%，其中肺重症医学领域的学员人数最多（60.1%）。女性重症监护专科培训学员的比例从38.7%略有增加至39.4%（P = 0.57）。白人学员从57.4%显著下降至49.3%（P = 0.0001）；同样，亚裔学员从30.8%显著下降至27.5%（P = 0.004）。黑人或非裔美国学员的比例无统计学显著差异（4.9%对4.4%；P = 0.44）。自我认定为多种族的学员人数从52人（1.9%）显著增加至91人（2.7%）（P = 0.043）。认定为西班牙裔的学员比例无显著差异（6.7%对7.5%；P = 0.23）。
在重症监护专科培训项目中，女性以及种族和民族少数群体（黑人及西班牙裔）学员的比例仍然偏低。需要进一步研究以更好地了解我们新兴的重症监护医师队伍中的这些人口统计学趋势，并增强多样性。
