Department of Family Medicine, Loyola Medicine-MacNeal Family Medicine Residency Program, Berwyn, Illinois.
College of Science, Health and Pharmacy, Roosevelt University, Schaumburg, Illinois.
JAMA Netw Open. 2023 Dec 1;6(12):e2347817. doi: 10.1001/jamanetworkopen.2023.47817.
Diversity is an essential element of an effective health care system. A key to developing a diverse workforce is establishing a diverse student population in health professions programs.
To examine the diversity of students in Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), Doctor of Dental Surgery (DDS), Doctor of Dental Medicine (DMD), and Doctor of Pharmacy (PharmD) programs with emphasis on the trends of underrepresented minoritized groups (American Indian or Alaska Native, Black or African American, Hispanic or Latino, and Native Hawaiian or Other Pacific Islander) and sex relative to the overall age-adjusted US population.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used deidentified, self-reported data from 2003 to 2019 from the Association of American Medical Colleges, American Association of Colleges of Osteopathic Medicine, American Dental Education Association, American Dental Association, and American Association of Colleges of Pharmacy. Data analysis was performed from 2003 to 2004 and from 2018 to 2019.
Data on the race, ethnicity, and sex of applicants, matriculants, and degrees conferred by health professions programs were collected and compared with the age-adjusted population in the US Census (aged 20-34 years) over time.
The main outcomes were trends in the proportions of underrepresented minoritized groups and sex diversity among applicants, matriculants, and degrees conferred relative to the overall age-adjusted US population. Trends were measured using the representation quotient, which is defined as the ratio of the proportion of each subgroup to the total population of applicants, matriculants, or graduates relative to the proportion for that subgroup within the US Census population of similar age. Regression analysis was used to evaluate the trend over time.
A total of 594 352 applicants were analyzed across the examined programs. From 2003 to 2019, the proportions of individuals from underrepresented groups increased for DDS and DMD (applicants, from 1003 of 8176 to 1962 of 11 298 [5.1%]; matriculants, from 510 of 4528 to 966 of 6163 [4.2%]; degrees awarded, from 484 of 4350 to 878 of 6340 [2.7%]), PharmD (applicants, from 9045 of 71 966 to 11 653 of 50 482 [9.0%]; matriculants, from 5979 of 42 627 to 10 129 to 62 504 [6.3%]; degrees awarded, from 922 of 7770 to 2190 of 14 800 [3.0%]), and DO (applicants, from 740 of 6814 to 3478 of 21 090 [5.4%]; degrees awarded, 199 of 2713 to 582 of 6703 [1.4%]) programs, but decreased for MD programs (applicants, from 6066 of 34 791 to 7889 of 52 777 [-2.3%]; matriculants, 2506 of 16 541 to 2952 of 21 622 [-2.4%]; degrees awarded, from 2167 of 15 829 to 2349 of 19 937 [-0.1%]). Compared with age-adjusted US Census data, all programs had more Asian students and fewer male, American Indian or Alaska Native, Black or African American, Hispanic or Latino, and Native Hawaiian or Other Pacific Islander students (representation quotient <1).
In this cross-sectional study, most of the health professions in the study saw increases in underrepresented minority applicants, matriculants, and degrees conferred from 2003 to 2019; however, all programs were below the age-adjusted US Census data. The increased racial, ethnic, and sex diversity in the programs illustrates progress, but additional strategies are needed to achieve a more representative health care workforce.
多样性是有效医疗保健系统的一个基本要素。建立多元化员工队伍的关键是在医疗保健专业课程中建立多元化的学生群体。
检查医学博士 (MD)、骨科医学博士 (DO)、牙科外科学博士 (DDS)、牙科医学博士 (DMD) 和药学博士 (PharmD) 课程中学生的多样性，重点关注代表性不足的少数群体（美洲印第安人或阿拉斯加原住民、黑人和非裔美国人、西班牙裔或拉丁裔以及夏威夷原住民或其他太平洋岛民）和性别与整体年龄调整后美国人口的相对趋势。
设计、地点和参与者：这项横断面研究使用了 2003 年至 2019 年期间美国医学协会、美国骨科医学院协会、美国牙科教育协会、美国牙科协会和美国药学学院协会的匿名、自我报告数据。数据分析是从 2003 年至 2004 年和 2018 年至 2019 年进行的。
收集了健康专业课程申请人、入学学生和授予学位的种族、民族和性别的数据，并随着时间的推移与美国人口普查（20-34 岁）的年龄调整人口进行了比较。
主要结果是代表性不足的少数群体的比例以及申请人、入学学生和授予学位的性别多样性与整体年龄调整后美国人口的趋势。使用表示性商数来衡量趋势，该商数定义为每个亚组的比例与申请人、入学学生或毕业生的总人口相对于美国人口普查中同年龄段该亚组的比例之比。回归分析用于评估随时间的趋势。
在研究的检查计划中分析了 594352 名申请人。从 2003 年到 2019 年，DDS 和 DMD（申请人，从 8176 人中的 1003 人到 11298 人中的 1962 人[5.1%]；入学学生，从 4528 人中的 510 人到 6163 人中的 966 人[4.2%]；授予的学位，从 4350 人中的 484 人到 6340 人中的 878 人[2.7%]）、PharmD（申请人，从 71966 人中的 9045 人到 50482 人中的 11653 人[9.0%]；入学学生，从 42627 人中的 5979 人到 62504 人中的 10129 人[6.3%]；授予的学位，从 7770 人中的 922 人到 14800 人中的 2190 人[3.0%]）和 DO（申请人，从 6814 人中的 740 人到 21090 人中的 3478 人[5.4%]；授予的学位，从 2713 人中的 199 人到 6703 人中的 582 人[1.4%]）计划中有所增加，但 MD 计划中有所减少（申请人，从 34791 人中的 6066 人到 52777 人中的 7889 人[2.3%]；入学学生，从 16541 人中的 2506 人到 21622 人中的 2952 人[2.4%]；授予的学位，从 15829 人中的 2167 人到 19937 人中的 2349 人[0.1%]）。与年龄调整后的美国人口普查数据相比，所有课程的亚洲学生人数都有所增加，而男性、美洲印第安人或阿拉斯加原住民、黑人和非裔美国人、西班牙裔或拉丁裔以及夏威夷原住民或其他太平洋岛民学生人数都有所减少（表示性商数<1）。
在这项横断面研究中，从 2003 年到 2019 年，研究中的大多数医疗保健专业都看到了代表性不足的少数族裔申请人、入学学生和授予的学位有所增加；然而，所有课程都低于年龄调整后的美国人口普查数据。该计划中种族、民族和性别的多样性增加表明取得了进展，但需要采取额外的策略来实现更具代表性的医疗保健劳动力。
