Amaya Sebastian, Elmitwalli Islam, Nazir Wajahat, Kalsotra Sidhant, Yemele Kitio Sibelle A, Tobias Joseph D, Nafiu Olubukola
Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Department of Anesthesiology & Pain Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
J Racial Ethn Health Disparities. 2025 Mar 27. doi: 10.1007/s40615-025-02379-9.
Evolving demographic trends in the USA have prompted stakeholders to demand a healthcare workforce that reflects the general population. Despite improvements in gender representation in medicine and anesthesiology, Black and Hispanic trainees remain underrepresented. As today's trainees become tomorrow's leaders, this disparity threatens to perpetuate minority underrepresentation in anesthesiology leadership roles. Previous assessments of anesthesiology leadership overlooked crucial roles involved in the residency selection process, such as anesthesiology chairs and program directors (PDs), which significantly influence the specialty's demographics. We analyzed the racial, ethnic, and gender distribution of these key "gatekeeper roles" to understand the potential root causes of minority underrepresentation in anesthesiology leadership positions.
This was a cross-sectional study of anesthesiology residency and fellowship programs available on the Fellowship and Residency Electronic Interactive Database Access (FREIDA) website. We extracted demographic data (gender, race, and ethnicity) of anesthesiology chairpersons, residency program directors, and fellowship program directors as reported on the FRIEDA website or from other online sources (department website or Google search). Three independent reviewers extracted demographic data, and an additional reviewer assisted with resolving demographic assignment conflicts when necessary.
There were 603 anesthesiology faculty leaders from 171 academic anesthesiology programs of whom 145 were departmental chairs, 169 were residency PDs, and 289 were fellowship PDs. Overall, only 34% (n = 205) of these leaders were women. Departmental chairpersons were predominantly White (85.5%), with minimal representation from other racial or ethnic groups. Similar racial, ethnic, and gender underrepresentation was observed among residency and fellowship program directors (PDs) except in pediatric anesthesiology (women = 51.8%).
Considerable racial, ethnic, and gender inequities were identified in crucial leadership roles in academic anesthesiology. These findings suggest an urgent need for targeted actions to ensure equitable representation, particularly in positions that influence residency and fellowship selection processes, which ultimately determines the demographic composition of anesthesiologists in the USA. Promoting diversity in leadership roles can help ensure a more equitable and representative healthcare workforce, which is essential for improving patient care and fostering innovation.
美国不断变化的人口趋势促使利益相关者要求医疗保健劳动力能反映总人口的情况。尽管医学和麻醉学领域的性别代表性有所改善，但黑人及西班牙裔受训人员的比例仍然偏低。由于如今的受训人员将成为明日的领导者，这种差距可能会使少数群体在麻醉学领导岗位上的代表性持续不足。以往对麻醉学领导力的评估忽略了住院医师选拔过程中涉及的关键角色，如麻醉学系主任和项目主任（PDs），这些角色对该专业的人口构成有重大影响。我们分析了这些关键“守门人角色”的种族、民族和性别分布，以了解少数群体在麻醉学领导岗位上代表性不足的潜在根本原因。
这是一项对麻醉学住院医师培训和专科培训项目的横断面研究，数据来源于专科培训和住院医师培训电子交互式数据库访问（FREIDA）网站。我们提取了FRIEDA网站或其他在线来源（系网站或谷歌搜索）报告的麻醉学系主任、住院医师培训项目主任和专科培训项目主任的人口统计学数据（性别、种族和民族）。三名独立评审员提取人口统计学数据，必要时另一名评审员协助解决人口统计学分配冲突。
来自171个学术麻醉学项目的603名麻醉学教员领导中，有145名系主任，169名住院医师培训项目主任，289名专科培训项目主任。总体而言，这些领导者中只有34%（n = 205）是女性。系主任主要是白人（85.5%），其他种族或民族群体的代表极少。在住院医师培训和专科培训项目主任（PDs）中也观察到类似的种族、民族和性别代表性不足情况，但儿科麻醉学除外（女性占51.8%）。
在学术麻醉学的关键领导角色中发现了相当大的种族、民族和性别不平等。这些发现表明迫切需要采取针对性行动，以确保公平代表性，特别是在影响住院医师培训和专科培训选拔过程的职位上，这最终决定了美国麻醉医师的人口构成。促进领导角色的多样性有助于确保建立一支更公平、更具代表性的医疗保健劳动力队伍，这对于改善患者护理和促进创新至关重要。
