Uriarte Sarah A, Persad-Paisley Elijah M, Barber Doucet Hannah
The Warren Alpert School of Medicine at Brown University Providence Rhode Island USA.
Boston University Chobanian & Avedisian School of Medicine Boston Massachusetts USA.
AEM Educ Train. 2025 Apr 7;9(2):e70028. doi: 10.1002/aet2.70028. eCollection 2025 Apr.
The emergency medicine (EM) patient population is racially and ethnically diverse, and the presence of racial and gender minority physicians may help overcome health disparities among these patients. The purpose of this study was to examine representation and its trends of racial, ethnic, and gender identities entering the EM workforce.
Reports on race, ethnicity, and gender for medical school graduates, EM applicants, and residents were obtained for the years 2005-2021. Racial and ethnic groups included Asian, Black, Hispanic, and White; gender identities included men and women. The proportion of each identity in each cohort was divided by a denominator of their corresponding U.S. medical school graduate proportion, producing representation quotients among applicants and matriculants (RQ, RQ) that refer to the group's medical school graduate representation. Mann-Whitney -tests were used on RQ averages to assess for differences in representation among applicants compared to matriculants. Linear regressions of yearly RQs were used to assess representation trends.
Men who self-identified as Black (RQ 1.50), Hispanic (RQ 1.84), or White (RQ 1.15) had the highest EM applicant representation trend relative to other groups while making up 3.5%, 5.4%, and 36.3% of all applicants, respectively. Asian women were the least represented group among applicants (RQ 0.52), dropping from 10.7% of medical school graduates to 5.7% of EM residency applicants. Among EM matriculants, Hispanic men (RQ 1.56) and White men (RQ 1.43) were the only overrepresented groups. Linear regression indicated that nearly all groups had significant increases in applicant representation over time, except for Asian women and Black men. White men and White women were the only two groups to experience increases in matriculant representation compared to their applicant counterparts.
Asian men, Asian women, and Black women remain underrepresented in EM residencies. Additional recruitment efforts to ensure their equitable representation are necessary in future application cycles.
急诊医学（EM）患者群体在种族和民族上具有多样性，种族和性别少数群体医生的存在可能有助于克服这些患者之间的健康差距。本研究的目的是考察进入急诊医学劳动力队伍的种族、民族和性别身份的代表性及其趋势。
获取了2005年至2021年医学院毕业生、急诊医学申请者和住院医师的种族、民族和性别报告。种族和民族群体包括亚洲人、黑人、西班牙裔和白人；性别身份包括男性和女性。每个队列中每种身份的比例除以其相应的美国医学院毕业生比例作为分母，得出申请者和录取者中的代表性商数（RQ、RQ），该商数指该群体在医学院毕业生中的代表性。对RQ平均值进行曼-惠特尼检验，以评估申请者与录取者之间代表性的差异。使用年度RQ的线性回归来评估代表性趋势。
自我认定为黑人（RQ 1.50）、西班牙裔（RQ 1.84）或白人（RQ 1.15）的男性相对于其他群体在急诊医学申请者中具有最高的代表性趋势，而他们分别占所有申请者的3.5%、5.4%和36.3%。亚洲女性是申请者中代表性最低的群体（RQ 0.52），从医学院毕业生的10.7%降至急诊医学住院医师申请者的5.7%。在急诊医学录取者中，西班牙裔男性（RQ 1.56）和白人男性（RQ 1.43）是仅有的代表性过高的群体。线性回归表明，除了亚洲女性和黑人男性外，几乎所有群体的申请者代表性都随时间显著增加。与申请者相比，白人男性和白人女性是仅有的两个录取者代表性增加的群体。
亚洲男性、亚洲女性和黑人女性在急诊医学住院医师中的代表性仍然不足。在未来的申请周期中，需要加大招募力度以确保他们得到公平的代表。
