Assessment of Subspecialty Choices of Men and Women in Internal Medicine From 1991 to 2016

Stone, Anna; Carlson, Kelly M; Douglas, Pamela S.; Morris, Kathleen; Walsh, Mary Norine

doi:10.1001/jamainternmed.2019.3833

Cited by 44 publications

(38 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cardiology is not a diverse profession, with underrepresentation of women and Black, Latinx, and other groups. 2 The American College of Cardiology, American Heart Association, and other societies have recognized this as a problem for the profession that limits access to talent and impacts the care of an increasingly diverse patient population. 9 The goal of a more diverse profession can be accomplished only by attracting a broader range of trainees.…”

Section: Discussionmentioning

confidence: 99%

“…The proportions of women and underrepresented racial and ethnic groups (UREGs) (defined as Black, Hispanic, Latinx, or Native American) 1 in cardiology training programs do not reflect population demographic characteristics. Although the percentage of women internal medicine residents increased from 30.2% to 43.2% between 1991 and 2016, 2 only 21.3% of cardiovascular fellows in 2016 were women, in stark contrast to 76.9% of geriatrics and 42.9% of hematology-oncology fellows. This may be due to negative perceptions of cardiology among internal medicine residents, 3 who highlight adverse job conditions, interference with family life, and a lack of existing diverse faculty.…”

Section: Introductionmentioning

confidence: 96%

See 1 more Smart Citation

Evaluation of Women and Underrepresented Racial and Ethnic Group Representation in a General Cardiology Fellowship After a Systematic Recruitment Initiative

et al. 2021

Self Cite

View full text Add to dashboard Cite

IMPORTANCEThe proportion of women and underrepresented racial and ethnic groups (UREGs) matriculating into general cardiology fellowships remains low. OBJECTIVE To assess a systematic recruitment initiative aimed at ensuring adequate matriculation of women and UREGs in a general cardiology fellowship. DESIGN, SETTING, AND PARTICIPANTSThis quality improvement study took place at a large, tertiary academic medical center and associated Accreditation Council for Graduate Medical Education Cardiovascular Disease fellowship. Participants included cardiology fellowship and divisional leadership and general cardiology fellow applicants to the Duke Cardiovascular Disease Fellowship Program from 2017 to 2019. Data analysis was performed from December 2019 to May 2020. EXPOSURE Multipronged initiative that created an environment committed to ensuring equity of opportunity. This included the creation of a fellowship diversity and inclusivity task force that drafted recommendations, which included reorganization of the fellowship recruitment committee, and changes to the applicant screening process, the interview day, applicant ranking process, and postmatch interventions. MAIN OUTCOMES AND MEASURES The percentage of matriculating and overall women and UREGs before and after the interventions were recorded. RESULTS The fellowship received a mean (SD) of 462 (55) applications annually before the interventions (2006-2016) and 611 (27) applications annually after the interventions (2017-2019).Between the 10-year period before the interventions and the 3-year period during the interventions, there was a significant increase in the annual mean (SD) percentage of women (22.4% [2.9%] vs 26.4% [0.07%]; P < .001) and UREG applicants (10.5% [1.1%] vs 12.5% [1.9%]; P = .01) to the program. Among applicants interviewed, the percentage of women increased from 20.0% to 33.5% (P = .01) and that of and UREGs increased from 14.0% to 20.0% (P = .01). Before the interventions, a mean (SD) of 23.2% (16.2%) women and 9.7% (7.8%) UREGs matriculated as first-year fellows, whereas after the interventions, a mean (SD) of 54.2% (7.2%) women and 33.3% (19.0%) UREGs matriculated as first-year fellows. The proportion of the entire fellowship who were women increased from a 5-year mean (SD) of 27.0% (8.8%) to 54.2% (7.2%) after 3 years of interventions, and that of UREGs increased from 5.6% (4.6%) to 33.3% (19.0%). Overall, the proportion of applicants in the entire population who were either women or from UREGs increased from 27.8% to 66.7%. (continued) Key Points Question Is there an association between implementing a systematic recruitment initiative and improved representation of women and underrepresented racial and ethnic groups (UREGs) in a general cardiology fellowship? Findings In this quality improvement study, a recruitment initiative was associated with an increase in the percentage of matriculating women, from 23.2% in the 10 years before the initiative to 54.2% in the 3 years after the initiative, and UREG fellows, from 9.7% before the init...

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Evaluation of Women and Underrepresented Racial and Ethnic Group Representation in a General Cardiology Fellowship After a Systematic Recruitment Initiative

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Also, with faculty data, the comparisons made in this study are based on faculty department and not specialty; for IM, this approach does not allow for the identification of the actual practice specialties of faculty members. 20 Although we did not have these data available at the faculty level, 2 recently published articles 52 , 53 examined trends by sex and race/ethnicity for IM residents and IM subspecialty fellows. Santhosh and Babik 52 found that although the overall total of IM residents and IM subspecialty fellows increased from 2006 to 2018 (from 21 855 to 26 228 residents and 8144 to 10 578 fellows), the proportion of URM IM residents was unchanged (2688 [12.3%; 95% CI, 11.9%-12.7%] to 3599 [13.7%; 95% CI, 13.3%-14.1%]; P = .28) but increased to various extents for all subspecialty fellowships.…”

Section: Discussionmentioning

confidence: 99%

“…Santhosh and Babik 52 found that although the overall total of IM residents and IM subspecialty fellows increased from 2006 to 2018 (from 21 855 to 26 228 residents and 8144 to 10 578 fellows), the proportion of URM IM residents was unchanged (2688 [12.3%; 95% CI, 11.9%-12.7%] to 3599 [13.7%; 95% CI, 13.3%-14.1%]; P = .28) but increased to various extents for all subspecialty fellowships. Stone et al 53 examined trends related to sex and found that from 1991 to 2016 the absolute number and the proportion of female IM residents increased substantially (5602 [30.2%] to 10223 [43.2%]), but the proportion of female IM subspecialty fellows decreased during this same period (33.3% in 1991 and 23.6% in 2016). In addition, given the cross-sectional nature of these data and a lack of information regarding faculty and student experiences, we cannot infer causality from any of the results presented.…”

Section: Discussionmentioning

confidence: 99%

Trends in Internal Medicine Faculty by Sex and Race/Ethnicity, 1980-2018

et al. 2020

View full text Add to dashboard Cite

Key Points Question Did sex and racial/ethnic diversity in the academic internal medicine workforce between 1980 and 2018 reflect the changing demographic composition of the general population (in 2017) and medical student body? Findings This cross-sectional study used data on full-time medical school faculty appointed to US internal medicine departments from 1980 to 2018, matriculants to US medical schools from 1980 to 2018, and the general US population from 1980 to 2017. The study found that progress was made in diversifying the academic workforce; however, it may not yet reflect the diversity of US medical students or the US population. Meaning These findings suggest that continued improvement of recruitment and retention efforts for women and groups who are underrepresented in medicine as medical students and faculty in internal medicine is needed.

show abstract

“…The outlook for attracting more women into cardiology is also grim. Although the proportion of fellows who were women doubled from 10.1% in 1991 to 21.3% in 2016, even the more recent “improved” number is lower than that for every other subspecialty in medicine back in 1991 except gastrointestinal and pulmonary/critical care ( 4 ). In 2019, the American College of Graduate Medical Education included work force diversity in its program evaluation requirements, a wakeup call for cardiology ( 5 ).…”

mentioning

confidence: 99%