Diversity in the Pulmonary and Critical Care Medicine Pipeline. Trends in Gender, Race, and Ethnicity among Applicants and Fellows

Santhosh, Lekshmi; Babik, Jennifer M.

doi:10.34197/ats-scholar.2019-0024in

Cited by 24 publications

(23 citation statements)

References 16 publications

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“…This includes the overall proportion of intensivists who are women and the proportion of women who are conference speakers, lead authors, and peer reviewers and in leadership positions within critical care societies ( 6 – 10 ). A recent analysis revealed that fewer than one-third of fellows in US critical care training programs are women and that the proportion of women trainees appears to have plateaued over the last decade ( 11 ), In a 2019 Canadian qualitative study examining the drivers of gender inequity in critical care medicine, respondents highlighted the inflexible and long work hours, the lack of women role models, and the overt value placed on traditionally masculine traits ( 12 ). The latter factor may also have an impact on trainee evaluations.…”

Section: Discussionmentioning

confidence: 99%

Impact of Gender on Clinical Evaluation of Trainees in the Intensive Care Unit

Spring

Abrahams²,

Ginsburg

et al. 2021

ATS Scholar

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Background: Gender disparities in medical education are increasingly demonstrated, including in trainee assessment. Objective: This study aimed to evaluate whether gender differences exist in trainees’ evaluation during intensive care unit (ICU) rotations, which has not been previously studied. Methods: We reviewed the in-training evaluation reports (ITERs) for trainees rotating through five academic ICUs at the University of Toronto over a 10-year period (2007–2017). We compared the mean global score for the rotation and the mean score for seven training subdomains between men and women trainees. All scores were reported on a scale of 1 (unsatisfactory) to 5 (outstanding). Results: Over the 10-year period, there were 3,203 ITERS overall, representing 1,207 women and 1,996 men trainees. The mean overall score was lower for women than for men trainees: 4.26 (standard deviation [SD], 0.58) for women and 4.30 (SD, 0.60) for men ( P = 0.04). This difference was driven by anesthesia trainees, in whom the mean overall score was 4.21 for women and 4.37 for men ( P < 0.001), with men trainees scoring consistently higher across all seven training subdomains. Within surgical, internal medicine, and critical care residents, there were no differences between men and women in the overall score or the scores across any of the seven subdomains. Across all ITERS, women were less likely than men to receive an overall rating of 5 (outstanding) for the ICU rotation (33% women vs. 37% men; odds ratio, 0.83; 95% confidence interval, 0.71–0.96). Conclusion: Overall, quantitative evaluation scores between women and men trainees in the ICU are relatively similar. Within anesthesia trainees, scores for men were consistently higher across all domains of evaluation, a finding that requires further investigation.

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Section: Discussionmentioning

confidence: 99%

Impact of Gender on Clinical Evaluation of Trainees in the Intensive Care Unit

Spring

Abrahams²,

Ginsburg

et al. 2021

ATS Scholar

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“…Taking a closer look at equity in recruitment requires us to examine the ways in which UIM candidates, and particularly Black persons, experience structural discrimination. In the pipeline for PCCM, there is a marked loss in the percentage of Black Internal Medicine (IM) residents applying to PCCM fellowships and subsequently matching ( 8 ). Below, we discuss how bias in United States Medical Licensing Exam (USMLE) scores, letters of recommendation (LORs), and undergraduate medical education clerkship narrative evaluations can manifest and impact selection processes and propose potential methods to mitigate that bias.…”

Section: Definitionsmentioning

confidence: 99%

While You Don’t See Color, I See Bias: Identifying Barriers in Access to Graduate Medical Education Training

et al. 2021

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There is a need to acknowledge and address issues of implicit and explicit bias within medical education. These biases can impact standardized test questions and scores, evaluations of clinical performance, and subsequent letters of recommendation, all of which can affect the selection of diverse candidates advancing through medical training. Biased behavior toward trainees can negatively impact their learning environment and career trajectory. This article outlines key definitions related to bias and discusses the ways in which bias potentially impacts selection and entry into Pulmonary and Critical Care Medicine fellowship training. Finally, we will describe some ways to mitigate bias within the fellowship selection process and training programs.

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“…Finally, issues surrounding gender equity and diversity in medicine are critical to our practice and the education and training of our next generation. We have published important work in this area, such as an article by Santhosh and Babik ( 10 ) that reports trends in gender, race, and ethnicity among pulmonary/critical care medicine fellows and applicants over the last decade and finds continued disparities. Recognizing the need to openly address the role structural racism plays in persistent disparities in medicine, ATS Scholar has sought to publish papers that provide meaningful insight and propose thoughtful solutions to this issue in health profession education.…”

mentioning

confidence: 99%