Trends in Demographics of Neurology House Staff in the United States

Abstract

BackgroundThe lack of an adequate number of neurologists is a worldwide problem. As populations age, the prevalence of neurological disorders will likely increase, thereby increasing the demand for neurologists. In addition to the growing demand, inadequate diversity in the neurology healthcare workforce still exists. The purpose of this study is to examine the demographic characteristics of neurology residents and fellows. MethodologyThis cross-sectional study used data from the following publicly available databases: Accreditation Council for Graduate Medical Education, Association of American Medical Colleges, and the United States Census Bureau. Trends (from 2007 to 2018) in demographic characteristics were assessed using the slope and the associated p-value of a simple linear regression model, with the year as the independent variable. All pvalues of <0.05 were considered significant. ResultsFrom 2007 through 2018, the percentage of US medical school graduates in neurology residency decreased from 58% to 55% (slope = -0.25; p = 0.0004), while the percentage of international medical graduates (IMGs) decreased from 36% to 32% (slope = -0.29; p = 0.0141) and doctor of osteopathy (DO) graduates increased from 6% to 13% (slope = 0.58; p < 0.0001). Although the percentage of female neurology residents increased from 39.5% in 2007 to 43.1% in 2018 (slope = 0.03; p = 0.8659), female physicians were underrepresented in vascular neurology fellowship (34% in 2018). Collectively, the percentage of underrepresented minorities in neurology residencies was low and increased only slightly over time (from 8% in 2011 to 9% in 2018; slope = 0.17; p = 0.0788). In 2018, the proportion of underrepresented minorities was smaller in neurology fellowships (5.5% neurophysiology, 12.5% epilepsy, 10.4% neuromuscular, and 12.4% vascular) compared to the population as a whole (31.3%). ConclusionsIMGs still play an important role in filling a significant portion of the neurology residencies and fellowships. DO graduates have slowly increased in neurology residencies and fellowships. Members of several racial/ethnic minority groups and women are underrepresented in neurology house staff and efforts need to be taken to increase diversity.

Priority of Gender and Racial Disparity in Neurology Journals: A Bibliometric Analysis, 2016–2021

“…One study found that gender and racial disparity persists in the recruitment or neurology residents, who are major contributors to academic research [2]. There are lower percentages of underrepresented minorities in neurology residencies and fellowships compared to active physicians overall [3]. Additionally, in 2017 79.8% of people who were of chairperson rank in academic neurology were white and although the proportion of female faculty in neurology has increased, they remain underrepresented in leadership roles [4].…”

Neurology ® Education Fulfilling an Age Old Mantra in Medicine

“…One study found that from 2007 to 2018, the percentage of US and international neurology residents has diminished over time. 2 Early exposure and mentorship are 2 critical ingredients that must be accomplished for students to envision themselves in a neurology career. Students must gain exposure to clinical neuroscience and see how basic science can be applied to a patient with neurologic disease.…”

“…Even when comparing with the percentage of active physicians who are URM, the proportion of underrepresented trainees is lower in neurology residencies and fellowships. 2 Lack of mentorship and role models play a significant role in the number of underrepresented students pursing medical careers. 9 The pathway into medicine is arduous.…”