End of Affirmative Action-Who Is Impacted Most? Analysis of Race and Sex Among US Internal Medicine Faculty.

BACKGROUND: For over 50 years, the United States (US) used affirmative action as one strategy to increase diversity in higher education including medical programs, citing benefits including training future public and private sector leaders. However, the recent US Supreme Court ending affirmative action in college admissions threatens advancements in the diversity of medical college faculty. OBJECTIVE: Our study evaluated the demographic trends in Internal Medicine (IM) faculty in the US by assessing sex and race/ethnicity diversity to investigate who is likely to be impacted most with the end of affirmative action. DESIGN: Longitudinal retrospective analysis SUBJECTS: IM faculty from the Association of American Medical Colleges faculty roster from 1966 to 2021 who self-reported sex and ethnicity MAIN OUTCOMES: The primary study measurement was the annual proportion of women and racial/ethnic groups among IM faculty based on academic rank and department chairs. RESULTS: Although racial/ethnic diversity increased throughout the era of affirmative action, African American, Hispanic, and American Indian populations remain underrepresented. White physicians occupied > 50% of faculty positions across academic ranks and department chairs. Among the non-White professors, Asian faculty had the most significant increase in proportion from 1966 to 2021 (0.6 to 16.6%). The percentage of women increased in the ranks of professor, associate professor, assistant professor, and instructor by 19.5%, 27.8%, 25.6%, and 26.9%, respectively. However, the proportion of women and racial/ethnic minority faculty decreased as academic rank increased. CONCLUSION: Despite an increase in the representation of women and racial/ethnic minority IM faculty, there continues to be a predominance of White and men physicians in higher academic ranks. With the end of affirmative action, this trend has the danger of being perpetuated, resulting in decreasing diversity among IM faculty, potentially impacting patient access and health outcomes.

Equity, diversity, and inclusion in academic American otolaryngology faculty: an elusive dream.

We analyze gender and racial disparities in academic otolaryngology from 2007 to 2018 in the United States (US). A cross-sectional retrospective analysis was done using data from the American Association of Medical Colleges. The distribution of gender and race, academic ranks, tenure tracks, and degrees was reported. The total number of otolaryngologists increased from 1,490 to 2,239, where 53 percent were females. All races experienced an increase; however, Whites and Asians had a greater increase compared to Black and Hispanics. Regarding percentages at different ranks, White were the majority (>50 percent) in every category. As for tenure, the general trend was a decrease in the total number of tenured physicians from 327 in 2007 to 318 in 2018, where Black, Hispanic, and Asian tenured physicians increased, while White tenured physicians decreased. White male otolaryngologists were the majority for every subgroup (>60 percent), whereas Black faculty made up less than 1 percent of tenured category. Female representation gradually increased for all levels of tenure. As for all degrees, Whites were the majority for all levels of education (>60 percent). There were some improvements in the representations for the females in all and Asians on the tenure track. However, progress for the URM remains an elusive dream.

Equity, Diversity, and Inclusion in Academic American Surgery Faculty: An Elusive Dream.

BACKGROUND: In the context of shifting population demographics in the United States, a diverse workforce in health care can lead to improved patient outcomes and enhance access to culturally competent care for minorities. The objective of this study was to analyze and quantify the relationship of gender, race, and academic rank, tenure status, and degree in American academic surgical faculty. MATERIALS AND METHODS: A 12-y retrospective cross-sectional analysis of the data from the Association of American Medical Colleges was performed. The distribution of race and gender across academic ranks, tenure, and degree types were recorded from 2007-2018. Simple descriptive statistics and chi-square analysis was used to analyze the time trends and association between gender and race across academic rank, tenure status, and degree types. RESULTS: When averaged over the 12 y of this study, there were significantly more whites (69.8%) and males (74.5%) among the academic surgery faculty compared with other races and females, respectively (P value <0.05). Asians and females experienced the greatest increase in proportional representation across all academic ranks with an absolute increase of 7% and 5% in full professor, 5% and 6% in associate professor, and 7% and 3% in chairperson (P value <0.05), respectively. No significant association was observed between gender and race with tenure status or degree type. CONCLUSIONS: Female and Asians are increasing in proportional representation; however, racial and gender disparities remain prevalent at higher academic ranks and positions of leadership, especially among black and Hispanic academic surgeons.

Hallmark of success: top 50 classics in oral and maxillofacial cone-beam computed tomography.

PURPOSE: The aim of this study was to identify the top 50 cited articles on the use of cone-beam computed tomography (CBCT) for oral and maxillofacial applications and to summarise the characteristics of the most impactful research articles in this domain. MATERIAL AND METHODS: A database was generated by combining the search results from Thomson Reuters Web of Science and Elsevier's Scopus to ensure that all top-cited publications were captured. We used three search fields to generate the database: 1) CBCT, 2) oral and maxillofacial pathologies, and 3) oral and maxillofacial anatomical structures. Publications were then ranked by citation counts and reviewed by two independent reviewers. RESULTS: A total of 50 top publications were included in the study. Their citation count ranged from 43 to 170 with a median of 55.5. Five publications were cited more than 100 times. All except for one paper were published after 2000. The most well published journal was the American Journal of Orthodontics and Dentofacial Orthopedics (n = 12), and the United States of America (n = 15) was the most productive country in the field. The majority of the studies (n = 27) discussed the imaging of primary tooth pathologies, but there are also a significant number of articles that discuss imaging of bone grafts or dental implants (n = 7), upper airways (n = 5), the skull (n = 4), and other maxillofacial structures (n = 7). CONLCUSIONS: Our study identifies 50 research articles with the highest number of citations in oral and maxillofacial CBCT, discusses the characteristics and commonalities between these articles, and predicts future trends in the field.

The Use of Facial CT for the Evaluation of a Suspected Simple Dentoalveolar Abscess in the Emergency Department.

INTRODUCTION: Facial computed tomography (CT) is often performed in the emergency department as a part of the diagnostic workup for patients presenting with the signs and symptoms of dentoalveolar abscess (DA). This investigation evaluated the diagnostic yield of the facial CT and its effects on management change in patients suspected of DA. Furthermore, we assessed secondary consequences of routine facial CT use in this population by using turn-around time (TAT), cost, and radiation exposure as the key parameters. MATERIAL AND METHODS: We retrospectively reviewed records of suspected DA patients over a 5-year period, from June 2008 to June 2013. TAT was calculated for patients from the time the examination was ordered by the emergency department physician, to the time the report was finalized by the attending radiologist. Effective radiation dose for facial CT was calculated by multiplying dose length product by the standard conversion coefficient K (K = 0.0021 mSv/mGy x cm). CT cost was included for reference but was not analyzed extensively due to the lack of standardization of costs across the various institutions. RESULTS: Our investigation consisted of 117 patients; 75 males of average age 41 (±12) years and 42 females of average age 44 (±17) years. Out of the total 117 patients that underwent CT for the suspicion of a simple DA, only a single individual (0.85%) underwent a management change. Mean TAT of facial CT was 110 (±63) minutes, and a median TAT was 87 (±71) minutes. Average effective radiation dose for a facial CT was 2.4 (±0.4) mSv. Approximate estimated cost of a contrast enhanced facial CT was $253 and non-contrast facial CT was $209. CONCLUSION: Our study shows that routine use of facial CT has a very limited diagnostic value in the workup of simple DA and rarely results in management change. The overall impact on patient management is miniscule in the context of prolonged TAT, radiation exposure, and adding to the rising medical costs.

Advancing Diversity in Microbiology: A 55-Year Retrospective Analysis.

Background For over 50 years, affirmative action helped advance equity, diversity and inclusion (EDI) in educational institutions in the United States (U.S.). However, the recent U.S. Supreme Court decision to end affirmative action in college admissions threatens the progress toward EDI. Objective This study aimed to assess the progress in promoting gender and racial diversity within the discipline of microbiology over a 55-year period. We sought to analyze the representation of women and minority groups in faculty ranks, tenure positions, and leadership to identify disparities and trends and determine who will likely be impacted most with the end of affirmative action. Materials and methods This longitudinal retrospective study utilized publicly available and non-identifiable Association of American Medical Colleges (AAMC) data on full-time microbiology faculty from 1967 to 2021. Faculty members were categorized based on academic ranks and tenure status, while gender and racial data were also considered. Results The analysis revealed a consistent dominance of white faculty, with over 60% representation across all academic ranks throughout the study period. The Asian and female faculty representation decreased in senior academic ranks. We observed a positive trend in the annual increase of women in faculty positions, academic ranks, chairs, and tenure positions. Furthermore, Asian faculty demonstrated the most robust surge in representation. However, disparities persisted for black, Hispanic, and Native American faculty members, reflecting broader challenges in their representation. Discussion Although efforts to enhance diversity within microbiology have yielded positive results, underrepresented minority groups still face obstacles in attaining leadership positions and senior academic ranks. The diminishing proportion of women at higher academic ranks raises concerns about potential attrition or lack of promotion opportunities. The end of affirmative action poses a risk of perpetuating this trend, leading to a decline in diversity among microbiology faculty.

Sticky Floor and Glass Ceilings in Academic Medicine: Analysis of Race and Gender.

Purpose This paper examines the changes in the representation of women and racial minorities in academic medicine, compares the proportion of minorities in medicine and the general United States (US) population, and discusses potential explanations for observed trends. Methods A retrospective cross-sectional analysis of the Association of American Medical Colleges (AAMC) database was done and used to collect data on the gender and race of physicians in academic medicine. Data was collected for instructors, assistant professors, associate professors, full professors, and chairpersons from 2007 to 2018, and trends were presented. Results White physicians represented most academic physicians at every academic level, peaking in proportion at 82.74% of chairpersons and were lowest at the level of instructor at 59.30%. A similar distribution existed when gender was compared, with men comprising 84.67% of chairpersons and forming the majority at levels of full, associate, and assistant professors. However, most physicians at the level of instructors are women at 55.44%. Conclusions Though women and racial minorities have gained greater representation in academic medicine over the past decade, high-level academic positions are not as accessible to them. Existing efforts of advocacy for women and minority races have proven fruitful over the past decade, but much more work needs to be done.

Gender of Department Chair and Paid Parental Leave Benefits in Academic Radiology Residency Programs.

RATIONALE AND OBJECTIVES: Residency training often overlaps with prime childbearing years, yet variability in availability and duration of parental leave in residency can complicate the decision to become parents. Gender disparities in attitudes towards parenthood in residency is well recognized, with females generally reporting more concerns surrounding prolonged training, hindrance of future career plans, and negative perception from peers. However, gender of the department chair has not yet been examined as a factor influencing parental leave policies for residents in Radiology. MATERIALS AND METHODS: The gender of the department chair and parental leave policies for residents in 209 ACGME accredited diagnostic radiology programs across the United States were procured from their websites. These programs were stratified into 6 geographical regions to identify regional differences. Chi-squared analyses were used to compare availability of paid parental benefits with the gender of department chairs. RESULTS: Seventy-seven percent of diagnostic radiology program department chairs were male. 34 of 49 programs (69%) with female department chairs advertised paid parental benefits, compared to 61 of 160 programs (38%) chaired by males (P < 0.001). When stratified by region, this gender difference remained statistically significant in the mid-Atlantic and New England. CONCLUSION: Female gender of the department chair was associated with the increased availability of paid parental leave benefits for residents, yet females hold fewer academic leadership positions than males. Future discussions regarding parental leave policies for residents will have to consider the unique challenges in residency such as length of training and burden on coresidents.

Physical Medicine and Rehabilitation Faculty Diversity Trends by Sex, Race, and Ethnicity, 2007 to 2018 in the United States.

INTRODUCTION: Sex and race/ethnicity disparities persist in academic Physical Medicine and Rehabilitation (PM&R). This study contributes to the current body of knowledge by demonstrating changes in academic PM&R by sex and race/ethnicity in multiple categories over a 12-year period. OBJECTIVE: To evaluate workforce disparities in academic PM&R by measuring sex and race/ethnicity diversity in academic degree, rank, and tenure status. DESIGN: Surveillance study. SETTING AND METHODS: Self-reported data for PM&R from the Association of American Medical Colleges (AAMC) annual Faculty Roster report from 2007 to 2018. MAIN OUTCOME MEASURES: The 12-year average percentage composition in academic degree, rank, and tenure status was calculated to compare the overall distribution. Counts and proportion changes were plotted to depict the temporal trends. Absolute changes in racial percentage composition were graphed to highlight the progress. RESULTS: From 2007 to 2018, the increase by sex was roughly equal (male = 216; female = 236), whereas most of the increase was in White faculty (207). The representation of female and Underrepresented in Medicine (URiM) faculty decreased as academic level advanced. Instructors is the only category with a higher proportion of female faculty, from 2007 (53%) to 2018 (59.3%), whereas male faculty occupied over 75% of the full professor positions at any time. Among the non-White faculty, Asian faculty had the greatest increase in proportion of full professors (3.7% to 10%) and Hispanic/Latino faculty in associate professors (2% to 7.1%), whereas full professors who were Black/African American decreased from 4 persons (2.5%) to 2 persons (0.8%). CONCLUSION: An increase in total number of female and URiM faculty was observed in academic PM&R over 2007 to 2018, but sex and ethnicity/race disparities persisted, especially in higher ranks and leadership positions. For non-White faculty, greater disparities existed, pointing toward the need to target challenges faced by URiM race/ethnicity status.

Gender Differences in Faculty Rank and Leadership Positions Among Physician Biochemistry Faculty in North America: A Retrospective, Cross-Sectional Study.

Purpose This study sought to assess gender differences among physician faculty in medical biochemistry and genetics programs in North America. It compared the distribution of academic and leadership ranks, years of active research, number of citations and publications, and Hirsch-index (h-index) by gender. Variable associations with the h-index were assessed. Method This was a cross-sectional retrospective study for which data was collected from June 2019 to October 2019 on academic and administrative physician faculty members for medical biochemistry and genetics programs. The website of Fellowship and Residency Electronic Interactive Database, Canadian Resident Matching Service website, and the medical biochemistry profile from the Canadian Medical Association to identify relevant programs and SCOPUS was used to gather faculty data. Results The analyses included 147 faculty members. More male faculty held higher academic rank positions and first-in-command leadership positions than female faculty. Men had more median years of active research, citation numbers, publication numbers, and h-index than women across all academic ranks. Upon performing multivariable linear regression, female faculty showed 0.39 times the odds of having a higher h-index than male faculty, keeping all other variables constant (p<0.01).  Conclusions In our study, it was shown that male physician faculty surveyed had higher performance than female faculty in academic rank and research productivity. Certain barriers may be contributing factors, including lack of mentorship or flexible institutional policies, women choosing clinical educator tracks, or gender bias. Considering the low retention rates of women in academic research, there is a need to address barriers in order to achieve gender parity.

Race, ethnicity, and gender in academic obstetrics and gynecology: 12-year trends.

BACKGROUND: Diversity among healthcare teams enhances team function and improves the quality of patient care and outcomes. Women and racial minorities are historically underrepresented in medicine. However, the representation of gender and racial or ethnic groups in academic obstetrics and gynecology in the United States has not been described in recent years. OBJECTIVE: This study aimed to describe the recent state and trends in gender and racial or ethnic disparities in academic obstetrics and gynecology. STUDY DESIGN: Data from the Association of American Medical Colleges between 2007 and 2018 were analyzed to describe the trends in the representation of women and racial (white, Asian, black) or ethnic (Hispanic) groups. The 12-year trends in representation by academic ranks (all academic physicians, full professor, associate professor, instructor), leadership positions (chairperson), and tenure (not on track for tenure, on track for tenure, or tenured) were depicted. The 12-year trends were assessed using linear regression to determine whether the slope depicting the change in representation of each group from 2007 to 2018 was significantly nonzero. In addition, average representation of each group across the 12-year period was compared using a Student t test (for gender) or analysis of variance (for race and ethnicity). RESULTS: In 2018, there were 152 institutions and 6302 academic physicians included in the data set. On average across the 12-year period, academic physicians in obstetrics and gynecology were 43% male, 57% female, 68% white, 12% Asian, 8% black, and 5% Hispanic. Across the 12-year period, there was an increase in the total number of physicians from 4755 to 6302 (+166 per year; 95% confidence interval, 146-186; P<.0001), a 15% increase in the proportion of women (+1.38% per year; 95% confidence interval, 1.08%-1.68%; P<.0001), and an increase in the proportion of physicians from racial minorities (Asian, +0.11% per year; 95% confidence interval, 0.08-0.15; P<.0001; black, +0.07% per year; 95% confidence interval, 0.04-0.09; P=.0002; Hispanic, +0.06% per year; 95% confidence interval, 0.02-0.1; P=.0039). There was a greater proportion of white physicians in higher academic ranks (eg, full professor), leadership positions (eg, chairperson), and tenure than the proportion of white physicians overall, whereas the opposite was true for black and Hispanic physicians. Although women now make up 64% of all academic physicians in obstetrics and gynecology, there remains a far higher proportion of males in leadership positions (chairperson) and higher academic ranks (full professor). Similarly, a greater proportion of males were tenured than females. CONCLUSION: Across the 12-year period, the representation of women and racial minorities has increased in academic obstetrics and gynecology in the United States. There is now a predominance of women, but there remains a trend for a predominance of white and male physicians in higher academic ranks, leadership positions, and tenure. It will be important to assess how these groups are represented in the coming years as the changing demographics of incoming cohorts progress through their careers to more senior positions. Promoting diversity in medical schools, leadership positions, and higher academic ranks may be an important area of focus.