Latina Women in the U.S. Physician Workforce: Opportunities in the Pursuit of Health Equity.

PURPOSE: Some progress has been made in gender diversity in undergraduate medical education and the physician workforce, but much remains to be done to improve workforce disparities for women, particularly women from underrepresented populations, such as Latinas. This study examines the current level of representation and demographic characteristics of Latina physicians, including age, language use, nativity, and citizenship status. METHOD: The authors used data from the 2014-2018 U.S. Census Bureau's American Community Survey (ACS) 5-year estimates for their analyses. During the time period covered by this analysis, ACS response rates ranged from 92.0% to 96.7%. The authors included in this study individuals who self-reported their occupation as physician and who self-identified their race/ethnicity as either non-Hispanic White (NHW) or Hispanic/Latino, regardless of race. The authors used person-level sampling weights provided by the ACS to convert the original 1% sample to a 100% enumeration of the population. RESULTS: According to the ACS 2014-2018 5-year estimates, NHW physicians make up 65.8% (660,031/1,002,527) of physicians in the United States. Women comprise 36.1% (361,442) of the total U.S. physician population; however, Hispanic/Latina women comprise only 2.4% (24,411). The female physician population is younger than the male physician population, and Hispanic female physicians are the youngest. Latina physicians are far more likely to speak Spanish at home than NHW physicians. Immigrants make up 40.1% (9,782/24,411) of the Hispanic female physician population, and 12.3% (3,012/24,411) of Hispanic female physicians are not U.S. citizens. CONCLUSIONS: This study suggests that Latina physicians in the United States are younger, more likely to be bilingual and speak Spanish at home, and very underrepresented, compared with NHW female and male physicians. Increasing their share of the U.S. physician workforce would benefit the pursuit of health equity for an ever more diverse population.

Undocumented students pursuing medical education: The implications of deferred action for childhood arrivals (DACA).

There are about 1.8 million young immigrants in the United States who came or were brought to the country without documentation before the age of 16. These youth have been raised and educated in the United States and have aspirations and educational achievements similar to those of their native-born peers. However, their undocumented status has hindered their pursuit of higher education, especially in medical and other graduate health sciences. Under a new discretionary policy, Deferred Action for Childhood Arrivals (DACA), many of these young immigrants are eligible to receive permission to reside and work in the United States. DACA defers deportation of eligible, undocumented youth and grants lawful presence in the United States, work permits, Social Security numbers, and, in most states, driver's licenses. These privileges have diminished the barriers undocumented students traditionally have faced in obtaining higher education, specifically in pursuing medicine. With the advent of DACA, students are slowly matriculating into U.S. medical schools and residencies. However, this applicant pool remains largely untapped. In the face of a physician shortage and the implementation of the Affordable Care Act, an increase in matriculation of qualified undocumented students would be greatly beneficial. This Perspective is intended to begin discussion within the academic medicine community of the implications of DACA in reducing barriers for the selection and matriculation of undocumented medical students and residents. Moreover, this Perspective is a call to peers in the medical community to support undocumented students seeking access to medical school, residency, and other health professions.