2019 HSC Section 2 - Practice Management

Reprinted by permission of Am J Surg. 2018; 216(4):678-682.

The American Journal of Surgery 216 (2018) 678 e 682

Contents lists available at ScienceDirect

The American Journal of Surgery

journal homepage: www.americanjournalofsurgery.com

Racial and ethnic disparities in promotion and retention of academic surgeons Jonathan S. Abelson a , Natalie Z. Wong b , Matthew Symer a , Gregory Eckenrode a , Anthony Watkins a , Heather L. Yeo a , c , * a NewYork-Presbyterian Hospital, Weill Cornell Medicine, Department of Surgery, New York, NY, USA b Weill Cornell Medical College, New York, NY, USA c Weill Cornell Medicine, Department of Healthcare Policy and Research, New York, NY, USA

a r t i c l e i n f o

a b s t r a c t

Article history: Received 16 February 2018 Received in revised form 2 May 2018 Accepted 14 July 2018 Keywords: Minority groups Surgeons Academic medical centers

Background: Racial/ethnic diversity remains poor in academic surgery. However, no study has quanti fi ed differences in the rates of retention and promotion of underrepresented minority (URM) academic surgeons. Methods: The American Association of Medical Colleges Faculty Roster was used to track all fi rst-time assistant and associate professors appointed between 1/1/2003 and 12/31/2006. Primary endpoints were percent promotion and retention at ten-year follow-up. Results: Initially, the majority of assistant and associate professors of surgery were White (62%; 75%). Black assistant professors had lower 10-year promotion rates across all specialties (p < 0.01). There were no race/ethnicity-based differences in promotion for associate professors. Retention rates were higher for White assistant professors than Asian or Black/Hispanic/Other minority faculty (61.3% vs 52.8% vs. 50.8% respectively; p < 0.01). There was no difference in 10-year retention rates among associate professors based on race/ethnicity. Conclusions: Underrepresented minority surgeons are less likely to remain in academia and Black as- sistant professors have the lowest rates of promotion. These fi ndings highlight the need to develop institutional programs to better support and develop minority faculty members in academic medicine. © 2018 Published by Elsevier Inc.

Schools Medical Healthcare disparities

Introduction

of the general population in the U.S., 61% of all assistant professors of surgery, but 79% of all full professors of surgery in 2015. 7 Studies of specialty-nonspeci fi c data show that ethnic/racial minority physicians are promoted at a lower rate and are more likely to report considering leaving academia compared to their White peers. 9 e 12 However, understanding of the experience of racial/ethnic minority U.S. surgeons has been largely subspecialty- oriented. 13 e 15 No study has quanti fi ed the retention and promotion of ethnic/racial minority surgeons in academia on a national level. As a result, we sought to characterize promotion and retention rates of racial/ethnic minority faculty in academic surgery in comparison to their White counterparts, using the Association of American Medication Colleges (AAMC) Faculty Administrative Management Online User System (FAMOUS) database. The sec- ondary objective was to compare promotion and retention rates based on race/ethnicity in academic surgery versus non-surgical specialties, including obstetrics/gynecology (ob/gyn), internal medicine, and pediatrics. We hypothesized that academic surgery

Increasing diversity in the physician workforce is a critical step towards eliminating healthcare disparities in the United States. Compared to their White counterparts, racial/ethnic minority physicians are more likely to serve underserved communities, care for uninsured patients, be sought out by minority patients, and enroll minority patients in clinical trials. 1 e 5 Despite multifaceted efforts to increase diversity in the physician workforce, racial/ ethnic minority physicians remain disproportionately underrep- resented in healthcare, especially in academic leadership posi- tions. 6 , 7 Academic surgery in particular is a fi eld with historically and persistently low racial/ethnic diversity, incongruent with the patient population it serves. 8 For example, Whites represented 61%

* Corresponding author. Weill Cornell Medicine Department of Surgery, 525 East 68th St., Box 172, New York, NY, 10065, USA. E-mail address: hey9002@med.cornell.edu (H.L. Yeo).

https://doi.org/10.1016/j.amjsurg.2018.07.020 0002-9610/ © 2018 Published by Elsevier Inc.

32