2019 HSC Section 2 - Practice Management

J.S. Abelson et al. / The American Journal of Surgery 216 (2018) 678 e 682

Table 2 Promotion rates of faculty by race/ethnicity and department.

Table 3 Retention rates of faculty by race/ethnicity and department.

White Asian Black Hispanic Other p-value

White Asian Black Hispanic Other p-value

Surgery Assistant Professor 34% 33% 19% 32% Associate Professor 41% 44% 50% 38% Obstetrics and Gynecology Assistant Professor 26% 21% 12% 25% Associate Professor 31% 27% 38% 33% Internal Medicine Assistant Professor 32% 26% 19% 25% Associate Professor 37% 39% 26% 40% Pediatrics Assistant Professor 30% 24% 16% 26% Associate Professor 38% 39% 26% 36%

Surgery Assistant Professors 57% 49% 49% 49% Associate Professors 64% 62% 70% 66% Obstetrics and Gynecology Assistant Professors 47% 44% 47% 38% Associate Professors 61% 54% 73% 62% Internal Medicine Assistant Professors 54% 44% 45% 52% Associate Professors 71% 65% 60% 67% Pediatrics Assistant Professors 57% 52% 49% 58% Associate Professors 70% 70% 74% 69%

27%

< 0.01

46%

< 0.01

32% 0.25

65% 0.91

12%

< 0.01

35% 0.07 44% 0.26

36% 0.87

24%

< 0.01

45% 57%

< 0.01 < 0.01

39% 0.28

23%

< 0.01

52% 0.04 61% 0.42

24% 0.06

faculty of Other race/ethnicity had the fastest time promotion (5.5 years) and White professors had the slowest time to promotion (6.1 years) (p ¼ 0.02). ( Supplemental Table 1 ). Survival analysis for promotion Survival analysis showed that overall and for assistant pro- fessors alone, Asian faculty had the fastest times to promotion while Black faculty had the slowest time (p ¼ 0.04). There were no differences in race/ethnicity-based promotion for associate pro- fessors of surgery ( Fig. 1 ). 10-Year retention rates Among assistant professors in surgery, retention rates at 10-year follow-up were highest for White faculty (57%) and lowest for Other racial/ethnic faculty (46%) (p < 0.01).There was no signi fi cant difference in 10-year rates of retention among associate professors in surgery. Similar trends were noted in all other specialities with White physicians having the highest rates of retention among as- sistant professors. Among associate professors, the only statistically signi fi cant difference in 10-year retention was in internal medicine with White faculty having the highest retention (71%) and Other racial/ethnic faculty having the lowest retention (57%) (p < 0.01). Ethnic/racial disparities in retention

The lowest overall rate of retention at 10 years was for Other race/ ethnicity assistant professors in ob/gyn (35%) ( Table 3 ).

Survival analysis for retention On survival analysis, White assistant professors of surgery were retained for the longest period of time (p < 0.01). There was no difference in time to leaving surgery for associate professors based on race/ethnicity ( Fig. 2 ).

Discussion

In this nationwide study of promotion and retention based on race and ethinicity among full-time academic surgeons we found that White assistant professors had signi fi cantly higher rates of promotion and retention at 10 years across all specialties. While Black assistant professors of surgery had signi fi cantly lower rates of promotion, this was similarly demonstrated in obstetrics and gy- necology internal medicine, and pediatrics. These fi ndings provide further insight into known ethnic/racial disparities among junior and senior academic faculty not only in surgery, but other spe- cialties as well. One important fi nding from this study is the signi fi cant racial/ ethnic disparity across specialties in promotion and retention seen for assistant professors, but not for associate professors. This

Fig. 1. Promotion of surgery assistant and associate professors by race/ethnicity (p ¼ 0.04; p ¼ 0.16, respectively).

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