Bias, Other Factors Limit Minority Representation in Academic Pediatrics

By Will Boggs MD

July 25, 2019

NEW YORK (Reuters Health) - Bias, racism and a lack of role models are barriers to greater representation of underrepresented minorities (URM) in academic pediatric medicine, researchers report.

"Diversity and inclusion are key in medicine, specifically academic medicine," Dr. Gabrina Dixon from Children's National Health System and George Washington University School of Medicine and Health Sciences, in Washington, D.C., told Reuters Health by email. "As academic physicians, one of our responsibilities is to teach the next generation of doctors. I hope this study gives insight into what URMs find beneficial and barriers to the process of advancing in academic pediatrics."

URMs accounted for only 8% of faculty at U.S. medical schools in 2010, and URM and women faculty are not being promoted or are leaving their faculty positions at higher rates compared with their white male counterparts.

Dr. Dixon's team examined the experiences of 25 faculty who are members of URMs to explore factors that influenced their pursuit of academic pediatrics and the barriers they encountered in three focus groups and 10 individual interviews.

Family support, early mentorship and community influenced these participants' decisions to enter academic pediatrics, the researchers report in Pediatrics, online July 23.

They cited as barriers in academic medicine the lack of other URMs in positions of leadership, being part of a low percentage of URMs practicing in academic pediatrics, and the impact of racism and implicit bias in the medical field.

They also cited financial burden (student loans and lower pay) as deterrents for being in academic medicine.

While successful in their careers, some faculty felt they were not deserving of the accolades they received.

"I remember hearing the former first lady, Michelle Obama, discuss having this feeling when she went to Princeton and throughout her career," Dr. Dixon said. "Imposter syndrome is not exclusive to medicine but can be seen in many professional fields among minorities, due to minorities being told that they do not belong or they are not as good as their non-minority colleagues."

"America is becoming more diverse, and it is important to ensure our academic pediatric workforce is as diverse as the patients we serve," she said.

"Without intentional efforts (guided by data from URM physicians like our study population), workforce diversity will continue to lag behind our country's growing diversity, and the gulf between our patients' varied needs and what we offer will widen," the researchers conclude.

"Pediatric departments should take organizational responsibility in setting up sponsorship programs or encouraging sponsorship as an outcome of successful mentorship programs," writes Dr. Jean L. Raphael from Baylor College of Medicine, in Houston, Texas, in an accompanying editorial. "In academic pediatrics, sponsorship may take the forms of recommendations to leadership positions (e.g., vice chairs, directorships, and division heads), nominations for awards, or endorsements for national speaking opportunities."

"URMs must become aware of the sponsorship effect and learn how to cultivate collaborative relationships with senior leaders, a skillset distinct from being an effective mentee," he adds.

"Because workforce diversity remains a priority, mentorship will continue to play a central role in helping URMs thrive in academic medicine," Dr. Raphael concludes. "However, strategies such as sponsorship may play a complementary role and accelerate career advancement."


Pediatrics 2019.