Proportion of Black US Med School Faculty Has Barely Budged in Three Decades

By Linda Carroll

August 18, 2021

(Reuters Health) - Between 1990 and 2020, the proportion of U.S. medical school faculty self-identifying as Black or African American has increased only minimally and still falls far short of reflecting the Black proportion of the country's current population, a new study finds.

While the absolute number of faculty across the 16 specialties studied nearly tripled over three decades, the proportion of faculty who identified as Black or African American rose by about one third, from 2.68% in 1990 to 3.84% in 2020, an increase of 1.16 percentage points. Assistant professors made up the largest group among faculty self-identifying as Black or African American, and their proportion grew by less than 1 percentage point, from 1.38% in 1990 to 2.27% in 2020, according to the results in JAMA.

"Even though there has been some change over the last 30 years, the overall proportion of faculty who are African American is well below the national average and is not representative of the populations these physicians serve," said the study's lead author, Dr. Christopher Bennett, a professor of emergency medicine at the Stanford University School of Medicine in California.

"We published a study earlier this year and found the same thing in residents," Dr. Bennett said. "There have been some increases, but they are still small."

The study did not look at causes of the persisting disparity between Black and white faculty, but Dr. Bennett suspects it's due to a combination of factors ranging from structural racism to lack of mentorship to unconscious biases.

Of the 16 specialties, 14 had less than 5% of faculty identifying as Black or African American, and none approached the 2020 U.S. population estimate of 13.4% Black or African American, the authors note.

At the current rates of change, "it will take more than 100 years for the proportion of Black faculty members to catch up with the percentage of Black people in the general population overall," Dr. Bennett said. "For some of the surgical specialties it could take longer, like 150 years. This will not fix itself. It's going to take a serious dedicated effort."

To take a closer look at the proportion of faculty who identify as either Black or African American, Dr. Bennett and his coauthor, Albee Ling, turned to the Association of American Medical Colleges Faculty Roster, which reports the yearly aggregate number of all full-time faculty at U.S. medical schools by academic rank and self-reported sex, race, and ethnic origin.

For the race category, faculty are told to choose from a list, with one option being "Black or African American," and they can self-identify with more than one race. Demographic information is reported by medical schools when faculty are first appointed.

In the current study, the researchers focused on faculty who self-identified as Black or African American in the 16 clinical specialties reported in the roster from 1990 to 2020.

Overall, the total number of faculty rose from 58,561 in 1990 to 157,816 in 2020. In 1990, 1,568 faculty members (2.68%) self-identified as Black or African American as compared with 6,068 (3.84%) in 2020.

More ground was gained by female Black physicians. In 1990, 0.96% female faculty self-identified as Black or African American, as compared with 2.32% in 2020. In 1990, 1.72% of male faculty self-identified as Black or African American, as compared to 1.52% in 2020.

The proportion of assistant professors self-identifying as Black or African American was 1.38% in 1990 versus 2.27% in 2020. The proportion of full professors self-identifying as Black or African American was 0.28% in 1990 versus 0.42% in 2020.

There were significant variations by specialty, with obstetrics and gynecology having the highest (8.5%) proportion of Black faculty in 2020 and one of the largest increases (2.47 percentage points) over the study period, while otolaryngology had the smallest proportion of Black faculty in 2020 (1.96%), and the smallest increases were in emergency medicine and radiology (0.32 percentage points each).

"The findings are disappointing but not surprising," said Dr. Kirk Campbell, a professor of medicine in the division of nephrology and vice chair of diversity and inclusion at the Icahn School of Medicine at Mount Sinai in New York City, who wasn't involved in the study. "They are also part of an unfortunate self-sustaining pattern where medical school faculty, who are mentors, researchers, educators, policymakers, and critically the same individuals who set admissions policies and standards, do not reflect the demographic diversity of the U.S. population."

Why does this disparity persist?

"The main reason is the leaky pipeline which starts long before physicians could be eligible for faculty roles," Dr. Campbell said in an email. "African Americans have disproportionately lower high school and college graduation rates. The percentage of Black male students in U.S. medical schools actually decreased over the last 40 years."

Dr. Campbell agreed that the problem isn't going to fix itself.

"Clearly there is no easy fix, and any comprehensive approach has to be multipronged, including a concerted effort to close the gap in undergraduate academic performance and enhanced early exposure to academic careers through access to effective mentorship," Dr. Campbell said. "We also need to remember that demographic diversity is just one step towards achieving inclusive excellence. Ensuring that faculty members from diverse backgrounds progress to senior leadership roles and have meaningful, impactful careers where they can pay it forward, requires additional sustained effort."

SOURCE: https://bit.ly/3xS1CzG and https://bit.ly/3AMKUns JAMA, online August 17, 2021.

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