A Call to Action: Black/African American Women Surgeon Scientists, Where are They?

Abstract

Objective: To determine the representation of Black/AA women surgeons in academic medicine among U.S. medical school faculty and to assess the number of NIH grants awarded to Black/AA women surgeon-scientists over the past 2 decades. Summary of Background Data: Despite increasing ethnic/racial and sex diversity in U.S. medical schools and residencies, Black/AA women have historically been underrepresented in academic surgery. Methods: A retrospective review of the Association of American Medical Colleges 2017 Faculty Roster was performed and the number of grants awarded to surgeons from the NIH (1998–2017) was obtained. Data from the Association of American Medical Colleges included the total number of medical school surgery faculty, academic rank, tenure status, and department Chair roles. Descriptive statistics were performed. Results: Of the 15,671 U.S. medical school surgical faculty, 123 (0.79%) were Black/AA women surgeons with only 11 (0.54%) being tenured faculty. When stratified by academic rank, 15 (12%) Black/AA women surgeons were instructors, 73 (59%) were assistant professors, 19 (15%) were associate professors, and 10 (8%) were full professors of surgery. Of the 372 U.S. department Chairs of surgery, none were Black/AA women. Of the 9139 NIH grants awarded to academic surgeons from 1998 and 2017, 31 (0.34%) grants were awarded to fewer than 12 Black/AA women surgeons. Conclusion: A significant disparity in the number of Black/AA women in academic surgery exists with few attaining promotion to the rank of professor with tenure and none ascending to the role of department Chair of surgery. Identifying and removing structural barriers to promotion, NIH grant funding, and academic advancement of Black/AA women as leaders and surgeon-scientists is needed.

Moving forward: Recommendations to overcome existing structural racism

“…34 Studies have shown that Black patients who had a Black physician as their healthcare provider received proper preventative care and experienced improved health outcomes. 35 BIPOC patients with racially concordant physicians communicated that their physicians explained their medical problems in detail, listened to their concerns, and treated them with respect. These patients were also more likely to choose preventative care and services and not delay in seeking care.…”

“…These patients were also more likely to choose preventative care and services and not delay in seeking care. 35,36 Additionally, evidence is available to support that Black male patients treated by Black physicians could potentially experience reduced cardiovascular mortality. 37 These findings suggest that immense value and improved outcomes result when Black patients are treated by physicians with a similar racial background.…”

“…Providing effective mentors and sponsors of URiM faculty for navigating promotion and tenure requirements at the institutional level, in addition to greater transparency of the promotion process will increase the number of URiM faculty in leadership roles. 35 Traditionally, one avenue for promotion stemmed from research productivity of the surgeon scientist. Black faculty are less likely to receive NIH funding compared with white faculty, even after controlling for demographics, education and training, research productivity, and NIH experience.…”

Introducing the MAVEN Leadership Training Initiative to diversify the scientific workforce

“…In the United States (US), women receive more than half of undergraduate and postgraduate degrees in the biomedical sciences ( Valantine et al, 2016 ), but men – especially non-Hispanic white men – hold the majority of scientific leadership positions. This paucity of diversity is most striking at the levels of center head, division chief, department chair, and dean, and a recent analysis found that the lowest representation of women and racial-ethnic minorities occurred at the full professor/senior scientist level ( Berry et al, 2020 ; Gold et al, 2020 ). Women make up only 18% of full professors in the biomedical sciences, and this statistic has remained largely unchanged over the last 20 years ( Nikaj et al, 2018 ; Valantine et al, 2016 ).…”

Engage me: Will residency program directors listen?

“…Gender imbalance is a problematic issue that is seen in many specialties, especially orthopedics (84.6% males), neurosurgery (82.5% males), and interventional radiology (80.8% males) [ 2 ]. One study notes that Black/African American women make up only 0.79% of the US medical school surgical faculty and are recipients to just 0.34% of NIH grants awarded to academic surgeons [ 3 ]. Program Directors (PDs) have a responsibility to develop a more diverse physician workforce through recruitment and have played integral roles in the movement towards closing this gap in diversity within surgical training.…”