Current Status of Gender and Racial/Ethnic Disparities Among Academic Emergency Medicine Physicians

Madsen, Tracy E.; Linden, Judith A.; Rounds, Kirsten; Hsieh, Yu Hsiang; Lopez, Bernard L.; Boatright, Dowin; Garg, Nidhi; Heron, Sheryl; Jameson, A. Gregory; Kass, Dara; Lall, Michelle D.; Melendez, Ashley M.; Scheulen, James J.; Sethuraman, Kinjal N.; Westafer, Lauren M.; Safdar, Basmah

doi:10.1111/acem.13269

Cited by 93 publications

(168 citation statements)

References 20 publications

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“…This difference in promotion is despite the fact that women are more likely to be fellowship trained, less likely to be core faculty, and less likely to hold administrative roles but work similar hours as their male counterparts. Women are less likely to be chairs, vice‐chairs, or emergency department directors . Most strikingly, even after adjusting for a comprehensive list of variables including race, region, rank, years of experience, clinical hours, core faculty status, administrative roles, board certification, and fellowship training, the mean salary for women is $19,418 less than men .…”

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confidence: 97%

“…Women are less likely to be chairs, vice‐chairs, or emergency department directors . Most strikingly, even after adjusting for a comprehensive list of variables including race, region, rank, years of experience, clinical hours, core faculty status, administrative roles, board certification, and fellowship training, the mean salary for women is $19,418 less than men . This gender salary gap has notably remained stable over the past few years …”

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confidence: 99%

“…An additional theory is that women are more likely to face career stagnation manifested by promotion disparities. 2018 AAMC data show a decline in female representation at each escalating faculty rank position, from instructor (46.7%) to assistant professor (39.6%) to associate professor (28.9%) and full professor (18.1%) . This difference in promotion is despite the fact that women are more likely to be fellowship trained, less likely to be core faculty, and less likely to hold administrative roles but work similar hours as their male counterparts.…”

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confidence: 99%

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Gender Disparities in Academic Emergency Medicine: Strategies for the Recruitment, Retention, and Promotion of Women

Agrawal

Madsen

Lall

et al. 2019

AEM Education and Training

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Although women comprise half of all medical students, the number of female academic emergency medicine (EM) physicians remains at approximately 27%. In addition, despite having equivalent credentials, female EM faculty remain underrecognized and undercompensated when compared to their male counterparts. Recent studies have shown superior outcomes among patients treated by EM physicians who are women; however, disparities in advancement persist. This white paper, prepared on behalf of the Academy for Women in Academic Emergency Medicine, describes recent evidence demonstrating gender disparities in the EM workforce including content presented at the 2019 Society for Academic Emergency Medicine Annual Scientific Meeting. The authors describe strategies to address the identified problems. Specific recommendations include individual as well as institutional/systems-level approaches to creating directed programming and initiatives to recruit, support, and promote women at all aspects of the career continuum.

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confidence: 97%

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confidence: 99%

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confidence: 99%

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Gender Disparities in Academic Emergency Medicine: Strategies for the Recruitment, Retention, and Promotion of Women

Agrawal

Madsen

Lall

et al. 2019

AEM Education and Training

Self Cite

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“…According to the 2013–2014 AAMC report, The State of Women in Academic Medicine , only 15% of department chairs and 16% of deans are women, with only a marginal increase observed over the past decade . In a 2015 survey of EM physicians, of 113 chair/vice chair positions, only 15% were women, and only 18% were nonwhite . The lack of women and underrepresented minorities (URM) at higher ranks is also congruent with cross‐sectional data from the AAMC, despite women constituting close to 50% of all graduating medical students …”

Section: Discussionmentioning

confidence: 60%

“…In a 2015 survey of EM physicians, of 113 chair/vice chair positions, only 15% were women, and only 18% were nonwhite . The lack of women and underrepresented minorities (URM) at higher ranks is also congruent with cross‐sectional data from the AAMC, despite women constituting close to 50% of all graduating medical students …”

Section: Discussionmentioning

confidence: 77%

The Vice Chair of Education in Emergency Medicine: A Workforce Study to Establish the Role, Clarify Responsibilities, and Plan for Success

Papanagnou

Messman

Branzetti

et al. 2019

AEM Education and Training

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Objectives: Despite increasing prevalence in emergency medicine (EM), the vice chair of education (VCE) role remains ambiguous with regard to associated responsibilities and expectations. This study aimed to identify training experiences of current VCEs, clarify responsibilities, review career paths, and gather data to inform a unified job description.Methods: A 40-item, anonymous survey was electronically sent to EM VCEs. VCEs were identified through EM chairs, residency program directors, and residency coordinators through solicitation e-mails distributed through respective listservs. Quantitative data are reported as percentages with 95% confidence intervals and continuous variables as medians with interquartiles (IQRs). Open-and axial-coding methods were used to organize qualitative data into thematic categories.Results: Forty-seven of 59 VCEs completed the survey (79.6% response rate); 74.4% were male and 89.3% were white. Average time in the role was 3.56 years (median = 3.0 years, IQR = 4.0 years), with 74.5% serving as inaugural VCE. Many respondents held at least one additional administrative title. Most had no defined job description (68.9%) and reported no defined metrics of success (88.6%). Almost 78% received a reduction in clinical duties, with an average reduction of 27.7% protected time effort (median = 27.2%, IQR = 22.5%). Responsibilities thematically link to faculty affairs and promotion of the departmental educational mission and scholarship.Conclusion: Given the variability in expectations observed, the authors suggest the adoption of a unified VCE job description with detailed responsibilities and performance metrics to ensure success in the role. Efforts to improve the diversity of VCEs are encouraged to better match the diversity of learners.From the

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Effect of Physician Gender and Race on Simulated Patients’ Ratings and Confidence in Their Physicians

et al. 2020

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IMPORTANCE Women and black physicians encounter workplace challenges because of their gender and race. It is unclear whether these individuals are assessed with lower patient satisfaction or confidence ratings compared with white male physicians. OBJECTIVE To examine whether physician gender and race affect participant ratings in scenarios in which physician competence is challenged. DESIGN, SETTING, AND PARTICIPANTS This randomized trial enrolled a geographically diverse sample of 3592 online respondents in the United States who were recruited from 2 crowdsourcing platforms: Amazon Mechanical Turk (n = 1741) and Lucid (n = 1851). A 2 × 2 factorial design for the gender and race of simulated physicians was conducted between March 9 and July 25, 2018. Participants were excluded before intervention if they were younger than 18 years, were pregnant, or had a history of cancer or abdominal surgical procedures. INTERVENTIONS A clinical vignette was presented to the participant with a picture of the emergency department physician. Participants were randomly assigned to physicians with different gender and race, with 823 assigned to black women, 791 to black men, 828 to white women, and 835 to white men. A contradictory diagnosis from an online symptom checker introduced doubt about the clinical diagnosis. MAIN OUTCOMES AND MEASURES A composite outcome (range, 0-100, with 0 representing low patient confidence and satisfaction and 100 representing the maximum on the composite scale) measured participant (1) confidence in the physician, (2) satisfaction with care, (3) likelihood to recommend the physician, (4) trust in the physician's diagnosis, and (5) likelihood to request additional tests. RESULTS Among 3277 adult participants, complete data were available for 3215 (median age, 49 years [range, 18-89 years]; 1667 [52%] female; 2433 [76%] white). No significant differences were observed in participant satisfaction and physician confidence for the white male physician control physicians (mean composite score, 66.13 [95% CI, 64.76-67.51]) compared with white female (mean composite score, 66.50 [95% CI, 65.19-67.82]), black female (mean composite score, 67.36 [95% CI, 66.03-68.69]), and black male (mean composite score, 66.96 [95% CI, 65.55-68.36]) physicians. Machine learning with bayesian additive regression trees revealed no evidence of treatment effect heterogeneity as a function of participants' race, gender, racial prejudice, or sexism. (continued) Key Points Question In a simulated clinical encounter, do participants evaluate physicians differently based on the physician's gender or race? Findings In this randomized trial of 3592 online respondents, simulated physician gender and race did not significantly affect participant satisfaction or confidence in physician clinical judgment compared with a white male physician control. Meaning Participants reported equal satisfaction and confidence in the simulated physicians' diagnosis and treatment plans regardless of the physician's gender or race.

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Current Status of Gender and Racial/Ethnic Disparities Among Academic Emergency Medicine Physicians

Cited by 93 publications

References 20 publications

Gender Disparities in Academic Emergency Medicine: Strategies for the Recruitment, Retention, and Promotion of Women

Gender Disparities in Academic Emergency Medicine: Strategies for the Recruitment, Retention, and Promotion of Women

The Vice Chair of Education in Emergency Medicine: A Workforce Study to Establish the Role, Clarify Responsibilities, and Plan for Success

Effect of Physician Gender and Race on Simulated Patients’ Ratings and Confidence in Their Physicians

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