Diversity of physicians in leadership and academic positions in Alberta: a cross-sectional survey

Abstract

BackgroundEfforts to reduce barriers and disparities faced by marginalised physicians are limited by a lack of data on the current diversity of the Canadian physician workforce. We aimed to characterise the diversity of the Albertan physician workforce.MethodsThis cross-sectional survey, open to all Albertan physicians from 1 September 2020 to 6 October 2021, measured the proportion of physicians from traditionally under-represented groups, including those with diverse gender identities, disabilities and from racial minorities.ResultsThere were 1087 respondents (9.3% response rate); of whom 33.4% identified as cisgender men (n=363), 46.8% as cisgender women (n=509) and less than 3% as gender diverse. Fewer than 5% were members of the LGBTQI2S+community. Half were white (n=547), 4.6% were black (n=50) and fewer than 3% were Indigenous or Latinx. Over one-third reported a disability (n=368, 33.9%). There were 303 white cisgender women (27.9%), 189 white cisgender men (17.4%), 136 black, Indigenous or person of colour (BIPOC) cisgender men (12.5%) and 151 BIPOC cisgender women (13.9%). Compared with BIPOC physicians, white participants were over-represented in leadership positions (64.2% and 32.1%; p=0.06) and academic roles (78.7% and 66.9%; p<0.01). Cisgender women had less often applied for academic promotion than cisgender men (85.4% and 78.3%, respectively, p=0.01), and BIPOC physicians had been denied promotion more frequently (7.7% compared with 4.4%; p=0.47).ConclusionMany Albertan physicians may experience marginalisation through at least one protected characteristic. There were race-based and gender-based differences in experiences of medical leadership and academic promotion which may explain observed disparities in these positions. To increase diversity and representation in medicine, medical organisations should focus on inclusive cultures and environments. Universities should focus efforts on supporting BIPOC physicians, especially BIPOC cisgender women, in applying for promotion.

Equity, diversity, inclusion, and social justice in CanMEDS 2025

“… 3 , 4 The physician workforce is recognized to have underrepresentation of several populations including those defined by their sex and gender; their identity as an Indigenous person or belonging to non-dominant racialized, ethnic, cultural or religious groups; by various abilities; and by familial socioeconomic status. 5 , 6 The experiences of members of these and other oppressed populations throughout their medical training are of disadvantage, discrimination, and exclusion 7 . Medical education systems have been constructed to reinforce meritocracy, support hierarchy, perpetuate differences between population groups, and promote the biomedical model to the exclusion of other knowledges.…”

Prevalence and characteristics of anti-Indigenous bias among Albertan physicians: a cross-sectional survey and framework analysis

“…The non-response analysis has been published elsewhere. 20 Data analysis was performed using Stata (College Station, Texas, USA).…”

“…The survey was developed and pilot tested by a diverse team of academic physicians and researchers at the University of Calgary, including First Nations, Métis, settler and racial minority people. The survey had seven total domains (65-175 questions) designed to measure the demographic diversity of currently practising physicians (maximum 59 items), 20 their experiences of the workplace (maximum 113 items) 21 and anti-Indigenous bias (3 items); the results for the other survey objectives are reported elsewhere. Participation was uncompensated, anonymous and voluntary.…”

“…There are about 260 000 Indigenous people living in the province, including approximately 114 000 Métis and 2500 Inuit people in addition to the 48 First Nations communities 24. Indigenous people comprise 6.5% of Alberta’s population but less than 1%–3% of physicians20 25 and 3% of nurses are working in Alberta 26. All physicians affiliated with Alberta Health Services (about 80% of practising physicians) participate in mandatory cultural safety training on an annual basis.…”

“…Assessment of non-response bias was guided by the framework developed by Halbesleben and Whitman35 using comparison of participant demographics with known demographic data about physicians in Alberta obtained from Statistics Canada and the Canadian Institute for Health Information. The non-response analysis has been published elsewhere 20. Data analysis was performed using Stata (College Station, Texas, USA).…”