Diversification of Academic Surgery, Its Leadership, and the Importance of Intersectionality
Diversification of Academic Surgery, Its Leadership, and the Importance of Intersectionality
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DOI：
10.1001/jamasurg.2021.1546
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发表时间：
2021-05-05
期刊：
影响因子：
16.9
通讯作者：
Trevino, Jose G.
中科院分区：
文献类型：
--
作者：
Riner, Andrea N.;Herremans, Kelly M.;Trevino, Jose G.
目的评估外科手术中按性别分层的少数族裔群体以及外科领导的趋势。设计、设置和参与者这项横断面和纵向分析评估了从美国医学院协会教师名册中获得的美国外科教师普查数据，这些数据来自美国医学院协会的教师管理在线用户系统数据库。从2013年12月31日到2019年12月31日的人口普查数据中记录的外科教职员工也被纳入分析范围。教师是从外科教师名册的类别中确定的，其中包括普通外科医生和亚专家、神经外科医生和泌尿科医生。按级别分层的外科教师的主要结果和衡量标准是性别和种族/民族。结果2019年的数据集中共有15 653名美国外科教职员工，其中包括3876名女性(24.8%)。来自种族/少数民族群体的女性教员在教师、助理和副教授职位任命中的代表性有所增加，在几乎所有级别上都比来自种族/少数民族群体的男性教员有更有利的发展趋势。白人教师保持着大多数领导职位，如正式教授(3997人中的3105人[77.7%])和主席(380人中的294人[77.4%])。在手术过程中，黑人(3997人中的106人[2.7%])和西班牙裔/拉丁裔(3997人中的176人[4.4%])的代表性不足程度最大。在正职教授中，尽管黑人和西班牙裔/拉丁裔男性代表略有增加(年度变化，分别为0.07%和0.10%)，但黑人女性代表保持不变(年度变化，0.00004%)，西班牙裔/拉丁裔女性代表下降(年度变化，-0.16%)。西班牙裔/拉丁裔(380人中有20人[5.3%])和黑人(380人中有13人[3.4%])担任主席的人数总体上没有变化，从2013年到2019年，只有1名黑人和1名拉美裔/拉丁裔女性升任主席。结论和相关性少数族裔教职员工获得学术外科领导职位的比例不成比例。交叉可能使种族/少数族裔群体的女性成员在获得领导职位方面比其男性同事更处于不利地位。这些发现突显了外科领导层多样化的紧迫性。(C)2021年美国医学会。版权所有。
IMPORTANCE Diversity in academic surgery is lacking, particularly among positions of leadership.OBJECTIVE To evaluate trends among racial/ethnical minority groups stratified by gender along the surgical pipeline, as well as in surgical leadership.DESIGN, SETTING, AND PARTICIPANTS This cross-sectional and longitudinal analysis assessed US surgical faculty census data obtained from the Association of American Medical Colleges faculty roster in the Faculty Administrative Management Online User System database. Surgical faculty members captured in census data from December 31, 2013, to December 31, 2019, were included in the analysis. Faculty were identified from the surgery category of the faculty roster, which includes general surgeons and subspecialists, neurosurgeons, and urologists.MAIN OUTCOMES AND MEASURES Gender and race/ethnicity were obtained for surgical faculty stratified by rank. Descriptive statistics with annual percentage of change in representation are reported based on faculty rank.RESULTS A total of 15 653 US surgical faculty, including 3876 women (24.8%), were included in the data set for 2019. Female faculty from racial/ethnic minority groups experienced an increase in representation at instructor and assistant and associate professorship appointments, with a more favorable trajectory than male faculty from racial/ethnic minority groups across nearly all ranks. White faculty maintain most leadership positions as full professors (3105 of 3997 [77.7%]) and chairs (294 of 380 [77.4%]). The greatest magnitude of underrepresentation along the surgical pipeline has been among Black (106 of 3997 [2.7%]) and Hispanic/Latinx (176 of 3997 [4.4%]) full professors. Among full professors, although Black and Hispanic/Latinx male representation increased modestly (annual change, 0.07% and 0.10%, respectively), Black female representation remained constant (annual change, 0.00004%) and Hispanic/Latinx female representation decreased (annual change, -0.16%). Overall Hispanic/Latinx (20 of 380 [5.3%]) and Black (13 of 380 [3.4%]) representation as chairs has not changed, with only 1 Black and 1 Hispanic/Latinx woman ascending to chair from 2013 to 2019.CONCLUSIONS AND RELEVANCE A disproportionately small number of faculty from minority groups obtain leadership positions in academic surgery. Intersectionality may leave female members of racial/ethnic minority groups more disadvantaged than their male colleagues in achieving leadership positions. These findings highlight the urgency to diversify surgical leadership. (c) 2021 American Medical Association. All rights reserved.