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. 2024 Jul;39(9):1556-1566.
doi: 10.1007/s11606-023-08554-0. Epub 2023 Dec 15.

End of Affirmative Action-Who Is Impacted Most? Analysis of Race and Sex Among US Internal Medicine Faculty

Rui Yang Xu  1 , Nilita Sood  2 , Jeffrey Ding  1 , Nadia Khan  1 , Sabeen Tiwana  3 , Javed Siddiqi  4 , Ateeq Rehman  5 , Namirah Jamshed  6 , Faisal Khosa  7
Affiliations

End of Affirmative Action-Who Is Impacted Most? Analysis of Race and Sex Among US Internal Medicine Faculty

Rui Yang Xu et al. J Gen Intern Med. 2024 Jul.

Abstract

Background: For over 50 years, the United States (US) used affirmative action as one strategy to increase diversity in higher education including medical programs, citing benefits including training future public and private sector leaders. However, the recent US Supreme Court ending affirmative action in college admissions threatens advancements in the diversity of medical college faculty.

Objective: Our study evaluated the demographic trends in Internal Medicine (IM) faculty in the US by assessing sex and race/ethnicity diversity to investigate who is likely to be impacted most with the end of affirmative action.

Design: Longitudinal retrospective analysis SUBJECTS: IM faculty from the Association of American Medical Colleges faculty roster from 1966 to 2021 who self-reported sex and ethnicity MAIN OUTCOMES: The primary study measurement was the annual proportion of women and racial/ethnic groups among IM faculty based on academic rank and department chairs.

Results: Although racial/ethnic diversity increased throughout the era of affirmative action, African American, Hispanic, and American Indian populations remain underrepresented. White physicians occupied > 50% of faculty positions across academic ranks and department chairs. Among the non-White professors, Asian faculty had the most significant increase in proportion from 1966 to 2021 (0.6 to 16.6%). The percentage of women increased in the ranks of professor, associate professor, assistant professor, and instructor by 19.5%, 27.8%, 25.6%, and 26.9%, respectively. However, the proportion of women and racial/ethnic minority faculty decreased as academic rank increased.

Conclusion: Despite an increase in the representation of women and racial/ethnic minority IM faculty, there continues to be a predominance of White and men physicians in higher academic ranks. With the end of affirmative action, this trend has the danger of being perpetuated, resulting in decreasing diversity among IM faculty, potentially impacting patient access and health outcomes.

Keywords: affirmative action; diversity; equity; internal Medicine; patient outcomes.

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Conflict of interest statement

Dr. Faisal Khosa received the Don Rix Physician Leadership Lifetime Achievement Award (2022); B.C. Achievement Foundation – Mitchell Award of Distinction (2022); University of British Columbia – Distinguished Achievement Award for Equity, Diversity & Inclusion (2022); and Vancouver Medical Dental & Allied Staff Association – Equity, Diversity & Inclusion Award (2022). In addition, Dr. Khosa is the recipient of the Health Professional-Investigator Award of the Michael Smith Foundation for Health Research (HPI-2022-2876).

Figures

Figure 1
Figure 1
Annual number of full-time Internal Medicine faculty per race/ethnicity across the medical schools in the US from 1966 to 2021, based on academic rank: A professor; B associate professor; C assistant professor, and D instructor.
Figure 1
Figure 1
Annual number of full-time Internal Medicine faculty per race/ethnicity across the medical schools in the US from 1966 to 2021, based on academic rank: A professor; B associate professor; C assistant professor, and D instructor.
Figure 2
Figure 2
Annual number of Internal Medicine department chairs per race/ethnicity across the medical schools in the US from 1977 to 2021.
Figure 3
Figure 3
Annual percentage of full-time Internal Medicine faculty per identified sex (men—blue, women—orange) across the medical schools in the US from 1966 to 2021, based on academic rank: A professor; B associate professor; C assistant professor, and D instructor.
Figure 4
Figure 4
Annual percentage of Internal Medicine department chairs identified sex (men—blue, women—orange) across the medical schools in the US from 1977 to 2021.
Figure 5
Figure 5
Annual percentage, by ethnicity, of A women full-time Internal Medicine (IM) faculty across the medical schools in the US from 1966 to 2021, B men full-time IM faculty across the medical schools in the US from 1966 to 2021, C women IM professors across the medical schools in the US from 1966 to 2021, D men IM professors across the medical schools in the US from 1966 to 2021, E women IM chairs across the medical schools in the US from 1977 to 2021, and F men IM chairs across the medical schools in the US from 1977 to 2021.
Figure 5
Figure 5
Annual percentage, by ethnicity, of A women full-time Internal Medicine (IM) faculty across the medical schools in the US from 1966 to 2021, B men full-time IM faculty across the medical schools in the US from 1966 to 2021, C women IM professors across the medical schools in the US from 1966 to 2021, D men IM professors across the medical schools in the US from 1966 to 2021, E women IM chairs across the medical schools in the US from 1977 to 2021, and F men IM chairs across the medical schools in the US from 1977 to 2021.
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References

    1. Chung A, Kruzel J. US Supreme Court rejects affirmative action in university admissions. Reuters [Internet]. 2023 Jun 29 [cited 2023 Jun 30]; Available from: https://www.reuters.com/legal/us-supreme-court-strikes-down-university-r...
    1. Jones N, Marks R, Ramirez R, Rios-Vargas M. 2020 Census Illuminates Racial and Ethnic Composition of the Country [Internet]. United States Census Bureau. [cited 2023 Oct 23]. Available from: https://www.census.gov/library/stories/2021/08/improved-race-ethnicity-m....
    1. Li SNJ, Siddiqi J, Mahmood A, Khosa F. Equity, diversity, and inclusion in academic Internal Medicine at US medical schools. Eur J Intern Med. 2020;71:89–91. doi: 10.1016/j.ejim.2019.10.027. - DOI - PubMed
    1. Ogunwole SM, Dill M, Jones K, Golden SH. Trends in Internal Medicine faculty by sex and race/ethnicity, 1980–2018. JAMA Netw Open. 2020;3(9):e2015205. doi: 10.1001/jamanetworkopen.2020.15205. - DOI - PMC - PubMed
    1. Niu BT, Nicolaou S, Levine D, Sanelli PC, Abujudeh H, Siddiqi J, et al. Trends in gender and racial profiles of US academic radiology faculty. J Am Coll Radiol. 2020;17(10):1337–43. doi: 10.1016/j.jacr.2020.03.019. - DOI - PubMed

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