Neha Vapiwala, MD Professor of Radiation Oncology at the Hospital of the University of Pennsylvania
Department: Radiation Oncology, Penn Medicine speaks about the JAMA Oncology - Diversity Trends by Sex and Underrepresented in Medicine Status Among US Radiation and Medical Oncology Faculty Over 5 Decades.
Link to Abstract:
A summary -
It's unclear how the historical exclusion of women and racial and ethnic minorities from medical school and, as a result, oncologic subspecialties, has influenced faculty diversity in oncology departments over time. Oncologic faculty diversity is a critical strategy for improving cancer care and addressing health inequities in an increasingly diverse US cancer community.
To describe comparisons with the general US population, medical students, RO and MO trainees, clinical department chairs, and faculty in other departments, and to report trends in academic faculty representation by sex, race, and ethnicity for radiation oncology (RO) and medical oncology (MO) departments.
Participants, context, and structure:
From 1970 to 2019, data from the Association of American Medical Colleges was utilized to examine trends by gender, race, and ethnicity among full-time US professors in RO and MO departments. Between October 2020 and April 2021, data was evaluated.
The following are the main objectives and assessments:
The proportions of women and people from underrepresented racial and ethnic groups (Black, Hispanic, and Indigenous people) in RO and MO academic departments were estimated, and trends were evaluated over a five-decade period. These proportions were compared to previously described cohorts. In addition, the proportions of women and URMs in RO and MO departments were estimated based on faculty rank.
In 1970, RO had 119 total faculty (10 women [8.4 percent] and 2 URM [1.7 percent]), while MO had 87 total faculty (11 women [12.6 percent ] and 7 URM [8.0 percent ]). In 2019, there were a total of 2115 faculty members in RO (615 women [29.1%] and 108 URM [5.1%]) and 819 total faculty members in MO (312 women [38.1 percent ] and 47 URM [5.7 percent ]). Both RO and MO saw a rise in total teacher numbers over time. In both RO (95 percent CI, 0.005 percent -0.110 percent; P =.06 for trend) and MO (95 percent CI, -0.03 percent to 0.16 percent; P =.06 for trend), faculty representation of URM women increased by 0.1 percent per decade, compared to non-URM women faculty, which increased by 0.4 percent (95 percent CI, 0.25 percent -0.80 percent) per decade in RO and 0.7 percent (95 percent CI, 0.47 percent For RO (0.03 percent per decade [95 percent CI, -0.008 percent to 0.065 percent]; P =.09 for trend) and MO (0.003 percent per decade [95 percent CI, -0.13 percent to 0.14 percent]; P =.94 for trend), faculty representation of URM men did not vary appreciably. In both 2009 and 2019, the representation of women and people of color in both specializations was lower than in the general population of the United States. In 2019, RO faculty had the lowest URM proportion of all cohorts evaluated, at 5.1 percent. In 2019, the overall number of URM faculty represented among both MO and RO remained low at every rank (MO: instructor, 2 of 44 [5 percent ]; assistant professor, 18 of 274 [7 percent ]; associate professor, 13 of 177 [7 percent ]; full professor, 13 of 276 [5 percent ]; and RO: instructor, 9 of 147 [6 percent ]; assistant professor, 57 of 927 [6 percent ]; associate professor, 20 of 510 [4 percent ]; full professor, 18 of 452 [4 percent ]).
Findings and validity:
According to this cross-sectional study, women's representation in RO and MO academic faculty has increased over time, whereas URM presence has lagged. Further research into URM patterns over time is needed to guide measures to improve URM representation in RO and MO.