Despite Progress, Emergency Medicine Still Dominated by Male Physicians
The Bottom Line
A new study from The American Journal of Emergency Medicine that included first author Judith Linden, MD, Senior Vice Chair of Emergency Medicine at Boston Medical Center—as well as researchers from other academic institutions—examined the temporal change in women and URiM composition with respect to leadership role and academic rank, over a six-year time span between 2015 and 2020.
A physicians' race and ethnicity were recorded as URiM based on the Association of American Medical Colleges (AAMC) deﬁnition as “racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.” White or Asian was coded as not URiM, while Black/African American, other races and Hispanic ethnicity were all recorded as URiM.
Physician leadership roles were divided into four main categories: no leadership role (primary position clinical only), operations leadership (overseeing clinical operations), education leadership (residency program/medical student education), research leadership (research director), and executive leadership (chair/vice chair).
Primary analyses focused on gender/racial differences in leadership roles and academic rank. Secondary analyses focused on disparities during the ﬁrst 10 years of practice. Statistical modeling was conducted to address the primary aim of assessing differences in gender and racial representation in EM leadership roles and rank over time.
More women were consistently in the early career cohort (within 10 years or less as faculty) in 2015 (75% vs. 61%) and in 2020 (75% vs. 63%). Men were signiﬁcantly more likely to have any leadership role compared to women in 2015 (54% vs. 45%) and in 2020 (43% vs. 35%). Higher academic rank (associate/professor) was signiﬁcantly more common among early career men than women in 2015 (21% vs. 13%) and in 2020 (23% vs. 17%).
In examining the effect of URiM status in leadership representation in 2015 and 2020, those who were identiﬁed as URiM were signiﬁcantly more likely than non-URiM to have no leadership role (57% vs. 54%). Across survey years URiM identiﬁed faculty were less likely to be in executive roles (4% vs. 18%) and education leadership roles (13% vs. 15%). Given the small number of URiM in this database, the authors were unable to perform an analysis to separate out Black women and men.