Exploring Minority Representation in Leadership Positions in Medical Education

• In Event: Reimagining Leadership for Equity Across the Career Continuum: Navigating in a Time of Transformation

Abstract

Objectives or Purpose
Medical schools in the United States suffer from a skewed representation of minority groups both in the student body and faculty. Faculty from minority groups face discrepancies in representations and career progression. Minority faculty are predominantly represented in the assistant professor or instructor ranks, and few minorities rise to leadership positions in medical schools. The lack of minorities in leadership positions can be seen as an “exclusion and denial” of their voices without which their issues, concerns, and achievements may not be explored or addressed. This lower representation at higher ranks and leadership positions potentially further affects the retention of minority faculty creating a “leaky pipeline”. Minorities need to be included in leadership positions to facilitate equitable distribution of power, ensure minority voices are included in policy decisions, and enable the disruption of systemic inequities.
Equity begins with parity in representation, i.e., equal percentage representation of a group at lower and higher organizational levels. An exploratory study was conducted to answer the research question: What is the level of parity representation in leadership positions at academic medical centers, examined by gender and by available race/ethnic categories?
Methods, techniques and data sources
The US Medical School Faculty data from 2010-2021 was used to see recent trends in minority representation at leadership levels of department chairs and deans. The Leadership Parity Index (LPI) was used to calculate parity representation and comparisons were made by gender and race/ethnicity.
Leadership Parity Index=(A group^' s percentage representation as leaders)/( The group' s percentage representation as faculty)
An LPI of 1.00 represents parity in the percentage of leaders and faculty. A value below 1.00 indicates under-representation and a value over 1.00 indicates over-representation. The goal is to have a parity index of 1.
Results and/or substantiated conclusions
Within the datasets studied, the LPI for women and Asians was consistently below parity, indicating under-representation. Faculty who identified as White had LPIs above parity. When parsed by gender and race/ethnicity, Asian women had the lowest LPI of all race/ethnicities.
Scientific or scholarly significance of the study or work
The “critical mass” argument holds that when a group constitutes 30-35% of the total, they would form a critical mass that would lead to more representation in leadership. Women and Asians have achieved critical mass representation within medical school faculty and student body. However, this has not translated into a proportional increase in leadership representation.
This study confirms that “critical mass” has failed to lead to diversity in medical school leadership. Therefore, diversity, equity, and inclusivity efforts need to take a nuanced approach to representation. The findings of this study show that aggregate data may not provide a true picture of equity and parity in medical schools.
The discourse around diversity and inclusion has focused on recruitment and retention through inclusion and engagement. However, it is insufficient to open the door and usher in more minority faculty. Rather, minority faculty need to be supported throughout their career, including adequate preparation for leadership positions.

Authors

• Anita Samuel, Uniformed Services University of the Health Sciences

• Michael Soh, Uniformed Services University of the Health Sciences

• Steven J. Durning, Uniformed Services University of the Health Sciences

• Ronald M. Cervero, Uniformed Services University of the Health Sciences

• Huiju Carrie Chen, Kaiser Permanente Bernard J. Tyson School of Medicine