Across the Foundation’s priority areas, our grantees are working to improve the health of the public through innovative research and programs. The Foundation awards up to 40 grants on a rotating schedule each year.
Promotion and Retention of diversity in medical education (PaRoDiME)
Institution: Yale School of Medicine
Grant Type: Board Grant
Award Amount: $250,000
Grant Awarded: May 2010Principal Investigator: Marcella Nunez Smith, MD, MHS
PaRoDiMe, a policy-oriented research project, seeks to contribute key evidence about the racial/ethnic distribution, promotion, and retention of faculty in medical schools across the United States through comprehensive secondary data analyses. Attracting and supporting medical school faculty diversity is critical to fostering a learning environment that prepares future physicians of all racial/ethnic backgrounds to provide high quality care to a multi-ethnic nation.
The racial/ethnic composition of the health care workforce does not reflect the diversity in the U.S. general population. African-Americans, Hispanic Americans, and American Indians represent 25% of the population, but only 8% of all physicians. These disparities extend to academic medical institution faculty. Historically underrepresented minorities (URM) comprise 7% of all current medical school faculty (n= 124, 777) and fewer than 5% of all new academic faculty. The vast majority of racial/ethnic minority academic medical school faculty are concentrated at the assistant professor level; among all racial/ethnic groups, men were more likely than women to hold full professor rank. Furthermore, racial/ethnic minority faculty report less career satisfaction and are promoted at lower rates than their white colleagues. Although generally viewed as a positive milestone in the history of U.S. medical education, the Flexner Report is also cited as contributing to these observed inequities in academic health center faculty diversity.
However, previous studies have not examined how promotion and retention patterns might contribute to this alarming shortage. Specifically, recent promotion rates of medical school faculty by racial/ethnic group are unknown, as is any understanding of job turnover rates of medical school faculty by racial/ethnic group. Without such data, it will be difficult to design effective interventions to attract and support a diverse academic physician workforce.
Researchers’ findings will have several policy implications. First, given the goal of the Association of American Medical Colleges (AAMC) to increase the number of available medical school slots by 30% in the next decade, it is ideal to address the issue of faculty diversity during this period of academic medical center expansion. Second, the Liaison Committee on Medical Education (LCME) recently endorsed a new diversity accreditation standard. The LCME is nationally-recognized as the singular authority to assure high quality standards are met in the structure, function, and performance of medical education programs leading to the M.D. degree in the United States and Canada. Accreditation by the LCME is a prerequisite for an institution’s participation in a broad range of academic activities, including eligibility for many federal grants and programs and eligibility of the graduates to sit for the United States Medical Licensing Examination tests and to apply for state licensure. Medical school leadership and the LCME are now tackling the complex task of operationalizing this newest standard; the findings of their proposed research will provide needed insight into how to assess whether new “policies and practices to achieve appropriate diversity” are successful.
Researchers’ findings will inform policies and best practices to support cultural diversity in medical education with direct and indirect impacts on the training of future generations of health care providers. They build on Hurtado’s model of institutional diversity climate, and this study will provide additional knowledge regarding one component of institutional diversity climate, i.e., structural diversity. As also supported by the work of Hurtado and colleagues, there are practical, theoretical, and empirical rationales for linking faculty diversity with the central educational and civic mission of medical education.
Using data from the Association of American Medical College’s (AAMC) Faculty Roster Database (1966-2008), they will examine historical and current trends in:
- Racial/ethnic distribution of academic medical faculty overall, as well as within specialty departments and by faculty rank across institutions;
- Promotion rates for academic medical faculty from different racial/ethnic groups of academic medical faculty, with sub-group analyses by sex, age at first hiring, specialty department, and generational cohort; and
- Turnover rates (i.e., rates of exiting the institution for any reason) for academic medical faculty from different racial/ethnic groups, with sub-group analyses by sex, age at first hiring, specialty department, and generational cohort.
They will also use these data to develop a measure of institutional diversity inclusive of cross-sectional institutional diversity, racial/ethnic distribution, promotion rates, and turnover rates.