Advancing physician diversity and representation

As I approach the end of my medical school training, I want to take a moment to reflect upon the invaluable education that my classmates — novices in medicine but rich in life experiences — have provided.

Nearly all of us identified with the common struggle of medical school: late night study sessions, difficult days, and the general balancing act of focusing on work as well as our own wellness. All of us also shared a history of successful academic achievement.

However, our differences were more profound than our similarities, and it is through many respectful discussions with my classmates that I learned about just how important diversity and inclusion is in a physician’s education. My peer’s collective diversity — in the form of varying life experiences, cultural backgrounds, religions, race and ethnicities, sexual orientations and gender identities — and our ability to appreciate one another not in spite of, but because of, our uniqueness is one of the most precious educational gifts that I will carry forward as I become a physician. Our generation is privileged — perhaps more privileged than many of our teachers — because we have had the opportunity to train with physicians from so many walks of life. I believe that this will inform our caring approach to our future patients, who will be as diverse as we are.

In recent years, there has been a growing body of research about the underrepresentation of women and minorities in higher education, and medical school in particular. Until I read this research, I was rather unaware of the significant barriers that female medical students must overcome in their careers. I entered medical school believing that advancing in my career would be merit based. If I worked hard, I would have equitable opportunities. But, here’s one thing that my teachers taught me: don’t make assumptions, look at the evidence base. Although I assumed that medicine was a meritocracy, the evidence base suggests otherwise.

For example, ground breaking research led by Dr. Julie Silver and colleagues at Harvard Medical School, has found profound underrepresentation of women physicians for recognition awards–at zero or near zero levels in many instances and across a range of specialties, including dermatology, neurology, anesthesiology, orthopedic surgery, head and neck surgery, and plastic surgery. That is a mighty thick glass ceiling to be looking up at.

Dr. Silver and colleagues suggested a six-step plan that medical societies consider adopting to encourage better support of the entire physician workforce. She explained why medical society recognition awards are so important and the steps in an article that was widely shared and discussed on social media and beyond. These steps are:

  1. Examine diversity and inclusion data through the lens of the organization’s mission, values, and culture.
  2. Report the results to members and stakeholders (including medical schools).
  3. Investigate potential causes to less-than-proportionate representation of women and others.
  4. Implement strategies designed to improve inclusion.
  5. Track outcomes to measure progress and inform future strategies.
  6. Publish the results to engage stakeholders and help advance diversity and inclusion physician workforce agendas.

Another recent example comes from a Harvard physician, Dr. Keith Lillemoe, who gave a presidential address to the American Surgical Association, which was published in the Annals of Surgery. Dr. Lillemoe said that there was not a lack of outstanding, qualified female candidates for open surgical leadership positions in America today. However, he explained that in order to have these women fill these spots leaders must focus on four key components of diversity and inclusion. These components include combating implicit bias, addressing compensation disparity, adapting mentorship programs, and proactively promoting worthy individuals.

When I began medical school, I was full of hope and optimism about the medical world I was joining. Now, as I finish my medical schooling, I remain hopeful, but my optimism is tempered by the reality of the data in front of me. While we vow to treat all patients with equality in our medical oath, the structures that determine our career advancement are not ruled by that same equality.

Underrepresentation of women physicians in our medical societies poses a barrier to the advancement of rising physicians’ careers. Even more troubling than this underrepresentation is the impact that it will have on the future of medicine. The evidence base suggests that if things do not change soon, women will not be filling those leadership roles. Career advancement proves challenging with a sticky floor below and a thick glass ceiling above. I believe that the opportunity to steer the future of medicine in a more diverse, and thus stronger, direction is currently in front of us.

Kirstin I. Weider is a medical student and can be reached on Twitter @KirstinWeider.

Image credit: Shutterstock.com

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