Trends in Internal Medicine Faculty by Sex and Race/Ethnicity, 1980-2018

Importance Increasing diversity in the physician workforce is a fulcrum for reducing health disparities. Efforts to increase the diversity in the internal medicine (IM) workforce may improve health equity among an increasingly diverse population with increasing prevalence of chronic disease. Objectives To assess diversity trends in the academic IM workforce and evaluate how well these trends reflected medical student diversity and the changing demographic composition of the general population. Design, Setting, and Participants This secondary analysis of a cross-sectional study analyzed data from January 1, 1980, to December 31, 2018, from the Association of American Medical Colleges Faculty Roster and Applicant Matriculant File, which capture full-time US medical school faculty and matriculants, respectively, and population data through 2017 from the US Census Bureau. Main Outcomes and Measures The study calculated the proportions of women and individuals from racial/ethnic groups that are traditionally underrepresented in medicine (URM) among IM faculty and faculty in all other clinical departments. These data were compared with the proportions of female and URM matriculants in US medical schools and the proportions of women and individuals from underrepresented racial/ethnic groups in the population. The analysis was stratified by sex, race/ethnicity, and intersections of sex and race/ethnicity. Results From 1980 to 2018, the absolute number of full-time IM faculty increased from 10964 to 42547. Although IM was the department classification with the most women faculty, in 2018 it continued to have a lower proportion of women (n = 17165 [40.3%]) compared with all other clinical departments (n = 48936 [43.2%]). Among IM faculty, the percentage of URM faculty members more than doubled during the study period (from 4.1% to 9.7%) but still made up only a small portion of faculty members. The percentage of female matriculants among medical school matriculants increased steadily (from 28.7% in 1980 to 51.6% in 2018) and was nearly identical to their population representation in 2017 (50.7% compared with 50.8%). Although the percentage of URM matriculants had nearly doubled since 1980 (from 11.3% to 18.1%), it still lagged far behind the proportion of individuals in the US population who are members of underrepresented racial/ethnic groups (18.1% vs 31.5% in 2017). Conclusions and Relevance This cross-sectional study found that progress has been made in diversifying academic IM faculty; however, it does not yet reflect the diversity of medical students or the US population. Continued efforts to increase the diversity of the academic IM workforce are needed. Question Did sex and racial/ethnic diversity in the academic internal medicine workforce between 1980 and 2018 reflect the changing demographic composition of the general population (in 2017) and medical student body? Findings This cross-sectional study used data on full-time medical school faculty appointed to US internal medicine departments from 1980 to 2018, matriculants to US medical schools from 1980 to 2018, and the general US population from 1980 to 2017. The study found that progress was made in diversifying the academic workforce; however, it may not yet reflect the diversity of US medical students or the US population. Meaning These findings suggest that continued improvement of recruitment and retention efforts for women and groups who are underrepresented in medicine as medical students and faculty in internal medicine is needed. This secondary analysis of a cross-sectional study of internal medicine faculty and medical school matriculants assesses diversity trends in the academic internal medicine workforce and evaluates how well these trends reflect medical student diversity and the changing demographic composition of the general population.