Data Highlights Underrepresentation of Racial and Ethnic Minority Groups in Resident Selection in 11 Specialties

by Linda Kossoff •

What racial and ethnic differences in resident selection exist in 11 chosen medical specialties?

BOTTOM LINE

Overrepresentation of White matched residents and underrepresentation of racial and ethnic minority groups other than Asian across competitive specialties suggests systemic disparities within the selection process, and research is needed to examine why these differences exist.

BACKGROUND: The Institute of Medicine and others have argued that a diverse healthcare workforce reflecting population demographics can improve access to high-quality care, patient satisfaction, and outcomes. However, there has been minimal improvement over time in the proportions of matched residents to U.S. programs from groups underrepresented in medicine.

STUDY DESIGN: Data study.

SETTING: Department of Otolaryngology–Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, Joint Base San Antonio–Fort Sam Houston, Texas.

SYNOPSIS: Researchers obtained reports from 2013 to 2018 from the Association of American Medical Colleges Electronic Residency Application Service containing the racial and ethnic representations of applicants, and resident data on Accreditation Council for Graduate Medical Education programs, in 11 competitive specialties. Yearly numbers of applicants and matched residents within a specialty were aggregated. Racial and ethnic proportions of total applicants were compared with matched residents for three groups: Asian, White (non-Hispanic), and underrepresented (African American or Black, American Indian or Alaska Native, Hispanic or Latino, and Native Hawaiian or Pacific Islander). The aggregate number of applicants ranged from 1,142 in radiation oncology to 17,917 in emergency medicine. The proportion of White applicants ranged from 0.52 in radiology (3,632/6,939) and radiation oncology (593/1,142) to 0.67 in orthopedic surgery (4,601/6,906). The proportion of White matched residents was significantly higher than the proportion of applicants in 54.5% (6/11) of the specialties. The proportion of underrepresented applicants ranged from 0.08 in otolaryngology (198/2,485) to 0.19 in obstetrics/gynecology (2,385/12,590); the proportion of matched underrepresented residents was significantly lower than applicants in all specialties. Study limitations included the lack of data before 2013.

CITATION: Bowe SN, Bly RA, Wang X, et al. Racial and ethnic differences in resident selection in 11 specialties, 2013–2018. JAMA. 2022;327:2450–2452.