“Systemic disparities” present in the selection of residences: study

replica, a recent movie which highlights the plight of two black women who died of complications in childbirth, may help continue a national conversation about the black maternal mortality rate in the United States. According to the Centers for Disease Control and Prevention, the maternal mortality rate for non-Hispanic black women is 2.9 times higher than the rate for non-Hispanic white women.


Increasing the number of black women in obstetrics/gynecology can help. But first, black medical school students must have access to residency programs.

A recent study which was published in JAMA focuses on racial and ethnic differences in the selection of residents in eleven specialties. Defined as underrepresented groups in the study are Blacks, American Indians, Alaska Natives, Hispanics, Latinos, Hawaiians and Pacific Islanders.

The JAMA The study yielded two results: matched white residents were overrepresented and non-Asian racial and ethnic minority groups were underrepresented in the 11 competitive specialties included in the study.

Further research is needed to determine the reasons for these differences, according to the researchers. This includes assessment through the screening, examination, interview and ranking stages of the selection process.

For example, in obstetrics and gynecology, although white individuals made up 53% of the candidate pool, they were present in a higher proportion among matched residents, 60%, according to the study. In comparison, 19% of obstetrics and gynecology applicants identified themselves as underrepresented, but only 11% of obstetrics and gynecology residents were underrepresented.

There were also lower percentages of matched residents among underrepresented applicants in the other 10 specialties studied, including general surgery (15% applicants; 9% matched), emergency medicine (12% applicants; 7% matched) and neurological surgery (13% candidate pool, 8% matched).

Sarah Bowe, MD, a U.S. Air Force pediatric otolaryngologist and study co-author, said Medscape Medical News“In our study, we found evidence of disproportionate selection, suggesting systemic disparities in the resident selection process. Efforts to diversify the physician workforce will remain stagnant if recruitment efforts do not translate into more proportionate selection rates.”

Critically important to meeting this challenge, Bowe said, are physicians and physician leaders who make “intentional efforts to develop underrepresented candidates in medicine.”

For example, physicians can participate in mentoring organizations that support underrepresented medical students, such as the Student National Medical Association (which supports current and future medical students from underrepresented minorities) and the Latino Medical Student Association. .

Increasing diversity improves patient experience

For black patients, being seen by a black doctor can create a feeling of comfort and may reduce anxiety and pain, according to a 2020 study published in pain medication. This is significant in light of a 2016 study, which was published in Proceedings of the National Academies of Sciences, which found that half of medical students and residents thought black patients felt less pain than white patients.

Yet the number of black doctors remains stubbornly low. A study 2019 found that black male students made up 2.9% of the national medical school student body; in 1978, 3.1% of the medical school’s national body was made up of black students. Of the number of black men in medical school, 15% are enrolled in historically black medical schools, such as Howard University College of Medicine, in Washington, DC, and Meharry Medical College, in Nashville.

According to the American Association of Colleges of Medicine (AAMC), 6.2% of medical students in 2019 were black. In January 2022, the AAMC announcement that the incoming class of medical students in the fall of 2021 was more diverse than at any time in history. Of the more than 22,000 students who started medical school in 2021, the number of blacks rose 21% from the previous year. In addition, there were 8.3% more Asian students in medical school and more than 7.1% more students of Hispanic or Latino origin than the previous academic year, according to the report. ‘AAMC.

About 2.6% of all active physicians in the United States are black women.

David Satcher, MD, PhD, who served as the Surgeon General of the United States from 1988 to 2002, wrote a viewpoint article that was published in JAMA in 2021 regarding the urgency of reinventing the patient-doctor relationship, due to racial disparities related to the COVID-19 pandemic.

Satcher, who also served as president of Meharry Medical College, noted that life expectancy dropped about 2.7 years for blacks and about 2 years for Latinos in the first 6 months of 2020. In comparison, the Whites are estimated to have lost less than 1 year.

JAMA. Published online June 28, 2022. Summary

Bowe’s comments are his own and do not reflect official Air Force policy.

Aine Cryts is a seasoned IT and healthcare writer.

For more information, follow Medscape on Facebook, Twitter, instagramand Youtube.

Martin E. Berry