G. Eckenrode1,2, M. Symer1, J. Abelson1, A. Watkins1, H. Yeo1,2 1Weill Cornell Medical College,Surgery,New York, NY, USA 2Weill Cornell Medical College,Healthcare Policy,New York, NY, USA
Introduction: Racial and ethnic diversity is low in academic surgery, especially in leadership positions. However, no study has quantified differences in the rates of retention and promotion of racial and ethnic minority surgeons in academia. We used the American Association of Medical Colleges (AAMC) Faculty Roster to track a large cohort of academic surgeons and evaluate their rates of promotion and retention by race.
Methods: The AAMC Faculty Roster is a comprehensive database which aggregates national, longitudinal data on academic faculty. All first-time assistant and associate professors appointed between January 1, 2003 and December 31, 2006 in surgery were included. Individuals were followed for up to 10 years from their initial appointment; until they were promoted, stayed at their current rank, or left full-time academia. Faculty who switched institutions were included in the analysis. Log-rank test was used to determine the impact of race and ethnicity on promotion (increase in academic rank) and retention (persistence in academic surgery regardless of rank). Individuals of Black, Hispanic, or Other race/ethnicity (such as American Indian or other/multiple/unknown) were grouped due to data limitations.
Results:There were 3,966 academic surgeons who began academic appointments from 2003 to 2006, of whom 2,683 were assistant professors and 1,283 were associate professors. Faculty were predominantly White (n=2,617), followed by Asian (n=559), and Black, Hispanic, or Other race/ethnicity (n=790). There was a non-significant trend toward lower promotion of Black/Hispanic/Other assistant professors (Black/Hispanic/Other 26.7% promoted at 10 years, Asian 33.3%, White 34.4%, p=0.07). There was a similar difference in 10-year promotion rates of associate professors between these groups (Black/Hispanic/Other n=53, 28.8%; Asian n=43, 30.3%; White n=294, 30.7%; p=0.10). However, retention rates were significantly higher for White assistant professors (n=1,017, 61.3% retained at 10 years) than Asian (n=220, 52.8% retained) or Black/Hispanic/Other faculty (n=308, 50.8% retained; p<0.01). There was no significant difference in 10-year retention rates among associate professors based on race/ethnicity (Black/Hispanic/Other 71.2%, Asian 69.7%, White 69.3%, p=0.72).
Conclusion:Overall, promotion rates in academic surgery over a 10-year period were low, with a trend to lower rates among underrepresented minorities. In addition, there is a clear disparity in the retention of minority assistant professors of surgery. Other differences in the retention and promotion of minority faculty were not significant, possibly due to the small numbers of minority faculty even in this national study. Racial/ethnic minority faculty face unique barriers in remaining in academic surgery particularly at the start of their career. To build a diverse workforce in academic surgery, a renewed focus should be made on retaining early-career minority faculty.