Trends in the Diversity of Pediatric Faculty, 2000-2020

Background: Workforce diversity is increasingly emphasized in academic medicine, especially regarding recruitment/retention of physicians underrepresented in medicine (UIM). The AAMC Diversity 3.0 initiative stresses that diversity and inclusion in academic medicine are important for addressing health disparities. In pediatrics, a recent study highlighted the lack of diversity among trainees over time. However, trends in the diversity of pediatric faculty have not been clearly illuminated.

Methods: Repeated cross-sectional study of sex, race/ethnicity, and rank in pediatric faculty using AAMC Faculty Rosters from 2000-2020. The AAMC Medical Minority Applicant Registry defines UIM as self-identification as African American/Black (AA/B), Hispanic, American Indian/Alaska Native (AI/AN), or Native Hawaiian/Pacific Islander (NH/PI). Trends in UIM (#UIM/#faculty) were compared longitudinally by sex, race/ethnicity and rank using the Cochran Armitage test for all years, 2000-2020. A two-sided alpha of 0.05 was used for all statistical tests. Data on race/ethnicity of trainees were compared to the general population using US Census Bureau data.

Results: A total of 367,863 pediatric faculty were included. Between 2000 and 2020, the total number of pediatric faulty increased from 9,510 (2000) to 17,033 (2020). Significantly increased trends occurred in UIM faculty representation at all ranks: professor (4.2% in 2000 to 7.7% in 2020, P<.0001); associate professor (7.4% in 2000 to 10.4% in 2020, P=.0001); and assistant professor (11.3% in 2000 to 13.9% in 2020, P=.0001); while significantly decreased trends occurred in non-UIM faculty representation at all ranks. UIM male representation remained unchanged over time (4.0% in 2000 to 4.0% in 2020, P=0.14), while significantly increased trends occurred in UIM female representation (4.4% in 2000 to 7.8% in 2020, P<.0001). Among the different UIM groups, female faculty significantly increased representation at all ranks except for AI/AN. AA/B males significantly decreased representation at the associate (1.4% in 2000 to 1.0% in 2020, P=0.04) and assistant professor levels (1.6% in 2000 to 1.0% in 2020, P<.0001), and AI/AN males significantly decreased representation at the assistant professor rank (0.17% in 2000 to 0.04% in 2020, P<.0001). In 2020, UIM pediatric faculty representation was considerably lower in comparison to representation in the 2019 US population: AA/B, 4.4% versus 13.4%; AI/AN, 0.17% versus 1.3%; NH/PI, 0.08% versus 0.2%; Hispanic, 7.13% versus 18.3%.

Conclusion: In the past 20 years, the percentage of UIM pediatric academic faculty significantly increased over time but was largely driven by the increase in UIM female representation, while male UIM representation remained stagnant, and even decreased in AA/B males. The percentage of UIM faculty representation was considerably lower in comparison to US representation. The stagnation of UIM male representation and lack of faculty diversity reflective of the US population may have a critical impact on the field of pediatrics’ ability to recruit/retain a diverse workforce and promote equitable care.