A survey study believed to be one of the first efforts
to put hard numbers around long-held
beliefs about diversity in medical school faculties has
affirmed that awareness and sensitivity to
racial and ethnic diversity are believed to be poor by most
faculty, and even poorer among faculty who
are members of underrepresented minorities.
The survey was conducted at the Johns Hopkins
University School of Medicine but is likely a
reflection of diversity issues thought to persist at
academic medical institutions across the country,
said principal investigator Lisa Cooper, a professor of
medicine in the Johns Hopkins University School
of Medicine and the Johns Hopkins Bloomberg School of
Public Health.
"What we are seeing at Johns Hopkins is likely to be
the case in medical schools everywhere,
namely that enhancing racial and ethnic diversity in
medicine in general, and in academic medicine in
particular, remains a challenge," Cooper said. The study
results appear in the January issue of
Academic Medicine.
The medical professions have long recognized that
diversity among health care providers can
improve the health of patients among racial and ethnic
minorities and majorities alike, Cooper said.
She added that studies have demonstrated that minority
physicians are more likely to practice in
underserved areas and to care for patients of their own
racial or ethnic group, as well as for low-income patients,
Medicaid-insured and uninsured patients, and patients with
poorer health status.
Studies also suggest that minorities welcome practitioners
who are part of their communities and
sensitive to their cultures.
Cooper, who received a 2007 MacArthur Fellowship for
her landmark studies on racial barriers
to health care, notes that medical schools have striven to
increase diversity among the physician
workforce by implementing programs that increase the number
of minority medical students, such as
targeted recruitment efforts and scholarships.
But even though minority faculty at medical schools
serve as important role models for their
students and recruitment magnets for minorities, diversity
among faculty continues to lag, Cooper
said. Previous studies have shown that minority faculty
have lower job satisfaction than majority
faculty.
Cooper said that the new study, prompted by serious
efforts at Johns Hopkins to recruit and
retain more minority faculty, was designed to quantify the
differences in racial and ethnic perceptions
that contribute to this disparity.
The study was led by Cooper and Eboni G. Price, who
was a fellow in general internal medicine at
Johns Hopkins during the time of this work and is now an
assistant professor of medicine at Tulane
University. Along with their colleagues, Cooper and Price
surveyed 703 tenure-track physicians at the
Johns Hopkins University School of Medicine from 2004 to
2005. The researchers focused on
physicians in clinical departments that had at least one
member of an underrepresented minority, a
category defined as black, Hispanic (Mexican-American and
mainland Puerto Rican) or Native
American. They mailed surveys to both majority and minority
faculty. Of the 352 physicians who
returned their surveys, 30 were underrepresented
minorities. At the Johns Hopkins School of
Medicine, whites make up 74.6 percent;
blacks/African-Americans, 3.8 percent; Hispanics, 2.9
percent; Asians, 18.6 percent; and Native Americans, 0.8
percent of the overall faculty.
The survey, comprising 80 items, asked respondents to
rate their level of agreement with a
series of statements, such as, "Faculty are recruited to my
department in an unbiased manner," and
"At Hopkins, networking opportunities for career
advancement tend to include ethnic minorities."
Overall, the statements were intended to measure
perceptions of bias in five areas: department or
divisional activities, professional satisfaction, career
networking, mentorship and intentions to stay in
academia.
Results showed that fewer than one-third of all the
respondents reported experiences of bias
in their own department's or division's activities.
However, when asked whether they believed overall
faculty recruitment was unbiased, only 21 percent of
underrepresented minority faculty agreed,
compared to 50 percent of majority faculty.
Only 12 percent of underrepresented minority faculty
were satisfied with the institution's
racial and ethnic diversity, compared to 47 percent of
majority faculty. Underrepresented minority
faculty were also three times less likely to believe that
networking opportunities included minorities.
Notably, more than 80 percent of all groups of
respondents believed they would be in a career
in academic medicine in five years. However, only 42
percent of underrepresented minority faculty
said they would still be at Johns Hopkins in five years,
compared to 70 percent of majority faculty.
Cooper said that it's unclear whether underrepresented
minority faculty planned to leave because of
negative experiences or whether they believed that other
promising opportunities would be available
elsewhere.
Either way, Cooper said, there is work to be done at
Johns Hopkins and other academic medical
centers to increase job satisfaction for all faculty and
for underrepresented minorities in particular.
More transparent and diversity-sensitive recruitment
practices and increased networking
opportunities are needed, along with more studies like hers
to quantify the problem and attempt to
solve it.
Other researchers who participated in this study are
Neil R. Powe, David E. Kern, Sherita Hill
Golden and Gary S. Wand.
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