Segmental Analysis of Racial and Ethnic Diversity in the Pipeline to Anesthesiology Fellowship from 2012-2022

Abstract

Purpose

Racial and ethnic minorities have historically experienced inequities in pain assessment and analgesia delivery, as well as worse perioperative outcomes. An equally diverse physician workforce is necessary to care for the needs of this population. Despite ACGME's interest in prioritizing expansion and support of a diverse workforce, the percentage of URiM Anesthesiology trainees is lagging behind the demographic shift in the US.

Methods

We extracted data from the Accreditation Council for Graduate Medical Education (ACGME) graduate medical education Data Resource Book from 2012 to 2022. We performed a Chi-squared analysis of the demographic data of Anesthesiology residents and subspecialty fellows by race and ethnicity then compared to US census demographics & AAMC Matriculant Data File.

Results

Asian residents and fellows are overrepresented in nearly all categories, ie. Anesthesiology residency, Pediatric Anesthesia, Pain Medicine, Adult Cardiothoracic Anesthesia, Critical Care Medicine, and Colon & Rectal Surgery fellowship (all pp<0.001). Black, Hispanic, and Native American doctors are all underrepresented in Anesthesiology residency programs (p<0.001). At the fellowship level, Black candidates are underrepresented in Adult Cardiothoracic Anesthesia (p<.01), Pain Medicine (p<0.001), Pediatric Anesthesia (p<.05), and Critical Care (p<.001). Hispanic candidates are underrepresented in nearly all subspecialty programs: Colon & Rectal surgery (p<.001), Critical Care (p<.001), Obstetric Anesthesia (p<.05), Pediatric Anesthesia (p<.05), Pain Medicine (p<0.001), and Adult Cardiothoracic (p<.001).

Conclusion

The onus now lies with academic medical institutions to cultivate diversity by recruiting and retaining URiM trainees so that the field can better reflect the population and bridge the gap to healthcare equity.