Academic radiology has a diversity problem
Although great strides have been made in promoting equity, inclusion and diversity in radiology, academic settings still lack adequate representation, according to new data published in the journal Current Problems in Diagnostic Radiology.
Between 1966 and 2021, White men held the significant majority of academic radiology positions. And though meaningful changes were made in some demographics, underrepresented minorities (URM) remain sparse in academia, authors of the paper noted.
“The field of radiology continues to be one of the least diverse disciplines, ranking 17th (out of 20) in female representation and 20th in the representation of historically underrepresented minorities in medicine (Black/African American, Hispanic/Latino, Native American and Pacific Islander),” corresponding author Faisal Khosa, MD, with the department of diagnostic imaging at BC Cancer Vancouver, and colleagues wrote.
Experts derived their data from the American Association of Medical Colleges database of radiology faculty members over a period of 55 years. The group compared academic rank and tenure status for five different ethnoracial groups (White, Asian, Black, Hispanic, and Native American) and subdivided the groups based on two gender identities—men and women.
While white men comprised the majority of academic positions throughout the entire 55 years studied, their presence decreased “significantly” every year, with a .51% drop per year observed for white individuals and a .30% decrease among men. Two groups saw meaningful changes throughout the years—white women (+0.20% per year) and Asian men (+0.23% per year), followed by Asian women.
Conversely, Black, Hispanic and Native American individuals accounted for less than 5% of all academic radiologists throughout the timeframe. And although women did see a significant growth in presence, their representation was consistently outpaced by men.
How education affects diversity
Many of these findings, both from the beginning of the period studied and the end, aligned with U.S. census data. However, Asian representation in academic radiology outpaced census data. This could be due, at least in part, to changes in immigration laws, coupled with the education these individuals received prior to coming into the U.S. at that time.
“With the reforms of the Immigration and Nationality Act (Hart-Cellar Act) in 1965 and the Refugee Act in 1980, there was an influx of Asian immigrants, a large proportion of whom were highly educated and trained in science, technology and medicine,” the authors noted. “In fact, Asian immigrants were found to be twice as likely to have at least a bachelor's degree upon entry to the US and a higher median household income compared to non-Asian immigrants.”
This finding is not exclusive to just radiology, but to many medical specialties. Coming into the U.S. with an education already under their belt might have given this demographic a leg up on their other underrepresented peers, the group suggested.
“The underrepresentation of URM groups may be a result of systemic barriers hindering their ability to gain access to higher educational opportunities, particularly in the US where the cost of education continues to be a barrier for many students coming from socioeconomically disadvantaged backgrounds.”
A multifaceted issue
The reasons behind the lag in diversity are multifactorial. But the lack of well rounded representation could be at least somewhat rooted in the design of the initiatives intended to improve it, the group indicated. They highlighted how efforts to promote gender and racial diversity as separate entities have disproportionately helped white women and minority men, leaving other individuals among these groups, especially underrepresented women, behind.
They added that the end of affirmative action in 2023 makes these findings even more concerning, as institutions are no longer required to consider candidates with varying ethnic and racial backgrounds. As such, it is important for medical schools to take charge and “prioritize initiatives that incorporate the intersectionality framework and address this marked disparity seen in URM groups.”
The study abstract is available here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.