Diversity and Radiology: Where Things Stand

Is radiology becoming more representative of the increasingly diverse population of the country? While the authors of a new study cite improved female representation among academic faculty in radiology departments, they note that the numbers of female and Black applicants to radiology residency are low and relatively unchanged over the course of a decade.

For the study, recently published in Radiology, researchers compared data from two different time periods (2010-2011 and 2019-2020) to assess gender, race and ethnic trends among medical students, applicants to radiology residency programs, radiology residents and faculty within radiology departments at academic institutions.

The study authors noted increases in the percentage of women who were associate professors (improving from 23 percent in 2010 to 28 percent in 2019); professors (improving from 17 percent in 2010 to 22 percent in 2019); and department chairs (improving from 13 percent in 2010 to 17 percent in 2019).

However, the researchers only saw a marginal percentage increase from 2010 to 2019 for female applicants to radiology residency programs despite a five percent increase for women in medical school graduates during the same time period. Out of the study’s 8,756 female graduates of medical school in 2010, 388 (4.4 percent) applied to radiology residency programs, according to the study. In 2019, the study authors noted 11,160 female medical school graduates in the study database and 656 female applicants (5.8 percent) for radiology residency programs. Researchers also pointed out a decrease in female radiology residents from 2010 (1,260) to 2019 (1,166).

“Identifying and addressing the reasons for a low proportion of female radiology residency applicants, despite a highly diverse pool of medical students, would be key to increasing their representation in the field,” wrote study co-author Ajay Malhotra, MD, MMM, a professor at the Yale University School of Medicine, and colleagues.

In regard to the racial and ethnic composition of academic radiology faculty, the study authors noted that Asians saw proportional increases in the numbers of assistant professors (improving from 26 percent in 2010 to 29 percent in 2019); associate professors (improving from 19 percent in 2010 to 28 percent in 2019); and professors (improving from 13 percent in 2010 to 21 percent in 2019). There was also a seven percent increase in the numbers of Asian educators chairing radiology departments (improving from 9 percent in 2010 to 16 percent in 2019), according to the researchers.

However, Malhotra and colleagues found the proportion of Black educators at the assistant professor (3 percent), associate professor (2 percent) and professor levels (2 percent) remained the same between 2010 and 2019. Outside of a 1 percent increase in associate professor representation (from 3 percent to four percent), educators of Hispanic, Latino or Spanish origin saw no increases in the proportion of assistant professor (5 percent) and professor (3 percent) titles between 2010 and 2019.

The study authors also noted marginal increases between 2010 and 2019 for Black radiology residents and those of Hispanic, Latino, or Spanish descent. Black residents comprised 3 percent (139) of the 4,531 radiology residents in the study database in 2010 and 4 percent (166) of the 4,312 radiology residents in 2019. People of Hispanic, Latino or Spanish origin accounted for 5 percent (219) and 6 percent (254) of the radiology residents in 2010 and 2019 respectively.

Acknowledging the lack of Black and Hispanic representation at multiple levels in academic radiology, Malhotra and colleagues suggested that recruitment targeted during the medical school and residency application periods may help address these issues.

Study limitations included the faculty data being drawn from academic radiology practices, which may curtail extrapolation of the study findings to practices outside of academic settings, according to the study authors. They also acknowledged a lack of clarity as to whether race and sex were self-reported. In regard to residency program applicants and residents, Malhotra and colleagues noted the data did not distinguish between race and ethnicity, which may have led to inconsistencies in the reporting of statistics involving Hispanic and Latino populations.