AEM Early Access 06: Gender and Racial Disparities Among Academic Emergency Medicine Physicians

Welcome to the sixth episode of AEM Early Access, a FOAMed podcast collaboration between the Academic Emergency Medicine Journal and Brown Emergency Medicine. Each month, we'll give you digital open access to an AEM Article in Press, with an author interview podcast and suggested supportive educational materials for EM learners.

Find this podcast series on iTunes here.

           A FOAM Collaboration: Academic Emergency Medicine Journal and Brown EM

           A FOAM Collaboration: Academic Emergency Medicine Journal and Brown EM

LISTEN NOW: Author INTERVIEW WITH DR. TRACY MADSEN

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Dr. Tracy Madsen

Assistant Professor, Division of Sex and Gender in Emergency Medicine (SGEM)

Department of Emergency Medicine

Alpert Medical School, Brown University

Full text of this month's article (open access through November 1, 2017): Click below

Tracy E. Madsen, et al., “Current Status of Gender and Racial/Ethnic Disparities Among Academic Emergency Medicine Physicians,” A Joint 2015 Report by Academy for Women in Academic Emergency Medicine (AWAEM), Academy for Diversity & Inclusion in Emergency Medicine (ADIEM) and Academy of Administrators in Academic Emergency Medicine (AAAEM).

ARTICLE SUMMARY:

Objective: A 2010 survey identified disparities in salaries by gender and underrepresented minorities.  With an increase in the EM workforce since, the authors aimed to 1) describe the current status of academic EM workforce by gender, race and rank, and 2) evaluate if disparities still exist in salary or rank by gender.

Methods: Information on demographics, rank, clinical commitment, and base and total annual salary for full-time faculty members in U.S. academic EDs was collected in 2015 by the Academy of Administrators in Academic Emergency Medicine (AAAEM) Salary Survey.  Multiple linear regression was used to compare salary by gender while controlling for confounders.

Results:

  • Response rate was 47% for 1371 full-time faculty

  • 33% were women

  • 78% White, 4% Black, 5% Asian, 3% Asian Indian, 4% other, and 7% unknown race

  • White vs nonwhite race:

    • 62% vs 69% instructor/assistant

    • 23% vs 20% associate

    • 15% vs 10% full professors

  • Women vs men (p<0.05):

    • 74% vs 59% instructor/assistant

    • 19% vs 24% associate

    • 7% vs 17% full professors

    • 37% vs 31% fellowship trained

    • 59% vs 64% Core Faculty

    • 47% vs 57% had administrative roles

    • 1069 vs 1051 clinical hours worked

  • 15% of 113 Chair/Vice-Chair positions were women, 18% were nonwhite race

  • Mean salary: $278,631

    • Mean salary of women was $19,418 less (SD +/- $3,736, p<0.001) even after adjusting for race, region, rank, years of experience, clinical hours, core faculty status, administrative roles, board certification, and fellowship training

Conclusions: In 2015, disparities in salary and rank persist among full-time U.S. academic EM faculty, even after controlling for key factors that have been speculated to contribute to salary differences, such as rank, clinical hours, and training.  There were also gender and underrepresented minority disparities in rank and leadership positions.  Future efforts should focus on evaluating salary data by race and developing system-wide practices to eliminate disparities.

Suggestions for further reading:

Jena AB, Olenski AR, Blumenthal DM, A S, P U, R J. Sex Differences in Physician Salary in US Public Medical Schools. JAMA Intern Med. 2016;176(9):1294. 

Heron SL, Lovell EO, Wang E, Bowman SH. Promoting Diversity in Emergency Medicine: Summary Recommendations from the 2008 Council of Emergency Medicine Residency Directors (CORD) Academic Assembly Diversity Workgroup. Acad Emerg Med. 2009;16(5):450-453. 

Choo EK, Kass D, Westergaard M, et al. The Development of Best Practice Recommendations to Support the Hiring, Recruitment and Advancement of Women Physicians in Emergency Medicine. Pines JM, ed. Acad Emerg Med. June 2016. 

Faculty Editor/Reviewer: Dr. Gita Pensa 

Podcast credits: Intro/exit music by Scott Holmes and freemusicarchive.org. Also featuring "Money", Pink Floyd, from The Dark Side of the Moon.