Domestic production vs international immigration: Options for the US physician workforce

Abstract Objectives This study assessed historical and current gender, racial, and ethnic diversity trends within US pathology graduate medical education (GME) and the pathologist workforce. Methods Data from online, publicly available sources were assessed for significant differences in racial, ethnic, and sex distribution in pathology trainees, as well as pathologists in practice or on faculty, separately compared with the US population and then each other using binomial tests. Results Since 1995, female pathology resident representation has been increasing at a rate of 0.45% per year (95% confidence interval [CI], 0.29-0.61; P < .01), with pathology now having significantly more females (49.8%) compared to the total GME pool (45.4%; P < .0001). In contrast, there was no significant trend in the rate of change per year in black or American Indian, Alaskan Native, Native Hawaiian, and Pacific Islander (AI/AN/NH/PI) resident representation (P = .04 and .02). Since 1995, underrepresented minority (URM) faculty representation has increased by 0.03% per year (95% CI, 0.024-0.036; P < .01), with 7.6% URM faculty in 2018 (5.2% Hispanic, 2.2% black, 0.2% AI/AN/NH/PI). Conclusions This assessment of pathology trainee and physician workforce diversity highlights significant improvements in achieving trainee gender parity. However, there are persistent disparities in URM representation, with significant underrepresentation of URM pathologists compared with residents.

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Diversity by Race, Ethnicity, and Sex within the US Psychiatry Physician Workforce

Academic Psychiatry ◽

10.1007/s40596-020-01276-z ◽

2020 ◽

Vol 44 (5) ◽

pp. 523-530 ◽

Cited By ~ 1

Author(s):

Rhea Wyse ◽

Wei-Ting Hwang ◽

Awad A. Ahmed ◽

Erica Richards ◽

Curtiland Deville

Keyword(s):

Physician Workforce ◽

The Us ◽

Race Ethnicity

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Commentary on “Otolaryngology–Head and Neck Surgery Physician Workforce Issues An Analysis for Future Specialty Planning” by Kim, Cooper, and Kennedy

Otolaryngology ◽

10.1177/0194599811433979 ◽

2012 ◽

Vol 146 (2) ◽

pp. 203-205 ◽

Cited By ~ 6

Author(s):

Shannon P. Pryor ◽

Linda Brodsky ◽

Sujana S. Chandrasekhar ◽

Lauren Zaretsky ◽

Duane J. Taylor ◽

...

Keyword(s):

Head And Neck ◽

Neck Surgery ◽

The United States ◽

Head And Neck Surgery ◽

Physician Workforce ◽

Modeling Methods ◽

The Us ◽

Workforce Issues ◽

Time Work ◽

Part Time

An impending physician shortage has been projected. The article by Kim, Cooper, and Kennedy, titled “Otolaryngology–Head and Neck Surgery Physician Workforce Issues: An Analysis for Future Specialty Planning,” is an attempt to evaluate and address this potential shortage as it applies to otolaryngology. The authors of this comment have concerns about the article’s assumptions, design, and recommendations. Kim et al attempt to extrapolate data from other specialties and other countries to the US otolaryngology workforce, use that data in modeling methods without demonstrated validity, and based on their analysis, they recommend drastic changes to otolaryngologic training and practice in the United States. Particularly troublesome are (1) the emphasis placed on gender and part-time work and (2) the measurement of productivity defined as hours worked per week. Before redefining our specialty, more thorough and systematic data acquisition and review are necessary to meet the needs of our patients now and in the future.

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International Medical Graduates in the US Physician Workforce and Graduate Medical Education: Current and Historical Trends

Journal of Graduate Medical Education ◽

10.4300/jgme-d-17-00580.1 ◽

2018 ◽

Vol 10 (2) ◽

pp. 214-218 ◽

Cited By ~ 17

Author(s):

Awad A. Ahmed ◽

Wei-Ting Hwang ◽

Charles R. Thomas ◽

Curtiland Deville

Keyword(s):

Internal Medicine ◽

Medical Education ◽

Family Medicine ◽

Graduate Medical Education ◽

International Medical ◽

Physician Workforce ◽

International Medical Graduates ◽

Graduate Medical ◽

Medical Graduates ◽

The Us

ABSTRACT Background Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. Objective We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. Methods We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties. A 2-sided test was used for comparison, with P < .001 considered significant. To assess significant increases in IMG GME trainee representation for the total pool and each of the specialties from 1990–2015, the slope was estimated using simple linear regression. Results IMGs showed significantly greater representation among active practicing physicians in 4 specialties: internal medicine (39%), neurology (31%), psychiatry (30%), and pediatrics (25%). IMGs in GME showed significantly greater representation in 5 specialties: pathology (39%), internal medicine (39%), neurology (36%), family medicine (32%), and psychiatry (31%; all P < .001). Over the past quarter century, IMG representation in GME has increased by 0.2% per year in the total GME pool, and 1.1% per year for family medicine, 0.5% for obstetrics and gynecology and general surgery, and 0.3% for internal medicine. Conclusions IMGs make up nearly a quarter of the total GME pool and practicing physician workforce, with a disproportionate share, and larger increases over our study period in certain specialties.

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