Studies: Implicit racial, gender bias pervade academic medicine

Racial and gender bias still play a role in medical training, according to new research. (Getty/Jupiterimages)

Women are less likely than men to be selected to speak during grand rounds, lectures that share new research and guidelines within clinical groups, according to a new study, one of three published this week in JAMA Internal Medicine that suggest racial and gender bias are significant issues in medical academics.

Researchers at the University of Pittsburgh School of Medicine examined grand rounds data from nine clinical specialties at 79 medical schools and found that just 26% of grand rounds speakers were women, according to the research letter published in JAMA Internal Medicine. This is despite the fact that women make up about 47% of medical students, 46% of residents and 36% of medical faculty nationwide.

"The people at the podiums do not resemble the people in the audience," Julie Boiko, M.D., a pediatric resident at the University of California, San Francisco, who also led the study while a medical student at the Pitt School of Medicine, said in an announcement. "While gender representation and equality in medicine has been an important area of student discussion in recent years, this is the first time we have data to support that there may be a gender bias in speaker selection at academic grand rounds.”

The researchers in total studied more than 200 grand rounds websites and listings for speaker series, which included more than 7,000 individual sessions, for the speakers’ genders and institutions. The team plans to continue research on factors that can lead to better gender parity on grand rounds rosters.

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Two related studies also published in JAMA Internal Medicine found that gender and racial bias extend to other spheres of medical training. Researchers at the University of Chicago found that though male and female emergency medicine residents are evaluated similarly in their first year, men had a higher rate of milestone attainment that women later in residency, and the authors warned faculty to be aware of gender bias when evaluating medical residents.

A Yale School of Medicine study took a look at the racial makeup of members of the Alpha Omega Alpha honor society. The researchers studied a group of more than 4,600 medical students and found that membership in AOA was six times greater for white students than for black students, and was nearly two times greater for white students than Asian students.

In an accompanying editorial, Molly Cooke, M.D., a professor of medicine at the University of California, San Francisco, wrote that it’s “striking how early these stereotypes become entrenched.” She noted that in the past she attended a daycare career day for her son, and a young boy objected to her being a doctor, saying, “Boys are doctors; girls are nurses.”

“To the extent that those role models do not mirror the sex and racial composition of the trainee pool, we are delivering the implicit but powerful message that these leadership roles and examples of excellence are for someone else,” Cooke wrote. “Women, blacks, Asians and Latinos need not apply.”