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Increased Diversity Among Neurology Residents, but Lags Remain

The percentage of women, Asian/Pacific Islanders, and Blacks in neurology residency programs have increased in recent years, but significant lags in diversity remain relative to the overall number of students in US medical schools, according to findings presented during the 2021 virtual AAN Annual Meeting.

From 2011 to 2019, the percentage of Asian/Pacific Islanders increased from 9 percent to 20.3 percent (p=0.02); women from 41.3 percent to 43.1 percent (p=0.04), and Blacks from 2.5 percent to 3.7 percent (p=0.02), according to information from the Accreditation Council for Medical Education Data Resource Book.

From 2011 to 2019, however, the percentage of Alaskan Natives/American Indians and Latinos/Hispanics in neurology programs did not change significantly. Alaskan Natives/American Indians comprised 0.24 percent of residents in 2011 vs. 0.21 percent in 2019 (p=0.40). Latinos/Hispanics were at 5.3 percent in 2011 vs. 5.1 percent in 2019 (p=0.55).

“Although we saw gains in the percentage of women and Blacks in residency programs, we can still do better," said Fabiola Valenzuela, a fourth-year medical student at the University of Texas Rio Grande Valley School of Medicine in Edinburg, TX, who conducted the research.​

“The literature has demonstrated that most of the active strategic changes occur due to leadership from academic faculty in neurology, including chairs and deans of medical schools. When the leadership in neurology departments acknowledge that there is a need for diversity, equity, and inclusion, then changes actually take place in the department," Valenzuela told Neurology Today At the Meetings.

“All of the literature has demonstrated that one of the highest predictors for someone to go into a specific field or academic neurology is mentorship," Valenzuela said. “So neurology clerkship directors are in a key position to provide this mentorship or to connect students to strong mentors who will sponsor them and trigger their interest in neurology," she said.

Valenzuela noted that several ethnic and racial groups remain underrepresented in neurology residency programs relative to the numbers of US medical students overall: Blacks comprise 7.1 percent of all US medical students, for example, yet only roughly half of them are neurology residents, according to data from the Association of American Medical Colleges.

This trend is especially important for Blacks as 2018 US Census Bureau data showed ethnic and racial minority groups comprise 39.3 percent of the US population. Blacks and Hispanics/Latinos account for 13.5 percent and 18.4 percent of the US population, respectively, but they comprise 2.5 percent and 5.5 percent of neurologists, respectively.

“Neurology has been less successful at increasing diversity in comparison to medicine as a whole. It is important that we identify the obstacles to this. Potential reasons include a lack of mentors and role models of color and insufficient exposure to neurology while in medical school," she said.

Representation matters. It is very valuable that physicians are looking at the number of underrepresented doctors and providers who are caring for patients with neurologic disorders because we should resemble the population that we serve, noted Clarimar Borrero-Mejias, MD, a pediatric neurologist at Johns Hopkins All Children's Hospital in St. Petersburg, FL, and a member of the AAN Diversity Leadership Program.

“There is data demonstrating that patients who are cared for by people who look like them and people who may have had similar life experiences, tend to have better health outcomes. Therefore, it is important that we consider the ethnic, social and cultural background of the patients we serve and take this information into account when we recruit and retain physicians in the field of neurology," Dr. Borrero-Mejias told Neurology Today At the Meetings.

“The data reported on this abstract shows that the number of underrepresented neurologists has increased, however, the increase is not representative of the population that we serve, so there's a lot of opportunity for improving upon the recruitment of college students, graduate students, and medical students into the field of neurology," noted Dr. Borrero-Mejias. “Increasing representation in medicine will result in improved care for our patients and communities because the best doctors and providers out there are those that patients can relate to."

Valenzuela and Dr. Borrero-Mejias had no disclosures.

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AAN Abstract S18.004: Valenzuela F, Romero Arenas MA. An assessment of gender and racial/ethnic diversity amongst neurology residents and physicians.