US Dermatology Department Faculty Diversity Trends by Sex and Underrepresented-in-Medicine Status, 1970 to 2018

Importance: Faculty diversity has important implications for improving the cultural competency and diversity of medical students and residents. However, dermatology is one of the least diverse fields in medicine. Objectives: To measure faculty diversity by sex, race, and ethnicity in academic dermatology departments in US medical schools and to evaluate how this representation compares with the diversity of the US population, medical students, department chairs, and faculty in other clinical departments. Design, Setting, and Participants: In this cross-sectional study, data from the Association of American Medical Colleges Faculty Roster were evaluated to differentiate full-time faculty by sex and designation as a minority underrepresented in medicine (URM; currently including black, Hispanic, American Indian/Alaska Native, Native Hawaiian, and Pacific Islander individuals). Trends in female and URM representation among academic dermatology departments were analyzed from 1970 to 2018. Main Outcomes and Measures: The numbers and proportions of US dermatology department faculty by sex, race, and ethnicity. Results: The number of full-time US dermatology department faculty increased from 167 in 1970 to 1464 in 2018. The number of female faculty increased from 18 (10.8%) in 1970 to 749 (51.2%) in 2018; the number of URM faculty grew from 8 (4.8%) in 1970 to 109 (7.4%) in 2018. Proportions of female and white dermatology department faculty were similar to the US population in 2018; however, like other clinical departments, the proportion of URM faculty was lower than in the general population. There was an inverse association between increasing faculty rank and the proportion of female faculty overall, but this was not the case among URM faculty. At every rank, there was a proportionately low number of URM faculty represented. Across all specialties, department chairs were least diverse, with white individuals representing 79.7% (n = 2856 of 3585) of all chairs in 2018 and women representing 19.4% (n = 694 of 3585) of all chairs. Conclusions and Relevance: Expansion of faculty in US dermatology departments over the past half century has led to greater female representation, now similar to that in the general population. Higher-ranking faculty is associated with lower diversity. Although dermatology department faculty diversity by sex, race, and ethnicity has partially improved over the past 49 years, continued attention to the lagging representation of URM faculty should be a priority for the field of academic dermatology.