Objectives. We compared faculty promotion rates by race/ethnicity across US academic medical centers. Methods . We used the Association of American Medical College's 1983 through 2000 faculty roster data to estimate median institution-specific promotion rates for assistant professor to associate professor and for associate professor to full professor. In unadjusted analyses, we compared medians for Hispanic and Black with White faculty using the Wilcoxon rank sum test. We compared institution-specific promotion rates between racial/ethnic groups with data stratified by institutional characteristic (institution size, proportion racial/ethnic minority faculty, and proportion women faculty) using the χ 2 test. Our sample included 128 academic medical centers and 88?432 unique faculty. Results. The median institution-specific promotion rates for White, Hispanic, and Black faculty, respectively, were 30.2%, 23.5%, and 18.8% ( P .01) from assistant to associate professor and 31.5%, 25.0%, and 16.7% ( P .01) from associate to full professor. Conclusions. At most academic medical centers, promotion rates for Hispanic and Black were lower than those for White faculty. Equitable faculty promotion rates may reflect institutional climates that support the successful development of racial/ethnic minority trainees, ultimately improving healthcare access and quality for all patients. The racial/ethnic composition of the healthcare workforce does not reflect the diversity in the US general population. Although combined Blacks and Hispanics represent 28.7% of the total US population, 1 only 8.4% of all practicing US physicians are Black or Hispanic. 2,3 These disparities extend to academic medical center faculty. Historically underrepresented racial/ethnic minorities constitute 7% of all current academic medical center faculty and fewer than 5% of all new academic medical center faculty. 2,4 The rationale for supporting racial/ethnic diversity across the academic medical center faculty workforce is multifold. Faculty diversity increases the quality of training for all students, and racial/ethnic minority faculty often serve as important professional resources for racial/ethnic minority trainees. 5,6 This is a critical role within the social mission of academic medical centers to develop a diverse practicing physician workforce, which is necessary to reduce healthcare discrimination and increase healthcare access and quality. 7–9 Racial/ethnic minority faculty also often provide leadership in medical education, health policy, and research scholarship related to racial/ethnic health inequities. Despite these benefits, academic medical centers struggle to retain racial/ethnic diversity across faculty ranks. Institutional discrimination in the promotion process has been suggested as a potential explanation for the persistent lack of diversity at the senior faculty level associate professor and full professor ranks. 10 The majority of Black and Hispanic academic medical center faculty are concentrated at the assistant professor level; among all racial/ethnic groups, men are more likely than are women to hold full professor rank. 4 Aggregated national data have described lower career satisfaction among racial/ethnic minority academic medical center faculty, lower promotion rates compared with White peers despite adjustment for established measures of productivity, and decreased likelihood of being awarded research grants from the National Institutes of Health after controlling for several key factors. 10–14 Other research has concluded that many physician academic medical center faculty, particularly racial/ethnic minorities, experience a poor institutional diversity climate or discrimination at work. 15–18 Although recent data demonstrate increases in the overall numbers of first time racial/ethnic minority assistant professors and medical students, 10,19 national averages that reveal lower and slower promotion rates for racial/ethnic minority faculty raise concerns about the success of organizational efforts to successfully diversify the academic medical center faculty workforce. 10,13 Despite consistent national data on differential career trajectories for racial/ethnic minority academic medical center faculty, it is unknown whether all academic medical centers face similar challenges in the promotion process. The Association of American Medical College's Faculty Roster database provided us a unique opportunity to examine in detail the promotion disparities between racial/ethnic faculty at individual academic medical centers in the United States. We hypothesized that Black and Hispanic faculty would have lower rates of promotion to associate professor and full professor than would White faculty at most academic medical centers. We also sought to explore whether larger academic medical centers and academic medical centers with higher proportions of Black, Hispanic, or women faculty would approach promotion rate
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