Underrepresented in medicine resident physician distribution by race, gender, and specialty trends from 2013–2019

Importance: While significant racial disparities in the physician workforce have existed for decades, recent attention on this mismatch and the current sociopolitical climate have led to an increase in recruitment efforts of Underrepresented in Medicine (URiM) physicians by residency programs. The effect of these efforts on URiM distribution across residency programs has not yet been comprehensively studied. Objective: To describe the distribution of URiM residents across the top 20 most populous medical and surgical specialties by race and gender as well as trends observed from 2013 to 2019. Design: Multicenter, retrospective cross sectional analysis Setting: US residency programs Participants: All first-year residents matching in the 20 most populous specialties as documented in the Association of American Medical Colleges (AAMC) Data Resource Books during the study period. Main Outcomes: The primary outcome of this study was to describe the percentages of URiM resident physicians in the US by race and gender, as defined by the AAMC during the study period. Secondary outcomes include an analysis of URiM race and gender distribution as well as URiM distribution in competitive vs noncompetitive specialties, surgical vs nonsurgical specialties, and primary care specialties. Results: From 2013-2019, there were 228,645 entries by 211,356 first-year residents to the top 20 most populous specialties. In total, 15.2% of entries were URiM residents. Forty-six percent of applicants identified as female. All but two specialties studied had an increase in URiM representation. No specialty had greater than 4% increase in URiM representation. In 2019, there were differences in specialty representation when individual race and gender categories within URiM were considered. The URiM percentages were as follows in specialty subtypes: surgical (16%) vs nonsurgical (16.4%) and competitive (12.3%) vs noncompetitive (18.2%). The top 3 specialities with the highest percentage of URiM residents were primary care specialties. Conclusion: Despite the increase in recruitment efforts for URiM applicants at the residency level, there was only a slight change in total URiM distribution by specialty over the study time period. Individual race categories and gender had an impact on the distribution of residents in the most recent year