Fall 2021 (Volume 31, Number 3)
Overcoming Challenges, Seizing
Opportunities, and Driving Change
By Grace C. Wright, MD, PhD, FACR
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It was 1983. As a first-year
medical student,
I entered a class
of bright-eyed trainees,
unaware that this was
the start of a journey of
creating inclusion and
bending the arc of diversity
in rheumatology
and medicine. Living in
New York City, I was in a
melting pot, rich in diverse
cultures, cuisines,
languages, religions, ethnicities, races. . . Despite this, I was
the only Black woman in my class. The only “foreign” student.
The first MD-PhD in my category of one. And, while this can
be considered a significant personal accomplishment, it is
also a reflection of the unequal inclusion and limited representation
of minorities, particularly females, not only in rheumatology
but in medicine and other industries.
The socioeconomic challenges and barriers faced by
under-represented communities as they try to seek, access,
and/or afford opportunities and services have resulted in
centuries of inequality that are still palpable today, despite
increased social awareness and movements towards
inclusion and equality. In a 2018 survey conducted by the
Association of American Medical Colleges (AAMC), 56% of
surveyed US-based active physicians identified as White,
compared to 5% who identified as Black or African American.1 Interestingly, demographic data of 2019 medical
school students showed that, while most students identified
as White (47%), the proportion of students identifying
as other racial/ethnic minorities increased,2 suggesting a
shift towards diversification in the medical workforce. In
fact, among young physicians, more women identified as
non-White compared to their male counterparts.3
Rheumatology (and medicine in general) has experienced a
gender shift over the past decade, with increasing numbers of
female health providers working in community practices and
academia4 and, in 2025, 56% of adult rheumatologists are expected
to be female. This stands in stark contrast to the few women
in leadership positions such as associate or full professors,
chiefs of rheumatology departments, editors of academic journals,
recipients of research and federal grants, etc.5-7 Furthermore,
female rheumatologists are also estimated to earn less
than male counterparts with lower salaries, more time spent
per patient (resulting in fewer patients seen per day) and reduced
working hours due to family or lifestyle demands.8
As healthcare professionals, we are aware of the deep
inequalities that exist in healthcare and the implications of
these inequalities on patient outcomes and healthcare costs.
But within these disparities, these challenges, and frustrations,
there is also opportunity to implement initiatives to encourage
women, and under-represented groups to advance in
medicine, and to ensure that they will have equal career advancement
opportunities. One such initiative is the Association
of Women in Rheumatology (AWIR) which is dedicated
to increasing equity, diversity and inclusion in rheumatology.9
Grace C. Wright, MD, PhD, FACR
President & CEO, Grace C. Wright MD PC
President, Association of Women in Rheumatology
New York, New York
References:
1. AAMC. Diversity in Medicine: Facts and Figures 2019. Available at https://www.aamc.org/data-reports.
Accessed July 29, 2021.
2. AAMC. Undergraduate Medical Education Data Available at https://www.aamc.org/data-reports.
Accessed July 30, 2021.
3. AAMC. US Physician Workforce. Available at https://www.aamc.org/data-reports.
Accessed July
20, 2021.
4. Battafarano DF, Ditmyer M, Bolster MB, et al. 2015 American College of Rheumatology Workforce
Study: Supply and Demand Projections of Adult Rheumatology Workforce, 2015-2030. Arthritis
Care Res (Hoboken). 2018; 70(4):617-626.
5. Jorge A, Bolster M, Fu X, et al. The Association Between Physician Gender and Career Advancement
Among Academic Rheumatologists in the United States. Arthritis Rheumatol. 2021; 73(1):168-172.
doi: 10.1002/art.41492. Epub 2020 Nov 8.
6. Mayer AP, Blair JE, Ko MG, et al. Gender distribution of U.S. medical school faculty by academic
track type. Acad Med. 2014; 89(2):312-7.
7. Bagga E, Stewart S, Gamble GD, et al. Representation of Women as Authors of Rheumatology
Research Articles. Arthritis Rheumatol. 2021; 73(1):162-167.
8. The Rheumatologist. Rheumatology & The Gender Pay Gap. Available at https://www.the-rheumatologist.
org/article/rheumatology-gender-pay-gap/?singlepage=1.
Accessed July 29, 2021.
9. Association of Women in Rheumatology. Available at https://awirgroup.org.
Accessed July 29, 2021.
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