When I first started residency in anesthesiology, I thought it was a pretty diverse medical specialty. I was one of only a couple of white males in my residency class. There was also nearly 50% female representation.
I assumed this was the norm for anesthesiology. This was quite a change from the surgery residency program where I started my training which was almost entirely white males. Once I finished residency training, I realized that there was a significant lack of diversity in the field.
Some may view anesthesiology as a diverse specialty, but the data demonstrate otherwise. According to data from the American Association of Medical Colleges, anesthesiology ranks near the middle in diversity among specialties. We are not nearly as well represented by females as allergy, obstetrics, or pediatrics. Minorities are underrepresented in anesthesiology compared to primary care.
We do know that women and minorities are underrepresented in medicine overall compared to the U.S. population, but it is difficult to tease out specialty specific data since the tracking of this data is based on voluntary self-report.
One survey of the ASA House of Delegates from 2017 found that the proportion of women and minorities in ASA leadership roles was significantly lower than the general medical workforce (A&A:124(5), May 2017). Given that it is important to have diverse leadership to reduce workforce disparities by encouraging more minority representation, it is not surprising that the anesthesia workforce is not as diverse as it needs to be.
The Virginia Society of Anesthesiologists only collects data on gender. The U.S. population is 50.8% female and the general physician workforce is 38% female. The VSA membership is about 30% female. Although I don’t have the data to analyze, I believe the VSA is comprised of less than the 32% minorities that make up the U.S. population and the 8.9% of the general medical workforce. We clearly could be doing better.
Although I believe there are more women and minorities in the VSA now compared to the past, we are not reducing the gap enough and must do more to keep up with our rapidly changing cultural demographics.
So how do we promote diversity and inclusion in our specialty? Given the increased attention and awareness related to this issue currently, now is a great time to increase our effort in this endeavor.
I think there are three key steps to improving our diversity. First, we should actively promote diversity and inclusion in the VSA leadership. I am pleased to report our efforts in the regard have been admirable, with female representation greater than 50% and with minority representation of approximately 25% of the Board of Directors.
This is the right direction to make sure that the decision making body of the organization has composition that more closely resembles the population at large. It is hopeful that these leaders will continue to serve as role models and mentors to our next generation of anesthesiologists and we will see our diversity increase, with more diverse populations assuming leadership positions.
Second, the VSA leadership should have education and information for its Board members who are volunteers representing all regions of the Commonwealth. However, it’s not enough to just have cultural competency training for the Board. We can also learn from the diversity of backgrounds and experiences among our varied Board members.
I am looking forward to engaging with my fellow Board members in a thoughtful and meaningful discussion about promoting diversity and inclusion in the VSA. It is imperative that we create a sustained and intentional program to promote heterogeneity in anesthesiology.
Finally, the VSA leadership must promote diversity to the membership. It is the membership who interact with students and trainees who are the future of our specialty. Members should seek out variety in the future anesthesiologists who will join our ranks.
We also should encourage our members, particularly those representing minority groups, to volunteer for leadership roles, committees, and other opportunities in VSA and ASA. The ASA Committee on Professional Diversity is a stellar example of how the active role of leadership can broaden the appeal of anesthesiology and embrace our differences. Since created, this committee has had tremendous success in growing the diversity of the ASA leadership.
In the not too distant future, there will no longer be a group that identifies as the majority in the U.S. Our demographics are changing. Anesthesiology and the VSA must change as well to grow into the specialty of the future that is representative and inclusive of all people and that demonstrates our differences, not just our similarities, as physician anesthesiologists.