Arora, Harleen

Azam, Mustafa

Kohen, Laurie L

Rehman, Rafey

Rehman, Sheema

English

Henry Ford Health System Scholarly Commons

Henry Ford Health Henry Ford Health Scholarly Commons Dermatology Articles Dermatology 3-1-2022 Gender and ethnic representation of incoming Mohs micrographic surgery fellows in the United States: A look into fellowship diversity Rafey Rehman Mustafa Azam Sheema Rehman Harleen Arora Laurie L. Kohen Follow this and additional works at: https://scholarlycommons.henryford.com/dermatology_articles RESEARCH LETTERGender and ethnic representation ofincoming Mohs micrographicsurgery fellows in the United States:A look into fellowship diversityTo the Editor: The US population is becomingincreasingly diverse, and it has been estimated thatno single ethnic or racial group will contribute tomajority of the population by 2043.1 Althoughdermatology has been one of the least-diversespecialties in medicine, there is paucity of researchon diversity trends in different dermatology sub-specialties, including Mohs micrographic surgery, inthe United States.2 The purpose of this study was tocharacterize gender and ethnic trends of incomingMohs micrographic surgery fellowship classes in theUnited States over a 10-year period from 2011 to2020.Demographic information of incoming Mohsmicrographic surgery fellows was retrieved fromthe Graduate Medical Education census publishedin the Journal of the American Medical Association.3Information regarding gender and ethnic represen-tation was collected from 2011 to 2020, and thesedata were then subsequently analyzed.Overall, men and women represented an averageof 52.2% and 47.8%, respectively, of the incomingfellows during this 10-year interval (Fig 1). Thedistribution of different ethnicities during this timewas as follows: 76.7% Whites, 16.2% Asians, 3.7%Hispanics, 2.0% Blacks, 0.3% Native Hawaiian orPacific Islanders, 0.0% American Indian or AlaskaNatives, 0.8% multiracial groups, and 3.9% other orunknown identities (Fig 2). The average yearly rateof change for the various gender and ethnic back-grounds were as follows: 0.76% for men, 10.76%for women, 11.01% for Whites, 0.46% for Asians,0.5% for Hispanics, 0.77% for Blacks, 0.05%for Native Hawaiian or Pacific Islander, 0.0% forAmerican Indian or Alaska Natives, 10.59% formultiracial groups, and 0.02% for other or un-known identities.Over the last decade, the proportion of womenmatriculating into US Mohs micrographic surgeryfellowships has been similar to the female US popu-lation,whichhasbeen estimated at 50.8%per the 2020US census.4 Our analysis revealed that the proportionofwomen entering these fellowships has been slowlyincreasing at an average rate of 0.76% per year.Interestingly, the proportion of incoming Black andHispanic fellows has steadily decreased over the lastdecade, reaching their lowest points (0.0%) in the2017-2018 and 2018-2019 match cycles, respectively.Although Blacks and Hispanics represent 13.4% and18.5% of the US population, respectively, this pro-portion is not reflected in the incoming fellowshipclasses. Our analysis also revealed that there wereFig 1. Incoming male and female US Mohs micrographic surgery fellows from 2011 to 2020.ª 2021 by the American Academy of Dermatology, Inc. Published byElsevier Inc. This is an open access article under the CC BY-NC-NDlicense (http://creativecommons.org/licenses/by-nc-nd/4.0/).JAAD INT MARCH 2022 11Downloaded for Anonymous User (n/a) at Henry Ford Hospital / Henry Ford Health System (CS North America) from ClinicalKey.com by Elsevier on April 28, 2022. For personal use only. No other uses without permission. Copyright ©2022. Elsevier Inc. All rights reserved.only 2 academic years (2012-2013 and 2015-2016)in which Native Hawaiian or Pacific Islander individ-uals matriculated into Mohs micrographic surgeryfellowships.The study limitations include lack of data collectionfor the multiracial category from 2010 to 2014 and thenotion that some applicants may identify with ethnic-ities that others would not identify. The lack ofdiversity within the incoming Mohs fellows mighthave been a direct result of the lack of diversity ingeneral dermatology, which might have led to theless-diverse fellowship applications. More work isneeded to determine the trend of different ethnicproportions that complete medical school and derma-tology residency in order to elucidate where thebottleneck in terms of diversity is significant. Futurestudies should also investigate how to increase di-versity in both general dermatology residency andMohs micrographic surgery fellowship programs inorder to create a workforce that can best serve thechanging US population.Rafey Rehman, BS,a Mustafa Azam, BS,a SheemaRehman, BS,b Harleen Arora, MD,c and LaurieKohen, MDcFrom the Oakland University William BeaumontSchool of Medicine, Rochester,a Michigan StateUniversity College of Osteopathic Medicine, EastLansing,b and Department of Dermatology, Hen-ry Ford Hospital, Detroit, Michigan.cFunding sources: None.IRB approval status: Not applicable.Correspondence to: Laurie Kohen, MD, Departmentof Dermatology, Henry Ford Hospital, 3031 W.Grand Blvd, Detroit, MI 48202E-mail: lkohen1@hfhs.orgConflicts of interestNone disclosed.REFERENCES1. Office UCBPI. U.S. Census Bureau projections show a slowergrowing, older, more diverse nation a half century fromnowepopulationenewsroomeU.S. Census Bureau. AccessedOctober 10, 2021. https://www.census.gov/newsroom/releases/archives/population/cb12-243.html2. Deville C, Hwang WT, Burgos R, Chapman CH, Both S,Thomas CR. Diversity in graduate medical education in theUnited States by race, ethnicity, and sex, 2012. JAMA InternMed. 2015;175(10):1706-1708.3. Brotherton SE, Etzel SI. Graduate medical education,2019-2020. JAMA. 2020;324(12):1230-1250.4. U.S. Census Bureau. QuickFacts: United States. AccessedOctober 10, 2021. https://www.census.gov/quickfacts/fact/table/US/PST045219https://doi.org/10.1016/j.jdin.2021.10.004Fig 2. Ethnic representation of incoming US Mohs micrographic surgery fellows from 2011 to2020.JAAD INTMARCH 202212 Research LetterDownloaded for Anonymous User (n/a) at Henry Ford Hospital / Henry Ford Health System (CS North America) from ClinicalKey.com by Elsevier on April 28, 2022. For personal use only. No other uses without permission. Copyright ©2022. Elsevier Inc. All rights reserved.

Gender and ethnic representation of incoming Mohs micrographic surgery fellows in the United States: A look into fellowship diversity

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Gender and ethnic representation of incoming Mohs micrographic surgery fellows in the United States: A look into fellowship diversity

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