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Gender and Racial Disparity Among US Forensic Psychiatry Fellows: Broken System by Default

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Abstract

Diversity enhances the performance of the healthcare system by providing better patient outcomes and reducing physician burnout. In this study, we explored the gender and racial trends in the recruitment of women and racial minorities into forensic psychiatry fellowship programs in the US. Retrospective data analysis was performed by utilizing the data from the Accreditation Council for Graduate Medical Education (ACGME)’s annual Data Resource Books from the year 2007 to 2021. Demographic data, including gender and race, were extracted for forensic psychiatry fellows. The number of female trainees increased significantly to become a majority, i.e., 58.8% of all forensic psychiatry trainees in 2020–2021 were female compared to 27.78% of women forensic psychiatry fellows in 2007–08. Between 2011–12 and 2020–2021, there was a relative increase in White (Non-Hispanic), Asian/Pacific Islander and Black (Non-Hispanic) forensic psychiatry fellows, by 54.75%, 114.4%, and 0.36% respectively. Despite the overall increase in the numbers of ethnic minorities in US psychiatry residency and fellowship programs, racial minorities remain significantly under-represented in forensic psychiatry fellowship programs. We need to revise policies to promote underrepresented minorities in medicine (URMM) in forensic psychiatry.

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References

  1. Ahmadi M, et al., Influences for Gender Disparity in Academic Neuroradiology. AJNR Am J Neuroradiol, 2018;39(1):18–23. https://doi.org/10.3174/ajnr.A5443.

  2. Jordan A, Jegede O. Building Outreach and Diversity in the Field of Addictions. Am J Addict. 2020;29(5):413–7. https://doi.org/10.1111/ajad.13097.

    Article  PubMed  Google Scholar 

  3. Wyse R, et al. Diversity by Race, Ethnicity, and Sex within the US Psychiatry Physician Workforce. Acad Psychiatry. 2020;44(5):523–30. https://doi.org/10.1007/s40596-020-01276-z.

    Article  PubMed  Google Scholar 

  4. Hannawi S, Al Salmi I. Time to address gender inequalities against female physicians. Int J Health Plann Manage. 2018;33(2):532–41. https://doi.org/10.1002/hpm.2476.

    Article  PubMed  Google Scholar 

  5. Lett LA, Orji WU, Sebro R. Declining racial and ethnic representation in clinical academic medicine: A longitudinal study of 16 US medical specialties. PLoS One. 2018;13(11):e0207274. https://doi.org/10.1371/journal.pone.0207274.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Gonzaga AMR, et al. A Framework for Inclusive Graduate Medical Education Recruitment Strategies: Meeting the ACGME Standard for a Diverse and Inclusive Workforce. Acad Med. 2020;95(5):710–6. https://doi.org/10.1097/acm.0000000000003073.

    Article  PubMed  Google Scholar 

  7. Lett LA, et al. Trends in Racial/Ethnic Representation Among US Medical Students. JAMA Netw Open. 2019;2(9):e1910490. https://doi.org/10.1001/jamanetworkopen.2019.10490.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Association of American Medical Colleges (AAMC), Current Trends in Medical Education. 2015. https://www.aamcdiversityfactsandfigures2016.org/report-section/section-3/. Accessed 25 Dec 2021.

  9. Association of American Medical Colleges (AAMC), Diversity in Medicine: Facts and Figures 2019. 2019. https://www.aamc.org/data-reports/workforce/interactive-data/figure-1-percentage-applicants-us-medical-schools-sex-academic-years-1980–1981-through-2018–2019. Accessed 25 Dec 2021.

  10. Niu BT, et al. Trends in Gender and Racial Profiles of US Academic Radiology Faculty. J Am Coll Radiol. 2020. https://doi.org/10.1016/j.jacr.2020.03.019.

    Article  PubMed  Google Scholar 

  11. Zhu K, et al. Equity, Diversity, and Inclusion in Academic American Surgery Faculty: An Elusive Dream. J Surg Res. 2021;258:179–86. https://doi.org/10.1016/j.jss.2020.08.069.

    Article  PubMed  Google Scholar 

  12. Lu JD, et al. Gender and racial underrepresentation in academic dermatology positions in the United States: A retrospective, cross-sectional study from 2007 to 2018. J Am Acad Dermatol. 2020;83(5):1513–6. https://doi.org/10.1016/j.jaad.2020.06.067.

    Article  PubMed  Google Scholar 

  13. Li SNJ, et al. Equity, diversity, and inclusion in academic internal medicine at US medical schools. Eur J Intern Med. 2020;71:89–91. https://doi.org/10.1016/j.ejim.2019.10.027.

    Article  PubMed  Google Scholar 

  14. Saleem S, et al., Racial and gender disparities in neurology. Postgrad Med J, postgradmedj-2020-138584. 2020. https://doi.org/10.1136/postgradmedj-2020-138584.

    Article  PubMed  Google Scholar 

  15. Chaudhary AMD, et al. US Psychiatry Faculty: Academic Rank, Gender and Racial Profile. Acad Psychiatry. 2020;44(3):260–6. https://doi.org/10.1007/s40596-020-01192-2.

    Article  PubMed  Google Scholar 

  16. Chaudhary AMD, et al. Gender and Racial Disparities among US Psychiatry Residents: A Review of Trends. Psychiatr Q. 2021. https://doi.org/10.1007/s11126-021-09888-w.

    Article  PubMed  Google Scholar 

  17. Hafeez D, et al. Gender distribution in psychiatry journals’ editorial boards worldwide. Compr Psychiatry. 2019;94:152119. https://doi.org/10.1016/j.comppsych.2019.152119.

    Article  PubMed  Google Scholar 

  18. Sheikh MH, et al. Influences for Gender Disparity in Academic Psychiatry in the United States. Cureus. 2018;10(4):e2514. https://doi.org/10.7759/cureus.2514.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Temel G, Budak H, Saka NE. Approach and Reporting to Forensic Psychiatric Cases: Examples of Forensic Psychiatry Practices in the World. Namık Kemal Tıp Dergisi, 2020;8:93–101. https://doi.org/10.37696/nkmj.662819.

  20. Jennifer Bronson PhD, Marcus Berzofsky DrPH. Special Report: Indicators of Mental Health Problems Reported by Prisoners and Jail Inmates, 2017. 2011–12 (pp. 1–17). https://www.bjs.gov/content/pub/pdf/imhprpji1112.pdf.

  21. Winicov N. A systematic review of behavioral health interventions for suicidal and self-harming individuals in prisons and jails. Heliyon. 2019;5(9):e02379. https://doi.org/10.1016/j.heliyon.2019.e02379.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Reingle Gonzalez JM, Connell NM. Mental health of prisoners: Identifying barriers to mental health treatment and medication continuity. Am J Public Health. 2014;104(12):2328–33. https://doi.org/10.2105/ajph.2014.302043.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Price M, et al. Gender differences in the practice patterns of forensic psychiatry experts. J Am Acad Psychiatry Law. 2004;32(3):250–8.

    PubMed  Google Scholar 

  24. Accreditation Council for Graduate Medical Education (ACGME) Data Resource Book. https://www.acgme.org/About-Us/Publications-and-Resources/Graduate-Medical-Education-Data-Resource-Book. Accessed 25 Dec 2021.

  25. American Psychiatric Association (APA). 2018 Resident/Fellow Census. 2020. http://www.psychiatry.org. Accessed 25 Dec 2021.

  26. Jagsi R, et al. Sexual Harassment and Discrimination Experiences of Academic Medical Faculty. JAMA. 2016;315(19):2120–1. https://doi.org/10.1001/jama.2016.2188.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Brotherton SE, Etzel SI, Graduate Medical Education. 2017–2018. JAMA, 2018;320(10):1051–1070. https://doi.org/10.1001/jama.2018.10650.

  28. Rodriguez JE, Campbell KM, Adelson WJ. Poor representation of Blacks, Latinos, and Native Americans in medicine. Fam Med. 2015;47(4):259–63.

    PubMed  Google Scholar 

  29. Osseo-Asare A, et al. Minority Resident Physicians’ Views on the Role of Race/Ethnicity in Their Training Experiences in the Workplace. JAMA Network Open. 2018;1(5):e182723–3. https://doi.org/10.1001/jamanetworkopen.2018.2723.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Ryland H, et al. Unmet Needs During Residency Training Programmes in Psychiatry. New Directions in Psychiatry. Cham: Springer; 2020. pp. 157–79.

    Google Scholar 

  31. Agapoff Iv JR, Olson DJ. Challenges and Perspectives to the Fall in Psychiatry Fellowship Applications. Acad Psychiatry. 2019;43(4):425–8. https://doi.org/10.1007/s40596-019-01033-x.

    Article  PubMed  Google Scholar 

  32. Fisher CE. General psychiatric residents and corrections: Moving forensic education beyond the classroom. Acad Psychiatry. 2014;38(6):680–4. https://doi.org/10.1007/s40596-014-0216-6.

    Article  PubMed  Google Scholar 

  33. Frierson RL. Examining the Past and Advocating for the Future of Forensic Psychiatry Training. J Am Acad Psychiatry Law. 2020;48(1):16–25. https://doi.org/10.29158/jaapl.003919-20.

    Article  PubMed  Google Scholar 

  34. Jones A, New BJS data: Prison incarceration rates inch down, but racial equity and real decarceration still decades away. Prison Policy Initiative. 2020. https://www.prisonpolicy.org/blog/2020/10/30/prisoners_in_2019/. Accessed 25 Dec 2021.

  35. Wilbur K, et al. Developing Workforce Diversity in the Health Professions: A Social Justice Perspective. Health Prof Educ, 2020;6. https://doi.org/10.1016/j.hpe.2020.01.002.

  36. Morris NP, Hirschtritt ME, Edwards ML. Variations in Application Instructions for Forensic Psychiatry Fellowships. Acad Psychiatry. 2020;44(2):155–8. https://doi.org/10.1007/s40596-019-01128-5.

    Article  PubMed  Google Scholar 

  37. Bradford J, Chaimowitz G. Vicarious trauma and occupational hazard for forensic mental health professionals. Int J Risk Recovery. 2020;3(1):1–2. https://doi.org/10.15173/ijrr.v3i1.4533.

  38. Booth BD, et al. Toward a New Model of Training in Canadian Forensic Psychiatry. J Am Acad Psychiatry Law. 2021;49(3):381–95. https://doi.org/10.29158/JAAPL.200112-20.

    Article  PubMed  Google Scholar 

  39. Wasser T, Chandra S, Michaelsen K. Enhancing forensic exposures in residency training. J Ment Health Train Educ Pract. 2020;15(1):13–9. https://doi.org/10.1108/JMHTEP-04-2019-0021.

    Article  Google Scholar 

  40. Vincent-Höper S, et al., Sexually Harassing Behaviors from Patients or Clients and Care Workers’ Mental Health: Development and Validation of a Measure. Int J Environ Res Public Health, 2020. 17(7). https://doi.org/10.3390/ijerph17072570.

  41. McBain SM, et al. The effect of a forensic fellowship program on general psychiatry residents’ in-training examination outcomes. J Am Acad Psychiatry Law. 2010;38(2):223–8.

    PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Public Health Department, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Sundas Saboor

  2. Child and Adolescent Psychiatry, Institute of Living, Hartford, CT, USA

    Sadiq Naveed

  3. Psychiatry Department, University Hospitals/Case Western Reserve University, Cleveland, Ohio, USA

    Amna Mohyud Din Chaudhary

  4. Psychiatry Department Resident, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, Queens, NY, USA

    Beenish Safdar

  5. Frontier Medical and Dental College, Abbottabad, Khyber Pakhtunkhwa, Pakistan

    Sonia Khan

  6. Radiology Department, University of British Columbia, Vancouver, BC, Canada

    Faisal Khosa

  7. Institute of Living, 200 Retreat Ave, Hartford, CT, USA

    Sadiq Naveed

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  1. Sundas Saboor
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  2. Sadiq Naveed
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  3. Amna Mohyud Din Chaudhary
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  4. Beenish Safdar
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  5. Sonia Khan
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  6. Faisal Khosa
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Contributions

Sundas Saboor, MD, Sadiq Naveed, MD, MPH, DFAACAP, Amna Mohyud Din Chaudhary, MD, Beenish Safdar, MD, Sonia Khan, MD, and Faisal Khosa, MD, MBA, FFRRCSI, FRCPC made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work. All authors drafted the work or revised it critically for important intellectual content. All authors approved the version to be published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Sadiq Naveed.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical Approval

This study did not involve human or animal subjects and was a secondary analysis of data compiled and provided by Accreditation Council for Graduate Medical Education (ACGME) Data Resource Books. Institutional Review Board (IRB) approval was not obtained for this study.

Disclaimer Statement

Dr. Khosa is the recipient of the Global Humanitarian Award—American College of Radiology (2021) and the May Cohen Equity, Diversity, and Gender Award—Association of Faculties of Medicine of Canada (2020).

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Saboor, S., Naveed, S., Chaudhary, A.M.D. et al. Gender and Racial Disparity Among US Forensic Psychiatry Fellows: Broken System by Default. Psychiatr Q 93, 651–662 (2022). https://doi.org/10.1007/s11126-022-09972-9

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  • DOI: https://doi.org/10.1007/s11126-022-09972-9

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