Association Between the Demographic Profile of Military Physicians and Career Outcomes

INTRODUCTION: Few publicly available statistics or studies exist regarding the racial and ethnic composition of U.S. Military medical providers and their specialties. The absence of data limits the ability to investigate outcomes for underrepresented minority (URM) military medical providers and the effects of provider-patient racial and ethnic concordance. Given these conditions, the overall objective of this study was to understand career and military achievements for URM graduates of -Uniformed Services University of the Health Sciences (USU) School of Medicine (SOM).

MATERIALS AND METHODS: Contingency table statistical analysis was conducted to determine differences in career and military achievements for URM and non-URM graduates. The critical value of significance was set at 0.05 for chi-square tests. If the cell count was lower than 5, we reported Fisher's exact test result. For groups with less than 5 participants, racial/ethnic categories were combined so as to preserve as much data as possible. Finally, we adjusted the critical value of statistical significance using Bonferroni's correction method to avoid an inflated Type I error rate.

RESULTS: There was a statistically significant association between race and ethnicity and the highest rank achieved to date (χ2 = 17.175 [P = .002]), and spending 7 or more consecutive days on a humanitarian mission as a physician (χ2 = 9.027 [P = .003]). In each of these instances, by comparing the expected count of graduates to the observed count, the proportion of URM graduates achieving specific military milestones was lower than that of non-URM graduates.

CONCLUSIONS: Few statistically significant differences in career and military achievements among URM and non-URM USU SOM graduates were found in this study. However, significant associations, highest rank achieved to date and 7 days or more on a humanitarian mission, are important for building pathways to leadership. Factors such as access to URM faculty mentors, presence of social networks of URM peers, and inclusive policies and programs have been demonstrated to help mitigate each of these points of disparity. These resources serve to build service members' portfolios of career, leadership, and military accomplishments once they have matriculated into medical school and well into their military and medical careers.