Diversity and inclusion create more welcoming
environments and result in better job
satisfaction and patient outcomes

The lack of diversity in radiology and what can be done to fix it

December 10, 2019
by John R. Fischer, Senior Reporter
About 50 percent of medical school graduates are women, yet only 27 percent take up residencies in radiology. At the same time, only 15 percent of medical school graduates who identify as underrepresented minorities pursue careers in radiation oncology and diagnostic radiology.

These are just a couple of the statistics brought up during a session called “Why Diversity and Inclusion Matter: Beyond Gender and Ethnicity” at RSNA last week. Among the factors influencing these numbers are outlooks of different age groups, criteria for accepting medical school residents, outlooks on radiology, and the ability to offer not just diverse but inclusive environments.

“Diversity involves having a mix of people with different traits in workplaces and communities,” said Dr. Yoshimi Anzai, associate chief medical quality officer and a professor of radiology at the University of Utah Health. “Having them together is a form of diversity, but inclusion goes far beyond that. Inclusion is more about efforts and practices to make people with different backgrounds culturally and socially accepted and welcome.”

She added that such differences shape our views and when brought together through interaction and work with one another, empower people to respect each other’s views. The result is greater job satisfaction and feeling “like you are part of something.” Achieving this type of work environment, she says, requires organization commitments, diverse leadership and a comfortable environment in which people feel they can express their voices and views.

One challenge to establishing these environments is the availability in medicine of underrepresented minorities; racial and ethnic populations underrepresented in the medical profession world relative to the numbers of the general population. Of the 16 percent of Hispanics who make up the U.S. population, only 5.5 percent enter into the medical workforce. The same can be said for the 12 percent of the population made up by African-Americans, with six percent becoming physicians. LGBT individuals are assumed to be part of these minorities by some, though a lack of data exists for properly recording their numbers in medicine.

Dr. Carolynn DeBenedectis, director of the radiology residency program and associate professor of breast imaging at University of Massachusetts Medical School, says salvaging the situation requires recruitment at both med school and college levels.

“We’re losing underrepresented minorities because they’re not going into medical school. I cannot recruit into my radiology residency more underrepresented minorities than are in medical school. The general population is 30 percent and then drops to 15 percent in medical school and keeps going down and down into diagnostic radiology faculty, which is very low.”

The same predicament, she says, is affecting women, despite their making up half of medical school graduates. “We’re losing women, even after they go into radiology. This extends far beyond program directors. This is something that every leader in a department has to take seriously because we’re losing these valuable employees. I think this is where the inclusivity comes into play.”

Other tactics that can help include bias training for department staff, having diverse selections of interviewers for radiology applicants, pipeline programs, and diverse mentorships as well as sponsorships.

Such measures can also help propel diversity in leadership, which is lacking at senior levels and in basic science departments, according to Dr. Paul J. Rochon, director of the IR fellowship and residency programs at the University of Colorado School of Medicine. He believes that radiologists must be more open about how their profession works, especially when it comes to patient interaction.

“We need to dispel the stereotype that radiologists are isolated from patient interaction. We know that is not true but our medical students and other specialties, that is what they believe," said Rochon.

Radiology departments and leadership should also keep in mind the diverse views of younger generations versus older ones. For instance, millennials are more socially and digitally connected. They desire to stay engaged and active in their work, and are more likely to switch careers or positions within the first two years of their first job.

“They are more engaged when they are in an organization that they feel fosters an inclusive culture,” said Dr. Carolyn Meltzer, the William P. Timmie professor and chair of radiology and imaging sciences, and executive associate dean of faculty academic advancement, leadership and inclusion at Emory University School. “This puts more of a focus for us as leaders in radiology to be sure we address our culture.”