Diversity in Academic Otolaryngology: Career Outcomes for Underrepresented Groups

Introduction: Otolaryngology remains one of the surgical specialties with the lowest rates of racial/ethnic and gender diversity. While prior research highlights disparities in female representation and underrepresented in medicine (URM) groups, limited data exist on their impact on career outcomes. This study characterizes core otolaryngology faculty in U.S. residency programs, assesses for disparities while investigating how race/ethnicity and gender correspond with academic rank and research productivity in academic otolaryngology, and evaluates the role of institutional diversity initiatives.

Methods: We conducted a cross-sectional analysis of faculty from 102 U.S. otolaryngology residency programs using data from publicly available registries. Demographics, academic titles, leadership roles, and research productivity (h-index, publications, citations) data were collected from May to June 2024. Generalized estimating equations analyzed associations between demographics and career outcomes.

Results: Among 1,802 faculty, 6.6% were URM and 29.8% were female. URM faculty had fewer citations (adjusted mean ratio [AMR] = 0.68, 95% confidence interval [CI] 0.49–0.93), though other research metrics were comparable after adjusting for potential confounders. Female faculty had fewer years in practice (AMR = 0.65, 95% CI 0.58–0.72), lower h-index (AMR = 0.76, 95% CI 0.69–0.85), fewer publications (AMR = 0.64, 95% CI 0.54–0.76), and fewer citations (AMR = 0.69, 95% CI 0.54–0.87). DEI initiatives increased female-to-male faculty ratios (adjusted odds ratio [AOR] = 1.33, 95% CI 1.07–1.65) but did not significantly impact URM representation.

Conclusions: URM faculty representation remains low in academic otolaryngology despite established URM faculty having comparable research productivity, academic rank, and leadership attainment as their majority counterparts. Compared to their male colleagues, female otolaryngologists face barriers in academic productivity and rank attainment. DEI initiatives seem to improve gender parity but require targeted efforts to support URM advancement.