Understanding the Lack of Under-represented Racial and Ethnic Minorities in Ophthalmology.

To adequately address the racial and ethnic disparities in eye care for our increasingly diverse society there needs to be a significant increase in physicians from under-represented minority groups (URMs) who pursue careers in ophthalmology. Studies have shown that patient–physician racial congruence tends to improve patient satisfaction and medical compliance.[1] However, there are significant racial and ethnic disparities that exist within medicine as a whole and, more specifically, within the field of ophthalmology.[2] One way to address this gap is to diversify the physician workforce by increasing the number of physicians from URMs.[2] URM is defined by membership in certain ethnic and racial minority groups (i.e., Black, Hispanic, American-Indian, Alaskan Native, Native Hawaiian, and Pacific Islander). These ethnic/racial minority groups have been deemed underrepresented in medicine (URiM).[3] According to recent United States (U.S.) Census data, URM groups comprise 30.7% of the American population.[3] However, a study published in 2016 based on information from the U.S. Census, Association of American Medical Colleges (AAMC), and the American Medical Association (AMA), found that only 6% of practicing ophthalmologists were from URM minority groups (3.3% Hispanic, 2.5% Black, and 0.2% Native American).[3] Fairless et al reviewed the medical school faculty demographic data from the 2019 American Association of Medical Colleges Faculty Roster and discovered that ophthalmology has the third lowest proportion of URM faculty within all clinical departments at U.S. medical schools.[4] Similarly, URiM trainees comprise only 7.7% of ophthalmology residents across the country, a figure that has been essentially stagnant, despite widespread efforts to increase URM matriculants in medical schools.[3] A recent call to action highlighted the significant need to increase the number of URiMs within ophthalmology training programs, academic institutions, and private practices.[2] Here, we explore potential explanations for the low numbers of URMs in ophthalmology, in an effort to provide insights to improve the diversity of the ophthalmology workforce.