Diversity in Academic Otolaryngology: Career Outcomes for Underrepresented Groups

Objective The aim of this study was to evaluate disparities in gender and racial/ethnic representation among otolaryngology faculty and assess how these demographics correspond with academic rank, research productivity, and institutional diversity initiatives. Methods This is a cross-sectional analysis. Faculty from 102 otolaryngology residency programs were reviewed between May and June 2024 using public registries. Data included demographics, academic title, leadership roles, and research productivity. Generalized estimating equations were employed to assess associations between race/ethnicity, gender, and career outcomes, adjusting for confounders. Results Of the 1,802 identified faculty, 118 (6.6%) identified as underrepresented in medicine and 536 (29.8%) were female. Faculty underrepresented in medicine demonstrated fewer citations (adjusted mean ratio [AMR] = 0.68, 95% confidence interval [CI] 0.49-0.93), but other productivity and advancement metrics were comparable to non-underrepresented peers. 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). Institutions with diversity, equity, and inclusion initiatives demonstrated increased female-to-male faculty ratios (adjusted odds ratio [AOR] = 1.33, 95% CI 1.07-1.65), though no association was observed for those identified as underrepresented in medicine. Conclusion While faculty underrepresented in medicine remain few in academic otolaryngology, those in faculty positions achieve comparable career outcomes. Female otolaryngologists experience disparities in productivity and academic advancement. Diversity, equity, and inclusion initiatives are associated with greater gender parity but require targeted expansion to address racial/ethnic advancement.