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Diversity in emergency medical services (EMS) leadership is crucial for equitable care. This study found EMS fellowships lack gender and racial diversity, with few women and predominantly White fellows, highlighting a need for targeted recruitment to improve healthcare outcomes.

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Area of Science:

  • Medical Education and Training
  • Emergency Medical Services (EMS)
  • Health Equity

Background:

  • Ensuring emergency medical services (EMS) personnel reflect patient diversity is vital for equitable healthcare.
  • Historical underrepresentation of women and minorities in EMS leadership may perpetuate care disparities.
  • Increasing diversity in EMS fellowships is a key strategy for advancing equity in EMS leadership and patient care.

Purpose of the Study:

  • To examine demographic trends in emergency medical services (EMS) fellowships over an 11-year period.
  • To assess the implications of these trends for advancing equity in EMS care delivery.
  • To identify opportunities for improving diversity within EMS leadership.

Main Methods:

  • Analysis of publicly available Accreditation Council for Graduate Medical Education (ACGME) Data Resource Books (2012-2023).
  • Demographic data (gender, race/ethnicity) for EMS fellows, emergency medicine residents, and all residents/fellows were extracted.
  • Chi-square tests and Cochran-Armitage Trend Test were used to analyze demographic proportions and trends.

Main Results:

  • Over 11 years, 66% of EMS fellows were male and 34% were female, with lower female representation than in other specialties.
  • The majority of EMS fellows identified as White (75%), with a higher proportion of White fellows compared to other specialties.
  • No significant trends in gender or race/ethnicity proportions were observed among EMS fellows over the study period.

Conclusions:

  • For the first decade of fellowship accreditation, EMS fellows remained predominantly White and male.
  • A significant disparity exists in the representation of women and underrepresented minorities within EMS fellowships.
  • EMS leadership, including fellowship directors, must actively recruit diverse candidates to foster equity in medical direction.