Women, Racial-Ethnic Minorities Remain Underrepresented in Academic Neurology

Over the past 5 decades, diversity in gender, racial, and ethnic representation among neurology faculty in the United States has increased; however, these changes are less pronounced among senior academic ranks and leadership positions. These are the results of a study presented at the 2025 American Academy of Neurology (AAN) annual meeting, held from April 5 to 9, 2025, in San Diego, California.

“We were struck by how pronounced these disparities remained despite the growing number of women and individuals from underrepresented groups entering neurology and the decades of institutional and organizational diversity initiatives,” lead study author Wendy Tsai, 4^th year medical student at the University of British Columbia in Vancouver, Canada, and incoming neurology resident at the University of Toronto, told Neurology Advisor.

Previous research has highlighted gender, racial, and ethnic underrepresentation in academic neurology, yet there is a lack of research longitudinally examining these trends over decades. In a cross-sectional study, researchers sought to assess gender, racial, and ethnic trends in neurology department faculty appointments in the US from 1972 to 2021.

The researchers analyzed data on the gender, race, and ethnicity of active full-time neurology department faculty using annual reports from the Association of American Medical Colleges (AAMC) US Medical School Faculty. They used multivariable linear regression to assess trends in these 3 areas by academic rank (1972-2021) and department chair (1977-2021) status. Using variance and pairwise t-tests and Tukey’s honestly significance difference, the researchers evaluated subgroup differences and performed multiple comparisons, respectively.

Among US neurologists, representation of the following groups increased from 1972 to 2021:

• Women (32.9%);
• American Indian or Alaska Natives (0.1%);
• Asian (16.3%);
• Black (1.4%);
• Native Hawaiian or other Pacific Islanders (0.1%); and
• Hispanic (0.4%).

The annual growth rate also increased among the following groups:

• Women (0.71%; 95% CI, 0.66-0.76%; P <.0001);
• Asian (0.35%; 95% CI, 0.23-0.47%; P =.0001);
• Black (0.030%; 95% CI, 0.016-0.044%; P =.001); and
• Hispanic (0.023%; 95% CI, 0.006-0.039%; P =.01).

The researchers noted there were more men vs women (all, P <.0001) and White vs Asian and Black neurologists (both, P <.0001) in each academic rank, with higher ranks showing greater underrepresentation. Among neurology chairs (1977-2021), there were more men vs women and White vs Asian and Black neurologists (all, P <.0001).

“Our findings highlighted that despite progress towards diversity, systemic barriers continue to limit equitable advancement in neurology. More intentional, top-down strategies are needed to foster representational diversity and meaningful change in neurology,” said Tsai.

For example, the AAN implemented the Diversity Leadership program to train, mentor, and engage neurologists with leadership. The incorporation of “mentorship programs, diversity and cultural competency training for faculty and trainees, and equitable and transparent hiring and promotion policies” could help increase diversity in neurology, noted Tsai.

She suggests institutions could “adopt a top-down approach to diversification, whereby the presence of diverse leadership promotes and sustains diversity at the faculty and trainee levels. Institutions also should regularly evaluate their policies to identify barriers and solutions to a diverse neurology workforce.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.