Hidden Curriculum and the Demographic Stoicism That Keeps Women and Minorities Away From Radiology: A Mixed-Methods Study of Medical Students

ObjectiveTo understand how women and historically underrepresented minority medical students perceive radiology as a potential career choice.MethodsMedical students representing a broad spectrum of radiology exposure from a single institution were invited to participate in a mixed-methods study. Participants completed a 16-item survey about demographics and perceptions of radiology. Ten focus groups were administered to probe decision making regarding career selection. The themes influencing women and historically underrepresented minority students are presented.ResultsForty-nine medical students, including 29 (59%) women and 17 (35%) underrepresented minorities, participated. Most participants (28 of 48, 58%) reported men outnumbered women in radiology. Female participants reported a lack of mentorship and role models as major concerns. Outreach efforts focused on the family-friendly nature of radiology were viewed as patronizing. Demographic improvements in the field were viewed as very slow. Forty-six percent (22 of 48) of participants indicated that radiology had a less underrepresented racial or ethnic workforce than other medical specialties. Minority participants especially noted a lack of radiology presence in mainstream media, so students have few preconceived biases. A failure to organically connect with the mostly White male radiologists because of a lack of shared background was a major barrier. Finally, participants described a hidden curriculum that pushes minority medical students away from specialty fields like radiology and toward primary care fields to address underserved communities and health care disparities.DiscussionWomen and historically underrepresented minority medical students perceive major barriers to choosing a career in radiology. Radiology departments must develop sophisticated multilevel approaches to improve diversity.