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Open research questions in Diversity and Career in Medicine

58 unresolved questions extracted from the limitations and future-work sections of 856 Diversity and Career in Medicine papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • ImportanceThe transition from medical school to residency forms a national training network, yet its large-scale structure and implications for trainee outcomes remain poorly characterized.

    Institutional Standing and Trainee Outcomes in the 2025 US Residency Match · 2026 · DOI

  • Surveys reveal that most female physicians feel that their parental leave benefits are insufficient and often rely on short-term disability, paid time off (PTO), or unpaid leave to recover from childbirth and care for their newborns.

    A crisis within the physician shortage in the United States: the need for consistent 12-week paid parental leave · 2026 · DOI

  • The narrative approach introduces selection bias, and the underly- ing literature is subject to publication bias toward large academic cen- ters. Few studies in this literature employ longitudinal designs or report on long-term outcomes of workforce interventions, making it difficult to establish causal pathways from intervention to equity out- come. Future research should prioritize prospective evaluations of rural training tracks, telemedicine program effectiveness, and inter- sectional recruitment strategies.

    Inequitable access to neurosurgical care in the United States · 2026 · DOI

  • Our study had limitations worth noting. The response rate of 41% falls within the typical range for surveys assessing outcomes in similar pathway programs. However, this rate, combined with the relatively small cohort sizes, made yearby-year analysis difficult and limited our ability to gather comprehensive quantitative and qualitative data. Additionally, many respondents did not complete the optional sections of the survey, resulting in some response samples being as low as 20 participants. This introduces potential response bias, as the survey may have disproportionately attracted alumni who are more successful or those who remain interested in healthcare careers, possibly overrepresenting those still pursuing the program’s goals six years later. Notably, the study sample has a large proportion of Asian students (29%, 19/64) compared to the overall makeup of Cass Technical High School (9.4%), as well as the 2013–2019 DoT 1 3Medical Science Educator cohorts (21.3%). As such, both the study sample and the DoT population may differ from the overall Cass Technical High School student body. Therefore, limitations related to response bias and small subgroup samples impact the interpretation of our findings. Future studies with sufficient sample sizes could further analyze differences in subgroups. Additionally, the retrospective nature of the survey could cause potential recall bias within the study design. Our data did not collect the number of students who wanted to be physicians, independent of the pathway program. Future studies will need to expand to participants at additional high schools with programs similar to DoT to validate results across contexts. This would allow study findings to be more generalizable and transferable to other underserved populations. Despite substantial investment in the DoT program to support aspiring physicians, DoT has not yet seen measurable matriculation outcomes, suggesting substantial gaps along the pathway. Nevertheless, we find key factors such as awareness, preparedness, and social capital that shape students’ persistence in their aspirations towards medical school. Our findings indicate that awareness fosters motivation, preparedness builds confidence, and social capital provides access and opportunities. Cultivating this synergy may help pathway programs enhance their support and guidance of students.

    Where Are They Now? The University of Michigan Medical School Doctors of Tomorrow Pathway Program · 2026 · DOI

  • This study had several limitations. The use of purposive and snowball sampling may have introduced selection bias, as those more interested in leadership and equity issues may have been more likely to respond. The small sample size limited our ability to perform subgroup analyses (e.g., by age, race/ethnicity or subspecialty). Because the survey was forwarded by intermediaries and responses were anonymous, we could not determine the total number of surgeons invited, calculate a response rate or definitively exclude duplicate submissions. This prevented us from fully evaluating the representativeness of our sample and introduced the possibilities of nonresponse bias and limited generalizability of our results. Data were self-reported and, thus, subject to social desirability bias and individual interpretation of leadership experiences, although anonymity of responses was intended to mitigate this concern. Although the survey was informed by previously published DEI instruments, it was not independently validated. Finally, the discrepancies between reported receipt of leadership training and mentorship (similar rates by gender) and the significantly different perceptions of access to these resources as barriers may reflect a limitation of our survey design. The binary items (“Have you received any formal leadership training?” and “Have you had a mentor?”) did not account for differences in type, depth, quality or continuity. As a result, comparable participation rates may mask meaningful disparities in access, which could explain why women were more likely to perceive limited access. Although leadership training is widely endorsed, previous studies have suggested that current efforts are insufficient and that training should be integrated earlier in surgeons’ careers [12-14]. In the present study, about 59% of respondents reported having received formal leadership training, a finding consistent with concerns that training opportunities in orthopaedics may be limited relative to demand [10,13,14]. We also found that, although the proportions of men and women who had received such training did not differ, women perceived lack of access to leadership training as a greater barrier than men did, which could reflect differences in how respondents interpreted the adequacy, quality or usefulness of available training opportunities. We speculate that women may be more attuned to structural shortages in leadership training, whether because of their own or observations of their peers’, experiences and that this could contribute to their heightened awareness of barriers. Most of our respondents reported having had a mentor at some point in their careers, but compared with men, women perceived lack of access to mentorship as a significantly greater barrier to leadership advancement.

    Exploring Gender Differences in Perceived Barriers to Advancement in Orthopaedic Surgery: A Cross-Sectional Survey · 2026 · DOI

  • The sample was limited to a single geographic region in Southeast Asia (Pakistan), potentially restricting general- izability. Self-reported data may be susceptible to social desirability bias, particularly regarding sensitive topics like modesty and religious beliefs. The study did not incor- porate qualitative interviews, which could have enriched understanding of nuanced attitudes and beliefs. Future studies should adopt a longitudinal and multicentric design to capture broader demographic variations. Qual- itative exploration through patient and provider interviews would add depth to understanding underlying beliefs and coping strategies. It would also be beneficial to assess the impact of specific interventions, such as communica- tion training or cultural competency modules, on patient satisfaction and provider efficacy.

    Gender dynamics in diagnostic imaging: Understanding patient preferences and enhancing radiologist preparedness for opposite-gender interactions · 2026 · DOI

  • This study’s findings should be interpreted in light of several limitations. Firstly, our analysis relies entirely on data collected from publicly available state medical cham- ber websites. The accuracy, completeness, and timeliness of this information are contingent upon the diligence of the respective chambers in maintaining their online reg- istries; potential omissions or outdated entries cannot be fully excluded. Secondly, gender assignment was neces- sarily based on textual and visual cues from public pro- files, resulting in a binary (male/female) classification. This methodological approach, while standard for registry- based studies, does not capture the full spectrum of gender identity or account for non-binary individuals or instances where self-identification may differ from public records. Thirdly, the cross-sectional design provides only a snap- shot as of January 2023. This precludes the analysis of tem- poral trends in leadership representation, individual career trajectories towards TPD roles, or the causal factors under- lying the observed disparities. Fourthly, while the German Weiterbilder role shares key functions with Training Pro- gram Directors in other countries, inherent differences in national healthcare systems, contextual factors, accredita- tion processes (e.g., ACGME), appointment procedures, and specific regulatory duties may constrain direct inter- national comparisons, particularly with US or UK mod- els. Finally, this quantitative analysis does not incorporate qualitative data; insights into the lived experiences, specific challenges, or perceived barriers related to leadership and gender equity from the perspectives of TPDs or trainees are beyond the scope of this study.

    Gender and East–West disparities in German neurosurgical training leadership · 2026 · DOI

  • With 37%, the overall response rate was good, which is a strength of our study. JHaS members are a representative sample of the next generation of GPs and pediatricians, as we do not have a national registry in Switzerland. In the interview, we used different types of questions (direct/ indirect) to more clearly depict the needs and desires of young GPs and pediatricians. We had six specific issues related to the feasibility of emergency duty for young GPs and pediatricians, which is a big issue considering work-life balance. Women are probably overrepresented in the study population; however, women are the larger proportion of the medical students and practicing young doctors, so the sample remains representative. The lack of a national registry of practicing GPs and pediatricians is a limitation but the increasing proportion of female medical students and young doctors in Switzerland is well documented. 2024, 1’426 students absolved gradu- ation in human medicine, 63% were female (www.bag. admin.ch). Asking JHaS members may have resulted in some selection bias, as members may be more active and interested in participating than non-members. Finally, we only covered the French and German speaking regions, so that our results are not generalizable to the Italian- speaking region of Switzerland.

    Work preferences and motivations of young general practitioners in Switzerland: findings from a cross-sectional survey of the Swiss Young General Practitioners Association (JHaS) · 2026 · DOI

  • The analysis lacks investigation into why new hire percentages for women (29% in physics, 34% in astronomy in 2024) remain higher than overall faculty percentages despite declining from 2020 and 2022 peaks.

    Upward trend in percentage of women physics and astronomy faculty in US · 2026 · DOI

  • Burnout and declining fulfillment are prevalent among facial plastic surgeons (FPS), yet the organizational drivers of these challenges remain underexplored.

    More Healing Hands Through More Harmonized Voices: The SCALPEL Study · 2025 · DOI

  • Specifically, this study attempted to address the following gaps in the literature: (1) studying grades actually assigned to students (as opposed to self-reported ones), (2) using longitudinal data over an 8-year period, providing stability of data, (3) analyzing three important, potentially confounding covariates, (4) using a comprehensive multivariate statistical design, and (5) investigating not just the main effects of gender and race, but also their potential interaction.

    Race and Gender Bias in Clerkship Grading · 2023 · DOI

  • Relatively little is known with regard to the study of gender identity and professional development in emergency medicine (EM), with even fewer studies specifically examining women EM residents.

    “I just assume they don't know that I'm the doctor”: Gender bias and professional identity development of women residents · 2022 · DOI

  • In addition, despite having equivalent credentials, female EM faculty remain underrecognized and undercompensated when compared to their male counterparts.

    Gender Disparities in Academic Emergency Medicine: Strategies for the Recruitment, Retention, and Promotion of Women · 2019 · DOI

  • There are several limitations to our study. First, it uses some survey data, and the questions used may not ideally capture the constructs of the conceptual framework used. However, the items included in the AAMC surveys are largely identical to those used in similar career-decision studies in emergency medicine and in other medical fields.18 In regard to the issue of veracity of the data collected before our analysis, the source of the information is critically important. The academic information contained in this study came directly from the organization that provides the application software. Unlike many other similar studies, there are no self-reported data on scores, grades, and other academic factors from students, which can result in misreporting of such data. A second potential limitation is a result of using surveybased data, which can be limited by nonresponse issues. In this case, the change of an item in the survey during the timeframe of our analysis limited our sample size to greater than 17,000 subjects (Figure). Although this has the potential to bias the results, there is no clear reason to believe that there are major differences between respondents before and after survey item change (Table E1, available online at http://www.annemergmed.com). DISCUSSION The results support our hypothesis that female students and those underrepresented in medicine have less interest in a career in emergency medicine at medical school graduation. This finding is true even when different interests, academic competitiveness, debt load, and other factors are controlled for. To our knowledge, our study provides the first evidence that demonstrates that continued issues with recruiting a diverse emergency medicine workforce may be the result of currently undefined factors. Before this study, stakeholders in emergency medicine could consider several explanations for why female students and those underrepresented in medicine were less likely to choose emergency medicine. Each of these explanations were based on individual student preferences and not a result of external forces on the process. Specifically, explanations that women and students underrepresented in medicine had different values or preferences in comparison to other medical students and those differences resulted in less interest in emergency medicine. Those explanations are not supported by our results. Controlling for the importance placed on career attributes and values that have been shown to be correlated with an interest in emergency medicine, academic competitiveness to match in emergency medicine, and the importance of service to underserved populations in the decisionmaking model did not correct for the observed lower graduating career interest in emergency medicine for female students and those underrepresented in medicine.

    Diversity in Emergency Medicine: Are We Supporting a Career Interest in Emergency Medicine for Everyone? · 2019 · DOI

  • The paper notes insufficient investment in 'leadership training and development' for the current medical workforce but does not specify evidence-based competency frameworks, effectiveness metrics, or evaluation designs for assessing which leadership development interventions best support women physicians' advancement to senior medical leadership positions.

    Women and medicine · 2010 · DOI

  • The paper states that 'Further debate is needed to achieve consensus on how best to plan and organise child and elder care for those doctors with family responsibilities' but does not identify which organisational models, cost-sharing mechanisms, or accessibility standards should be evaluated or compared across different medical institutions.

    Women and medicine · 2010 · DOI

  • The paper identifies an 'urgent need' for the Department of Health to collate 'an accurate longitudinal data set' for workforce planning but does not specify the required temporal scope, variables to be tracked, sampling methodology, or comparison populations needed to support evidence-based reconfiguration of trainee workforces in medical specialties.

    Women and medicine · 2010 · DOI

  • The paper recommends 'separate teaching and research career tracks' as a pragmatic approach to support clinical academics but provides no comparative analysis of existing separate-track models, their implementation costs, or evidence of their effectiveness in improving research and teaching excellence outcomes for women and men in medical academia.

    Women and medicine · 2010 · DOI

  • The paper notes that women are 'under-represented in academic medicine' which leads to under-representation in medical leadership, but does not establish the quantitative threshold or specific pipeline analysis identifying at which career stage women disproportionately exit academic medicine pathways.

    Women and medicine · 2010 · DOI

  • The paper asserts that academia is 'particularly difficult for women to take part in and sustain on a part-time or flexible basis' but lacks empirical data comparing retention rates, career progression trajectories, and research productivity outcomes between full-time and flexible-track women clinical academics across different medical specialties.

    Women and medicine · 2010 · DOI

  • The Medical Schools Council 2007 research documented 'poor understanding among undergraduates of what is meant by clinical academia' and evidence of discrimination in some branches of medicine, but the paper does not specify which medical specialties exhibit discrimination or propose validated assessment instruments to measure understanding of academic medicine pathways.

    Women and medicine · 2010 · DOI

  • The paper identifies job-sharing in part-time medical work as creating 'enormous matching difficulties' but provides no systematic analysis of the specific organizational structures, scheduling algorithms, or matching methodologies that could resolve these pairing challenges in clinical medicine settings.

    Women and medicine · 2010 · DOI

  • Surgery-specific peer-support programs and debriefing models have been developed and are generally well received, although rigorous outcome data remain limited.

    The surgeon as second victim: a review of the phenomenon in surgery with implications for neurosurgical practice · 2026 · DOI

  • Little is known about how medical students and trainees develop an interest in extramural specialties such as youth health care (YHC).

    Where Do I Belong? Searching for fit in an unseen specialty: medical students paths to Youth Health Care · 2026 · DOI

  • The concept of a surgical culture shift warrants further study, as do ways of broadening the diversity of role models available to students, including gender, ethnicity and personality.

    Do you want to be a surgeon? A qualitative study of medical students in Australia · 2026 · DOI

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58 open questions have been extracted from the limitations and future-work passages of 856 Diversity and Career in Medicine papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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