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Diversity in Canadian Radiology: Success Requires Leadership Commitment

The importance of improving diversity, inclusion, and representation is increasingly recognized throughout the health-care system, including radiology. A Google search for ‘‘diversity in radiology’’ shows that academic centers are driving diversity efforts. However, interestingly, the first search engine hit is from a vendor. There is a clear business case for increasing diversity in radiology and a substantial benefit for Canadian radiology practices. Enhancing representation of our increasingly diverse Canadian patient population is good for patients, our colleagues, and the future of the specialty. Even though there are recognized methods to improve diversity and inclusion within radiology training programs and practices, the success of these initiatives is dependent on active and ongoing leadership support and accountability. The best way to provide high-quality care to patients is through a physician population reflective of the diversity of the population served. Many studies, both in the health-care setting and in business, show that increased diversity drives innovation and improves outcomes. Governments, businesses, and health-care organizations have demonstrated that maintaining diverse perspectives at the decision-making table is essential to meeting the needs of constituents, consumers, and patients. Although it is challenging to find data documenting variation in the cultural background, ability status, race, religion, sexual orientation, or social class in Canadian radiology practices and training programs, there is an undisputed gender disparity in radiology practices in Canada. Despite the fact that women are now overrepresented in Canadian medical schools, they remain a minority in diagnostic radiology training programs and are underrepresented in radiology practices. The proportion of women radiologists has remained relatively stable over decades, and current trends suggest that this is not increasing and may in fact be decreasing. There is a marked paucity of women in political, academic, and departmental radiology leadership positions across the country. Some provincial radiology organizations have no women leaders at all. In 1981, the American Association for Women in Radiology was founded to address the unique needs of female radiologists, specifically because female radiologists were subordinate to male radiologists both in the workplace and at the national level with respect to political power and financial compensation. Unfortunately, although much has changed in regard to technology in the field of radiology since the 1980s, the significant gender disparity has not. A recent review by the Canadian Medical Association and the Federation of Medical Women of Canada, Addressing Gender Equity and Diversity in Canada’s Medical Profession, indicated that there are significant positive impacts from increasing the role of women in medicine. The impact of women in medicine can influence medical culture and practice, the quality of patient care, and the organizational structure of the health-care system. This ultimately benefits patients, learners, and the health-care system. The review identified significant opportunities for enhancing the health and livelihood of women and other marginalized groups if we’re able to overcome ongoing barriers produced by discrimination and bias at the individual and systemic levels. The current Canadian radiology workforce does not reflect the diversity of the Canadian patient population. One of the best ways to improve the future is to create it, and by working to align our practices with the very diversity that contributes to our Canadian identity, we can leverage untapped ability and experience to strengthen our practice and the care we deliver to our patients. The American College of Radiology (ACR) Commission for Women and Diversity has demonstrated that radiology (and radiology oncology) training programs are less diverse than medical school graduate programs and less diverse than other medical specialties. They also found that teams comprised of diverse viewpoints, perspectives, ideas, and backgrounds tend to outperform homogeneous ones and suggested a wider talent pool and ability to match patient and customer needs lead to improved service and better outcomes. They found that diversity leads to better ideas and innovation and improves the patient experience. Of note, they identified the importance of