Distribution of Men and Women Among NCAA Head Team Physicians, Head Athletic Trainers, and Assistant Athletic Trainers | Health Care Workforce | JAMA Internal Medicine | JAMA Network
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Table 1.  National Collegiate Athletic Association Head Team Physician Sex Distribution
National Collegiate Athletic Association Head Team Physician Sex Distribution
Table 2.  National Collegiate Athletic Association Athletic Trainer Sex Distribution
National Collegiate Athletic Association Athletic Trainer Sex Distribution
1.
Association of American Medical Colleges. 2016 Physician specialty data report. https://www.staging.aamc.org/data/workforce/reports/457712/2016-specialty-databook.html. Accessed August 5, 2019.
2.
Jena  AB, Olenski  AR, Blumenthal  DM.  Sex differences in physician salary in US public medical schools.  JAMA Intern Med. 2016;176(9):1294-1304. doi:10.1001/jamainternmed.2016.3284PubMedGoogle ScholarCrossref
3.
Jena  AB, Khullar  D, Ho  O, Olenski  AR, Blumenthal  DM.  Sex differences in academic rank in US medical schools in 2014.  JAMA. 2015;314(11):1149-1158. doi:10.1001/jama.2015.10680PubMedGoogle ScholarCrossref
4.
National Collegiate Athletic Association. Member directory. https://web3.ncaa.org/directory/. Accessed October 2, 2019.
5.
National Collegiate Athletic Association. Sport sponsorship: participation and demographics search. https://web1.ncaa.org/rgdSearch/exec/main. Accessed October 2, 2019.
6.
National Collegiate Athletic Association. Divisional differences and the history of multidivision classification. http://www.ncaa.org/about/who-we-are/membership/divisional-differences-and-history-multidivision-classification. Accessed August 5, 2019.
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    Research Letter
    Physician Work Environment and Well-Being
    November 4, 2019

    Distribution of Men and Women Among NCAA Head Team Physicians, Head Athletic Trainers, and Assistant Athletic Trainers

    Author Affiliations
    • 1Orthopedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, Ohio
    • 2Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
    • 3Franciscan Health Network, Purdue University, West Lafayette, Indiana
    JAMA Intern Med. 2020;180(2):324-326. doi:10.1001/jamainternmed.2019.5092

    The percentage of female physicians in the United States has increased. In 2016, 35.2% of active physicians were women.1 However, gender disparities persist in many areas of medicine, such as compensation,2 academic rank,3 medical society awards, and national conference keynote speakers.

    In the National Collegiate Athletic Association (NCAA), the number of male and female athletes is similar. In 2019, 56% of student athletes were men and 44% were women.4 In this study, we determined the distribution of men and women among NCAA head team physicians and head and assistant athletic trainers.

    Methods

    In June 2019, we used the NCAA member directory5 to collect data on head team physicians and athletic trainers in the NCAA for the 2018-2019 academic year. Two authors (C.L. and C.D.) independently determined each physician’s gender (as well as primary specialty for head team physicians in Division I) based on name, online photograph, and internet profiles. Discrepancies were resolved through discussion and obtaining additional information.

    Aggregated gender data were obtained for head and assistant athletic trainers from the NCAA Sports Sponsorship, Participation and Demographics Search database.4 Institutions submit the name of 1 head and multiple assistant athletic trainers (the number of assistant athletic trainers varies among institutions) along with information on their gender. We report the distribution of men and women in these positions from all NCAA institutions grouped by Divisions I, II, and III. The division of an NCAA institution is determined by school size, sports offered, and athletic financial aid.6 The distribution of men and women in the 3 position categories by NCAA divisions was compared using the Pearson χ2 test. All tests were 2-sided and deemed to be significant at P<.05. Analyses were performed using SAS, version 9.4 (SAS Institute Inc). The Cleveland Clinic Institutional Review Board determined this study to be exempt from human subjects review owing to use of publicly available data. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guidelines.

    Results

    In the 2018-2019 academic year, there were 1121 NCAA institutions: 353 in Division I, 318 in Division II, and 450 in Division III. A total of 1145 head team physicians were reported with 46 schools listing 2 physicians and 7 schools listing 3. Vacancies were reported for 37 positions (5 in Division I, 10 in Division II, and 22 in Division III). For all divisions (excluding institutions reporting vacancies), 129 (11.2%) head team physicians were women and 1016 (88.7%) were men. There were 38 (10.0%), 29 (9.0%), and 62 (13.9%) female head team physicians in Divisions I, II, and III, respectively. There were no significant gender differences among divisions (Table 1).

    Table 2 summarizes the data for athletic trainers. Overall, 366 (31.7%) head athletic trainers were women: 78 (19.8%), 109 (36.4%), and 179 (40.0%) for Divisions I, II, and III, respectively. For assistant athletic trainers, the comparable number of women were 1150 (48.1%), 409 (56.2%), and 547 (60.1%). For both head and assistant athletic trainers, many of the gender differences among divisions were significant (Table 2).

    Discussion

    Fewer female physicians and athletic trainers than men have sports medicine leadership roles within NCAA institutions. Although nearly half of NCAA athletes are women and more than a third of active US physicians are women, only about 11% of the head team physicians are women.

    We did not study the factors contributing to these discrepancies. Other limitations of the study include potential gender misclassification and nonbinary gender expression, as well as a lack of information about changes in the percentages of men and women in positions over time.

    The findings of this study suggest that the executive leadership of NCAA institutions should identify organizational and social barriers to gender equity in sports medicine leadership roles. Colleges and universities should implement strategies to promote inclusion and career development, and appoint more women as head team physicians and head athletic trainers.

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    Article Information

    Accepted for Publication: September 1, 2019.

    Corresponding Author: Caitlin Lewis, MD, Cleveland Clinic, 5555 Transportation Blvd, Garfield Heights, OH 44125 (lewisc6@ccf.org).

    Published Online: November 4, 2019. doi:10.1001/jamainternmed.2019.5092

    Author Contributions: Dr Lewis had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

    Study concept and design: Lewis, Day.

    Acquisition, analysis, or interpretation of data: All authors.

    Drafting of the manuscript: Lewis, Jin.

    Critical revision of the manuscript for important intellectual content: Lewis, Day.

    Statistical analysis: Jin, Day.

    Administrative, technical, or material support: Lewis, Day.

    Study supervision: Day.

    Conflict of Interest Disclosures: None reported.

    References
    1.
    Association of American Medical Colleges. 2016 Physician specialty data report. https://www.staging.aamc.org/data/workforce/reports/457712/2016-specialty-databook.html. Accessed August 5, 2019.
    2.
    Jena  AB, Olenski  AR, Blumenthal  DM.  Sex differences in physician salary in US public medical schools.  JAMA Intern Med. 2016;176(9):1294-1304. doi:10.1001/jamainternmed.2016.3284PubMedGoogle ScholarCrossref
    3.
    Jena  AB, Khullar  D, Ho  O, Olenski  AR, Blumenthal  DM.  Sex differences in academic rank in US medical schools in 2014.  JAMA. 2015;314(11):1149-1158. doi:10.1001/jama.2015.10680PubMedGoogle ScholarCrossref
    4.
    National Collegiate Athletic Association. Member directory. https://web3.ncaa.org/directory/. Accessed October 2, 2019.
    5.
    National Collegiate Athletic Association. Sport sponsorship: participation and demographics search. https://web1.ncaa.org/rgdSearch/exec/main. Accessed October 2, 2019.
    6.
    National Collegiate Athletic Association. Divisional differences and the history of multidivision classification. http://www.ncaa.org/about/who-we-are/membership/divisional-differences-and-history-multidivision-classification. Accessed August 5, 2019.
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