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The reasons for sex inequity in medicine are complex and partly interface ethnic background, specialty choice, and practice location. Multiple factors influence career choices including cultural values, balancing family responsibilities with professional growth, and career mentoring and support. Over the last 40 years, the Sophie Davis/CUNY School of Medicine (CSOM) has pursued a mission to increase diversity in medicine at the same time in which it has fostered the importance of primary care and service in underserved areas of New York State. Data from 1524 CSOM graduates show an increase in the number of women and underrepresented groups, with about a quarter of them working in Health Professional Shortage Areas (HPSAs). When compared with their male counterparts, our female graduates report lower income for similar work hours, with this disparity increasing slightly between female and male doctors working in HPSAs. In addition, our female graduates have chosen primary care specialties at a ratio of nearly 2:1 when compared with their male peers. Despite these inequities, our female graduates report satisfaction with their career choices, primarily due to a strong commitment to serving back patients in those communities where some of them come from. More research is needed to identify specific factors that perpetuate pay inequity at the state level to minimize the implications of disparity for women doctors, particularly those working in low-income communities. [ABSTRACT FROM AUTHOR]

Background The case fatality rate (CFR) from invasive meningococcal disease (IMD) in New York City (NYC) is greater than national figures, with higher rates among females than males across all age groups. Methods We conducted a retrospective cohort study among 151 persons aged ≥15 years diagnosed with IMD in NYC during 2008–2016 identified through communicable disease surveillance. We examined demographic, clinical, and community-level associations with death to confirm the elevated risk of mortality among female IMD patients after adjusting for confounders and to determine factors associated with female IMD mortality. Relative risks of death were estimated using multivariable log-linear Poisson regression with a robust error variance. Results Females had a higher CFR (n = 23/62; 37%) following IMD than males (n = 17/89; 19%) (adjusted relative risk [aRR], 2.1; 95% confidence interval [CI], 1.2–3.8). Controlling for demographic and clinical factors, there was a significant interaction between sex and fatal outcomes related to meningitis: the relative risk of death for females with meningitis was 13.7 (95% CI, 3.2–58.1) compared with males. In the model restricted to females, altered mental status (aRR, 7.5; 95% CI, 2.9–19.6) was significantly associated with an increased risk of death. Conclusions Female mortality from IMD was significantly increased compared with males, controlling for other predictors of mortality. Sex-based differences in recognition and treatment need to be evaluated in cases of meningococcal disease. Our study highlights the importance of analyzing routine surveillance data to identify and address disparities in disease incidence and outcomes. [ABSTRACT FROM AUTHOR]