Recruitment and Retainment Trends in Diverse Family Medicine Academic Leadership: A CERA Secondary Analysis

Background and Objectives: Increasing the representation of female and Black, Indigenous, and People of Color (BIPOC) identities among family medicine faculty leaders is important for improving community health outcomes. While prior studies show rising percentages, they don’t clarify whether these gains stem from recruitment or retention. We examined the proportion of leaders who are female and BIPOC to determine how long they’ve held their roles. Methods: We conducted a secondary analysis of Council of Academic Family Medicine Educational Research Alliance (CERA) survey data from 2011 to 2023. Leadership duration was classified as <1 year (recruitment) and ≥5 years (retention). Descriptive statistics and Pearson’s correlation test evaluated trends in duration across leadership roles over time. Results: Increases in BIPOC representation were observed only among leaders with ≥5 years of duration. Increases in the proportion of BIPOC male and female clerkship directors with ≥5 years rose from 4.8% each in 2012 to 19.3% and 14.0% in 2023 (P=0.005, P=0.009). BIPOC female program directors with ≥5 years of duration increased from 4.4% in 2018 to 17.3% in 2023 (P=0.001). No significant trends were identified among department chairs or among leaders with <1 year of duration. Conclusions: In family medicine academic leadership, observed increases in BIPOC men and women clerkship directors and BIPOC women program directors are driven by retention rather than recruitment into leadership roles. Departments should therefore sustain and scale retention practices while implementing formal mentorship and sponsorship programs, transparent promotion pathways, and targeted outreach to ensure equitable growth in leadership diversity.