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Gimenez C, Balassanian R, Banet N, Barkan G, DeRobbio K, Henderson-Jackson E, Jenkins E, Kilic A, Lai L, Lura T, Morgenstern N, Mito J, Reid MD, Rivera-Colon G, Stewart J, Lowe ACY. Science, Medicine, and Cytology: an educational program of the Diversity, Equity, and Inclusion Committee of the American Society of Cytopathology. J Am Soc Cytopathol 2024; 13:244-253. [PMID: 38834386 DOI: 10.1016/j.jasc.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 04/01/2024] [Accepted: 04/10/2024] [Indexed: 06/06/2024]
Abstract
INTRODUCTION As our field of pathology continues to grow, our trainee numbers are on the decline. To combat this trend, the ASC Diversity, Equity, and Inclusion Committee established the Science, Medicine, and Cytology SumMer Certificate program to improve exposure to pathology/cytopathology with a focus on diversity, equity, and inclusion. Herein, we report our findings of the first 2 years of the program. MATERIALS AND METHODS An online course was developed targeting students who are underrepresented in medicine at the high school and college level. It consisted of several didactic sessions, presenting the common procedures involving cytopathologists and cytologists. Interviews with cytopathologists were also included. Participants were surveyed for demographic information and provided course evaluations. RESULTS In the first year of the program (2021), 34 participants completed the program, which increased to 103 in 2022. In both years there was a diversity in participant demographic backgrounds; however, only a minority of participants self-identified as being underrepresented in medicine. A vast majority (>85%) of participants in both years were high school or college students. In 2021, 100% of participants stated that the program format was effective and 94% thought the content was appropriate for their level of education; in 2022 the results were similar. In 2021, 66% considered health care as a potential career; this value increased in 2022 to 83%. In 2021 and 2022, 31% and 38%, respectively, considered cytology as a career. CONCLUSIONS Evaluations were excellent, generating interest in cytopathology. Barriers in reaching underrepresented minorities exist and additional work is needed. Expansion to a wider audience may increase outreach.
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Affiliation(s)
- Cecilia Gimenez
- Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, New York; Division of Cytopathology, Northwell Health Laboratories, Greenvale, New York.
| | - Ronald Balassanian
- Department of Pathology, University of California, San Francisco, San Francisco, California
| | - Natalie Banet
- Department of Pathology, Cleaveland Clinic Community Oncology Group, Cleaveland, Ohio
| | - Guliz Barkan
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois
| | - Kristen DeRobbio
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Elizabeth Jenkins
- Department of Pathology, American Society of Cytopathology, Wilmington, Delaware
| | - Ayse Kilic
- Department of Pathology, Loyola University Chicago, Maywood, Illinois
| | - Lisa Lai
- Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Theresa Lura
- James H Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee
| | - Nora Morgenstern
- Department of Pathology, NYC Health and Hospitals Elmhurst, Queens, New York
| | - Jeffrey Mito
- Department of Pathology, Harvard Medical School, Boston, Massachusetts
| | - Michelle D Reid
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia
| | - Glorimar Rivera-Colon
- Department of Pathology, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jimmie Stewart
- Department of Pathology, Regents of The University of Minnesota, Minneapolis, Minnesota
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Teles MS, Mamidanna S, Mattes MD. Assessment of Student Perceptions of Aspects of a Career in Radiation Oncology. J Am Coll Radiol 2024; 21:1079-1089. [PMID: 38369041 DOI: 10.1016/j.jacr.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/27/2024] [Accepted: 02/03/2024] [Indexed: 02/20/2024]
Abstract
PURPOSE To determine medical students' views of various aspects of a career in radiation oncology (RO) to identify areas that may benefit from reform and to guide initiatives to stimulate broader and more diverse student interest in the specialty. METHODS AND MATERIALS An electronic survey was sent to student oncology interest group members at seven US medical schools. The survey asked students to rate 19 aspects of RO on a 5-point bipolar Likert-type scale. Descriptive statistics are reported, along with subgroup analyses based on participants' demographics. RESULTS The response rate was 51.1% (n = 275 of 538). The most favorably rated aspects of RO were outpatient working hours (mean ± SD Likert-type rating of 4.51 ± 0.82), routinely working with other physicians (4.45 ± 0.76), and use of advanced technology to treat patients. The most unfavorably rated aspects of RO were less geographic flexibility for residency or employment (1.98 ± 1.04), spending a lot of time on a computer doing treatment planning (2.80 ± 1.21), and having a job that is not well understood by most doctors and the general public (2.89 ± 1.02). Gender was associated with significant differences in 8 of 19 questions in how each aspect of RO was viewed. Few differences were observed based on race or ethnicity, though Asian participants had a significantly more favorable view of RO being a more science-oriented specialty compared with White or underrepresented students, respectively (3.50 versus 3.21 versus 2.84, P = .01). CONCLUSIONS These findings inform the RO community in the development of more effective initiatives to encourage students to fully explore the specialty.
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Affiliation(s)
| | - Swati Mamidanna
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Malcolm D Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey; Member ASTRO Communications and Education Committees.
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Kiran N, Devi P, Kashi M, Anjali F, Geetha SD. The Impact of Gender Diversity on Excellence in Pathology Research and Education. Cureus 2024; 16:e56114. [PMID: 38618369 PMCID: PMC11014749 DOI: 10.7759/cureus.56114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2024] [Indexed: 04/16/2024] Open
Abstract
In this editorial, we inspect the critical role of gender diversity within the domain of pathology and its consequential impact on research innovation and clinical outcomes. The editorial commences with a historical overview of gender disparities in pathology, acknowledging advancements toward gender parity while highlighting persistent impediments to full inclusivity. The discourse emphasizes the intrinsic value of integrating diverse gender perspectives in research, illustrating how such inclusivity catalyzes innovation, mitigates research biases, and elevates the standard of patient care through a more comprehensive understanding of the field of pathology. Key barriers to gender diversity in pathology are systematically analysed, including disproportionate clinical burdens, time allocation conflicts due to societal roles, restricted access to specialized training, financial limitations, inadequate support networks, workplace discrimination, and the challenge of balancing family responsibilities with professional aspirations. We propose strategic interventions to address these barriers, advocating for increased awareness, diversity-focused training programs, and mechanisms for recognizing and rewarding the contributions of underrepresented genders in the field. Furthermore, we highlight exemplary initiatives that have successfully promoted gender diversity, such as the Johns Hopkins Pathology Department's outreach program, and the role of professional organizations, notably the American Society for Investigative Pathology and its "Women in Pathology" community, is discussed as pivotal in celebrating and advancing women's contributions to the field of pathology. In conclusion, we suggest that dismantling gender bias is imperative for realizing the full potential of pathology as a discipline. The editorial argues for a systemic embrace of gender diversity and inclusivity as fundamental to fostering research innovation, enhancing clinical practice, and ultimately improving patient outcomes. This scholarly examination calls for a concerted effort within the pathology community to integrate diverse perspectives, thereby enriching the field and contributing to the advancement of medical science.
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Affiliation(s)
- Nfn Kiran
- Pathology, Staten Island University Hospital, New York City, USA
| | - Pooja Devi
- Pathology/Hematopathology, University of Pennsylvania Health System, Philadelphia, USA
| | - Meena Kashi
- Pathology, Northwell Health, New York City, USA
| | - Fnu Anjali
- Internal Medicine, Sakhi Baba General Hospital, Sukkur, PAK
| | - Saroja Devi Geetha
- Pathology, Zucker School of Medicine, North Shore University Hospital/Long Island Jewish Medical Center, Northwell Health, Greenvale, USA
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He WY, Pinni SL, Karius A, Chen J, Landford WN, Kraenzlin F, Cooney CM, Broderick KP. Evaluating Diversity Promotion on Integrated Plastic Surgery Residency Program Websites and Instagram Accounts. Ann Plast Surg 2023; 91:644-650. [PMID: 37830505 DOI: 10.1097/sap.0000000000003671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
BACKGROUND Medical students applying to residency, including those from underrepresented groups, strongly value cultural fit and program diversity. Program websites and social media are thus an influential information source for prospective applicants and recruitment tool for residencies. We evaluated whether and how integrated plastic surgery residency program websites and social media display commitments to diversity online. METHODS We evaluated program websites for 8 predetermined diversity elements, (1) nondiscrimination and (2) diversity statements, (3) community resources, (4) faculty and (5) resident biographies, (6) faculty and (7) resident photographs, and (8) resident resources, and assessed Instagram accounts for diversity-related images, captions, and hashtags. Our analysis used Mann-Whitney U , chi-squared, and t tests; significance level was P < 0.05. RESULTS We reviewed 82 program websites with a mean of 3.4 ± 1.4 diversity elements. Resident (n = 76, 92.7%) and faculty photographs (n = 65, 79.3%) and resident biographies (n = 43, 52.4%) were the most common. Seventy programs (85.4%) had Instagram accounts, the majority of which (n = 41, 58.6%) shared content related to diversity in race, ethnicity, gender, and/or sexual orientation. Programs located in smaller cities were more likely to have ≥4 website diversity elements ( P = 0.014) and mention diversity on Instagram ( P = 0.0037). Programs with women chairs/chiefs were more likely to mention diversity on Instagram ( P = 0.007). CONCLUSIONS In the age of virtual recruitment, program websites and social media should provide sufficient information, described in our diversity element checklist, to help prospective applicants determine fit from a diversity perspective. Residents, who often contribute to program social media, and women chairs/chiefs may be critical to driving diversity promotion.
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Affiliation(s)
| | - Sai L Pinni
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Alex Karius
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jonlin Chen
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Wilmina N Landford
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Franca Kraenzlin
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Carisa M Cooney
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kristen P Broderick
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
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Deville C, Charles-Obi K, Santos PMG, Mattes MD, Hussaini SMQ. Oncology Physician Workforce Diversity: Rationale, Trends, Barriers, and Solutions. Cancer J 2023; 29:301-309. [PMID: 37963363 DOI: 10.1097/ppo.0000000000000687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
ABSTRACT This chapter will discuss (1) the rationale for physician workforce diversity and inclusion in oncology; (2) current and historical physician workforce demographic trends in oncology, including workforce data at various training and career levels, such as graduate medical education and as academic faculty or practicing physicians; (3) reported barriers and challenges to diversity and inclusion in oncology, such as exposure, access, preparation, mentorship, socioeconomic burdens, and interpersonal, structural, systemic bias; and (4) potential interventions and evidence-based solutions to increase diversity, equity, and inclusion and mitigate bias in the oncology physician workforce.
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Affiliation(s)
- Curtiland Deville
- From the Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Patricia Mae G Santos
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Malcolm D Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Syed M Qasim Hussaini
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
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Russel SM, Carter TM, Wright ST, Hirshfield LE. How Do Academic Medicine Pathways Differ for Underrepresented Trainees and Physicians? A Critical Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:00001888-990000000-00537. [PMID: 37556817 PMCID: PMC10834859 DOI: 10.1097/acm.0000000000005364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
PURPOSE Academic medicine faces difficulty recruiting and retaining a diverse workforce. The proportion of medical students who are underrepresented in medicine (URiM) is smaller than the proportion of URiM's in the general population, and these numbers worsen with each step up the academic medicine ladder. Previously known as the "leaky pipeline," this phenomenon may be better understood as disparate "pathways with potholes," which acknowledges the different structural barriers that URiM trainees and faculty face in academic medicine. This critical scoping review analyzed current literature to determine what variables contribute to the inequitable "pathways and potholes" URiM physicians experience in academic medicine. METHOD The authors combined scoping review methodology with a critical lens. The comprehensive search strategy used terms about academic medicine, underrepresented groups, and leaving academic medical careers. One reviewer conducted screening, full text review, and data extraction while in consultation with members of the research team. Data extraction focused on themes related to pathways and potholes, such as attrition, recruitment, and retention in academic medicine. Themes were iteratively merged, and quality of contribution to the field and literature gaps were noted. RESULTS Included papers clustered into attrition, recruitment, and retention. Those pertaining to attrition noted that URiM faculty are less likely to get promoted even when controlling for scholarly output, and a hostile work environment may exacerbate attrition. Recruitment and retention strategies were most effective when multi-pronged approaches changed every step of the recruitment and promotion processes. CONCLUSIONS These studies provide examples of various "potholes" that can affect representation in academic medicine of URiM trainees and faculty. However, only a few studies examined the link between isolating and hostile work environments, the so-called "chilly climate," and attrition from academic medicine. Understanding these concepts is key to producing the most effective interventions to improve diversity in medicine.
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Affiliation(s)
- Sarah M Russel
- S.M. Russel is a third-year resident physician, Department of Otolaryngology/Head & Neck Surgery, University of North Carolina, Chapel Hill, North Carolina; ORCID: https://orcid.org/0000-0001-9299-8047
| | - Taylor M Carter
- T.M. Carter is a fourth-year resident physician, Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, and a surgical education fellow, University of Utah, Salt Lake City, Utah
| | - Sarah T Wright
- S.T. Wright is a librarian, Health Sciences Library, University of North Carolina, Chapel Hill, North Carolina
| | - Laura E Hirshfield
- L.E. Hirshfield is The Dr. Georges Bordage Medical Education Faculty Scholar and associate professor of medical education and sociology, Department of Medical Education, University of Illinois College of Medicine, Chicago, Illinois; ORCID: https://orcid.org/0000-0003-0894-2994
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7
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Mattes MD, Gayed G, Thomas CR, Deville C. Impact of a Virtual Introduction to Radiation Oncology Presentation on Stimulating Interest in the Specialty Among Diverse Medical Students at Multiple Institutions. J Am Coll Radiol 2023; 20:243-250. [PMID: 36513260 DOI: 10.1016/j.jacr.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/13/2022] [Accepted: 10/19/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Many US medical students lack access to radiation oncology (RO). The authors' hypothesis was that a virtual, cross-institutional presentation introducing students to a career in RO would be valuable in exposing students to RO who are less likely to access it otherwise and would increase students' interest in a career in RO regardless of their gender, race, or ethnicity. METHODS A 1-hour, live, virtual, extracurricular presentation was offered to deans of US medical schools lacking affiliated RO departments and/or having high enrollments of students underrepresented in medicine (UIM) and also student groups composed primarily of UIM students. Presentations were given individually to each school by a single radiation oncologist. An electronic survey captured data from participating students. RESULTS One hundred ninety-seven students from 13 institutions attended presentations; 114 students responded to the survey (response rate, 58%). Ninety-two students (81%) were aware of the specialty of RO before the presentation; however, UIM students were significantly less likely to be aware of RO than all others (69% versus 87%, P = .05). Only 19 students (17%) reported previously hearing presentations from radiation oncologist (29% among second- to fourth-year students versus 9% among first-year students, P = .01). Ninety-eight students (86%) expressed more interest in pursuing a career in RO after the presentation. There was no significant difference in interest in RO for any demographic subgroups. CONCLUSIONS Virtual RO exposure was feasible to deliver to students less likely to be exposed otherwise and successfully stimulated interest in the specialty regardless of students' gender, race, or ethnicity.
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Affiliation(s)
- Malcolm D Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey; Medical Student Clerkship Director at Rutgers New Jersey Medical School.
| | - George Gayed
- Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Charles R Thomas
- Chief of Radiation Oncology, Department of Radiation Oncology, Dartmouth-Hitchcock Norris Cotton Cancer Center, Lebanon, New Hampshire
| | - Curtiland Deville
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland; Medical Director of the Johns Hopkins Proton Therapy Center; and Clinical Director of Radiation Oncology at the Johns Hopkins Kimmel Cancer Center at Sibley Memorial Hospital
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Mattes MD, Munoz SM, Thomas CR, Deville C. Pilot Study Exploring the Feasibility of Incorporating Radiation Oncology Into Pre-existing Early Pathway Programs for Diverse Premedical Students. Int J Radiat Oncol Biol Phys 2023:S0360-3016(23)00063-9. [PMID: 36702316 DOI: 10.1016/j.ijrobp.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/09/2023] [Accepted: 01/15/2023] [Indexed: 01/24/2023]
Abstract
PURPOSE Many medical schools in the United States have affiliated pathway, preparatory, and/or prematriculation programs that enroll a high percentage of students historically underrepresented in medicine (URiM). The purpose of this pilot study was to better characterize exposures to radiation oncology (RO) among students in these programs and determine the feasibility of incorporating a radiation oncologist within their pre-existing format if nonexistent. METHODS AND MATERIALS During the summers of 2021 and 2022, a radiation oncologist gave a presentation about basic principles of cancer care to 18 unique student groups in 12 premedical programs affiliated with 8 medical schools. Participating students were asked to complete an anonymous postpresentation questionnaire. Descriptive statistics are reported. RESULTS A total of 467 students attended the presentations, and 241 completed the questionnaire (response rate 52.0%). The majority of participants reported being female (63.5%), URiM (66.4%), and low income (57.3%). Students were less likely to report previous teaching from a radiation oncologist (11.2%) than a surgical (17.0%) or medical oncologist (18.3%). Prior clinical shadowing with a radiation oncologist (2.9%) was also less likely than shadowing a surgical oncologist (5.0%), medical oncologist (6.6%), or any other physician (53.1%). Students were also less likely to previously believe that radiation could cure cancer (65.8%) compared with surgery (74.9%) or chemotherapy (89.3%). After the presentation, 168 students (69.7%) were more interested in a career in RO, and 211 students (87.6%) responded that the presentation was either quite or extremely valuable (median Likert-type score, 5; interquartile range, 4-5). CONCLUSIONS Many of the students in premedical programs lack prior exposure to RO or knowledge of multidisciplinary cancer care, which was ameliorated by a simple yet effective presentation across a variety of different types of programs in this study. Longitudinal assessment of different types of educational initiatives and students' ultimate career trajectory will help optimize future RO initiatives among premedical URiM students.
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Affiliation(s)
- Malcolm D Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
| | | | - Charles R Thomas
- Department of Radiation Oncology, Dartmouth-Hitchcock Norris Cotton Cancer Center, Lebanon, New Hampshire
| | - Curtiland Deville
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland
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Howard AP, Slaughter LS, Carey KM, Lillard JW. Bridges to biotechnology and bioentrepreneurship: improving diversity in the biotechnology sector. Nat Biotechnol 2021; 39:1468-1474. [PMID: 34754115 DOI: 10.1038/s41587-021-01110-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Angelita P Howard
- Department of Medical Education, Morehouse School of Medicine, Atlanta, GA, USA.
| | | | - Kaylin M Carey
- Department of Microbiology, Biochemistry & Immunology, Morehouse School of Medicine, Atlanta, GA, USA
| | - James W Lillard
- Department of Microbiology, Biochemistry & Immunology, Morehouse School of Medicine, Atlanta, GA, USA
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Nelson B, Kaminsky DB. Diversity, equity, and inclusion in pathology: Some progress, but room for improvement: Amid a troubling backslide in diversifying medicine, pathologists point to recent successes and remaining challenges in promoting diversity, equity, and inclusion (DEI). In part 1 of a 2-part series, we investigate what has and has not worked in efforts to diversify workforces. Cancer Cytopathol 2021; 129:837-838. [PMID: 34724362 DOI: 10.1002/cncy.22521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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The medical student's guide to pathology residency, fellowships, and careers. Ann Diagn Pathol 2021; 54:151805. [PMID: 34419854 DOI: 10.1016/j.anndiagpath.2021.151805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 12/23/2022]
Abstract
Recent studies have shown that relatively few MD, DO, and underrepresented in medicine (URM) students and physicians are matching into pathology residency in the United States (US). In the 2021 Main Residency Match, just 33.6% of filled pathology residency positions were taken by senior year students at US allopathic medical schools. This has been attributed to the fact that pathology is not a required rotation in most US medical schools, pathology is often taught in an integrated curriculum in the US where is does not stand out as a distinct field, and because the COVID-19 pandemic led to a suspension of in-person pathology rotations and electives. Ultimately, many US medical students fail to consider pathology as a career pathway. The objective of this article is to provide medical students with basic information, in the form of frequently asked questions (FAQs), about pathology training and career opportunities. This was accomplished by forming a team of MD and DO pathology attendings, pathology trainees, and a medical student from multiple institutions to create a pathology guide for medical students. This guide includes information about post-sophomore fellowships, 5 major pathology residency tracks, more than 20 fellowship pathways, and allopathic and osteopathic board examinations. This guide also contains photographs and descriptions of major pathology sub-specialties, including the daily and on-call duties and responsibilities of pathology residents. The exciting future of pathology is also discussed. This guide supports the agenda of the College of American Pathologists' (CAP) Pathologist Pipeline Initiative to improve student recruitment into pathology.
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Ware AD, Flax LW, White MJ. Strategies to Enhance Diversity, Equity, and Inclusion in Pathology Training Programs: A Comprehensive Review of the Literature. Arch Pathol Lab Med 2021; 145:1071-1080. [PMID: 34015822 DOI: 10.5858/arpa.2020-0595-ra] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Like many medical specialties, pathology faces the ongoing challenge of effectively enriching diversity, equity, and inclusion within training programs and the field as a whole. This issue is furthered by a decline in US medical student interest in the field of pathology, possibly attributable to increasingly limited pathology exposure during medical school and medical student perceptions about careers in pathology. OBJECTIVE.— To review the literature to identify the challenges to diversity, equity, and inclusion in pathology, with an emphasis on the pathology trainee pipeline. To evaluate the medical education literature from other medical specialties for diversity and inclusion-focused studies and initiatives, and determine the outcomes and/or approaches relevant for pathology training programs. DATA SOURCES.— A literature review was completed by a search of the PubMed database, as well as a similar general Google search. Additional resources, including the Web sites of the Association of American Medical Colleges, the Electronic Residency Application Service, and the National Resident Matching Program, were used. CONCLUSIONS.— Many strategies exist to increase diversity and encourage an inclusive and equitable training environment, and many of these strategies may be applied to the field of pathology. Interventions such as increasing exposure to the field, using a holistic application review process, and addressing implicit biases have been shown to promote diversity, equity, and inclusion in many medical specialties. In addition, increasing access to elective and pipeline programs may help to bolster medical student interest in careers in pathology.
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Affiliation(s)
- Alisha D Ware
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (Ware, White)
| | | | - Marissa J White
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (Ware, White)
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Asaad M, Glassman GE, Allam O. Virtual Rotations During COVID-19: An Opportunity for Enhancing Diversity. J Surg Res 2020; 260:516-519. [PMID: 33358013 DOI: 10.1016/j.jss.2020.11.071] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/09/2020] [Accepted: 11/15/2020] [Indexed: 10/22/2022]
Abstract
The COVID-19 pandemic has presented unique challenges to medical education. With the lack of in-person away rotations for the 2020-2021 residency application cycle, virtual rotations have surfaced as an alternative. The virtual rotations that the authors participated in allowed for active participation in various resident educational activities such as journal club, grand rounds, and morning conferences. One critical aspect of virtual rotations was the one-on-one meetings with the program leadership. In addition to a virtual tour of the hospital and campus, many programs offered virtual social hours with the residents to converse about the program, the city, and the match process. A few programs even allowed applicants to attend virtually live-streamed surgeries. These rotations offer students, especially those without a corresponding home program, an invaluable opportunity to express their interest in a particular program and gain foundational knowledge about the specialty. Virtual rotations also provide underrepresented minorities and international medical graduates with clinical exposure, mentorship, and networking opportunities, mitigating some of the challenges presented by COVID-19.
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Affiliation(s)
- Malke Asaad
- Department of Plastic Surgery, The University of Texas at MD Anderson Cancer Center, Houston, Texas.
| | | | - Omar Allam
- Division of Plastic Surgery, Yale School of Medicine, New Haven, Connecticut
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Wheeler SE, Hasskamp JH, Peck Palmer OM. Recognizing Laboratory Medicine's Collaborative Role in Identifying and Eliminating Health Disparities. J Appl Lab Med 2020; 6:274-284. [PMID: 33221844 DOI: 10.1093/jalm/jfaa143] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/03/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND A health disparity is a health outcome that presents in a lesser or greater extent between populations. Health disparities in diseases are products of complex interactions between social, economic, and to a lesser extent, biological factors and can be mediated by structural racism and discriminatory policies. The objective of this review is to understand how both laboratorians and nonlaboratorians think about the relationship between laboratory medicine and health disparities and to highlight ways in which laboratory medicine can play a role in eliminating health disparities. CONTENT We developed an electronic survey from which we selected the top responses reported by the 215 participants to frame a discussion around why laboratorians perceive health disparities exists, and how they can reduce health disparities. SUMMARY We found that both laboratorians and nonlaboratorians feel that laboratory medicine can and should play a role in reducing health disparities using many tools already in use in the clinical laboratory. The skills of laboratory workers in data generation, the establishment of reference ranges, control over the presentation of laboratory results, generation of test menus, and the development of novel diagnostics may impact health disparities. Laboratorians' responses in our survey indicated that they felt that they could reduce health disparities by using laboratory data to proactively track in cooperation with healthcare providers individuals with chronic conditions to prevent acute events, ensuring gender and ethnic diversity in new clinical trials, including appropriate curriculum in laboratory medicine training, using equations and reference intervals based on physiological differences and participating in unconscious bias training.
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Affiliation(s)
- Sarah E Wheeler
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Joanne H Hasskamp
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Octavia M Peck Palmer
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA.,Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Arno K, Davenport D, Shah M, Heinrich S, Gottlieb M. Addressing the Urgent Need for Racial Diversification in Emergency Medicine. Ann Emerg Med 2020; 77:69-75. [PMID: 33010957 DOI: 10.1016/j.annemergmed.2020.06.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Indexed: 10/23/2022]
Affiliation(s)
- Kimbia Arno
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL
| | - Dayle Davenport
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL.
| | - Meeta Shah
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL
| | - Scott Heinrich
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL
| | - Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL
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White MJ, Wyse RJ, Ware AD, Deville C. Current and Historical Trends in Diversity by Race, Ethnicity, and Sex Within the US Pathology Physician Workforce. Am J Clin Pathol 2020; 154:450-458. [PMID: 32785661 DOI: 10.1093/ajcp/aqaa139] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study assessed historical and current gender, racial, and ethnic diversity trends within US pathology graduate medical education (GME) and the pathologist workforce. METHODS Data from online, publicly available sources were assessed for significant differences in racial, ethnic, and sex distribution in pathology trainees, as well as pathologists in practice or on faculty, separately compared with the US population and then each other using binomial tests. RESULTS Since 1995, female pathology resident representation has been increasing at a rate of 0.45% per year (95% confidence interval [CI], 0.29-0.61; P < .01), with pathology now having significantly more females (49.8%) compared to the total GME pool (45.4%; P < .0001). In contrast, there was no significant trend in the rate of change per year in black or American Indian, Alaskan Native, Native Hawaiian, and Pacific Islander (AI/AN/NH/PI) resident representation (P = .04 and .02). Since 1995, underrepresented minority (URM) faculty representation has increased by 0.03% per year (95% CI, 0.024-0.036; P < .01), with 7.6% URM faculty in 2018 (5.2% Hispanic, 2.2% black, 0.2% AI/AN/NH/PI). CONCLUSIONS This assessment of pathology trainee and physician workforce diversity highlights significant improvements in achieving trainee gender parity. However, there are persistent disparities in URM representation, with significant underrepresentation of URM pathologists compared with residents.
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Affiliation(s)
- Marissa J White
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rhea J Wyse
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
- Michigan State University College of Human Medicine Grand Rapids Campus, Grand Rapids
| | - Alisha D Ware
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Curtiland Deville
- Department Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
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Geary A, Wang V, Cooper J, Roberts K, Yoo J. Analysis of Electronic Residency Application Service (ERAS) Data Can Improve House Staff Diversity. J Surg Res 2020; 257:246-251. [PMID: 32862052 DOI: 10.1016/j.jss.2020.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 06/29/2020] [Accepted: 08/02/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Training diverse house staff, including those who are underrepresented in medicine, is vital to provide high-quality patient care for the communities that we serve. In 2018, the Accreditation Council for Graduate Medical Education announced new common program requirements for systematic efforts to recruit and retain a diverse workforce. However, questions remain about how to implement such efforts. MATERIALS AND METHODS Electronic Residency Application Service (ERAS) data from eight residency programs spanning two recruitment cycles (2017-2018, 2018-2019) was reviewed. The number of candidates at each stage in the process (applicant, invited to interview, interviewed, and matched) was examined by self-identified race or ethnicity. These data were presented to residency program directors at our Graduate Medical Education committee meeting before the next recruitment cycle. Data were analyzed following the 2019-20 residency match. Odds ratios and Pearson's chi-squared test were used to assess statistical significance. RESULTS A total of 10,445 and 10,982 medical students applied to our 8 core residency programs in 2017 and 2018, respectively. Medical students who applied and self-identified as Asian, Black or African American, and Hispanic or Latino or Spanish origin had lower odds of being invited to interview than those who self-identified as White. After data presentation, the odds of inviting Black or African American applicants to interview increased significantly. The odds of attending an interview once invited were the same across groups. CONCLUSIONS Sharing ERAS data patterns with residency program directors was associated with a significant year over year change in interviewee diversity. Structured analysis of institutional ERAS data can provide insight into the resident selection process and may be a useful tool to improve house staff diversity.
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Affiliation(s)
- Alaina Geary
- Department of Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Victoria Wang
- Departments of Obstetrics and Gynecology, Surgery and Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - Jeffrey Cooper
- Departments of Obstetrics and Gynecology, Surgery and Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - Kari Roberts
- Departments of Obstetrics and Gynecology, Surgery and Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - James Yoo
- Department of Surgery, Harvard Medical School, Boston, Massachusetts.
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Liesman DR, Pumiglia L, Kemp MT, Alam HB. Perspectives From Rising Fourth Year Medical Students Regarding Strategies to Counteract the Effects of COVID-19 on Medical Education. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2020; 7:2382120520940659. [PMID: 32704544 PMCID: PMC7359646 DOI: 10.1177/2382120520940659] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/29/2020] [Indexed: 05/26/2023]
Abstract
The COVID-19 pandemic has put those who oversee medical education in a challenging position. Medical school administrators, students, and national governing bodies have been forced to make difficult decision as a result of public health concerns and government-enforced restrictions. We, as rising fourth-year medical students, would like to shed light upon the hard work that many of those in leadership positions have done as well as lay out some concerns that medical students who are preparing to apply to residency have. Additionally, we would like to suggest several potential approaches that attempt to address some of the problems arising from the pandemic. Continuing to balance education with the hurdles presented by COVID-19 will require a multi-faceted and coordinated approach. We believe that implementing virtual rotations, delaying the opening of the application, decentralizing clinical skills evaluations, and modifying graduation requirements are possible options among many that could aid in addressing some of the current challenges presented by COVID-19.
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Affiliation(s)
| | - Luke Pumiglia
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Michael T Kemp
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Hasan B Alam
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
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