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Zhang L, An C, Chen J, Li BU, Nakae S, Pang J. Characterizing Asian American medical students' experiences with microaggression and the impact on their well-being. MEDICAL EDUCATION ONLINE 2024; 29:2299534. [PMID: 38159282 PMCID: PMC10763848 DOI: 10.1080/10872981.2023.2299534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE This mixed-methods study quantified and characterized incidents of microaggressions experienced by Asian American medical students. The authors report on their impact and suggest improvements to create a more equitable and supportive learning environment. METHOD Quantitative and qualitative data were collected from 305 participants who self-identified as Asian American or Pacific Islander. An online, anonymous survey was sent to US medical students through the Asian Pacific American Medical Student Association (APAMSA). Questions explored incidence, characteristics of, and response to microaggressions. We conducted four focus groups to further characterize students' experiences. Data were organized and coded, and thematic analysis was used to identify core themes. RESULTS Racial microaggressions were prevalent among Asian American medical students. Nearly 70% (n = 213) of survey respondents reported experiencing at least one incident during their medical training to date. The most common perpetrators were patients (n = 151, 70.9%) and fellow medical students (n = 126, 59.2%), followed by professors (n = 90, 42.3%). The most prevalent themes included being perceived as a perpetual foreigner, the assumption of timidness, and ascription of the model minority myth. Students rarely reported the incident and usually did not respond immediately due to fear of retaliation, uncertainties about the experience or how to respond appropriately, and perception that they would bear the burden of advocacy alone. Experiences with microaggressions led to feelings of frustration and burnout and had a negative impact on mental health. Recommendations were made to improve the anonymous reporting systems in medical schools, and to increase diversity and inclusion in medical education and leadership. CONCLUSIONS Asian American medical students face high exposure to racial microaggressions during their medical education that adversely impact their mental health. Changes are needed in medical training to create a more equitable and inclusive learning environment.
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Affiliation(s)
- Lindy Zhang
- Sidney Kimmel Comprehensive Cancer Center and Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Crystal An
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Joanna Chen
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - B U.K. Li
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sunny Nakae
- Department of Medical Education, California University of Science and Medicine School of Medicine, Colton, CA, USA
| | - Joyce Pang
- Department of Surgery, University of New Mexico School of Medicine, Albuquerque, NM, USA
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Vieux U, Strange MP, Carey T, Ozdoba A, Hankerson S, Bell I. Is It Time to Rethink Psychiatry Residency Training? Meeting the Needs of a Multicultural Population. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2024:10.1007/s40596-024-02064-9. [PMID: 39384716 DOI: 10.1007/s40596-024-02064-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 09/20/2024] [Indexed: 10/11/2024]
Affiliation(s)
- Ulrick Vieux
- Hackensack Meridian School of Medicine, Nutley, NJ, USA.
| | - Maya P Strange
- University of Vermont Larner College of Medicine, Burlington, VT, USA
| | - Theadia Carey
- MSU-Authority Health Psychiatry Residency Training Program, Detroit, MI, USA
| | - Ana Ozdoba
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Iverson Bell
- University of Tennessee Health Science Center, Memphis, TN, USA
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Orionzi B. Intention Versus Implementation: Diversity, Equity, Inclusion, and Justice Efforts at Your Clinical Practice. Pediatr Ann 2024; 53:e354-e357. [PMID: 39377823 DOI: 10.3928/19382359-20240813-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/09/2024]
Abstract
Diversity, equity, inclusion, and justice (DEIJ) are important factors to be considered in medical education, academic and community health centers, and health care policy. DEIJ efforts have been shown to have a strong influence in advancing health equity, yet these efforts tend to fall on a small group of providers, usually of historically marginalized or minority backgrounds (eg, race and ethnicity, gender identity, sexual orientation, religion). To combat this inequity, more research needs to be done to identify where the burden is falling and what strategies can be set in place to counteract this taxing imbalance. Providers should educate themselves on the anti-DEIJ legislation sweeping across the country, recogniz- ing the misinformation, and advocating for efforts pushing back against this movement. Providers can also advocate for ways their institution or practice can reduce the burden for historically marginalized providers by supporting recognition of DEIJ-related efforts in traditional promotional measures or taking on activities allowing for participation in scholarly work that will advance careers. [Pediatr Ann. 2024;53(10):e354-e357.].
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Casillas CA, Beck AF, Rodriguez LR, Patel U, Rouse L, Ward VL, Jackson D, Dardess P, Unaka N. Hospital Diversity, Equity, and Inclusion Efforts: Perspectives of Patient and Family Advisors. Pediatrics 2024; 154:e2024065789. [PMID: 39228356 DOI: 10.1542/peds.2024-065789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Patient and family advisory councils are common within children's hospitals. However, lack of diversity among patient and family advisors (PFAs) may result in exclusion of crucial perspectives and perpetuate inequities. We sought to understand PFA perspectives on how children's hospitals should approach: (1) recruitment and support of PFAs from groups at greater risk of health inequities; and (2) development of meaningful partnerships with PFAs or patient and family advisory councils on institutional diversity, equity, and inclusion (DEI) efforts. METHODS We conducted a qualitative study of PFAs of children's hospitals from communities at greater risk for health inequities based on self-identified race, ethnicity, gender, socioeconomic status, disability, language, or other factors. Focus groups were virtual and group discussions were recorded, transcribed, and analyzed using inductive qualitative analysis. RESULTS In total, 17 PFAs participated across 5 focus groups (4 in English, 1 in Spanish). We identified 6 themes: (1) PFA diversity is necessary to understand existing health inequities; (2) diversity needs to be considered broadly; (3) recruiting for diverse PFAs requires intentionality, visibility of PFACs within and outside of the hospital, and deliberate connections with families and communities; (4) efforts to increase PFAC diversity must be accompanied by work to develop inclusive environments; (5) diversity efforts require meaningful engagement and equity; and (6) diverse PFACs can enrich DEI efforts but require organizational commitment and follow-through. CONCLUSIONS Insights from our qualitative study of PFAs can be used by healthcare systems to foster diversity and inclusion in PFACs and advance hospital DEI efforts.
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Affiliation(s)
- Carlos A Casillas
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Andrew F Beck
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Laura Rangel Rodriguez
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Ushma Patel
- Institute for Patient- and Family-Centered Care, McLean, Virginia
- Innovation and Value Initiative, Alexandria, Virginia
| | - LaToshia Rouse
- Birth Sisters Doula Services, Knightdale, North Carolina
| | - Valerie L Ward
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Darcel Jackson
- Children's National Hospital, Washington, District of Columbia
| | - Pam Dardess
- Institute for Patient- and Family-Centered Care, McLean, Virginia
| | - Ndidi Unaka
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- University of Cincinnati College of Medicine, Cincinnati, Ohio
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Colon Hidalgo D, Calhoun K, Neumeier A. Cultivating Diversity, Equity, and Inclusion in Pulmonary and Critical Care Training: A Path Toward Health Care Excellence. Crit Care Clin 2024; 40:789-803. [PMID: 39218486 DOI: 10.1016/j.ccc.2024.05.009] [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] [Indexed: 09/04/2024]
Abstract
Pulmonary and Critical Care Medicine (PCCM) fellowship training faces increasing competition but lacks diversity, hindering health care excellence. Despite a growing interest in the field, programs lack diverse representation. Addressing this issue is crucial to combat health disparities and bias, benefiting trainees, practitioners, and patients. Sustainable solutions are vital for achieving diversity, equity, and inclusion in PCCM. Strategies for achieving equity among training programs include adopting inclusive recruitment practices, recognizing differential attainment, addressing bias, fostering an equitable academic climate, and implementing multifaceted strategic processes to enhance diversity in mentorship including recognition and compensation for diversity and equity work.
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Affiliation(s)
- Daniel Colon Hidalgo
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, 12700 East 19th Avenue, 9C03, Aurora, CO 80045, USA
| | - Kara Calhoun
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, 12700 East 19th Avenue, 9C03, Aurora, CO 80045, USA
| | - Anna Neumeier
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, 12700 East 19th Avenue, 9C03, Aurora, CO 80045, USA; Denver Health Pulmonary, Critical Care and Sleep Medicine Division, 777 Bannock Street, Denver, CO 80204, USA.
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Dunleavy S, Douchee J, Liu T, Johnson NL, Komaromy M, Chatterjee A. Racism, not race: Quantitative analysis of the use of race and racism in the addiction literature. Soc Sci Med 2024; 360:117325. [PMID: 39293285 DOI: 10.1016/j.socscimed.2024.117325] [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: 05/15/2024] [Revised: 08/06/2024] [Accepted: 09/09/2024] [Indexed: 09/20/2024]
Abstract
RATIONALE Prior research has demonstrated that medical journals rarely mention racism, potentially contributing to an incorrect understanding of and inappropriate interventions for health inequities affecting Black and Brown communities in the US. While this infrequency of mentions of racism has been documented in the general medical literature, it is unknown if this pattern extends to the addiction literature, where some have argued that structural racism has played a specific role in shaping policy and treatment. OBJECTIVE To assess how frequently the addiction literature for the last 30 years has mentioned race and racism and if these rates vary with social movements. METHODS We created an algorithm to download and process over 30,000 published articles published from 1990 to 2022 in five major addiction journals: Addiction, Addictive Behaviors, Drug and Alcohol Dependence, Journal of Substance Abuse and Treatment, and International Journal of Drug Policy. Using this data, we reported temporal patterns of mentioning both race and racism across journals and article types. Further, we utilized interrupted time series analysis to identify if the social movements against police violence and the murder of George Floyd in 2020 were associated with significant changes in rates of mentioning racism. RESULTS While over 30% of the articles in addiction medicine journals included the word race, only 1.5% of articles mentioned racism. Based on an interrupted time series model, after the racial reckoning following the murder of George Floyd in 2020, mentions of racism increased in the addiction literature (OR = 3.21, 95% CI: [2.39, 4.32], P<.001). CONCLUSIONS A large chasm remains between how often authors mention race versus racism in addiction medicine, a field with a unique history intertwined with structural racism. Addressing inequities in addiction outcomes, including burgeoning inequities in overdose deaths, will require acknowledging racism in the scientific literature.
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Affiliation(s)
- Spencer Dunleavy
- University of Pennsylvania, Department of Family Medicine and Community Health, Philadelphia, PA, USA.
| | - Jeremiah Douchee
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Tina Liu
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Natrina L Johnson
- Grayken Center for Addiction, Boston, MA, USA; Section of General Internal Medicine, Boston Medical Center/Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Miriam Komaromy
- Grayken Center for Addiction, Boston, MA, USA; Section of General Internal Medicine, Boston Medical Center/Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Avik Chatterjee
- Grayken Center for Addiction, Boston, MA, USA; Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston Medical Center/ Chobanian and Avedisian School of Medicine, Boston, MA, USA
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Chell MA, Smith C, Leader Charge DP, Sun SW, Sundberg MA, Gampa V. Community Collaboration to Develop a Curriculum on Settler Colonialism and the Social Determinants of Health. TEACHING AND LEARNING IN MEDICINE 2024:1-8. [PMID: 39286916 DOI: 10.1080/10401334.2024.2403991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 07/17/2024] [Accepted: 08/16/2024] [Indexed: 09/19/2024]
Abstract
American Indian/Alaska Native (AI/AN) communities continue to experience health disparities and poor health outcomes, which are influenced by social determinants of health. The theory of settler colonialism provides a framework for understanding the structures that affect social determinants of health and the resulting health disparities. Western biomedicine and medical education have been implicated in perpetuating settler colonialism, and as a result Indigenous medical educators and leaders have called for increased education and understanding of the structural and social determinants of health affecting Indigenous populations. One important method is through community-based approaches to curriculum design. In collaboration with community leaders and experts, we identified the need for a curriculum on health in the context of settler colonialism, with a focus on resilience and community-directed efforts to improve wellness and care. Alongside Indigenous leaders and educators, we developed a unique curriculum focused on settler colonialism, the social determinants of health, and the assets inherent to the Native Nation where we work. Developed for non-Native learners and clinicians, the curriculum is designed to help provide context for the historical and political etiologies of health inequities experienced by the local community. Local educators helped shape a video lecture series associated with readings and experiential learning activities in 10 domains, providing an overview of settler colonialism and how it affects the social determinants of health. Our model of education draws upon the strengths and assets of communities and can improve health outcomes as well as learners' understandings of AI/AN-specific needs. We expect that our collaborative approach results in improved relationships among the Non-Native learners and providers and community members.
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Affiliation(s)
- Margaret A Chell
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
| | - Caroline Smith
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Damon P Leader Charge
- Office of Academic Affairs/Sanford School of Medicine, University of South Dakota, Vermillion, South Dakota, USA
| | - Stephanie W Sun
- Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael A Sundberg
- Departments of Medicine and Pediatrics, University of Minnesota - Twin Cities, Minneapolis, Minnesota, USA
| | - Vikas Gampa
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Sutkowi-Hemstreet A, Covington JK, Adams TN. Justice, Equity, Diversity, and Inclusion-Related Curricular Elements in Entry-Level Physical Therapist Education: A Delphi Study. JOURNAL, PHYSICAL THERAPY EDUCATION 2024:00001416-990000000-00129. [PMID: 39259596 DOI: 10.1097/jte.0000000000000361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 05/21/2024] [Indexed: 09/13/2024]
Abstract
INTRODUCTION The purpose of this Delphi study was to determine whether experts in justice, equity, diversity, and inclusion (JEDI) in the field of physical therapy could achieve consensus on the key JEDI-related curricular content topics to be included in entry-level physical therapist education. REVIEW OF LITERATURE Inequities exist at all levels of health care for historically underserved populations, including referrals, access, and quality of physical therapy services. The physical therapy field is facing challenges and opportunities in how to best prepare providers to address individual, community, and population health inequities. There is a lack of consensus in physical therapist education regarding essential curricular content related to justice, equity, diversity, inclusion, and antiracism. SUBJECTS Eighty-four experts in JEDI in the physical therapy profession were invited through email to participate in the Delphi process. METHODS A Delphi survey brought together 39 identified experts in justice, equity, diversity, and inclusion within the field of physical therapy to reach consensus on key JEDI-related curricular topics in physical therapist education. In the first-round survey, participants answered an open-ended question: "What JEDI-related curricular content should be included in entry-level physical therapist education?" The work team coded these free-text responses to populate an initial list of curricular elements. Over 2 subsequent rounds of surveys, the experts came to a consensus on which curricular elements should be addressed within physical therapist education. Nineteen experts completed all survey rounds. RESULTS In round I, coding of the expert group's responses generated 61 initial JEDI-related curricular elements. By round III, the group refined the list to 43 curricular elements; 41 of the 43 (95%) elements garnered 94% or higher consensus. The expert group deemed 30 of the elements "entry-level" content and 13 as more "advanced practice" topics. DISCUSSION AND CONCLUSIONS Experts had a strong consensus on key JEDI-related curricular elements that physical therapist education programs should include to best prepare providers to improve the health of society. Future scholarship will explore recommendations for how physical therapist education programs might prioritize and implement JEDI-related content.
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Affiliation(s)
- Allyson Sutkowi-Hemstreet
- Allyson Sutkowi-Hemstreet is the teaching specialist in the Department of Rehabilitation Medicine at the University of Minnesota, Division of PT, MMC 388, 420 Delaware St SE, Minneapolis, MN 55455 ( ). Please address all correspondence to Allyson Sutkowi-Hemstreet
- J. Kyle Covington is the director of educational innovation; director of post-professional education; and associate professor in the Doctor of Physical Therapy Division, Department of Orthopaedic Surgery at the Duke University School of Medicine
- Tiffany N. Adams is the director of diversity, equity, and inclusion and assistant professor in the Doctor of Physical Therapy Division, Department of Orthopaedic Surgery at the Duke University School of Medicine
| | - J Kyle Covington
- Allyson Sutkowi-Hemstreet is the teaching specialist in the Department of Rehabilitation Medicine at the University of Minnesota, Division of PT, MMC 388, 420 Delaware St SE, Minneapolis, MN 55455 ( ). Please address all correspondence to Allyson Sutkowi-Hemstreet
- J. Kyle Covington is the director of educational innovation; director of post-professional education; and associate professor in the Doctor of Physical Therapy Division, Department of Orthopaedic Surgery at the Duke University School of Medicine
- Tiffany N. Adams is the director of diversity, equity, and inclusion and assistant professor in the Doctor of Physical Therapy Division, Department of Orthopaedic Surgery at the Duke University School of Medicine
| | - Tiffany N Adams
- Allyson Sutkowi-Hemstreet is the teaching specialist in the Department of Rehabilitation Medicine at the University of Minnesota, Division of PT, MMC 388, 420 Delaware St SE, Minneapolis, MN 55455 ( ). Please address all correspondence to Allyson Sutkowi-Hemstreet
- J. Kyle Covington is the director of educational innovation; director of post-professional education; and associate professor in the Doctor of Physical Therapy Division, Department of Orthopaedic Surgery at the Duke University School of Medicine
- Tiffany N. Adams is the director of diversity, equity, and inclusion and assistant professor in the Doctor of Physical Therapy Division, Department of Orthopaedic Surgery at the Duke University School of Medicine
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Arps S, Noviski KM, Tucker L, Tutwiler A. Medical students' motivations for participating in an elective focused on social inequalities and health disparities. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:1353-1378. [PMID: 38315269 PMCID: PMC11369016 DOI: 10.1007/s10459-024-10313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/21/2024] [Indexed: 02/07/2024]
Abstract
In this study, we examine students' reasons for pursuing elective training focused on medical racism and systemic health inequities at a midwestern medical school. Data collection included semi-structured interviews with students who participated in an optional course focused on these topics. We analyzed their motivations, goals, and interests using reflexive thematic analysis and created three themes based on students' responses. Theme (1) "pre-existing conditions" focuses on students' knowledge, beliefs, worldviews and experience prior to the class. Theme (2) "enacting change" examines their desires to become effective physicians and improve medicine overall. Theme (3) "creating community" considers their preferences for a supportive and connected learning and social environment. We discuss the findings within the context of adult learning theory and Self-Determination Theory. The research provides insight about the overt and underlying factors that drive medical students' participation in training focused on social inequality. We also share recommendations for curriculum development and future research based on the patterns we found in students' discussions of their needs and expectations.
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Affiliation(s)
- Shahna Arps
- Department of Sociology and Anthropology, University of Toledo, Toledo, OH, USA.
| | | | - Lauren Tucker
- College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Ameisha Tutwiler
- College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
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Al Achkar M, Weidner A, Rogers TS, Seehusen DA, South-Paul JE. Never Felt at Home: A Qualitative Study of the Experiences of Faculty From Underrepresented Groups in Family Medicine and Strategies for Empowerment. Fam Med 2024; 56:476-484. [PMID: 39012288 PMCID: PMC11412293 DOI: 10.22454/fammed.2024.121883] [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: 07/17/2024]
Abstract
BACKGROUND AND OBJECTIVES Increasing diversity among medical educators is a vital step toward diversifying the physician workforce. This study examined how gender, race, and other attributes affect family medicine department chairs' experiences with sponsoring, mentoring, and coaching (SMC). We identified strategies at multiple levels to enhance SMC for faculty from underrepresented groups (URGs). METHODS Our qualitative study employed semistructured interviews with the chairs of departments of family medicine in the United States. We used inductive and deductive thematic analysis approaches to describe the experience and name usable strategies organized along the social-ecological model. RESULTS We interviewed 20 family medicine department chairs between December 2020 and May 2021. Many participants continued to be alarmed that leaders and role models from URGs have been rare. Participants described incidents of aggression in White- and male-dominated atmospheres. Such experiences left some feeling not at home. Some White male leaders appeared oblivious to the experiences of URG faculty, many of whom were burdened with a minority tax. For some URGs, surviving meant moving to a more supportive institution. Building spaces for resiliency and connecting with others to combat discrimination gave meaning to some participants. Participant responses helped identify multilevel strategies for empowerment and support for URG faculty. CONCLUSIONS Understanding the experiences of URG faculty is paramount to improving the environment in academic medicine-paving the way to enhancing diversity in the health care sector. Institutions and individuals need to develop multilevel strategies for empowerment and support to actively make diverse faculty feel at home.
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Affiliation(s)
| | - Amanda Weidner
- Family Medicine Residency Network, Department of Family Medicine, University of Washington, Seattle, WA
- Association of Departments of Family Medicine, Leawood, KS
| | - Tyler S Rogers
- Department of Primary Care, Martin Army Community Hospital, Fort Moore, GA
| | - Dean A Seehusen
- Department of Family and Community Medicine, Medical College of Georgia at Augusta University, Augusta, GA
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Enofe N, Tompkins A, Cooke DT, Freeman K, DiMaio JM, Merrill W, Erkmen CP. A Report of Salaries of Academic Cardiothoracic Surgeons Based on Race and Ethnicity. Ann Thorac Surg 2024; 118:569-578. [PMID: 38723883 DOI: 10.1016/j.athoracsur.2024.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 02/29/2024] [Accepted: 03/26/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Diversity in the physician workforce improves patient care, physician well-being, and innovation. Workforce diversity is dependent on fair compensation that is unbiased by race or ethnicity. The purpose of this study was to determine whether a disparity of representation and salary on the basis of race or ethnicity exists in academic cardiothoracic surgery. METHODS Study investigators performed a cross-sectional analysis of data collected by the Accreditation Council of Graduate Medical Education (ACGME) and the Association of American Medical Colleges (AAMC) faculty data for US medical school faculty 2021 and 2022. Salary data were not available if an academic rank and race or ethnicity had fewer than 6 cardiothoracic surgeons. Study investigators performed a descriptive analysis of the number of faculty and compared median and mean salaries according to academic rank using a paired t test. RESULTS Of the 758 academic cardiothoracic surgeons, 64.9% were White, 25.2% were Asian, 3.3% were Black or African American, 4.9% were Hispanic or Latino, and 1.7% were of other race or ethnicity. Cardiothoracic surgeons at the academic rank of professor were 74.6% White, 17.7% Asian, 3.4% Black or African American, 3.9% Hispanic or Latino, and 0.4% other races. Asian faculty earned 89% to 171%, Black or African American faculty earned 59% to 94%, and Hispanic or Latino faculty earned 84% to 165% of the median salary earned by White faculty. Black or African American faculty consistently and significantly (P = .002) earned lower median salaries compared with White faculty at each academic rank measured. CONCLUSIONS The academic cardiothoracic surgery workforce lacks diversity, especially at the highest academic ranks. Salary equity among races or ethnicities is complex, requiring additional study. However, Black or African American cardiothoracic surgeons experience low representation and salary disparity at every academic rank measured.
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Affiliation(s)
- Nosayaba Enofe
- Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, Pennsylvania
| | - Anastasiia Tompkins
- Center for Asian Health, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - David T Cooke
- Section of General Thoracic Surgery, Department of Surgery, University of California, Davis Health, Sacramento, California
| | - Kirsten Freeman
- Division of Cardiovascular Surgery, Department of Surgery, University of Florida, Gainesville, Florida
| | - J Michael DiMaio
- Department of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital, Plano, Texas
| | - Walter Merrill
- Department of Cardiac Surgery, Vanderbilt University Hospital, Nashville, Tennessee
| | - Cherie P Erkmen
- Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, Pennsylvania; Center for Asian Health, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.
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Flowers K, Hogans-Mathews S, Adu A, Ojo T, Washington JC, Ogbeide S, Flattes VJ, Lucero JE, Fulton A, Campbell KM, Rodríguez JE. Perceptions of the Leadership Through Scholarship Fellowship Graduates: An Exploratory Qualitative Study of Leadership. Fam Med 2024; 56:492-496. [PMID: 39018165 PMCID: PMC11412284 DOI: 10.22454/fammed.2024.564103] [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: 07/19/2024]
Abstract
BACKGROUND AND OBJECTIVES Despite increasing numbers of faculty identifying as underrepresented in medicine (URiM) over the last few decades, URiM representation in academic medicine leadership has changed little. The Society of Teachers of Family Medicine funded the Leadership Through Scholarship Fellowship (LTSF) to target this population and provide a framework for scholarly success. Based on responses to open-ended questions from a leadership survey, we characterize how early-career URiM family medicine faculty view leadership and assess attitudes and perceptions of leadership development. METHODS A survey, developed by survey experts from multiple institutions and consisting of multiple-choice and open-ended questions, was sent to the first two cohorts after the LTSF program. All LTSF participants identified as URiM and as early-career (5 years or less since fellowship or residency) family medicine faculty. Fellowship faculty collected anonymous survey responses through Qualtrics (Qualtrics, LLC). We conducted thematic analysis with emergent and iterative coding by two experienced qualitative researchers. RESULTS All of the fellows surveyed (N=19) completed the survey. The qualitative researchers identified the following themes: leadership development (with subthemes of collaborative scholarship and request for mentoring), and barriers to leadership and scholarship (with subthemes of lack of time, lack of support, and diminished opportunities for advancement). CONCLUSIONS These themes represent lessons learned from URiM faculty participating in a single faculty development fellowship. Collaborative scholarship, both as an early-career faculty need and a leadership responsibility, is a new contribution to the existing literature. While identified by URiM family medicine faculty, these themes are likely familiar to early-career faculty across all medical specialties and faculty identities. These lessons can guide senior academic leaders in preparing early-career faculty for leadership in academic medicine.
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Affiliation(s)
- Kerwyn Flowers
- Department of Family Medicine and Rural Health, College of Medicine, Florida State University, Tallahassee, FL
| | - Shermeeka Hogans-Mathews
- Department of Family Medicine and Rural Health, College of Medicine, Florida State University, Tallahassee, FL
| | - Adwoa Adu
- Department of Family Medicine, School of Medicine, University of South Carolina, Greenville, SC
| | - Temiwumi Ojo
- Department of Family Medicine, Stritch School of Medicine, Loyola University, Chicago, IL
| | | | - Stacy Ogbeide
- Department of Family Medicine, University of Texas Health Sciences Center, San Antonio, TX
| | - Valerie J Flattes
- Department of Family Medicine, University of Texas Health Sciences Center, San Antonio, TX
| | - Julie E Lucero
- College of Nursing, University of Utah, Salt Lake City, UT
- College of Health, University of Utah, Salt Lake City, UT
| | - Amy Fulton
- New Leadership Academy, University of Utah, Salt Lake City, UT
| | - Kendall M Campbell
- Department of Family Medicine, University of Texas Medical Branch, Galveston, TX
| | - José E Rodríguez
- Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, UT
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13
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Adebagbo OD, Guo L. Diversity, Equity, and Inclusion in Plastic Surgery: Where Do We Stand? Highlighting Overlooked Issues in Efforts to Improve Representation. JOURNAL OF SURGICAL EDUCATION 2024; 81:1187-1194. [PMID: 39019706 DOI: 10.1016/j.jsurg.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/08/2024] [Accepted: 06/10/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVE The lack of diversity among applicants successfully matching into integrated plastic surgery residency continues to be a topic of significant discussion, yet substantial improvements in representation remain elusive. This article aims to highlight the systemic barriers contributing to the decline in diverse plastic surgery trainees. DESIGN This perspective summarizes current and existing challenges in improving recruitment efforts of underrepresented in medicine (URiM) trainees and those from socioeconomically disadvantaged backgrounds. CONCLUSIONS While acknowledging current DEI initiatives, the authors point out those underappreciated modifiable and nonmodifiable obstacles that perpetuate the lack of equity and inclusivity in the match process. We emphasize the importance of continued commitment from program directors and chairs to these initiatives and its generational augmentative effects on achieving true and lasting diversity and equity.
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Affiliation(s)
| | - Lifei Guo
- Division of Plastic and Reconstructive Surgery, Lahey Hospital & Medical Center, Burlington, Massachusetts; Tufts University School of Medicine, Boston, Massachusetts.
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Dyess NF, Carr CB, Mavis SC, Caruso CG, Izatt S, French H, Dadiz R, Bonachea EM, Gray MM. Implicit Bias and Health Disparities Education in the Neonatal Intensive Care Unit. Am J Perinatol 2024; 41:1634-1644. [PMID: 38190976 DOI: 10.1055/a-2240-1979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
OBJECTIVE This study aimed to characterize implicit bias (IB) and health disparities (HD) education in neonatal-perinatal medicine (NPM), including current educational opportunities, resources, and barriers. STUDY DESIGN A national web-based survey was sent to NPM fellows, neonatologists, and frontline providers after iterative review by education experts from the National Neonatology Curriculum Committee. Quantitative data were analyzed with chi-square and Fisher's exact tests. Qualitative data were evaluated using thematic analysis. RESULTS Of the 452 NPM survey respondents, most desired additional IB (76%) and HD (83%) education. A greater proportion of neonatologists than fellows received IB (83 vs. 57%) and HD (87 vs. 74%) education. Only 41% of neonatologists reported that their institution requires IB training. A greater proportion of fellows than neonatologists expressed dissatisfaction with the current approaches for IB (51 vs. 25%, p < 0.001) and HD (43 vs. 25%, p = 0.015) education. The leading drivers of dissatisfaction included insufficient time spent on the topics, lack of specificity to NPM, inadequate curricular scope or depth, and lack of local educator expertise. A minority of faculty who were tasked to educate others have received specific educator training on IB (21%) and HD (16%). Thematic analysis of survey free-text responses identified three main themes on the facilitators and barriers to successful IB and HD education: individual, environmental, and curricular design variables. CONCLUSION NPM trainees and neonatologists desire tailored, active, and expert-guided IB and HD education. Identified barriers are important to address in developing an effective IB/HD curriculum for the NPM community. KEY POINTS · There is a gap between the current delivery of IB/HD education and the needs of the NPM community.. · NPM trainees and neonatologists desire tailored, active, and expert-guided IB and HD education.. · A successful curriculum should be widely accessible, NPM-specific, and include facilitator training..
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Affiliation(s)
| | - Cara Beth Carr
- Division of Neonatology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Stephanie C Mavis
- Division of Neonatal Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Catherine G Caruso
- Division of Neonatology, Department of Pediatrics, Oregon Health and Science University, Portland, Oregon
| | - Susan Izatt
- Division of Neonatology, Department of Pediatrics, Duke University, Durham, North Carolina
| | - Heather French
- Division of Neonatology, Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rita Dadiz
- Division of Neonatology, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Elizabeth M Bonachea
- Division of Neonatology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | - Megan M Gray
- Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
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15
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Perchik JD, Maxfield C, Mills M, Agarwal A, Hull NC, Darrow A, Wang M, Cooke E, Seekins J, Marx M, Wassef H, Gould J, Grimm L. Status of LGBTQ+ Inclusion: Multi-Institution Assessment of US Radiology Residencies. J Am Coll Radiol 2024:S1546-1440(24)00700-2. [PMID: 39216783 DOI: 10.1016/j.jacr.2024.08.008] [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: 03/13/2024] [Revised: 07/30/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION An inclusive residency program is crucial to the recruitment and retention of competitive and diverse applicants. The radiology lesbian, gay, bisexual, transgender, queer or questioning, or another diverse gender identity (LGBTQ+) inclusion audit was published in 2022, which provided a road map for assessing the inclusivity of a program's policies, facilities, culture, and engagement. In this multi-institutional trial, we detail the results of the LGBTQ+ inclusion audit for nine US radiology residency programs. METHODS A volunteer cohort of academic radiology programs was recruited through the Radiology Residency Education Research Alliance. The LGBTQ+ inclusion audit was modified to apply to a multi-institutional study. Participating programs performed the audit from December 2023 to February 2024. Pre- and postaudit surveys were distributed to capture participants subjective assessment of inclusivity at their programs. RESULTS Nine US radiology residency programs completed the audit. Audit scores ranged from 6 out of 10 to 9 out of 10; no program received a perfect 10 out of 10 score. Inclusive facilities and institutional culture scored highly, with eight of nine programs reporting all milestones met in these areas. The lowest-performing areas were department culture and community engagement with only three of nine and four of nine programs reporting "all milestones met." After the audit, programs overall reported improved self-perceived inclusivity, with postaudit survey scores increasing in areas related to department policy, inclusive facilities, and LGBTQ+ community outreach. DISCUSSION Participating radiology residency programs demonstrated an overall high level of LGBTQ+ inclusivity; however, all programs identified inclusion shortcomings in department policy and practice. Intentional review of a department can be a helpful tool to promote a welcoming and healthy environment for a diverse radiology practice.
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Affiliation(s)
- Jordan D Perchik
- Assistant Professor, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Charles Maxfield
- Professor of Radiology, Department of Radiology; and the Vice Chair of Education, Department of Diagnostic Radiology, Duke University, Durham, North Carolina
| | - Megan Mills
- Assistant Professor and Section Chief of Musculoskeletal Radiology, Department of Radiology, University of Utah, Salt Lake City, Utah
| | - Atul Agarwal
- Assistant Professor and the Division Chief of Neuroradiology at Indiana University Department of Diagnostic Radiology, Department of Radiology, Indiana University, Indianapolis, Indiana
| | - Nate C Hull
- Associate Professor, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Anne Darrow
- Radiology Resident, Department of Radiology, Cook County Hospital, Chicago, Illinois
| | - Morlie Wang
- Radiology Resident and Diagnostic Radiologist and Program Director for the Department of Diagnostic Radiology, Department of Radiology, Cook County Hospital, Chicago, Illinois
| | - Erin Cooke
- Professor of Radiology and the Program Director for Vanderbilt University Medical Center Department of Diagnostic Radiology, Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jayne Seekins
- Associate Professor in the Department of Diagnostic Radiology at Stanford University, Department of Radiology, Stanford University, Palo Alto, California
| | - Mary Marx
- Clinical Professor in the Department of Diagnostic Radiology, Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Heidi Wassef
- Clinical Professor and the Program Director for the Department of Diagnostic Radiology, Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Jennifer Gould
- Professor of Radiology, Department of Radiology, Washington University, St Louis, Missouri
| | - Lars Grimm
- Associate Professor of Diagnostic Radiology, Department of Radiology, Duke University, Durham, North Carolina
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Sasser CW, Moss A, Goli S, Grego AR, Knock M, Morbitzer K, Mortha SM, Eckel SF. Contributing factors for career goal advancement of pharmacy learners in the Black, Indigenous, and People of Color community. Am J Health Syst Pharm 2024; 81:e535-e542. [PMID: 38546346 DOI: 10.1093/ajhp/zxae089] [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] [Indexed: 08/20/2024] Open
Abstract
PURPOSE To explore factors influencing career goals and goal attainment for pharmacy learners (eg, students, residents, fellows) who identify as part of the Black, Indigenous, and People of Color (BIPOC) community. METHODS In late 2021 and early 2022, US-based pharmacy learners were invited to participate in two focus groups. In the first focus group, participants were asked to reflect on career goal influences, barriers, and facilitators. In the second focus group, participants were asked to provide suggestions for educational institution and healthcare organization improvement to support career goal attainment for learners in the BIPOC community. Focus group transcripts were coded using both deductive and inductive coding and thematic analysis. RESULTS Fifteen learners were included in the first focus group, and 10 learners were included in the second. The most common career goal motivators were self-efficacy factors. Barriers and facilitators were often closely related. The most common barriers were financial, lack of representation, and lack of support. Common facilitators included mentorship and informal networking opportunities. Participants suggested multiple strategies for educational institutions and healthcare organizations to support BIPOC learner success, including genuine investment, representation, financial support, improved access to professional development opportunities, partnering with other professional organizations, and prioritizing diversity, equity, and inclusion (DEI) initiatives. CONCLUSION Institutions should prioritize effective, positive mentoring relationships and exposure to BIPOC professionals. Training programs and associations should consider improving financial support and lowering the cost of involvement to reduce barriers. All stakeholders should prioritize DEI in their organizational culture to promote career advancement of BIPOC learners and professionals.
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Affiliation(s)
- Caroline W Sasser
- UNC Eshelman School of Pharmacy, Chapel Hill, NC, and Monash University Faculty of Pharmacy and Pharmaceutical Sciences, University College London School of Pharmacy, London, UK
| | - Adam Moss
- HCA Florida Ft. Walton-Destin Hospital, Fort Walton Beach, FL, USA
| | - Swaycha Goli
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - McKenna Knock
- UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | | | | | - Stephen F Eckel
- UNC Eshelman School of Pharmacy, Chapel Hill, NC, and UNC Medical Center, Chapel Hill, NC, USA
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Sumarli AN, Pineda LS, Vacaru A, Novak E, Brandt Z, Reynoso EE, Applegate RL, McCabe MD. Diversity, Equity, and Inclusion in US Anesthesiology Residency Matching. Anesth Analg 2024:00000539-990000000-00907. [PMID: 39159255 DOI: 10.1213/ane.0000000000007102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
Abstract
BACKGROUND Patient outcomes are improved with physician-patient gender, racial, and ethnic concordance. However, female, Black, Hispanic or Latino, Native Hawaiian-Pacific Islander (NH-PI), and American Indian-Native Alaskan (AI-AN) physicians are underrepresented in anesthesiology. The American Association of Medical Colleges 2018 Diversity in Medicine Report revealed that women comprise only 35% of anesthesiologists yet nearly half of medical school graduates are women. More than 77% of anesthesiologists are White or Asian. Anesthesiology applicant and match trends may provide insights needed to address underrepresentation within anesthesiology. We hypothesized that proportionally fewer women and racially and ethnically minoritized applicants apply and match into anesthesiology. METHODS This retrospective observational study identified 47,117 anesthesiology applicants among the 546,298 residency applicants in the Electronic Residency Application Service (ERAS) system between 2011 and 2022 and stratified applicants by self-reported gender, race, and ethnicity. The demographics of anesthesiology trainees reported in the 2014 to 2015, 2018 to 2019, and 2022 to 2023 Accreditation Counsel of Graduate Medical Education (ACGME) Data Resource Books were used as surrogates for matched applicants as demographics are not reported by the National Residency Match Program. To facilitate comparisons, ERAS applicants were grouped into 4-year epochs to align with consolidated ACGME reports corresponding to the application years. Odds ratios (OR); 95% confidence interval of applying to and matching into anesthesiology were analyzed. RESULTS Women had lower odds of applying to anesthesiology compared to men overall (OR, 0.55; 95% CI, 0.54-0.56, P < .0001) and maintained significantly lowered odds of applying within each epoch. Women had similar odds of matching into anesthesiology residency compared to men (OR, 1.10; 95% CI, 1.06-1.14, P < .0001). Black, Hispanic or Latino, Asian and NH-PI, and AI-AN applicants had similar odds to White applicants of applying to anesthesiology but odds of matching were significantly lower overall (P < .0001) for Asian and NH-PI (OR, 0.66; 95% CI, 0.63-0.70), Black (OR, 0.49; 95% CI, 0.45-0.53), Hispanic or Latino (OR, 0.50; 95% CI, 0.46-0.54), and AI-AN (OR, 0.20; 95% CI, 0.15-0.28) applicants. The odds of matching among some minoritized applicants increased in the ACGME 2022 to 2023 report year. CONCLUSIONS From 2011 to 2022, women had lower odds of applying to anesthesiology residency than men yet had similar odds of matching. Racial and ethnic minoritized groups had significantly lower odds of matching compared to White applicants despite similar odds of applying. These findings highlight disparities in the anesthesiology match and may help identify opportunities to promote workforce diversity within the field. More detailed reporting of gender, race, and ethnicity in annual match data may better define barriers to entry and identify opportunities for improvement.
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Affiliation(s)
- Alexander N Sumarli
- From the Department of Anesthesiology, Loma Linda University, Loma Linda, California
| | - Lauren S Pineda
- From the Department of Anesthesiology, Loma Linda University, Loma Linda, California
| | - Alexandra Vacaru
- School of Medicine, Loma Linda University, Loma Linda, California
| | - Emily Novak
- School of Medicine, Loma Linda University, Loma Linda, California
| | - Zachary Brandt
- School of Medicine, Loma Linda University, Loma Linda, California
| | - Edgardo E Reynoso
- From the Department of Anesthesiology, Loma Linda University, Loma Linda, California
| | - Richard L Applegate
- From the Department of Anesthesiology, Loma Linda University, Loma Linda, California
| | - Melissa D McCabe
- From the Department of Anesthesiology, Loma Linda University, Loma Linda, California
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Yemane L, Powell C, Edwards J, Shumba T, Alvarez A, Bandstra B, Brooks M, Brown-Johnson C, Caceres W, Dunn T, Johnson C, Perez FD, Reece-Nguyen T, Thomas RP, Watkins AC, Blankenburg R. Underrepresented in Medicine Trainees' Sense of Belonging and Professional Identity Formation after Participation in the Leadership Education in Advancing Diversity Program. Acad Pediatr 2024:S1876-2859(24)00321-8. [PMID: 39117029 DOI: 10.1016/j.acap.2024.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 06/10/2024] [Accepted: 08/01/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND There are persistent structural barriers that threaten inclusion and retention of underrepresented in medicine (UIM) residents and fellows (trainees) as future faculty in academic medicine. We developed the Leadership Education in Advancing Diversity (LEAD) Program at a single, academic institution, to address these barriers through a 10-month longitudinal curriculum across GME for trainees to develop leadership and scholarship skills in DEI. OBJECTIVE Explore how participation in LEAD impacted UIM trainees' sense of belonging and professional identity formation in academic medicine; as well as perceptions about pursuing a career in academic medicine and future leadership roles. METHODS IRB-approved qualitative study in August 2020-August 2021 with individual, semi-structured interviews of UIM LEAD graduates from the first 4 cohorts (2017-2021). Data were analyzed by two authors using modified grounded theory. RESULTS 14 UIM trainees were interviewed; seven themes emerged. Critical aspects of the program: (1) Creation of a community of shared DEI values (2) Mentorship (3) Role of allies. Results of the program: (4) Deepened appreciation of personal and professional identity as UIM (5) Fostered belonging in academic medicine (6) Appreciation of different careers in academic medicine and how to integrate DEI interests (7) Inspired trainees to pursue leadership roles. CONCLUSIONS LEAD can serve as a model for other institutions that seek to support UIM trainees' sense of belonging, professional identity formation, and perceptions about pursuing careers in academic medicine and future leadership roles.
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Affiliation(s)
- Lahia Yemane
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
| | - Carmin Powell
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
| | - Jeffrey Edwards
- Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Takudzwa Shumba
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Al'ai Alvarez
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Belinda Bandstra
- Department of Psychiatry and Behavioral Sciences, University of California Davis Health, Sacramento, California
| | - Michelle Brooks
- Department of Pediatrics, Stanford Medicine Children's Health, Palo Alto, California
| | - Cati Brown-Johnson
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Wendy Caceres
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Tamara Dunn
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Carrie Johnson
- Department of Pediatrics, Stanford Medicine Children's Health, Palo Alto, California
| | - Felipe D Perez
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Travis Reece-Nguyen
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Reena P Thomas
- Department of Neurology, Stanford University School of Medicine, Palo Alto, California
| | - Amelia C Watkins
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, California
| | - Rebecca Blankenburg
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
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19
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Roth LT, Carpenter P, Schwartz A, Lurie B. A National Survey to Assess LGBTQ+ Curricular Needs in Pediatrics Residency Programs. Acad Pediatr 2024:S1876-2859(24)00285-7. [PMID: 39098599 DOI: 10.1016/j.acap.2024.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/23/2024] [Accepted: 07/28/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVE Despite incremental increases in lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) health education, there are no uniform training requirements in graduate medical education and the extent to which pediatrics residency programs incorporate LGBTQ+ curricula remains unknown. We aimed to assess the current state of LGBTQ+ health education in pediatrics residency programs. METHODS We surveyed all 202 Accreditation Council for Graduate Medical Education (ACGME)-accredited categorical pediatrics program directors (PDs) in the United States. PDs were contacted via the Association for Pediatrics Program Directors (APPD) listserv with a link to an anonymous electronic survey. RESULTS We had a 53.4% response rate (107/202) with representation from all regions, sizes, and settings. Only 7.5% of programs have robust LGBTQ+ curricula, but many (71%) offer some sessions. About half (54.2%) believe their residents are not at all or somewhat prepared to care for LGBTQ+ patients after training. Many PDs are not at all or somewhat confident their residents learn about gender affirming care (49.5%) or are aware of community resources for LGBTQ+ youth (54.2%). In 91% of programs, 0-25% of faculty educate trainees about LGBTQ+ health. The majority (74.8%) of PDs are very or moderately likely to implement a standardized LGBTQ+ health curriculum. The most prominent barriers were inadequate time (55.1%) and lack of faculty training (51.4%). CONCLUSION Many pediatrics programs have implemented some LGBTQ+ health education; however, PDs lack confidence in residents' abilities to independently care for LGBTQ+ youth after training. An accessible and standardized curriculum is not only needed but desired by programs.
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Affiliation(s)
- Lauren T Roth
- Department of Pediatrics, Children's Hospital at Montefiore/Albert Einstein College of Medicine, 1525 Blondell Ave, Suite 102, Bronx NY 10461.
| | - Pamela Carpenter
- Association of Pediatric Program Directors, Degnon Associates, 6392 S April Meadows Drive, Salt Lake City, UT 84084.
| | - Alan Schwartz
- Department of Medical Education, University of Illinois Chicago, 808 S. Wood Street, MC 591 Chicago, IL 60612.
| | - Brian Lurie
- Department of Pediatrics, The Warren Alpert Medical School of Brown University/Hasbro Children's Hospital, 593 Eddy Street, Providence, RI 02903.
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20
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Zussman JW, Ma JY, Bindman JG, Cornes S, Davis JA, Brondfield S. Identifying Strategies for the Use of Gender and Sex Language in Clinical One-Liners. LGBT Health 2024; 11:484-494. [PMID: 38301142 DOI: 10.1089/lgbt.2023.0220] [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] [Indexed: 02/03/2024] Open
Abstract
Purpose: The "one-liner," commonly used in clinical communications, summarizes a patient's identity, presenting condition, medical history, and clinical findings. Imprecise, inconsistent use of gender and sex information in one-liners threatens the provision of affirming care to transgender, nonbinary, gender-expansive, and intersex patients and may exacerbate health care disparities. This study aimed to generate guidance for communicating gender and sex information in one-liners. Methods: This is an explanatory sequential, equal status mixed methods study of transgender, nonbinary, gender-expansive, and intersex people and clinicians caring for this population. Survey participants rated one-liners on a five-point Likert-type scale of appropriateness, considering affirmation and clinical utility, and provided open-ended comments. We conducted two focus groups with survey respondents to explore survey results and performed a thematic analysis of survey comments and focus group transcripts. Results: Survey respondents included 57 clinicians and 80 nonclinicians. One-liners containing patient pronouns were rated most appropriate, and appropriate patient descriptors included self-described gender identity or gender-neutral terms. In scenarios where patient sex information was not pertinent to the chief concern (CC), one-liners containing no sex information were rated most appropriate. Four themes were identified: inclusion of sex information based on relevance to the CC, accurate patient representation, influence of clinical setting, and risk of harm from inaccurate one-liners. Conclusion: This study generated data to support the appropriate use of gender and sex language in one-liners. Clinicians, educators, and trainees may use these findings to compose one-liners that are affirming and clinically useful for patients of diverse gender and sex identities.
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Affiliation(s)
- Jay W Zussman
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jessica Y Ma
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jay G Bindman
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Susannah Cornes
- School of Medicine, University of California San Francisco, San Francisco, California, USA
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - John A Davis
- School of Medicine, University of California San Francisco, San Francisco, California, USA
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Sam Brondfield
- School of Medicine, University of California San Francisco, San Francisco, California, USA
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
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Ezeoke OM, Williams J, Ogueri V, Hills BK. The Heart of the Matter: A Path to Building Diversity in Pediatric Cardiology. Pediatr Cardiol 2024; 45:1364-1371. [PMID: 36961540 DOI: 10.1007/s00246-023-03144-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023]
Abstract
Our essay discusses the impact of underrepresentation in medical training, with a focus on pediatric cardiology. We use the perspective of a physician who is underrepresented in medicine (URiM), and has chosen to pursue a career in pediatric cardiology, to initiate an analysis of the current path toward pediatric cardiology and the factors in undergraduate and graduate medical education which could currently be optimized to improve diversity in training. We argue that a lack of diversity among physicians leads to worse patient outcomes, and we describe steps to improve representation in the field. In order to improve representation in pediatric cardiology, we must reflect upon our current practices and implement systemic changes within cardiology training program recruitment and retention practices. These changes should include continuous mentorship of URiM trainees interested in cardiology and prioritization of research that investigates social determinants of health which may disproportionally affect minority patients.
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Affiliation(s)
- Ogochukwu M Ezeoke
- Division of Pediatric Cardiology, Congenital Heart Center - C.S. Mott Children's Hospital, University of Michigan, 1540 E. Hospital Drive, Ann Arbor, MI, 48109, USA.
| | - Jason Williams
- Division of Pediatric Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Vanessa Ogueri
- Division of Pediatric Cardiology, Children's National Hospital, Washington, DC, USA
| | - Brittney K Hills
- Department of Pediatric Cardiology, Cincinnati Children's Hospital, Cincinnati, OH, USA
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El-Desoky R, Diec S, Truong M, Rosario N. Who am I? Professional Identity Formation in Pharmacy Education Among Learners Underrepresented in Pharmacy. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100748. [PMID: 38944278 DOI: 10.1016/j.ajpe.2024.100748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 07/10/2023] [Accepted: 06/22/2024] [Indexed: 07/01/2024]
Abstract
Professional identity formation (PIF) throughout the pharmacy curriculum is important for learners to transform from layperson to pharmacist. To be effective, PIF activities need intentional development and support. Professional identity is often seen as the core component of PIF; however, there must be an emphasis on integrating and aligning an individual's personal identity through this process. Moreover, there has been an emphasis on upholding diversity, equity, inclusion, and antiracism efforts in pharmacy practice and education. There is a need to explore experiences of PIF among diverse populations, including learners underrepresented in pharmacy. This commentary explores the differences in PIF among underrepresented learners in health care disciplines and is a call to action to explore evidence-based interventions that are inclusive and tailored to individual learners. This commentary sets a foundation for additional scholarly work and recommendations regarding PIF among underrepresented learners.
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Affiliation(s)
- Rania El-Desoky
- University of Western Australia, Crawley, Western Australia, Australia.
| | - Sandy Diec
- University of Houston College of Pharmacy, Houston, TX, USA
| | - Mabel Truong
- University of Houston College of Pharmacy, Houston, TX, USA
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Contreras N, Essig R, Magarinos J, Pereira S. Abuse, Bullying, Harassment, Discrimination, and Allyship in Cardiothoracic Surgery. Thorac Surg Clin 2024; 34:239-247. [PMID: 38944451 DOI: 10.1016/j.thorsurg.2024.04.001] [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] [Indexed: 07/01/2024]
Abstract
Abuse, bullying, harassment, and discrimination are prominent workplace occurrences within cardiothoracic (CT) surgery that cause burnout and threaten the well-being of surgeons. Under-represented and marginalized groups experience higher incidences of these negative events, and CT surgery is one of the least diverse specialties. The CT surgery workforce and institutional leadership must prioritize mentorship, sponsorship, and allyship to promote a diverse and healthy specialty for surgeon recruitment, growth, and job satisfaction.
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Affiliation(s)
- Nicolas Contreras
- Division of Cardiothoracic Surgery, University of Utah and Huntsman Cancer Institute, 1950 Circle of Hope Drive, Salt Lake City, UT 84112, USA
| | - Rachael Essig
- Department of Surgery, Georgetown University Hospital, 3800 Reservoir Road, PHC4, Washington, DC 20007, USA. https://twitter.com/RachaelEssig
| | - Jessica Magarinos
- Department of Surgery, Temple University, 3401 North Broad Street, Philadelphia, PA 19147, USA
| | - Sara Pereira
- Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, 30 North Mario Capecchi Drive, 4N133, Salt Lake City, UT 84112, USA.
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24
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Romeo GR, Caputo T, Stanescu IW, Alkhaddo JB. The Arduous Path Toward Equitable Access to Endocrinology Care. J Endocr Soc 2024; 8:bvae134. [PMID: 39071475 PMCID: PMC11273240 DOI: 10.1210/jendso/bvae134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Indexed: 07/30/2024] Open
Abstract
Multiple factors contribute to the widening gap between supply and demand of endocrinology services. In addition to the inadequate growth of the workforce, the inefficient utilization of endocrinologists' expertise coupled with the rising prevalence of endocrine conditions has generated a crisis in access to specialty care. This mismatch is magnified in underserved communities and among certain racial/ethnic groups that carry a disproportionate burden of chronic diseases, like diabetes and osteoporosis, thus perpetuating the cycle of health disparities in vulnerable populations. Reorienting the framework of endocrine care toward more effective and equitable access will require comprehensive changes in operational processes, system-based policies, and in the diversity of our workforce. Specifically, the progressive transition to outcome-driven, team-based models of care can extend endocrinology services beyond the traditional boundaries of in-office referrals and promote job satisfaction. Further, the implementation of policies that directly tackle structural determinants of health is a prerequisite to a more precise and equitable deployment of specialty care. In this view, the recruitment and professional growth of clinicians underrepresented in medicine along the career ladder, including leadership roles, is a key conduit to revitalize our field and to innovate the delivery of endocrine care across all communities.
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Affiliation(s)
- Giulio R Romeo
- Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA
- Beth Israel Deaconess Medical Center, Department of Medicine, Harvard Medical School, Boston, MA 02215, USA
| | - Tiziana Caputo
- Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA
| | - Izabela W Stanescu
- Ambulatory Operation Services, Mass General Brigham, Harvard Medical School, Boston, MA 02215, USA
| | - Jamil B Alkhaddo
- Division of Endocrinology, Department of Medicine, Allegheny Health Network, Pittsburgh, PA 15212, USA
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25
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Borowsky HM, Schofield CL, Du T, Margo J, Williams KKA, Sloan D, Bullock K, Sanders JJ. Race Dialogues and Potential Application in Clinical Environments: A Scoping Review. J Gen Intern Med 2024:10.1007/s11606-024-08915-3. [PMID: 39042181 DOI: 10.1007/s11606-024-08915-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 06/25/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Race dialogues, conversations about race and racism among individuals holding different racial identities, have been proposed as one component of addressing racism in medicine and improving the experience of racially minoritized patients. Drawing on work from several fields, we aimed to assess the scope of the literature on race dialogues and to describe potential benefits, best practices, and challenges of conducting such dialogues. Ultimately, our goal was to explore the potential role of race dialogues in medical education and clinical practice. METHODS Our scoping review included articles published prior to June 2, 2022, in the biomedicine, psychology, nursing and allied health, and education literatures. Ultimately, 54 articles were included in analysis, all of which pertained to conversations about race occurring between adults possessing different racial identities. We engaged in an interactive group process to identify key takeaways from each article and synthesize cross-cutting themes. RESULTS Emergent themes reflected the processes of preparing, leading, and following up race dialogues. Preparing required significant personal introspection, logistical organization, and intentional framing of the conversation. Leading safe and successful race dialogues necessitated trauma-informed practices, addressing microaggressions as they arose, welcoming participation and emotions, and centering the experience of individuals with minoritized identities. Longitudinal experiences and efforts to evaluate the quality of race dialogues were crucial to ensuring meaningful impact. DISCUSSION Supporting race dialogues within medicine has the potential to promote a more inclusive and justice-oriented workforce, strengthen relationships amongst colleagues, and improve care for patients with racially minoritized identities. Potential levers for supporting race dialogues include high-quality racial justice curricula at every level of medical education and valuation of racial consciousness in admissions and hiring processes. All efforts to support race dialogues must center and uplift those with racially minoritized identities.
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Affiliation(s)
- Hannah M Borowsky
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
| | - Catherine L Schofield
- Ariadne Labs, Brigham and Women's Hospital and Harvard T. H Chan School of Public Health, Boston, MA, USA
| | - Ting Du
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Judy Margo
- Ariadne Labs, Brigham and Women's Hospital and Harvard T. H Chan School of Public Health, Boston, MA, USA
| | | | - Danetta Sloan
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Karen Bullock
- School of Social Work, Boston College, Chestnut Hill, MA, USA
| | - Justin J Sanders
- Ariadne Labs, Brigham and Women's Hospital and Harvard T. H Chan School of Public Health, Boston, MA, USA
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Department of Family Medicine, McGill University, Montreal, QC, Canada
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26
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Sivakumar A, Rana S, Rofaiel D, Ahmad T, Hari S, Yu CH. "The straw that broke the camel's back": An analysis of racialized women clinicians' experiences providing diabetes care. PLoS One 2024; 19:e0305473. [PMID: 38990933 PMCID: PMC11239002 DOI: 10.1371/journal.pone.0305473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/30/2024] [Indexed: 07/13/2024] Open
Abstract
INTRODUCTION Racialized women clinicians (RWCs) experience the brunt of unfair racial and gendered expectations, which is a direct result of their visible identity. Our study sought to understand how these experiences intersect to impact the personal and professional well-being of RWCs, and their approach to diabetes care. METHODS Data were collected from 24 RWCs working within Canadian diabetes care settings, who participated in semi-structured, one-on-one interviews conducted from April 2021 to September 2021. The data were qualitatively analyzed using thematic analysis to develop emergent themes, and interactions were explored using the socioecological model (SEM), adapted to our study context. RESULTS We identified three themes: (1) Discordance between self-identity and relational identity impacted how RWCs interacted with others, and how others interacted with them; (2) Tokenistic, "inclusive" organizational policies/practices and inherently racist and sexist social norms permitted acts of discrimination and led to the systematic othering and exclusion of RWCs within the workplace; and (3) Differential treatment of RWCs had both positive and negative impacts on participants' relational, workplace and self-identity. Using the SEM, we also found that differential treatment of RWCs stems from upstream policies, structures, and social norms, percolating through different levels of the SEM, including work environments and communities, which eventually impacts one's relational identity, as well as one's perception of oneself. CONCLUSION The differential treatment of RWCs arises predominantly from macro systems of the work environment. The burden to address these disparities must be shifted to the source (i.e., namely systems) by implementing interventions that equitably value diversity efforts, institute policies of accountability and correction of implicit biases, and prioritize an inclusive culture broadly across faculty and leadership.
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Affiliation(s)
- Arani Sivakumar
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
| | - Simrit Rana
- McMaster University, Hamilton, Ontario, Canada
| | | | - Tehmina Ahmad
- Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Shriya Hari
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
| | - Catherine H. Yu
- Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Gossa W, Hawks MK, Lounsbery JL, Goodie JL. Social Determinants of Health Education Within Family Medicine Clerkships: A CERA Study. Fam Med 2024; 56:447-451. [PMID: 38996356 PMCID: PMC11280194 DOI: 10.22454/fammed.2024.868511] [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] [Indexed: 07/14/2024]
Abstract
BACKGROUND AND OBJECTIVES Social determinants of health (SDoH) education has gained popularity in undergraduate medical education; however, emphasis varies, and the curricula or assessment methods are not uniform. This study sought to examine the current SDoH teaching and assessment methods within family medicine clerkships and to identify characteristics associated with SDoH curriculum with multicomponent (two or more) teaching strategies and higher Kirkpatrick levels of assessment (Level 3-behavior change and Level 4-results). METHODS An online survey was conducted through the 2023 Council of Academic Family Medicine Educational Research Alliance (CERA) Clerkship Directors Survey. RESULTS The survey response rate was 56.8% (96/169). The degree of SDoH emphasis in the medical school was positively associated with the number of teaching strategies (r=0.48; P<.001). We found a trend toward degree of SDoH emphasis being associated with higher Kirkpatrick levels of assessment (H[3]=7.83; P=.05). Having an SDoH faculty champion was associated with more teaching strategies (F[1,77]=8.73; P=.004), more types of assessments (F[1,78]=5.88; P=.018), and higher Kirkpatrick levels of assessment (H[1]=4.46; P=.035). Underrepresented in medicine clerkship director identity was not associated with the number of teaching strategies or higher Kirkpatrick levels of assessment. CONCLUSIONS Greater degrees of SDoH emphasis and having a faculty champion were associated, or trended toward association, with multicomponent teaching strategies and higher Kirkpatrick levels of assessment, which prepare students to provide SDoH responsive care that could lead to reduction in health inequities.
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Affiliation(s)
- Weyinshet Gossa
- Department of Family Medicine, Uniformed Services University of Health
SciencesBethesda, MD
| | - Matthew K. Hawks
- Department of Family Medicine, Uniformed Services University of Health
SciencesBethesda, MD
| | - Jody L. Lounsbery
- Department of Pharmaceutical Care & Health Systems, University of
Minnesota College of PharmacyMinneapolis, MN
- Department of Family Medicine and Community Health, University of
Minnesota Medical SchoolMinneapolis, MN
| | - Jeffrey L. Goodie
- Department of Family Medicine, Uniformed Services University of Health
SciencesBethesda, MD
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28
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Vassileva MT, Suresh V, Chan AC, Akinsete AV, Blanco I, Blazer A, Criscione-Schreiber L, Dowell S, Feldman CH, FitzGerald J, Gilbert M, Hughes G, Husni ME, Kerr G, Kwan O, Mantilla B, Nilson S, Rivadeneira AC, Rodríguez M, Smith BJ, Soulsby WD, Wong SCY, Yazdany J, Ross W. Improving Health Equity in Rheumatology Through Workforce Diversification and Support for Health Equity Research and Education. Arthritis Rheumatol 2024; 76:989-992. [PMID: 38240019 DOI: 10.1002/art.42804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/05/2024] [Accepted: 01/16/2024] [Indexed: 02/27/2024]
Affiliation(s)
| | | | | | | | | | - Ashira Blazer
- Hospital for Special Surgery, New York City, New York
| | | | | | | | - John FitzGerald
- University of California, Los Angeles and Veterans Affairs Greater Los Angeles
| | | | | | | | - Gail Kerr
- Washington, DC Veterans Affairs Medical Center, Georgetown and Howard University Hospitals, Washington, DC
| | | | | | | | | | | | | | | | | | | | - Will Ross
- Washington University in St. Louis, Missouri
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29
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Zickuhr L, Roberts E, Daugherty T, Rana A, Joshi H, Pollard B, Yu J, Jones HA, Goglin S. Revisiting Race, Ethnicity, and Disparities in Rheumatology Educational Materials: An Update Since 2020. Arthritis Care Res (Hoboken) 2024; 76:1045-1049. [PMID: 38499988 DOI: 10.1002/acr.25326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 03/05/2024] [Accepted: 03/15/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVE In 2020, one study by Strait and colleagues raised awareness that the clinical images in rheumatology educational materials underrepresent people with skin of color (P-SOC). Since then, publishers of rheumatology educational materials have focused on addressing this shortcoming. This study investigates the change in representation of P-SOC following the review of Strait et al. METHODS: We used the methods of the aforementioned study to collect images from commonly referenced rheumatology educational materials and categorized the skin tones within them as "light" or "dark." We calculated the proportional change in images depicting dark skin tones between 2020 and 2022 from the American College of Rheumatology (ACR) Image Library, the 10th edition of Kelley's Textbook of Rheumatology, and New England Journal of Medicine (NEJM) as well as between 2020 and 2024 from rheumatology articles within UpToDate. We compared results using one-sided Z-tests. RESULTS Overall, the proportion of images depicting dark skin tones increased 40.6% (P < 0.0001). The 10th edition of Kelley's Textbook of Rheumatology most significantly increased inclusion of P-SOC (90.1%; P = 0.0039), with ACR Image Library, UpToDate, and NEJM also enhancing representation (41.9%, P < 0.0001; 31.0%, P = 0.0083; 28.2%, P = 0.3046, respectively). CONCLUSION This study assesses the progress of rheumatology educational materials toward equitable representation of P-SOC. It demonstrates that awareness coupled with focused efforts from educational publishers can enhance the proportion of images depicting dark skin tones, thereby enriching the quality of foundational knowledge relayed to rheumatology providers with the goal of improving health experiences and outcomes for P-SOC with rheumatic diseases.
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Affiliation(s)
- Lisa Zickuhr
- Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Eric Roberts
- University of California, San Francisco, San Francisco
| | - Tyler Daugherty
- Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Amaad Rana
- Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Hirva Joshi
- Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Bruin Pollard
- Mayo Clinic College of Graduate Medical Education, Rochester, Minnesota
| | - Jonathan Yu
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Sarah Goglin
- University of California, San Francisco, San Francisco
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30
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Joseph KA, Williams R. Preventing the Demise of Diversity, Equity, and Inclusion. JAMA Netw Open 2024; 7:e2415379. [PMID: 38869905 DOI: 10.1001/jamanetworkopen.2024.15379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Affiliation(s)
- Kathie-Ann Joseph
- Departments of Surgery and Population Health, NYU Grossman School of Medicine, New York, New York
| | - Renee Williams
- Department of Medicine, Division of Gastroenterology and Hepatology, NYU Grossman School of Medicine, New York, New York
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31
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Nair S, Rodríguez JE, Elwood S, Wilson E, Ramanathan A, Stulberg D, Vail B, Rundell K, Peek CJ. Departmental Metrics to Guide Equity, Diversity, and Inclusion for Academic Family Medicine Departments. Fam Med 2024; 56:362-366. [PMID: 38652854 PMCID: PMC11229857 DOI: 10.22454/fammed.2024.865619] [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: 04/25/2024]
Abstract
PROBLEM Equity, diversity, and inclusion (EDI) efforts have accelerated over the past several years, without a traditional guidebook that other missions often have. To evaluate progress over time, departments of family medicine are seeking ways to measure their current EDI state. Across the specialty, unity regarding which EDI metrics are meaningful is absent, and discordance even exists about what should be measured. APPROACH This paper provides a general metrics framework, including a wide array of possibilities to consider measuring, for assessing individual departmental progress in this broad space. These measures are designed to be general enough to provide common language and can be customized to align with strategic priorities of individual family medicine departments. OUTCOMES The Diversity, Equity, and Inclusion Committee of the Association of Departments of Family Medicine has produced a common framework to facilitate measurement of EDI outcomes in the following areas: care delivery and health, workforce recruitment and retention, learner recruitment and training, and research participation. This framework allows departments to monitor progress across these domains that impact the tripartite mission, providing opportunities to capitalize on measured gains in EDI. NEXT STEPS Departments can review this framework and consider which metrics are applicable or develop their own metrics to align with their strategic priorities. In the future, collective departments could compare notes and measure aggregate progress together. Evaluating progress is a step in the journey toward the goal of ensuring that departments are operating from inclusive and just academic systems.
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Affiliation(s)
- Shalina Nair
- Department of Family and Community Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - José E Rodríguez
- Family and Preventive Medicine, University of Utah Health Equity, Diversity and Inclusion, Salt Lake City, UT
| | | | - Elisabeth Wilson
- Department of Community and Family Medicine, Dartmouth Hitchcock Health and Dartmouth Geisel School of Medicine, Lebanon, NH
| | - Annamalai Ramanathan
- Department of Family and Community Medicine, Medical College of Georgia, Augusta University, Augusta, GA
| | - Debra Stulberg
- Department of Family Medicine, University of Chicago, Chicago, IL
| | - Belinda Vail
- Department of Family Medicine and Community Health, Medical Center, University of Kansas, Kansas City, KS
| | - Kristen Rundell
- Department of Family and Community Medicine, University of Arizona College of Medicine, Tucson, AZ
| | - C J Peek
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
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32
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Ezell JM. The Health Disparities Research Industrial Complex. Soc Sci Med 2024; 351:116251. [PMID: 37865583 DOI: 10.1016/j.socscimed.2023.116251] [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: 08/14/2023] [Accepted: 09/14/2023] [Indexed: 10/23/2023]
Abstract
Research focused on health disparities-whether relating to one's race/ethnicity, gender expression, sexual orientation, citizenship status, income level, etc.-constitutes a large, generative, and highly profitable portion of scholarship in academic, clinical, and government settings. Health disparities research is expressed as a means of bringing greater attention to, and ultimately addressing via evidence-based implementation science, acts of devaluation and oppression that have continually contributed to these inequities. Philosophies underlying health disparities research's expansive and growing presence mirror the formal logic and ethos of the Military Industrial Complex and the Prison Industrial Complex. The "Health Disparities Research Industrial Complex," operationalized in this article, represents a novel mutation and extension of these complexes, primarily being enacted through these three mechanisms: 1) The construction and maintenance of beliefs, behaviors, and policies in healthcare, and society more broadly, that create and sustain disadvantages in minority health; 2) the creation and funding of research positions that inordinately provide non-minoritized people and those without relevant lived experiences the ability to study health disparities as "health equity tourists"; and 3) the production of health disparities research that, due to factors one and two, is incapable of fully addressing the disparities. In this piece, these and other core elements of the Health Disparities Research Industrial Complex, and the research bubble that it has produced, are discussed. Additionally, strategies for reducing the footprint and impact of the Health Disparities Research Industrial Complex and better facilitating opportunities for meaningful implementation in the field are presented.
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Affiliation(s)
- Jerel M Ezell
- Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA; Berkeley Center for Cultural Humility, University of California Berkeley, Berkeley, CA, USA.
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Carvajal DN, Zambrana RE. Authors' Response to Letter About "URiMs and Imposter Syndrome" Commentary. Fam Med 2024; 56:339-340. [PMID: 38652852 PMCID: PMC11216770 DOI: 10.22454/fammed.2024.336789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Affiliation(s)
- Diana N Carvajal
- Department of Family & Community Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Ruth Enid Zambrana
- Department of Family & Community Medicine, University of Maryland School of Medicine, Baltimore, MD
- Harriet Tubman Department of Women, Gender, and Sexuality Studies, University of Maryland, College Park, MD
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34
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Fernandez Montero YL, Corbin CE, Yole-Lobe M. Commenting on "URiMs and Imposter Syndrome: Symptoms of Inhospitable Work Environments". Fam Med 2024; 56:337-338. [PMID: 38506700 PMCID: PMC11216776 DOI: 10.22454/fammed.2024.131716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
- Yulsi L Fernandez Montero
- Department of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | | | - Menerva Yole-Lobe
- Department of Family & Preventive Medicine, Division of Physician Assistant Studies, Spencer Fox Eccles School of Medicine, The University of Utah, Salt Lake City, UT
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35
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Sevelius JM, Harris OO, Bowleg L. Intersectional Mentorship in Academic Medicine: A Conceptual Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:503. [PMID: 38673414 PMCID: PMC11050481 DOI: 10.3390/ijerph21040503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/07/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Academic medical institutions seek to recruit and retain a diverse workforce to foster equitable, supportive environments in which early-stage investigators, especially those who are underrepresented in medicine, can thrive. Intersectionality is a critical theoretical framework rooted in Black feminist activism and scholarship that elucidates how power and privilege are differentially structured for groups at different intersectional sociodemographic positions. As a dynamic method of analyzing multiple axes of power and inequality, intersectionality has the potential to offer a critical lens through which to view the mentor-mentee relationship. In this article, we seek to elaborate upon and extend the concept of intersectional mentoring, elucidate its essential components, and explore its application in the context of mentoring early-stage investigators in academic medicine. We propose that intersectional mentorship requires an orientation toward deep cultural humility, lifetime learning about the impact of systemic oppressions on present-day opportunities and experiences of mentees, and changing systems that perpetuate inequities by centering praxis-the application of principles of intersectionality through action to transform power dynamics in academic culture and institutions. Intersectional mentorship can help build a more equitable and representative workforce to advance intersectionally relevant and innovative approaches to achieving health equity.
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Affiliation(s)
- Jae M. Sevelius
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Orlando O. Harris
- Community Health Systems, School of Nursing, University of California, San Francisco, CA 94143, USA;
| | - Lisa Bowleg
- Applied Social Psychology, The George Washington University, Washington, DC 20052, USA;
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36
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Anaya M, Law W, Montoya HL, Moreira CM. Discharge Interventions for Limited English Proficiency Patients: A Scoping Review. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02003-2. [PMID: 38639867 DOI: 10.1007/s40615-024-02003-2] [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: 12/31/2023] [Revised: 03/30/2024] [Accepted: 04/07/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Limited English proficiency patients are required under federal law to receive language-concordant care, yet they still receive substandard discharge instructions compared to English-speaking patients. We aimed to summarize the interventions carried out to improve discharge instructions in the limited English proficiency population. METHODS We conducted a scoping review of academic and gray literature from the United States using Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols for Scoping Reviews guidelines. We searched PubMed, Embase, and CINAHL for studies to improve discharge communication. RESULTS Of the 3330 studies, 19 studies met the criteria. Core types of interventions included written interventions alone, educational interventions alone, written and educational interventions, audio and visual interventions, and other types of interventions. Even among the same core types of interventions, there were differences in types of interventions, outcomes examined, and results. DISCUSSION The majority of included interventions that studied satisfaction as an outcome measure showed improvement, while the other outcomes were not improved or worsened. More rigorous methodology and community involvement are necessary to further analyze discharge interventions for patients with limited English proficiency (LEP).
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Affiliation(s)
- Melanie Anaya
- The Warren Alpert Medical School, Brown University, 222 Richmond Street, Providence, RI, 02903, USA.
- Department of Surgery, Rhode Island Hospital, 593 Eddy Street, APC 4, Providence, RI, 02903, USA.
| | - William Law
- The Warren Alpert Medical School, Brown University, 222 Richmond Street, Providence, RI, 02903, USA
- Department of Surgery, Rhode Island Hospital, 593 Eddy Street, APC 4, Providence, RI, 02903, USA
| | - Hannah L Montoya
- The Warren Alpert Medical School, Brown University, 222 Richmond Street, Providence, RI, 02903, USA
- Department of Surgery, Rhode Island Hospital, 593 Eddy Street, APC 4, Providence, RI, 02903, USA
| | - Carla M Moreira
- The Warren Alpert Medical School, Brown University, 222 Richmond Street, Providence, RI, 02903, USA
- Department of Surgery, Rhode Island Hospital, 593 Eddy Street, APC 4, Providence, RI, 02903, USA
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Ventres WB, Stone LA, Bryant WW, Pacheco MF, Figueroa E, Chu FN, Prasad S, Blane DN, Razon N, Mishori R, Ferrer RL, Kneese GS. Storylines of family medicine X: standing up for diversity, equity and inclusion. Fam Med Community Health 2024; 12:e002828. [PMID: 38609082 PMCID: PMC11029210 DOI: 10.1136/fmch-2024-002828] [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] [Indexed: 04/14/2024] Open
Abstract
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'X: standing up for diversity, equity and inclusion', authors address the following themes: 'The power of diversity-why inclusivity is essential to equity in healthcare', 'Medical education for whom?', 'Growing a diverse and inclusive workforce', 'Therapeutic judo-an inclusive approach to patient care', 'Global family medicine-seeing the world "upside down"', 'The inverse care law', 'Social determinants of health as a lens for care', 'Why family physicians should care about human rights' and 'Toward health equity-the opportunome'. May the essays that follow inspire readers to promote change.
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Affiliation(s)
- William B Ventres
- Family and Preventive Medicine, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA
| | - Leslie A Stone
- Family and Preventive Medicine, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA
| | - Wayne W Bryant
- Family and Preventive Medicine, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA
| | - Mario F Pacheco
- Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Edgar Figueroa
- Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Francis N Chu
- San Jose Family Medicine Residency, Kaiser Permanente, San Jose, California, USA
| | - Shailendra Prasad
- Family Medicine and Community Health, University of Minnesota Medical School-Twin Cities Campus, Minneapolis, Minnesota, USA
| | - David N Blane
- School of Health and Wellbeing, University of Glasgow, Glasgow, Glasgow, UK
| | - Na'amah Razon
- Family and Community Medicine, University of California, Davis, Sacramento, California, USA
| | - Ranit Mishori
- Family Medicine, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Robert L Ferrer
- Family and Community Medicine, UT Health San Antonio Long School of Medicine, San Antonio, Texas, USA
| | - Garrett S Kneese
- UC San Diego Family Medicine Residency Program, San Diego, California, USA
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Campbell KM, Tumin D, Linares JI, Morley CP. The Relationship Between the Social Mission Content of Medical School Mission Statements and Minority Faculty Representation Among Faculty and Senior Leadership. J Immigr Minor Health 2024; 26:334-340. [PMID: 37902901 DOI: 10.1007/s10903-023-01555-5] [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: 10/01/2023] [Indexed: 11/01/2023]
Abstract
Medical schools with social missions have the potential to increase minority student interest in health disparities research. In previous work, the authors looked at the missions of medical schools to determine if they were associated with minority student representation. In this paper, the authors look at the representation of full-time faculty and senior leaders who are underrepresented in medicine in US medical schools. This study included all MD-granting medical schools in the US with available data on mission statement Social Mission Content (SMC) and faculty demographics. Data were analyzed for representation of faculty underrepresented in medicine (URM) among all faculty, among junior as compared to senior faculty, and among department chairs. In the 2013 data, Pearson correlation coefficients were calculated to characterize the association between SMC and contemporaneous URM faculty representation. In the 2014-2020 data, hierarchical linear models were used to estimate the association between SMC and the annual rate of change in URM faculty representation. In 2013, URM faculty accounted for 7.4% of all faculty at the median medical school, increasing to 8.4% in 2020. As of 2013, URM representation among junior faculty was 9.2% at the median school, 5.6% among senior faculty, and 4.3% among department chairs. The authors found a slow increase in the percentage of URM faculty members (but not department chairs). This trend did not vary between schools with lower vs. higher emphasis on a social mission (based on the mission statement). The increase in chair representation was determined to be associated with the type of the school, whether historically Black or Puerto Rican, and not precisely its mission.
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Affiliation(s)
- Kendall M Campbell
- Department of Family Medicine, University of Texas Medical Branch, Galveston, TX, USA.
| | - Dmitry Tumin
- Department of Pediatrics, East Carolina University Brody School of Medicine, Greenville, NC, USA
| | - Jhojana Infante Linares
- Department of Academic Affairs, Office of Data Analysis and Strategy, East Carolina University Brody School of Medicine, Greenville, NC, USA
| | - Christopher P Morley
- Department of Public Health & Preventive Medicine, Department of Family Medicine, and Department of Psychiatry & Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA
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Tsuchida RE, Mbele N, Chopra Z, Moll J, Burkhardt JC, Hekman DJ, Perry MA. Identifying the prevalence and characteristics of diversity, equity, and inclusion leaders in academic emergency medicine. AEM EDUCATION AND TRAINING 2024; 8:e10965. [PMID: 38525368 PMCID: PMC10955607 DOI: 10.1002/aet2.10965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 03/26/2024]
Abstract
Objectives Our study aims to better understand and describe the current state of diversity, equity, and inclusion (DEI) leadership in emergency medicine (EM) by identifying the prevalence of department DEI leadership positions, their demographics, and their job duty characteristics. Methods We disseminated an electronic survey from April to July 2022 to Society for Academic Emergency Medicine (SAEM) Association of Academic Chairs of Emergency Medicine, Academy for Diversity and Inclusion in Emergency Medicine, and the Equity and Inclusion Committee to identify department DEI leads. From July to August 2022, a 45-question survey was sent to all identified DEI leaders on individual characteristics, DEI experience, and DEI lead job description. Results We received a response from 79 out of 120 academic EM departments identified (65.8%). Of the responding institutions, 59 (74.7%) reported a DEI leader. A total of 74.6% of these DEI leaders responded at least partially to our survey and 57.6% responded in full. The most common titles were vice/associate chair of DEI (34.4%), director of DEI (28.1%), and DEI committee chair (18.8%). Most respondents (84.4%) were the inaugural DEI lead in their department and 84.4% of respondents did not have a formal DEI role in their department previously. On average, respondents have had their DEI title for 2 years (range 0-7 years) with an average of 7 years (range 0-30 years) of experience performing DEI work. Many (63.4%) do not receive any funded effort for their DEI roles. Most DEI leads were not tenure track (72.2%) and most commonly at the rank of assistant professor (47.2%) followed by associate professor (33.3%), full professor (16.7%), and instructor (2.8%). Conclusions This is the first known study to assess the characteristics of DEI department leaders in EM. EM DEI leadership positions are new, common, and led by diverse personal identities and are often not funded. Future directions could gain qualitative insight into this workforce to guide best practices in EM DEI leadership.
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Affiliation(s)
- Ryan E. Tsuchida
- Department of Emergency Medicine, School of Medicine and Public HealthUniversity of WisconsinMadisonWisconsinUSA
| | - Neema Mbele
- School of Medicine and Public HealthUniversity of WisconsinMadisonWisconsinUSA
| | - Zoey Chopra
- University of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Joel Moll
- Department of Emergency MedicineVirginia Commonwealth University School of MedicineRichmondVirginiaUSA
| | - John C. Burkhardt
- Department of Emergency MedicineUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Daniel J. Hekman
- Department of Emergency Medicine, School of Medicine and Public HealthUniversity of WisconsinMadisonWisconsinUSA
| | - Marcia A. Perry
- Department of Emergency MedicineUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
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Collazo A, Walcher CM, Campbell KM. Underrepresented in medicine (URiM) faculty development: Trends in biomedical database publication. J Natl Med Assoc 2024; 116:165-169. [PMID: 38220585 DOI: 10.1016/j.jnma.2024.01.005] [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: 08/06/2023] [Revised: 10/03/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Biomedical databases create an educational platform that allows institutions to share innovations and research discoveries. Identifying literature in biomedical databases that inform the faculty development experiences of faculty underrepresented in medicine (URiM) can help institutions identify resources to promote career advancement for this group. The authors sought to determine biomedical database trends in publications related to faculty development experiences of URiM faculty over the last twenty years. METHODS An electronic search for literature published between January 2003 to Dec 2022 was conducted in the databases CINAHL, PubMed, Scopus, and PsycInfo using keywords underrepresented minority, faculty development, career development, professional development, academic medicine, and workforce in the title, abstract, or body of the manuscript. Growth rates were calculated for each database. The statistical significance difference in median numbers of publication per database was evaluated using Krusksal Wallis and Dunn's test post hoc. RESULTS Search results found 1516 publications over the twenty-year period. Scopus published the most literature with 1,372 publications with a mean number of 68.6 per year (SD 83.47). Both Scopus and PubMed had increased growth rates at 41% and 25%, respectively. There were statistically significant differences in median publication numbers between Scopus, CINAHL, and PsycInfo (p < 0.001) but not PubMed (p 0.062). CONCLUSION Trends in publications related to URiM faculty development have increased over the last twenty years, most noted in the Scopus and PubMed biomedical databases.
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Affiliation(s)
- Ashley Collazo
- University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1123, United States
| | - Christen M Walcher
- University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1123, United States
| | - Kendall M Campbell
- University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1123, United States.
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Thakar MS, Rubio DM, Murrell AJ, Morone NE, Mitchell Miland C, White GE. The impact of inclusive mentoring and identity work on self-efficacy in career advancement and career commitment among underrepresented early-career faculty and post-doctoral fellows. J Clin Transl Sci 2024; 8:e61. [PMID: 38655454 PMCID: PMC11036437 DOI: 10.1017/cts.2024.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/28/2024] [Accepted: 03/14/2024] [Indexed: 04/26/2024] Open
Abstract
Objective Researchers from underrepresented groups leave research positions at a disproportionate rate. We aim to identify factors associated with self-efficacy in career advancement and career commitment among underrepresented post-doctoral fellows and early-career faculty. Methods Building Up is a cluster-randomized trial with 25 academic health institutions. In September-October 2020, 219 Building Up participants completed the pre-intervention assessment, which included questions on demographics, science identity, mentoring, self-efficacy in career advancement (i.e., advancement is open to me, confidence in career progression, confidence in overcoming professional barriers), and career commitment (i.e., intent to continue research training or studying in a field related to biomedical sciences). Using logistic and multinomial logistic regression, we identified characteristics independently associated with self-efficacy in career advancement and career commitment. Results The cohort is 80% female, 33% non-Hispanic/Latinx Black, and 34% Hispanic/Latinx. Having mentors that address diversity was significantly associated with the belief that advancement is open to them (OR = 1.7). Higher science identity (OR = 4.0) and having mentors that foster independence (OR = 1.8) were significantly associated with confidence in career progression. Higher science identity was also significantly associated with confidence in overcoming professional barriers (OR = 2.3) and intent to continue studying in a field related to biomedical sciences (OR = 3.3). Higher age (OR = 2.3) and higher science identity (OR = 4.2) were significantly associated with intent to continue research training. Discussion Science identity and mentoring play key roles in self-efficacy in career advancement and career commitment. These factors may contribute to retention of underrepresented early-career biomedical researchers.
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Affiliation(s)
- Maya S. Thakar
- Institute for Clinical Research Education, University of Pittsburgh Schools of
the Health Sciences, Pittsburgh, PA,
USA
| | - Doris M. Rubio
- Institute for Clinical Research Education, University of Pittsburgh Schools of
the Health Sciences, Pittsburgh, PA,
USA
| | - Audrey J. Murrell
- College of Business Administration, University of
Pittsburgh, Pittsburgh, PA,
USA
| | - Natalia E. Morone
- Department of Medicine, Boston University Chobanian &
Avedisian School of Medicine, Boston, MA,
USA
- Boston Medical Center, Boston, MA,
USA
| | - Chantele Mitchell Miland
- Institute for Clinical Research Education, University of Pittsburgh Schools of
the Health Sciences, Pittsburgh, PA,
USA
| | - Gretchen E. White
- Institute for Clinical Research Education, University of Pittsburgh Schools of
the Health Sciences, Pittsburgh, PA,
USA
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Cole D, Eneim AS, White CJ, Eddings CR, Beckett MQ, Clark V, Jeffery J, Wimalasena VK, Figueroa A, Rosado-Franco JJ, Alhariri R, Powell BH, Washington PW, Christensen LN, Wilson KL, Kavran JM. Deepening biomedical research training: Community-Building Wellness Workshops for Post-Baccalaureate Research Education Program (PREP) Trainees. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.10.584300. [PMID: 38559081 PMCID: PMC10979910 DOI: 10.1101/2024.03.10.584300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Problem All trainees, especially those from historically minoritized backgrounds, experience stresses that may reduce their continuation in science, technology, engineering, math, and medicine (STEMM) careers. The Johns Hopkins University School of Medicine is one of ~45 institutions with a National Institutes of Health funded Postbaccalaureate Research Education Program (PREP) that provides mentoring and a year of fulltime research to prepare students from historically excluded groups for graduate school. Having experienced the conflation of stresses during the COVID-19 pandemic and related shutdown, we realized our program lacked a component that explicitly helped PREP Scholars recognize and cope with non-academic stresses (financial, familial, social, mental) that might threaten their confidence and success as scientists and future in STEMM. Intervention We developed an early-intervention program to help Scholars develop life-long skills to become successful and resilient scientists. We developed a year-long series comprised of 9 workshops focused on community, introspection, financial fitness, emotional intelligence, mental health, and soft-skills. We recruited and compensated a cohort of PhD students and postdoctoral fellows to serve as Peer Mentors, to provide a community and the safest 'space' for Scholars to discuss personal concerns. Peer Mentors were responsible for developing and facilitating these Community-Building Wellness Workshops (CBWW). Context CBWW were created and exectued as part of the larger PREP program. Workshops included a PowerPoint presentation by Peer Mentors that featured several case studies that prompted discussion and provided time for small-group discussions between Scholars and Peer Mentors. We also included pre- and post-work for each workshop. These touch-points helped Scholars cultivate the habit of introspection. Impact The CBWW exceeded our goals. Both Peer Mentors and Scholars experienced strong mutual support, and Scholars developed life-long skills. Notably, several Scholars who had been experiencing financial, mental or mentor-related stress immediately brought this to the attention of program leadership, allowing early and successful intervention. At the completion of CBWW, PREP Scholars reported implementing many workshop skills into practice, were reshaping their criteria for choosing future mentors, and evaluating career decisions. Strikingly, Peer Mentors found they also benefitted from the program as well, suggesting a potential larger scope for the role of CBWW in academia. Lessons Learned Peer Mentors were essential in creating a safe supportive environment that facilitated discussions, self-reflection, and self-care. Providing fair compensation to Peer Mentors for their professional mentoring and teaching contributions was essential and contributed meaningfully to the positive energy and impact of this program.
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Affiliation(s)
- Dezmond Cole
- Department of Biological Chemistry, School of Medicine
| | - Andrew S. Eneim
- Department of Biophysics & Biophysical Chemistry, School of Medicine
| | - Cory J. White
- Department of Molecular and Comparative Pathobiology, School of Medicine
| | | | | | - Vincent Clark
- Chemistry-Biology Interface Program, Zanvyl Krieger School of Arts & Sciences
| | | | | | - Alexis Figueroa
- Division of Infectious Diseases, Department of Medicine, School of Medicine
| | | | | | - Bonita H. Powell
- Department of Biological Chemistry, School of Medicine
- Department of Molecular and Comparative Pathobiology, School of Medicine
| | | | | | | | - Jennifer M. Kavran
- Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health
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Warsame R, Kim YH, Ouk MY, Mara KC, Lacy MQ, Hayes SN, Shalle Z, Balls-Berry J, Jordan BL, Enders FT, Wolanskyj-Spinner AP, Spinner RJ. Academic Promotions in Medicine: An Appraisal of Fairness. Mayo Clin Proc 2024; 99:424-434. [PMID: 38432747 DOI: 10.1016/j.mayocp.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To investigate whether the process of conferring academic rank or components of the promotion packet contribute to the lack of parity in academic advancement for women and individuals underrepresented in medicine (URMs). PATIENTS AND METHODS We retrospectively reviewed prospective promotion applications to the position of associate professor or professor at Mayo Clinic from January 2, 2015, through July 1, 2019. Individuals with doctorate degrees who applied for either rank were included in the study. Data collected included demographic characteristics, curriculum vitae at time of application, committee score sheets, and deferral and approval decisions. Deferral rates for women compared with men and for URMs compared with non-URMs was the primary outcome. RESULTS Of 462 people who applied for associate professor, 10% (n=46) were deferred. Those promoted had worked longer at Mayo Clinic (median, 6 years vs 2 years; P=.01), had more mentees (median, 6 vs 4; P=.02), authored more publications (median [interquartile range (IQR)], 39 [32-52] vs 30 [24-35]; P<.001), and were more likely to be on a National Institutes of Health or institutional grant (P<.05). Of the 320 people who applied for professor, 8.8% (n=28) were deferred. Those promoted had authored more publications (median [IQR], 77 [60-99] vs 56 [44-66]; P<.001) and were less likely to hold an elected office to a professional society (22.6% vs 39.3%; P=.05). There was no significant association between deferral status and sex (P>.4) or race/ethnicity (P>.9) for either rank. CONCLUSION The process for academic advancement for professorships does not contribute to the gap in promotion rates for women and URMs.
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Affiliation(s)
- Rahma Warsame
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
| | - Yong-Hun Kim
- Mayo Clinic Alix School of Medicine, Rochester, MN
| | - Melody Y Ouk
- Mayo Clinic School of Health Sciences, Mayo Clinic, Rochester, MN
| | - Kristin C Mara
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Martha Q Lacy
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Sharonne N Hayes
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | | | - Joyce Balls-Berry
- Institute of Clinical and Translational Sciences, Washington University, St Louis, MO
| | - Barbara L Jordan
- Office of Education Diversity, Equity, and Inclusion, Mayo Clinic, Rochester, MN
| | - Felicity T Enders
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
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Betancourt RM, Baluchi D, Dortche K, Campbell KM, Rodríguez JE. Minority Tax on Medical Students: A Review of the Literature and Mitigation Recommendations. Fam Med 2024; 56:169-175. [PMID: 38467005 PMCID: PMC11136630 DOI: 10.22454/fammed.2024.268466] [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] [Indexed: 03/13/2024]
Abstract
BACKGROUND AND OBJECTIVES Accreditation standards for MD- and DO-granting institutions require medical schools to recruit a diverse student body and educate students about diverse groups of patients. The minority tax is a summary of responsibilities assigned to racial and ethnic underrepresented faculty to achieve diversity, equity, and inclusion in medical institutions in addition to their typical academic workload. This article provides a narrative review of medical students' experiences of the minority tax and recommendations on how medical educators can support an equitable learning environment by eliminating the minority tax. METHODS We searched the PubMed, Web of Science, and Scopus databases, Google Scholar, and medical society websites, blogs, and fora for terms, including minority tax, medical students, and undergraduate medical education. We included publications if they discussed the underrepresented in medicine medical students' experiences of the minority tax. RESULTS Our search yielded six peer-reviewed original research articles and six publications of commentaries, opinion pieces, or news pieces. Students who were underrepresented in medicine reported spending more hours on diversity efforts compared with students who were not underrepresented; moreover, students reported that they had to sacrifice academic excellence in order to fulfill these additional diversity duties. CONCLUSIONS The minority tax among medical students constitutes an unequitable and unjust barrier to career advancement, and it likely represents an early cause of attrition in the pipeline of underrepresented in medicine academic faculty. Medical educators can enact specific recommendations to eliminate or mitigate the minority tax experience for medical students.
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Affiliation(s)
- Renée M. Betancourt
- Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of MedicinePhiladelphia, PA
| | - Donna Baluchi
- Spencer S. Eccles Health Sciences Library, University of UtahSalt Lake City, UT
| | - Kristina Dortche
- Urology Residency Training Program, Cleveland ClinicCleveland, OH
| | - Kendall M. Campbell
- Department of Family Medicine, The University of Texas Medical BranchGalveston, TX
| | - José E. Rodríguez
- Department of Family and Preventive Medicine, University of UtahSalt Lake City, UT
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Thompson K, Hammond N, Lynch D, Van Der Merwe M, Modra L, Yong SA, Grattan S, Stokes-Parish J. Perceptions of gender equity among critical care and other health professionals: A cross-sectional survey. Aust Crit Care 2024; 37:265-272. [PMID: 37574389 DOI: 10.1016/j.aucc.2023.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/29/2023] [Accepted: 07/09/2023] [Indexed: 08/15/2023] Open
Abstract
OBJECTIVE The objective of this study was to determine the association between gender and perceived gender equity in the critical care workforce and other health specialties. DESIGN AND SETTING We conducted an online cross-sectional survey between September and November 2020. Data on demographics and perceptions of equity including the representation of women across departments and in leadership roles, knowledge of and access to flexible work practices and carers leave, and opportunities for promotion were collected. PARTICIPANTS The study population included health professionals from critical care (defined as intensive care and emergency) and other specialties. We conducted a descriptive gender-disaggregated analysis. RESULTS A total of 478 respondents (70% women) completed the survey. The mean age of respondents was 43.9 ± 11.2 years. Approximately half of respondents were medical practitioners (n = 235, 54%), followed by nurses (n = 135, 36%)-the remainder were from other professions. The critical care workforce accounted for 280 (64%) of responder practice settings. Statistically significant differences were reported between genders on issues such as having confidence that their department would resolve equity issues (87 [70.7%] men vs. 146 [48.2%] women; p = 0.007), access to flexible work practices (5/124 [4.0%] men vs. 20/305 [6.6%] women p = 0.001), and taking unpaid leave for carer responsibilities (91 [30.3%] women vs 9 [7.4%] men, p < 0.001). CONCLUSIONS This work highlights differences in how men and women perceive gender equity, particularly in the critical care workforce. These findings are important to understand health care practitioners' perceptions of gender equity, as these perceptions inform behaviour.
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Affiliation(s)
- Kelly Thompson
- The George Institute for Global Health, UNSW, Sydney, Australia; Nepean and Blue Mountains Local Health District, Kingswood, Australia
| | - Naomi Hammond
- The George Institute for Global Health, UNSW, Sydney, Australia; Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Doug Lynch
- EMR & Informatics Directorate, Monash Health, Clayton, Victoria, Australia
| | | | - Lucy Modra
- Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia; ICU, Austin Hospital, Melbourne, Victoria, Australia
| | - Sarah A Yong
- Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, Victoria, Australia; ANZIC-RC, Department of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - Sarah Grattan
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Jessica Stokes-Parish
- Bond University, Gold Coast, Australia; Intensive Care, John Flynn Private Hospital, Tugun, Queensland, Australia.
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Omoruyi EA, Brown CL, Orr CJ, Montez K. Examining Full-Time Academic General Pediatric Faculty Compensation by Gender, Race, and Ethnicity: 2020-2021. Acad Pediatr 2024; 24:309-317. [PMID: 37285912 PMCID: PMC11177246 DOI: 10.1016/j.acap.2023.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 05/22/2023] [Accepted: 05/27/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE In medicine, women have lower lifetime earnings than men. To our knowledge, an in-depth examination of academic general pediatric faculty compensation by gender, race, and ethnicity has not been conducted. We aimed to 1) explore full-time academic general pediatric faculty salary differences by race and ethnicity; 2) explore these differences among all full-time pediatric faculty. METHODS We performed a cross-sectional study using data on median full-time academic general pediatric faculty compensation for the academic year of 2020-2021 from the Association of American Medical Colleges Medical School Faculty Salary Survey report. Pearson's chi-square tests were used to evaluate the association of faculty rank with gender, race, ethnicity, and degree. We used hierarchical generalize linear models with a log link and a gamma distribution to model to assess the association of median salary with faculty race and ethnicity, adjusting for degree, rank, and gender. RESULTS Men academic general pediatric faculty consistently had higher median salaries than women faculty even after adjusting for degree, rank, race, and ethnicity. Underrepresented in medicine academic general pediatric faculty had a lower median salary when compared to White faculty, and this was similar when adjusted for degree, rank, race, and ethnicity. CONCLUSIONS Our results demonstrated broad disparities in general academic pediatric compensation by both gender and race and ethnicity. Academic medical centers must identify, acknowledge, and address inequities in compensation models.
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Affiliation(s)
- Emma A Omoruyi
- Department of Pediatrics (EA Omoruyi), McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Tex.
| | - Callie L Brown
- Department of Pediatrics, Department of Epidemiology and Prevention (CL Brown), Wake Forest University School of Medicine, Winston-Salem, NC.
| | - Colin J Orr
- Department of Pediatrics (CJ Orr), University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Kimberly Montez
- Department of Pediatrics, Department of Social Sciences and Health Policy (K Montez), Wake Forest University School of Medicine, Winston-Salem, NC.
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Feeley AA, Feeley IH, Sheehan E, Carroll C, Queally J. Impact of Mentoring for Underrepresented Groups in Undergraduate Medical Education: A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2024; 81:353-366. [PMID: 38160117 DOI: 10.1016/j.jsurg.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/11/2023] [Accepted: 11/11/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES Despite efforts to mitigate challenges to advance underrepresented groups (URG) groups' representation in medical education, diversity remains underwhelming. In response to this several mentoring programs to increase diversification within medical education have been implemented. However, the impact of these programs on URG representation across disciplines is unknown. The aim of this review is to evaluate the impact of structured mentoring programs on URGs in undergraduate medical education. DESIGN Systematic review. METHODS A comprehensive search strategy was performed of electronic databases including PubMed, Ovid Medline, and EMBASE between January and September 2022 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Both qualitative and quantitative outcomes including characteristics of the mentoring structure explored within each study were collected, and differences in study outcomes analyzed. RESULTS In total 17 studies were included for analysis. Mentoring within URGs resulted in an increase in research opportunities, exam performance, medical specialty applications, and residency matching. Structured feedback yielded positive experiences by both mentors and mentees participating in programs, with both emotional and cultural competence issues explored across studies included for analysis. CONCLUSIONS Mentoring for medical students underrepresented in medicine across mentoring relationships including peer, senior, formal, and informal structures yield positive outcomes within research, academic modules, and career pathways. Future applications of mentoring programs should consider the use of tandem mentoring from both senior and peer mentors to optimize benefits URG students derive from each mentoring relationship.
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Affiliation(s)
- Aoife A Feeley
- Connolly Hospital Blanchardstown, Dublin, Ireland; Royal College Surgeons Ireland, Dublin, Ireland.
| | - Iain H Feeley
- Midlands Regional Hospital Tullamore, Offaly, Ireland
| | - Eoin Sheehan
- Midlands Regional Hospital Tullamore, Offaly, Ireland
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Waselewski M, Amaro X, Huerto R, Berger J, Spinelli da Silva M, Siroky K, Torres A, Chang T. Youth preferences for healthcare providers and healthcare interactions: a qualitative study. BMC PRIMARY CARE 2024; 25:63. [PMID: 38383303 PMCID: PMC10882742 DOI: 10.1186/s12875-024-02300-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Patient-physician relationships in healthcare can influence healthcare provision, patient engagement, and health outcomes. Little is known about youth preferences on types and characteristics of their healthcare providers. The aim of this study was to assess youth perspectives on preferences for and interactions with their healthcare providers. METHODS We posed 5 open-ended questions to 1,163 MyVoice participants, a nationwide text message cohort of United States youth aged 14-24, on April 10, 2020 related to youth preferences for healthcare providers. Content analysis was used to develop a codebook. Responses were independently coded by two reviewers with discrepancies discussed to reach consensus. Descriptive statistics were calculated for demographics and frequency of codes. RESULTS 944 (81%) participants responded to at least one question. Respondents had a mean age of 18.9 years (SD: 2.8) and were a majority female (53.6%) and White (56.3%). Youth reported "kindness" or other personality traits (31%) and education (30%) as important in choosing their doctor. Patient-physician concordance was not important to many youths (44%) and among those who reported concordance as important (55%), having the same gender was the most noted (68%). Youth suggested respect, open conversation, and addressing issues directly to help alleviate uncomfortable situations, though some would simply switch providers. CONCLUSION Personality and empathy are important provider characteristics valued by youth. Female respondents preferred gender concordant providers, particularly for sexual health-related issues, and non-white respondents were more likely to prefer racial concordance. Strengthening professional and interpersonal skills among youth-serving providers may improve healthcare engagement and satisfaction among youth.
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Affiliation(s)
- Marika Waselewski
- Department of Family Medicine, University of Michigan, 2800 Plymouth Road, Building 14 G128, Ann Arbor, MI, 48109, USA
| | | | - Ryan Huerto
- Department of Adult and Family Medicine, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Jessica Berger
- Department of Family Medicine, University of Michigan, 2800 Plymouth Road, Building 14 G128, Ann Arbor, MI, 48109, USA
- University of Michigan, Ann Arbor, MI, USA
| | | | - Kate Siroky
- School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | - Tammy Chang
- Department of Family Medicine, University of Michigan, 2800 Plymouth Road, Building 14 G128, Ann Arbor, MI, 48109, USA.
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
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Russel SM, Farzal Z, Ebert C, Buckmire R, DeMason C, Shah R, Frank-Ito DO. Finding the Potholes in Academic Career Pathways for Underrepresented Groups in Otolaryngology. Otolaryngol Head Neck Surg 2024; 170:396-404. [PMID: 37668176 PMCID: PMC11073850 DOI: 10.1002/ohn.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/26/2023] [Accepted: 08/12/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE To assess inequities in representation among ranks and odds of promotion by race in academic otolaryngology. STUDY DESIGN Cross-sectional study. SETTING US academic medical centers. METHODS Demographic data was collected for medical students, residents, and faculty in the Association of American Medical Colleges and Accreditation Council for Graduate Medical Education databases for the academic year 2020 to 2021. The rank equity index (REI) was used to make pairwise comparisons between ranks to determine groups' representation between levels. Odds ratios (ORs) and 95% confidence intervals (CIs) demonstrating the likelihood that an individual of a particular rank/race would advance in their academic career were determined. RESULTS Representation comparing medical students with full professors for black, Latine, and Asian otolaryngologists was below parity (REI: 0.27, 0.85, 0.85, respectively). Black (OR: 0.20, CI: 0.15, 0.26), Latine (OR: 0.61, CI: 0.50, 0.75), and Asian (OR: 0.62, CI: 0.55, 0.71) medical students all faced lower odds of becoming otolaryngology residents compared to their white counterparts. Similar findings occurred when comparing resident and assistant professor representation. American Indian/Alaskan Native (AIAN) and Native Hawaiian/Pacific Islander (NHPI) REIs and ORs could not be assessed as only 1 self-reported AIAN and no NHPI faculty are present in the studied data. CONCLUSION Underrepresented in Medicine and Asian physicians faced worsening representation at each rung of the academic otolaryngology ladder. The greatest losses occurred when medical students transitioned to residents and residents transitioned to assistant professors. AIAN and NH faculty were absent in otolaryngology, indicating vital targets for recruitment efforts.
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Affiliation(s)
- Sarah M. Russel
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina, USA
| | - Zainab Farzal
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Charles Ebert
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Robert Buckmire
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Christine DeMason
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rupali Shah
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Dennis O. Frank-Ito
- Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina, USA
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina, USA
- Computational Biology and Bioinformatics PhD Program, Duke University, Durham, North Carolina, USA
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Napoé GS, Parviainen KEL, Gosman GG, Olawaiye AB, Edwards RP. A Framework for Diversifying Obstetrics and Gynecology Training Programs. Obstet Gynecol 2024; 143:204-209. [PMID: 37989143 DOI: 10.1097/aog.0000000000005467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/21/2023] [Indexed: 11/23/2023]
Abstract
There is an urgent need to diversify the physician workforce in obstetrics and gynecology to serve a diverse patient population and mitigate disparities in care. There is a paucity of data on how to improve recruitment of individuals from underrepresented minoritized groups to the field of obstetrics and gynecology. This article outlines important steps for sharing the department's commitment to diversity, equity, and inclusion; addresses ways to attract a diverse applicant pool; and reviews the importance of and need to perform a holistic review of applicants. This commentary also shares some approaches to support faculty and trainees that may lead to sustained increases in diversity. Using this framework, the authors successfully increased the diversity of their obstetrics and gynecology residency program.
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Affiliation(s)
- Gnankang Sarah Napoé
- Department of Obstetrics, Gynecology and Reproductive Sciences, UPMC Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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