An Analysis of Underrepresented in Medicine Away Rotation Scholarships in Surgical Specialties

Diversity Scholarships for Plastic Surgery Subinternships: A National Review of US Residency Programs

Background

Residency programs have developed monetary initiatives for students underrepresented in medicine (URiM). Our team sought to provide a centralized resource for URiM students seeking plastic surgery subinternships with funded opportunities.

Methods

A cross sectional analysis of URiM scholarships offered by US integrated plastic surgery programs (n = 91) between July and September 2023. The study used residency program web domains. Investigators collected information on the monetary value of scholarship, eligibility criteria, and required application documents. Inferential analyses were conducted to investigate whether programs' geographic region or Doximity ranking played a role in likelihood of scholarship existence.

Results

The study found that approximately 52.7% (n = 48) of programs have in place monetary support for underrepresented visiting medical students (eg, stipend or reimbursement). The average monetary support was $1670. A univariate test demonstrated that programs with lower rankings in both reputation and research were less likely to have a scholarship available than higher ranking programs (P = 0.002; P = 0.02, respectively). Programs located in the Midwest regions were 3.5 times more likely to have a diversity scholarship available (P = 0.034). In our multivariate analysis, reputation ranking and geographic region remained significant. A Pearson chi square test showed the greatest proportions of scholarships among geographically similar programs to be in the Midwest (70%), however, not statistically significant.

Conclusions

This study provides a centralized resource for URiM students interested in completing away rotations. Further investigation into development of these scholarship opportunities would be of much benefit and could guide other programs in the funding their own diversity scholarships.

Analyzing the Current State and Visibility of Diversity, Equity, and Inclusion Initiatives at Urology Residency Programs

OBJECTIVE

To analyze AUA urology residency program websites to determine visibility of diversity, equity, and inclusion (DEI) initiatives. There is growing interest in DEI initiatives by urology applicants, and in recent years, urology programs have invested in efforts to promote DEI.

METHODS

All ACGME-accredited urology residency program with a website were assessed. Military programs were excluded. A DEI Score Card was developed using published pillars of DEI, including five domains: departmental inclusion, pipeline growth, departmental education, community engagement, and faculty demographics. Program Doximity rank, address, and surrounding demographics were collected to determine predictors of investing in DEI.

RESULTS

One hundred forty-one urology residency websites were included for analysis. Only 40.7% of programs referenced DEI on their webpage, and 21.4% offered funded mentorship opportunities. Department education and community engagement were the least popular initiatives. The Western, Northeastern, and North Central sections had the highest DEI total score with wide variation across domains. Mention of DEI was not associated with program's county-level social vulnerability or percent minority but was associated with being a top 50 program (OR=4.0; 95% CI 1.8, 8.9; P = .0007).

CONCLUSION

Less than half of academic urology programs' websites referenced DEI initiatives. Using a DEI score card, our study shows that investment in DEI varies widely by AUA section, and greater investment is positively correlated with program rank. Our DEI score card serves as a tool that programs can use to assess their current DEI investment, identify areas for improvement, and ensure existing initiatives are visible to applicants.

Identification of Factors Associated with Orthopaedic Surgery Residency Programs That Preferentially Match Students Who Performed an Elective Rotation Before the Interview Process

Introduction

The role of elective rotations in the orthopaedic residency selection process varies between programs. Our study aims to identify factors associated with residency programs that interview and match a greater proportion of applicants who have completed an elective rotation with their program.

Methods

Data were collected through the American Orthopaedic Association's Orthopaedic Residency Information Network database. Bivariate correlations and multivariate regression models were used to identify independent predictors of programs with a greater proportion of interviewees or residents who completed an elective rotation at the respective program.

Results

One hundred seventy-eight of the 218 existing residency programs were included in this study. Programs that offered fewer interviews and more away rotation positions per year were associated with a greater odds of its interviewees (OR = 0.36, p = 0.01; OR = 4.55, p < 0.001, respectively) and residents (OR = 0.44, p = 0.04; OR = 4.23, p < 0.001, respectively) having completed an elective rotation with the program. In addition, programs with fewer attendings (OR = 0.39, p = 0.03) and in-person interviews (OR = 3.04, p = 0.04) matched a greater proportion of their rotators. However, programs that interviewed applicants during the elective rotation were less likely to match their rotators (OR = 0.35, p = 0.04).

Conclusion

Certain program characteristics independently predict the likelihood of a program interviewing and matching their rotators. These findings may provide information for applicants and programs regarding the rotation process.

Level of Evidence

III.

Exploring Underrepresentation: The Role of Diversity Statements in Ophthalmology Residency Programs

INTRODUCTION

The underrepresentation of underrepresented minorities (URMs) in the medical field, particularly in ophthalmology, poses a critical challenge to achieving diversity and equity. While URMs constitute 19% of medical school attendees, their presence is markedly lower in ophthalmology residency programs and among practicing ophthalmologists. This study seeks to investigate the prevalence of diversity statements on ophthalmology residency program websites and their role in the underrepresentation of URMs within the field.

METHODS

This observational, cross-sectional study analyzed the websites of 126 ophthalmology residency programs listed on the San Francisco (SF) Match website. Diversity statements were categorized based on their inclusion of specific underrepresented groups (race or ethnicity, gender, sexual orientation, and disability) and analyzed for correlation with program characteristics. Descriptive statistics and Chi-squared tests were utilized to assess the prevalence of diversity statements and their association with program size, ranking, geographical location, and institutional nature.

RESULTS

Of the 126 programs analyzed, 21 (16.7%) had diversity statements specific to the ophthalmology residency program, and 115 (91.3%) featured institutional-level diversity statements. Race or ethnicity was the most commonly addressed category in diversity statements (75.3%), followed by gender (65.9%), sexual orientation (61.1%), and disability (53.2%). Statistical analyses revealed no significant correlation between program size and the presence of diversity statements. However, higher-ranked programs were more likely to mention sexual orientation and disability. Significant differences were observed at the institutional level, with public institutions more likely to include specific diversity categories.

CONCLUSION

The study highlights a significant disparity in the presence and focus of diversity statements across ophthalmology residency programs. Despite a high prevalence of institutional-level diversity statements, program-specific initiatives are lacking, particularly in addressing disability inclusion. The findings suggest a need for a more comprehensive and targeted effort to address underrepresentation in ophthalmology.

Recent Trends in the Effect of Race and Gender on the Orthopedics Match

Introduction Orthopedics has a reputation for being competitive but not diverse. Leaders of the orthopedics community have been making efforts to increase the participation of women and minorities in the field by raising awareness and strengthening pipeline programs. We aim to explore the trends in the risk of not matching by comparing the proportions of women and underrepresented populations in the applicant pools versus proportions in residency programs. Simultaneously, we aim to evaluate if women or underrepresented population applicants exhibit a lower likelihood of applying to orthopedics compared to male and White applicants. Methods The study received an IRB exemption. The authors collected Accreditation Council for Graduate Medical Education (ACGME) data books for the years 2015-2016 to 2022-2023 to obtain demographic information on orthopedic residents in training during each of those academic years. The pool of corresponding applicants (for example: residents in training during the 2021-2022 academic year would consist of five classes, made up of applicants from 2016-2017 to 2020-2021) was then tabulated from Electronic Residency Applications Service (ERAS) statistics, which are publicly available on the Association of American Medical Colleges (AAMC) website. The race and gender composition of the applicant pool was compared to that of corresponding enrolled residents to calculate the relative risk (RR) of women not matching compared to men and underrepresented population applicants (Blacks, Hispanics, Asians, and Native Americans) compared to White applicants. ERAS data was subsequently used to calculate the percentages of each demographic applying to all residency programs and orthopedic programs. Results For female applicants into orthopedic residency, they had a similar RR of going unmatched when compared to their male counterparts. In the academic year 2020-2021, there was an exception to this as women had a slightly higher RR of going unmatched. All underrepresented populations had a higher risk of not matching compared to White applicants for all cycles, peaking for residents in training in 2020-2021. The trendline improved for residents in the following year. Throughout the study, women accounted for 46.61% of applicants applying for any residency; however, they only accounted for 16.98% of applicants applying for orthopedic residency. A similar discrepancy is noted among Asian applicants but not Black or Hispanic applicants. Conclusions Underrepresented populations were increasingly less likely to match into orthopedics relative to White applicants until 2021. In the academic year of 2021-2022, there was an improvement in this trend for all studied underrepresented populations. Although the exact explanation for this is unclear, it is associated with the transition to virtual applicant interactions. The female gender did not appear to be a consistent advantage or disadvantage in the match. Women and Asian applicants were less likely to apply to orthopedics than other specialties.

Improving Transparency in the Residency Application Process: Survey Study

BACKGROUND

Increasing numbers of residency applications create challenges for applicants and residency programs to assess if they are a good fit during the residency application and match process. Applicants face limited or conflicting information as they assess programs, leading to overapplying. A holistic review of residency applications is considered a gold standard for programs, but the current volumes and associated time constraints leave programs relying on numerical filters, which do not predict success in residency. Applicants could benefit from increased transparency in the residency application process.

OBJECTIVE

This study aims to determine the information applicants find most beneficial from residency programs when deciding where to apply, by type of medical school education background.

METHODS

Match 2023 applicants voluntarily completed an anonymous survey through the Twitter and Instagram social media platforms. We asked the respondents to select 3 top factors from a multiple-choice list of what information they would like from residency programs to help determine if the characteristics of their application align with program values. We examined differences in helpful factors selected by medical school backgrounds using ANOVA.

RESULTS

There were 4649 survey respondents. When responses were analyzed by United States-allopathic (US-MD), doctor of osteopathic medicine (DO), and international medical graduate (IMG) educational backgrounds, respondents chose different factors as most helpful: minimum United States Medical Licensing Examination (USMLE) or Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Step 2 scores (565/3042, 18.57% US-MD; 485/3042, 15.9% DO; and 1992/3042, 65.48% IMG; P<.001), resident hometown region (281/1132, 24.82% US-MD; 189/1132, 16.7% DO; and 662/1132, 58.48% IMG; P=.02), resident medical school region (476/2179, 22% US-MD; 250/2179, 11.5% DO; and 1453/2179, 66.7% IMG; P=.002), and percent of residents or attendings underrepresented in medicine (417/1815, 22.98% US-MD; 158/1815, 8.71% DO; and 1240/1815, 68.32% IMG; P<.001).

CONCLUSIONS

When applying to residency programs, this study found that the factors that respondents consider most helpful from programs in deciding where to apply differ by educational background. Across all educational groups, respondents want transparency around standardized exam scores, geography, and the racial or ethnic backgrounds of residents and attendings.

Understanding the Use of Program Resources During Virtual Recruitment by Psychiatry Residency Applicants

OBJECTIVE

This study aims to understand the residency resources used by psychiatry applicants who applied during the first two virtual recruitment seasons, match 2021 and 2022.

METHODS

Between January 27, 2022, and February 24, 2022, a non-probabilistic sample of psychiatry residents from the match 2018 through match 2022 cycles were asked to complete a survey via email and social media. Due to the continuation of virtual recruitment post-pandemic, an analysis of psychiatry residents in the match 2021 and 2022 cycles was conducted. Questions assessed the use of recruitment resources, including websites, the Fellowship and Residency Electronic and Interactive Database, virtual open houses, video tours, away rotations, and social media platforms. Descriptive statistics and chi-square analyses were used.

RESULTS

Psychiatry residents from the match 2021 and 2022 cycles completed the survey (n = 605), with 288 US allopathic medicine doctors (47.6%), 178 (29.4%) international medical graduates, and 139 (23.0%) osteopathic medicine doctors. More than half of respondents (n = 347, 57.4%) reported that the virtual interview season increased the number of programs they intended to apply to. Most respondents (n = 594, 88.3%) reported attending one or more psychiatry virtual open houses and 84.6% (n = 512) followed psychiatry residency programs on at least one social media platform. Program websites were reported to be the most influential digital platform for both applying and ranking.

CONCLUSION

Understanding the influence of recruitment resources is essential for residents and program leadership to optimize time and resources to assist applicants with their decision-making.