A Visiting Rotation for Underrepresented in Medicine Pediatric Residents Is Valuable for Recruitment Into Pediatric Fellowships

Abstract

To truly build an equitable health care system, we need a diverse physician workforce that reflects the demographics of the general population. Diversity improves clinical care outcomes, improves patient satisfaction, and is associated with improved treatment adherence when patients are treated by race-concordant physicians. Additionally, Black, Indigenous, and Hispanic/Latinx physicians are more likely to focus their care efforts on the most vulnerable patient populations in the United States.1 A sense of urgency has developed as recent trends show a decreasing proportion of underrepresented in medicine (UIM) pediatric subspecialty fellows.2,3 The drivers causing this workforce issue have not been fully identified, with limited exposure to subspecialty experiences as a potential contributor. Increasing the numbers of UIM physicians requires deliberate action by academic institutions to recruit and support UIM applicants across various medical subspecialties.The Promoting Resident Experiences in the Subspecialties at Stanford (PRESS) program is a 4-week funded and mentored pediatric subspecialty rotation for UIM residents who will be applying for subspecialty fellowship in the next year. PRESS was created with the following goals: (1) to increase recruitment of UIM trainees into pediatric subspecialty fellowships and academic medicine; (2) to improve inclusion, belonging, and career development of the next generation of UIM subspecialists through coaching and mentoring; and (3) to enhance our learning community by increasing the diversity among our trainees and institution, both during the rotation and afterward. Visiting residents self-select a subspecialty experience, are assigned a faculty mentor and a fellow mentor within the division, and are invited to events within the division, the department, and the larger graduate medical education community. They receive individualized mentorship and coaching on creating a CV and personal statement as well as strategies to increase success in the fellowship application process. Each resident receives funding to cover travel and living expenses during the rotation.Our inaugural cohort consisted of 5 residents. Our residents identified as African American/Black, Hispanic/Latinx, Asian, and North African, and hailed from 4 different states. Our second cohort will include 7 residents (37% acceptance rate), identifying as African American/Black, Hispanic/Latinx, and Southeast Asian, coming from 4 different states.A survey of the first cohort determined that all residents (100%) found the program to be valuable, offering a unique experience and a network of colleagues in and out of their chosen subspecialty. All residents stated that participation in the PRESS program encouraged them to apply to our institution when they would not have otherwise. All residents found the mentorship and individualized coaching helpful. One resident remarked: “It was an absolutely invaluable experience and nothing I probably would have gotten to experience on my own. The support and mentorship was great and I loved the desire for change. I would love for other UIM to experience medicine at an elite center…and I've already recommended that several people I know apply for next year.”Program leadership and residents cited the program as an effective recruiting tool, and leaders felt the PRESS program allowed them to consider applicants that they might not have otherwise. As one fellowship leader highlighted, there is the benefit of “participating in developing opportunities for exposure/recruitment of UIM trainees, [and the] ability to gain new perspectives.” Excitedly, one resident from our inaugural cohort matched into the pediatric cardiology fellowship at our institution. All other residents matched into their desired specialties.The PRESS program represents a feasible and effective program to expose and recruit UIM trainees into programs they would not have otherwise considered and to help them develop a sense of belonging in their subspecialty. It may also help fellowship programs and institutions expand their recruitment base, encouraging a more diverse applicant pool.