Underrepresented Minority Physicians Research Articles

Association Between Stress and Program Length in Underrepresented Minority Physician Assistant Students.

The purpose of this study was to determine if there was a relationship between physician assistant (PA) program length and stress measures in PA students, particularly PA students classified as underrepresented minorities in medicine. The stress measures included emotional and physical well-being. The 2019 End of Program survey data were analyzed using multiple regression to determine if emotional and physical well-being could be predicted by PA program length, age, gender, PA school debt, and UR minority in medicine status. Shorter PA programs were associated with higher physical well-being scores, although there was no difference between UR minority in medicine and non-UR minority in medicine students. Older students, males, and students with higher levels of PA school debt had lower scores for emotional and physical well-being. Shorter program lengths should be considered for optimal physical well-being in all students. Further research is needed to understand optimal program length and experiences of these students .

Bridging the Racial, Ethnic, and Gender Gap in Gastroenterology

Bridging the Racial, Ethnic, and Gender Gap in Gastroenterology

Diversity, Equity, Inclusion, and Belonging in Cardiovascular Disease Fellowship Training.

Diversity in the healthcare workforce enhances access to care, reduces health disparities, and improves quality of care for underserved populations. Yet there is a paucity of women and underrepresented minority physicians in cardiology training programs, and progress toward achieving a diverse cardiology workforce has been slow. Here we review the merits of diversity in health care, the current landscape of the cardiology workforce, barriers to increasing the proportion of women and underrepresented minority cardiologists, and specific strategies that have been proposed to sustain and enhance diversity in cardiology training programs.

Enhancing Residency Recruitment Processes to Facilitate a Diverse Work Force in Anesthesiology

Committee News| May 2022 Enhancing Residency Recruitment Processes to Facilitate a Diverse Work Force in Anesthesiology Sujatha Ramachandran, MBBS, MACM; Sujatha Ramachandran, MBBS, MACM Search for other works by this author on: This Site PubMed Google Scholar Camille Fontaine, MD; Camille Fontaine, MD Search for other works by this author on: This Site PubMed Google Scholar Tracey Straker, MD, MS, MPH, CBA, FASA Tracey Straker, MD, MS, MPH, CBA, FASA Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor May 2022, Vol. 86, 36–37. https://doi.org/10.1097/01.ASM.0000830860.56287.f1 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Cite Icon Cite Get Permissions Search Site Citation Sujatha Ramachandran, Camille Fontaine, Tracey Straker; Enhancing Residency Recruitment Processes to Facilitate a Diverse Work Force in Anesthesiology. ASA Monitor 2022; 86:36–37 doi: https://doi.org/10.1097/01.ASM.0000830860.56287.f1 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: internship and residency, mentors, workforce Building a diverse workforce of physician anesthesiologists should be paramount for hospitals and health care systems. More inclusive preoperative staff would better reflect current demographics nationwide, help address health care disparities, encourage minority patient participation in decision-making, improve patient outcomes and satisfaction, and foster greater innovation in medicine (JAMA Intern Med 2014;174:289-91; Proc Natl Acad Sci U S A 2020;117:9284-91). Despite these indisputable advantages of physician workforce diversity, the percentage of people identifying as belonging to racial/ethnic minority groups in medicine has continued to remain below that of the general U.S. population (JAMA Netw Open 2019;2:e1910490; N Engl J Med 2019;380:803-5). In anesthesiology, the percentage of under-represented minority (URM) physicians is around 11%. Medical schools are documenting upward trends in Black and brown female graduates (asamonitor.pub/3tLSg8M; JAMA Intern Med 2015;175:1706-8). As per the Association of American Medical Colleges (AAMC), between 1986... You do not currently have access to this content.

Microaggressions in Medicine.

Microaggressions are behaviors that stem from implicit bias and occur at an interpersonal level. In medicine, microaggressions may be encountered both in training and clinical practice. Although often unintentional or unconscious by the offender, microaggressions are harmful to the health and safety of women and underrepresented minority (URM) medical students, residents, physicians, other providers, and patients. This article aims to define microaggressions, present example scenarios, and provide discourse regarding microaggressions within the framework of medicine.

Ophthalmology Departments Remain Among the Least Diverse Clinical Departments at United States Medical Schools

The current demographics of the ophthalmology workforce do not reflect the diverse United States population, which has implications for addressing health disparities. The demographics of ophthalmology department faculty may influence the recruitment of underrepresented students into the field. This study sought to determine how the racial and ethnic demographics of ophthalmology department faculty compare with those of other clinical departments at United States medical schools. Secondary data analysis of medical school faculty demographic data from the 2019 American Association of Medical Colleges (AAMC) Faculty Roster. Clinical faculty and department chairs at United States medical schools. We analyzed the racial and ethnic demographics of clinical department faculty and department chairpersons using data from the 2019 AAMC Faculty Roster. We calculated the proportion of underrepresented minority (URM) faculty in ophthalmology and in 17 other clinical departments. We analyzed these data for statistically significant differences between ophthalmology and other clinical departments. In addition, we compared the percentage of URM ophthalmology faculty with the proportion of URM persons among graduating United States medical students and in the United States population using data from the Medical School Graduation Questionnaire and the United States census, respectively. The proportion of URM persons, defined as Black, Hispanic or Latino, Native American, or Native Hawaiian or Pacific Islander among clinical faculty and department chairs. Ophthalmology faculty are less racially and ethnically diverse than graduating medical students and the general United States population. When compared with 17 other clinical departments, ophthalmology has the third-lowest proportion of URM faculty, with only radiology and orthopedic surgery having a smaller proportion of URM faculty. These differences were statistically significant in most departments (12 of 18). No statistically significant difference was found in the proportion of URM department chairs in ophthalmology compared with most other clinical departments, although the absolute number of URM chairs in ophthalmology is low at only 8 chairpersons. More work must be done to increase the recruitment of URM physicians into ophthalmology faculty positions to obtain parity with other clinical departments and with the diverse patient populations that physicians serve.

Diversity pipelines: The rationale to recruit and support minority physicians.

Emergency physicians care for patients from all backgrounds with respect and expertise. We aspire to treat everyone equitably and make decisions at the bedside that are not based on age, race, socioeconomic status, gender, sexual orientation, religion, language, or any other category. In many settings, there is a stark contrast between the diversity of our patient populations and that of the physicians caring for them. Despite our intention to minimize the effects of implicit and explicit bias, when the physician workforce does not reflect the patient population, there may be significant assumptions, mistrust, and misunderstandings between people from different backgrounds.As medical professionals, increasing the diversity of our workforce and support for programs and policies that increase underrepresented minority (URM) physicians in emergency medicine is important. Increasing URM physicians will not only improve the quality of care for our patients, but also the quality of education and training in our profession. It is crucial that we prioritize pipeline programs that recruit and support URM physicians. This article describes the rationale to increase diversity within the profession of emergency medicine and the essential mechanisms to achieve this goal. In the same way that we hold individuals accountable to a clinical standard of care, we should hold our institutions to an organizational standard of diversity.

Mentoring Black Men in Medicine.

In recent years, there have been multiple publications about the dearth of Black men in medicine. Appreciating the fact that underrepresented minority physicians disproportionately care for America's underserved communities, the lack of diversity in health care is particularly disturbing. Of imminent concern is the critical shortage of Black men doctors. In this Perspective, the authors contend that while mentoring is often considered among the most important strategies to increase the number of Black men in medicine, unique challenges in this demographic can diminish its effectiveness. Among these challenges are below average primary school educational experiences and a general mistrust of society on the part of Black men, as well as difficulties overcoming stereotypes and social biases that others hold against them. Furthermore, acknowledging that mentorship is paramount in achieving success in the medical field, the authors provide a framework to assist mentors in recognizing and addressing situations and obstacles that may disrupt the mentoring relationship and hinder its potential to best serve Black men pursuing advancement in medicine. This framework is represented by the acronym RACE: Reluctance to discuss race, Access to mentors, Cultural mistrust and racial concordance, and Empathy.

Factors associated with underrepresented minority physician scientist trainee career choices

BackgroundRecently, there have been concerted efforts to improve racial and ethnic diversity in the physician-scientist workforce. Identifying factors associated with career choices among those underrepresented in medicine and science is a necessary first step to advance this objective. The aim of the present study was to assess the attitudes and factors associated with academic and research career interests among underrepresented predoctoral physician-scientists.MethodsA cross-sectional 70-question survey was distributed to all predoctoral single degree (MD or DO) and dual degree (MD/PhD or DO/PhD) trainees at 32 medical schools in the United States from 2012 to 2014. Main outcomes included factors important to advancement in academic medicine, intended medical specialty, and future career plans. To test the post-hoc hypothesis of whether trainees from underrepresented groups have differing perceptions of career trajectories and obstacles than their counterparts, we evaluated responses according to self-identified race/ethnic status using Chi-square and Fisher’s exact tests. All tests were two-sided and significance level of < 0.05 was used.ResultsThere were a total of 4433 responses representing all predoctoral training stages. The response rate was 27%. Most respondents were single degree trainees (MD/DO 79% vs MD/DO-PhD 21%). Most respondents self-identified as White (67%), followed by Multi-racial or Other (14.3%), Asian or Pacific Islander (10.4%), Hispanic (6%), and Black or African American (4.1%). Desired career sector, career intention, and clinical specialty interest differed across race/ethnic groups. With respect to career selection factors, anticipated non-work related responsibilities during residency were also significantly different between these groups. By multivariable regression analysis, Black or African American trainees were significantly less likely than White trainees to indicate a career in academia (OR 0.496, 95% CI 0.322–0.764) and basic research (OR 0.314, 95% CI 0.115–0.857), while Multi-racial or Other trainees were also less likely than White trainees to indicate a career in academia (OR 0.763, 95% CI 0.594–0.980).ConclusionsThese data represent the first in-depth survey of career aspirations, perceptions, and interests between demographically underrepresented and non-underrepresented predoctoral physician-scientist trainees. Our results identify key differences between these cohorts, which may guide efforts to improve diversity within the physician-scientist workforce.

What Will It Take to Recruit and Train More Underrepresented Minority Physicians in Family Medicine? A CERA Survey Analysis.

Both the Society of Teachers of Family Medicine (STFM) and the American Academy of Family Physicians have developed strategic plans to increase the training of underrepresented minority in medicine (URMM) family physicians to meet the needs of an increasingly diverse patient population in the United States. This study examines data from the 2017 Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA) Program Directors (PD12) Survey to assess whether recruitment strategies increase the diversity of underrepresented minority physicians in family medicine. Data were collected from an online electronic survey administered by the CERA of family medicine program directors in 2018. The data included specific questions about the diversity of URMM residents in family medicine programs and about initiatives that were used in their recruitment. We analyzed the data using the Pearson χ2 criteria for cause and effect of two variables. Family medicine residency programs that have initiatives dedicated to increasing resident diversity have a higher percentage of URMM residents. Specifically, residency programs that have URMM recruitment strategies are 2.5 to 4 times more likely to have a diverse residency population than those programs without strategies (P&lt;.001-.015). Striving to improve diversity in family medicine residency training in accordance with the ideals of STFM will require programs to design and implement initiatives to increase recruitment of URM residents.

The Creation of the Minority Housestaff Organization: a Liberated Space for Underrepresented Minority Physicians to Thrive in Medicine.

The Creation of the Minority Housestaff Organization: a Liberated Space for Underrepresented Minority Physicians to Thrive in Medicine.

Pathways for Recruiting and Retaining Women and Underrepresented Minority Clinicians and Physician Scientists Into the Radiation Oncology Workforce: A Summary of the 2019 ASTRO/NCI Diversity Symposium Session at the ASTRO Annual Meeting

Diversifying the radiation oncology workforce is an urgent and unmet need. During the American Society of Radiation Oncology (ASTRO) 2019 Annual Meeting, ASTRO's Committee on Health Equity, Diversity, and Inclusion (CHEDI) and the National Cancer Institute (NCI) collaborated on the ASTRO-NCI Diversity Symposium, entitled "Pathways for Recruiting and Retaining Women and Underrepresented Minority Clinicians and Physician Scientists Into the Radiation Oncology Workforce." Herein, we summarize the presented data and personal anecdotes with the goal of raising awareness of ongoing and future initiatives to improve recruitment and retention of underrepesented groups to radiation oncology. Common themes include the pivotal role of mentorship and standardized institutional practices – such as protected time and pay parity – as critical to achieving a more diverse and inclusive workplace.

Representation Trends of Underrepresented Minority Physicians in the US Radiation Oncology (RO) Workforce

Representation Trends of Underrepresented Minority Physicians in the US Radiation Oncology (RO) Workforce

Eliminating Institutional Barriers to Career Advancement for Diverse Faculty in Academic Surgery.

: There is critical need to address achievement barriers in Academic Medicine. Although opportunities for professional development of women and underrepresented minority physician scientists are growing, academic promotion rates remain historically low. Moreover, underrepresented groups are not likely to advance to decanal and leadership positions. To eliminate institutional barriers to achievement for diverse faculty, strategies to strengthen environment, recruitment, professional development, and leadership were implemented. This multifaceted approach is adaptable to Academic Surgery universally and we wish to share early progress.

Underrepresented Minority Physician Assistant Faculty Mentorship: It Takes a Village.

Underrepresented Minority Physician Assistant Faculty Mentorship: It Takes a Village.

The effect of racial and gender concordance between physicians and patients on the assessment of hospitalist performance: a pilot study

BackgroundLack of racial concordance between physicians and patients has been linked to health disparities and inequities. Studies show that patients prefer physicians who look like them; however, there are too few underrepresented minority physicians in the workforce. Hospitalists are Internal Medicine physicians who specialize in inpatient medicine. At our hospital, hospitalists care for 60% of hospitalized medical patients. We utilized the validated Tool to Assess Inpatient Satisfaction with Care from Hospitalists (TAISCH) to assess the effect of patient-provider race and gender concordance on patients’ assessment of their physician’s performance.MethodsFour hundred thirty-seven inpatients admitted to the non-teaching hospitalist service, cared for by a unique hospitalist physician for two or more consecutive days, were surveyed using the validated TAISCH instrument. The influence of gender and racial concordance on TAISCH scores for patient - hospitalist pairs were assessed by comparing the specific dyads with the overall mean scores. T-tests were used to compare the means. Generalized estimating equations were used to account for clustering.ResultsOf the 34 hospitalist physicians in the analysis, 20% were African American (AA-non-Hispanic), 15% were Caucasians (non-Hispanic) and 65% were in the “other” category. The “other” category consisted of predominantly physicians of South East Asian decent (i.e. Indian subcontinent) and Hispanic. Of the 437 patients, 66% were Caucasians, and 32% were AA. The overall mean TAISCH score, as these 437 patients assessed their hospitalist provider was 3.8 (se = 0.60). The highest mean TAISCH score was for the Caucasian provider-AA patient dyads at 4.2 (se = 0.21, p = 0.05 compared to overall mean). The lowest mean TAISCH score was 3.5 (se = 0.14) seen in the AA provider/AA patient dyads, significantly lower than the overall mean (p = 0.013). There were no statistically significant differences noted between mean TAISCH scores of gender and racially concordant versus discordant doctor-patient dyads (all p’s > 0.05).ConclusionsIn the inpatient setting, it appears as if neither race nor gender concordance with the provider affects a patient’s assessment of a hospitalist’s performance.

The Diversity Snowball Effect: The Quest to Increase Diversity in Emergency Medicine: A Case Study of Highland's Emergency Medicine Residency Program

Blacks, Hispanics/Latinos, American Indians, Pacific Islanders, Alaska Natives, and Native Hawaiians make up 33% of the US population. These same groups are underrepresented in medicine. In 2013, the physician workforce was 4.1% black, 4.4% Hispanic/Latino, 0.4% American Indian or Alaska Native, 11.7% Asian, and 48.9% white. Only 9.9% of emergency physicians identify as underrepresented minority (4.5% black, 4.8% Hispanic/Latino, and 0.6% American Indian/Alaska Native). Efforts to increase the number of underrepresented minority physicians are important because previous studies show improved outcomes when the patient and physician share the same racial/ethnic background. Starting in 2006, the faculty at the Highland EM Residency Program in Oakland, CA, began a diversification initiative to increase the number of underrepresented minority residents. The goal was to closely mirror the US population and match 30% underrepresented minorities with each incoming class. After the initiative, there was a 2-fold increase in the number of underrepresented minority residents (from 12% to 27%). This article is a review of the strategies used to diversify the Highland EM Residency Program. Most components can be applied across emergency medicine programs to increase the number of underrepresented minority residents and potentially improve health outcomes for diverse populations.

Matching Our Mission: A Strategic Plan to Create a Diverse Family Medicine Residency.

Increasing the number of underrepresented minority (URM) physicians improves access and quality of care. URMs are more likely to practice primary care and work in underserved communities. The racial and ethnic diversity of family physicians lags behind the general population. To create a more diverse residency, the Boston Medical Center Family Medicine Residency Program (BMCFMRP) developed, implemented, and evaluated a strategic plan for diversity recruitment. In academic year (AY) 2014-2015, we set goals to increase the number of URM applicants and the percentage of matched URMs. From 2014-2017, we implemented an intervention focused on: (1) increasing outreach to URM candidates, (2) revising interviews to minimize bias, and (3) analyzing recruitment data. From 2014-2017, the total number of URM applicants increased by 80% (61 to 110). Evaluating recruitment trends from 2010-2017, there was a statistically significant increase (P&lt;0.001) in the percentage of URM applicants from 13.3% (29 of 218 total applicants) to 19.9% (110 of 402). There was also a significant increase (P=0.029) in the percentage of matched URMs. Before the intervention, the percentage ranged from 0% to 20% (2011: 0% [n=0/6], 2014: 0% [n=0/10], 2013: 20% [n=2/10]). During the intervention, the percentage ranged from 25% to 50% (2017: 25% [n=3/12], 2016: 50% [n=6/12]). The implementation of a strategic plan for diversity recruitment increased the number of URM applicants and the percentage of URMs matching into the BMCFMRP. Additional research is needed to determine if these strategies produce similar results in residency programs at other institutions and in other medical specialties.

Abstract 5286: Meharry Medical College medical student summer program in integrative science and cancer research

Abstract The American Cancer Society estimates that 1,688,780 new cases of cancer will be diagnosed in 2017 and that 600,920 people will die from their disease. The burden of cancer is disproportionately borne by the poor and underserved. Underrepresented minority physician scientists and clinician researchers are uniquely qualified to address these disparities as they have frequently experienced them in their own families and communities. As some portion of health disparities is rooted in socioeconomic status and lesser education, economically deprived and first generation college students of all races and ethnicities also experience these disparities. Unfortunately, the number of physicians who do research has been declining so the need for programs that educate students in the art and science of research is increasing. The Meharry Medical College Summer Program in Integrative Science and Cancer Research (MMC-SPiISCR) has provided Meharry medical students with the opportunity to participate in short-term cancer research experiences for eleven years. The program is unique in combining weekly half-day workshops at MMC, an historically black college or university, with a research experience supported by faculty mentors at the Vanderbilt University School of Medicine (VUSM),an institution that includes the Vanderbilt Ingram Cancer Center, one of only 69 NCI-Designated Cancer Centers in the United States and District of Columbia. The workshops include topics emphasizing bioethics and responsible conduct of research as well as presentations by Meharry faculty on their cancer research, cancer disparities, cancer and big data and more. The overarching goal of this program is to inspire Meharry medical students to aspire to medical careers in academic medicine and/or careers that will ultimately include cancer research. To date, 73 MMC students have started and completed the program and 94% are from underrepresented minority groups. The male to female ratio reflects the male to female ratio of the class. Over half of the participants presented their work at meetings outside of the program including AACR National Meeting, AACR Science of Cancer Disparities, Society of Black Academic Surgeons, Student National Medical Association, American Medical Association Research Symposium, American Society for Clinical Oncology, KBRIN Bioinformatics Summit and the Meharry-Vanderbilt-TSU Cancer Partnership Annual Retreat. The students are authors on 27 manuscripts and these numbers are still growing as is the interest of program participants in doing a year of research. Surveys of both mentors and program participant mentees overwhelmingly support the strength of this program and participation in the future. This comprehensive program will go far towards fueling the physician-scientist pipeline with researchers whose life experiences mirror those of minority and underserved patients. Citation Format: Dana R. Marshall, Carol Freund-Taylor, Philip Lammers, Leon Dent, Samuel Adunyah, Billy Ballard. Meharry Medical College medical student summer program in integrative science and cancer research [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5286.

Rationales for expanding minority physician representation in the workforce: a scoping review.

The purpose of this study was to conduct a scoping review of the literature and to categorically map a 15-year trajectory of US undergraduate medical education rationales for and approaches to expanding under-represented minority (URM) physician representation in the medical workforce. Further aims were to comparatively examine related justifications and to consider international implications. From 1 June to 31 July 2015, the authors searched the Cochrane Library, ERIC, PsycINFO, PubMed, Scopus, Web of Science and Google Scholar for articles published between 2000 and 2015 reporting rationales for and approaches to increasing the numbers of members of URMs in undergraduate medical school. A total of 137 articles were included in the scoping review. Of these, 114 (83%) mentioned workforce diversity and 73 (53%) mentioned concordance. The patient-physician relationship (n = 52, 38%) and service commitment (n = 52, 38%) were the most commonly cited rationales. The most frequently mentioned approaches to increasing minority representation were pipeline programmes (n = 59, 43%), changes in affirmative action laws (n = 32, 23%) and changes in admission policies (n = 29, 21%). This scoping review of the 2000-2015 literature on strategies for and approaches to expanding URM representation in medicine reveals a repetitive, amplifying message of URM physician service commitment to vulnerable populations in medically underserved communities. Such message repetition reinforces policies and practices that might limit the full scope of URM practice, research and leadership opportunities in medicine. Cross-nationally, service commitment and patient-physician concordance benefits admittedly respond to recognised societal need, yet there is an associated risk for instrumentally singling out members of URMs to fulfil that need. The proceedings of a 2001 US Institute of Medicine symposium warned against creating a deterministic expectation that URM physicians provide care to minority populations. Our findings suggest that the expanding emphasis on URM service commitment and patient-physician concordance benefits warrants ongoing scrutiny and, more broadly, represent a cautionary tale of unintended consequences for medical educators globally.