Background and Objectives: Recruitment of underrepresented minorities (URM) in medicine has risen to the forefront as a strategy to address health inequities, but the experiences of URM residents within their own programs are poorly understood. We describe the development and implementation of a diversity, equity, and inclusion (DEI) climate survey at our residency program, the results of which have informed our DEI efforts. Methods: A resident-faculty work group collaboratively developed an 81-item questionnaire, informed by other institutional climate surveys. We administered the survey annually from 2018 through 2021 to all residents and faculty at our large academic family medicine residency program. The anonymous survey covered six key areas: general climate, climate for specific group, personal experience with discrimination and harassment, recruitment, burnout, and curriculum. Results: Average response rates were 84% and 50% for residents and faculty, respectively. Survey results show low satisfaction with resident and faculty diversity; higher rates of burnout for respondents who self-identify as URM, persons of color (POC), and/or LGBTQ; and racial and gender differences in experiences of workplace discrimination and sexual harassment. Conclusions: Instituting an annual internal climate survey at our residency has provided invaluable information regarding the perspectives and experiences of our residents and faculty that has informed our DEI initiatives. We envision that our survey will inform continual improvement and serve as a model for similar introspection leading to meaningful action at other programs.

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Epidermoid cysts are very common and therefore relevant to Family Medicine physicians in the primary care setting. Epidermoid cysts can undergo transformation if they become infected or ruptured, resulting in keratin granulomas. Importantly, these may be misdiagnosed or confused with malignancy and should be differentiated histologically after excision if a presumed epidermal cyst has an atypical presentation. In this article we are reporting a case of temporal keratin granuloma as a result of an epidermoid cyst rupture in a middle-aged man.

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