Antiracism in Residency: A Multimethod Intervention to Increase Racial Diversity in a Community-Based Residency Program

Abstract

Background and Objectives: In order to address racial health inequity, it is imperative to create diverse physician workforce and leadership. We describe and report on the outcomes of a comprehensive diversity initiative at our residency with the goal of increasing the racial diversity of residents and faculty. Methods: At a community-based family medicine residency program, we instituted a multifaceted diversity initiative. The four components were mission statement revision, a diversity task force, an antiracism curriculum, and an ongoing system to evaluate progress. Results: From 2014 to 2017, the proportion of persons of color among the residents increased from 28% (10/36) to 68% (27/40). Faculty diversity increased from 9% to 27% over the same period. Conclusions: This multimethod diversity initiative dramatically increased the proportion of underrepresented and other minorities in the residency program. The intervention succeeded due to the commitment of leadership and resources to addressing racism and making diversity a top priority on an institutional level.

Racism Is Real. Racism Is Complicated. Racism Is Real Complicated.

“…Workshop participants gained knowledge, confidence, and skills in allyship. 10 As both Jessicah Guh, MD, and Maria Harsha Wusu, MD, demonstrate in their separate articles, intentional actions can result in increased presence of URM as family medicine residents and faculty. 10,11 Both employed a distinct multifaceted approach that should be viewed as a singular intervention.…”

“…10 As both Jessicah Guh, MD, and Maria Harsha Wusu, MD, demonstrate in their separate articles, intentional actions can result in increased presence of URM as family medicine residents and faculty. 10,11 Both employed a distinct multifaceted approach that should be viewed as a singular intervention. Whether by revising recruiting approach and increasing standardization of the interview process to decrease unintended bias, 11 revising a mission statement, getting outside review of the recruitment process, adding education on the impact of race on health, or moving from process-oriented to goal-oriented ranking, 10 both included some form of evaluation and tracking of their efforts as part of their respective intervention.…”

“…The relatively small number of URM in medicine resulted in some of the studies necessarily combining various people types. 7,10 For analysis, Hobbs et al divided their groups into white and nonwhite, which included black, Hispanic, Asian, and other. 7 Guh et al used the typical term "URM" then added "persons of color" (POC [all not non-Hispanic White]) and FAMILY MEDICINE COMMENTARIES modified URM (POC minus Chinese, Korean, and Indian) to describe and execute various aspects of the study.…”

“…7 Guh et al used the typical term "URM" then added "persons of color" (POC [all not non-Hispanic White]) and FAMILY MEDICINE COMMENTARIES modified URM (POC minus Chinese, Korean, and Indian) to describe and execute various aspects of the study. 10 The need to lump to generate collective impact is a reminder of the underrepresentation; overaggregation can run the risk of creating a false narrative of "them" versus "us." However, breaking down data among smaller subpopulations can help identify inequities that may be masked by combining subpopulations.…”

The Time Is Now

“…13 Fortunately, there is cause for optimism. Two articles 14,15 in this issue demonstrate the benefit of simple, intentional efforts to increase diversity at two residency programs. These efforts are a call to all of us to look carefully at our residency recruitment and selection procedures.…”