Evidence for Increasing Diversity in Graduate Medical Education: The Competence of Underrepresented Minority Residents Measured by an Intern Objective Structured Clinical Examination

Lypson, Monica L.; Ross, Paula T.; Hamstra, Stanley J.; Haftel, Hilary M.; Gruppen, Larry D.; Colletti, Lisa M.

doi:10.4300/jgme-d-10-00050.1

Cited by 20 publications

(9 citation statements)

References 19 publications

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“…12,16 Step one scores may predict future examination scores, but do not necessarily correlate with a resident's clinical performance. 12,16,17 In AY 2016-2017, we continued blinded interviews and evolved to a structured interview format with each interviewer asking standardized questions reflecting the program's mission and the characteristics valued in residents. While employment research has long supported structured interviews, medical education studies evaluating their use are limited and outcomes are mixed.…”

Section: Revising Interviewsmentioning

confidence: 99%

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

Wusu

Tepperberg

Weinberg

et al. 2019

Fam Med

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Background and Objectives: 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. Methods: 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. Results: 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<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]). Conclusions: 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.

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Section: Revising Interviewsmentioning

confidence: 99%

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

Wusu

Tepperberg

Weinberg

et al. 2019

Fam Med

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“…A second group of studies found evidence that the selection of URMs into medical specialties was affected by specific biases in pre-selection measures, typically because low URM pre-selection scores were not consistent with equivalent in-training performance. The evidence included gender biases affecting letters of recommendation [ 41 , 43 , 47 , 50 , 59 ], sociolinguistic biases affecting selection interviews for IMGs [ 28 , 30 , 54 ], and bias against candidates sitting the USMLE 1 including women [ 15 , 39 ] and IMGs [ 51 ]. This research focused on the need to measure and correct for biases, or to develop more valid alternative measures, which is also both reasonable and preliminary.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of specialist selection methods with implications for diversity in the medical workforce

et al. 2021

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Purpose There is growing concern that inequities in methods of selection into medical specialties reduce specialist cohort diversity, particularly where measures designed for another purpose are adapted for specialist selection, prioritising reliability over validity. This review examined how empirical measures affect the diversity of specialist selection. The goals were to summarise the groups for which evidence is available, evaluate evidence that measures prioritising reliability over validity contribute to under-representation, and identify novel measures or processes that address under-representation, in order to make recommendations on selection into medical specialties and research required to support diversity. Method In 2020–1, the authors implemented a comprehensive search strategy across 4 electronic databases (Medline, PsychINFO, Scopus, ERIC) covering years 2000–2020, supplemented with hand-search of key journals and reference lists from identified studies. Articles were screened using explicit inclusion and exclusion criteria designed to focus on empirical measures used in medical specialty selection decisions. Results Thirty-five articles were included from 1344 retrieved from databases and hand-searches. In order of prevalence these papers addressed the under-representation of women (21/35), international medical graduates (10/35), and race/ethnicity (9/35). Apart from well-powered studies of selection into general practice training in the UK, the literature was exploratory, retrospective, and relied upon convenience samples with limited follow-up. There was preliminary evidence that bias in the measures used for selection into training might contribute to under-representation of some groups. Conclusions The review did not find convincing evidence that measures prioritising reliability drive under-representation of some groups in medical specialties, although this may be due to limited power analyses. In addition, the review did not identify novel specialist selection methods likely to improve diversity. Nevertheless, significant and divergent efforts are being made to promote the evolution of selection processes that draw on all the diverse qualities required for specialist practice serving diverse populations. More rigorous prospective research across different national frameworks will be needed to clarify whether eliminating or reducing the weighting of reliable pre-selection academic results in selection decisions will increase or decrease diversity, and whether drawing on a broader range of assessments can achieve both reliable and socially desirable outcomes.

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“…21 In a study looking at incoming internal medicine residents at the University of Michigan from 2002 to 2006, it was found that the URM residents scored significantly lower than non-URM residents for all years; however, they performed the same as non-URM residents in initial clinical skills assessments. 22 Recognizing the competitiveness of otolaryngology, it is plausible that medical students, notably interested AAaAD students, may not be considered for an interview for residency based on examination outcomes.…”

Section: Discussionmentioning

confidence: 99%

African American Otolaryngologists: Current Trends and Factors Influencing Career Choice

et al. 2019

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Objectives 1) Identify factors that influence African American physicians to choose a career in otolaryngology; 2) determine the predominant practice setting for African American otolaryngologists who can be role models; and 3) determine if the presence of an African American otolaryngologist in academic setting influences career choice. Methods Survey methodology included a 15‐item survey to determine trends in practice and factors that influenced choice of specialty. Results The results were reviewed for trends influencing career choice and practice location and stratified by age group. Most African American otolaryngologists are in academic practice and have subspecialty fellowship training. Enjoying medical student clerkship was the most frequently cited reason why African Americans chose otolaryngology as a career regardless of age. Early exposure was a driving factor in those 30 to 40 years old. Receiving mentorship was less influential in career choice for all age groups, but there was a positive association between those who were mentored in training and those who mentor faculty. Conclusion The findings suggest the continued need for initiatives to increase African Americans in our specialty. Encouraging early exposure, intentional mentoring of students, and development of African American role models who can be mentors may help increase the number of African American otolaryngologist faculty. This can help our specialty achieve racial parity in a percentage that matches the number of African Americans in the United States workforce. Level of Evidence 5 Laryngoscope, 130:2336–2342, 2020

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Evidence for Increasing Diversity in Graduate Medical Education: The Competence of Underrepresented Minority Residents Measured by an Intern Objective Structured Clinical Examination

Cited by 20 publications

References 19 publications

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

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

Systematic review of specialist selection methods with implications for diversity in the medical workforce

African American Otolaryngologists: Current Trends and Factors Influencing Career Choice

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