Increasing URiM Family Medicine Residents at University of Utah Health

Abstract

Introduction: The Department of Family and Preventive Medicine is home for the University of Utah’s Family Medicine Residency program. Although Utah’s diversity is steadily increasing, the race/ethnic diversity of the program’s family medicine residency does not reflect the state’s general population. Methods: From 2017 to 2021, the residency instituted several adjustments to recruitment processes, including modification of an existing screening system to better highlight resiliency in overcoming challenging life experiences; promotion of commitment to diversity during interview days; incorporation of increased participation from diverse faculty and residents on interview days; and addition of outreach from the Office of Health, Equity, Diversity, and Inclusion. Underrepresented in medicine (URiM) applicants were the first to be offered interviews in an identical screening score cohort, and were ranked highest in rank lists in cohorts with identical final rank scores. Results: Over the past five match cycles, Latinx residents have increased from zero to six, and underrepresented Asian residents from zero to two. In the 2021 match cycle, five of 10 incoming residents (50%) are URiM. Overall, URiM residents are now 30%, and residents of color 36%, of a total of 30 residents across all 3 training years. We found that eight URiM interviews were needed for every one URiM match. Conclusion: Intentional resident recruitment initiatives can transform racial/ethnic diversity in a family medicine residency program in a short amount of time.

Interventions Associated With Racial and Ethnic Diversity in US Graduate Medical Education

“…After removal of duplicate articles and abstract screening, 73 full-text articles were reviewed, of which 27 articles published between November 2012 and October 2021 met inclusion in this review. Nineteen studies described data in medical specialties 9,[20][21][22][23]27,28,[30][31][32][33][35][36][37][38][39]41,43,44 and 9 in surgical specialties. 21,[24][25][26]29,34,40,42,45 Two studies focused on fellowship programs.…”

“…21,[24][25][26]29,34,40,42,45 Two studies focused on fellowship programs. 22,43 Six of the 27 studies were in emergency medicine, 23,27,30,35,38,39 while family medicine 31,33,44 and pediatrics 9,37,41 had 3 articles each.…”

“…Thirteen programs (48%) deemphasized the US Medical Licensing Examination (USMLE) Step 1 scores when reviewing applications. 23,[28][29][30]33,34,36,[38][39][40][41][42]44 Specifically, some programs removed…”

“…28,30,32 Thirteen studies (48%) used holistic review, evaluating candidates within the context of their lived experiences and emphasizing their competencies beyond standardized examinations. 23,[28][29][30]33,34,36,[38][39][40][41][42]44 Two initiatives used situational awareness tests, placing greater emphasis on applicants' contributions in their extracurricular activities. 23,34 Additionally, 2 programs ensured that applications were independently reviewed by several people or by a URiM recruitment committee to diminish unconscious bias against URiM applicants.…”

“…43 Seven programs created URiM-specific interview days or events. 9,22,23,30,37,43,44 When possible, URiM applicants were paired with a URiM faculty interviewer.…”