Outcomes From a Novel Graduate Medical Education Leadership Program in Advancing Diversity, Equity, and Inclusion

Abstract

Background Academic medicine needs more diverse leadership from racial/ethnic minorities, women, people with disabilities, and LGBTQIA+ physicians. Longitudinal structural support programs that bring together underrepresented in medicine (UiM) and non-UiM trainees are one approach to build leadership and scholarship capacity in diversity, equity, and inclusion (DEI). Objective To describe the creation, satisfaction with, and feasibility of a Leadership Education in Advancing Diversity (LEAD) Program and evaluate scholars' changes in self-efficacy, intended and actual behavior change, and outputs in leadership and DEI scholarship. Methods In 2017, we created the LEAD Program, a 10-month longitudinal, single institution program that provides residents and fellows (“scholars”) across graduate medical education (GME) with leadership training and mentorship in creating DEI-focused scholarship. In the first 3 cohorts (2017–2020), we assessed scholars' self-efficacy, actual and planned behavior change, and program satisfaction using IRB-approved, de-identified retrospective pre-/post-surveys. We measured scholarship as the number of workshops presented and publications developed by the LEAD scholars. We used descriptive statistics and paired 2-tailed t tests to analyze the data. Results Seventy-five trainees completed LEAD; 99% (74 of 75) completed the retrospective pre-/post-surveys. There was statistically significant improvement in scholars' self-efficacy for all learning objectives. All trainees thought LEAD should continue. LEAD scholars have created workshops and presented at local, regional, and national conferences, as well published their findings. Scholars identified the greatest benefits as mentorship, developing friendships with UiM and ally peers outside of their subspecialty, and confidence in public speaking. Conclusions LEAD is an innovative, feasible GME-wide model to improve resident and fellow self-efficacy and behaviors in DEI scholarship and leadership.

Diversity in the Plastic Surgery Match: The Effect of Program Chair, Program Director, and Faculties’ Race and Sex on Matched Applicants

“…The establishment of a longitudinal mentorship program and incorporation of a holistic applicant review process may likewise foster applicant diversity 21 . Finally, integrated plastic surgery programs should focus on incorporating an inclusive residency selection process, including bias training, panel interviews, a standardized interview protocol, and a recruitment committee comprised of diverse members 20,22,23 …”

“…Furthermore, initiatives focused on recruiting underrepresented minorities to fellowship programs have been shown to increase minority representation in academic faculty roles later in their careers 21 . Finally, incorporating diversity, equity, and inclusion training for faculty members may help reduce implicit biases present within residency and faculty recruitment, as well as improve the retention of diverse applicants 22 …”

“…21 Finally, incorporating diversity, equity, and inclusion training for faculty members may help reduce implicit biases present within resi- dency and faculty recruitment, as well as improve the retention of diverse applicants. 22 In addition to the "top-down" method, further measures may be used to address racial and sex disparities during the integrated plastic surgery residency application process. Minority medical students and residents are more likely to incur debt during their medical education, resulting in a significant financial burden.…”

Challenges and Opportunities for Graduate Medical Education: Steps to Keep Physician Training in North Carolina Exceptional

“…The largest is Duke University Hospital, with 102 accredited training programs. The other medical centers with moderate to large GME footprints (19 or more accredited programs) include University of North Carolina Hospitals (86 programs), Wake Forest University Baptist Medical Center (66), ECU Health Medical Center (31), Carolinas Medical Center (26), Campbell University (23), and Mountain Area Health Education Center (19). Two military-based hospitals have small GME footprints: Womack Army Medical Center (6) and Naval Medical Center (2).…”

“…To counteract this risk, institutions and training programs should offer leadership training for their physician trainees that emphasizes the critical role of the physician as a leader and role model. Leadership training by GME should also emphasize and teach effective methods to advance diversity, equity, and inclusion [19]. The leadership training venues could also be the place to teach physician trainees about the financial realities of health care and their role in keeping the bottom line green while emphasizing that medicine must retain its service and moral missions.…”