Diversity and Facing Discrimination in Family Medicine Residencies: A CERA Survey of Program Directors

Abstract

Background and Objectives: Increasing the number of underrepresented minorities in medicine (URM) has the potential to improve access and quality of care and reduce health inequities for diverse populations. Having a diverse workforce in residency programs necessitates structures in place for support, training, and addressing racism and discrimination. This study examines reports of discrimination and training initiatives to increase diversity and address discrimination and unconscious bias in family medicine residency programs nationally. Methods: This survey was part of the Council of Academic Family Medicine Educational Research Alliance (CERA) 2018 national survey of family medicine residency program directors. Questions addressed the presence of reported discrimination, residency program training about discrimination and bias, and admissions practices concerning physician workforce diversity. We performed univariate and bivariate analyses on CERA survey response data. Results: We received 272 responses to the diversity survey items within the CERA program director survey from 522 possible residency director respondents, yielding a response rate of 52.1%. The majority of residency programs (78%) offer training for faculty and/or residents in unconscious/implicit bias and systemic/institutional racism. A minority of program directors report discrimination in the residency environment, most often reported by patients (13.2%) and staff (7.2%) and least often by faculty (3.3%), with most common reasons for discrimination noted as language or race/skin color. Conclusions: Most family medicine residency program directors report initiatives to address diversity in the workforce. Research is needed to develop best practices to ensure continued improvement in workforce diversity and racial climate that will enhance the quality of care and access for underserved populations.

Evaluating the Uptake of Antiracism Training, Policies, and Practices in Departments of Family Medicine

“…Our findings can be used to support DFM contemplating such training and to guide those planning to implement antiracist work in their own departments by focusing on the DOI attributes to facilitate adoption. 25 For example, relative advantage was significantly associated in our model and had the largest difference in innovation agreement scores among those who implemented antiracist action (37%) versus those that did not (3%). It may behoove DFM to focus on explicitly aligning their mission and vision to be reflective of antiracist principles, and act on them accordingly.…”

Evaluation of Family Medicine Residency Programs for Diversity, Equity, and Inclusion Milestones

“…Smaller assessments have included the development of a climate assessment tool at a single program 14 or institution, 15 and the Racial Justice Report Cards developed by White Coats for Black Lives for medical schools and residencies, which were used to evaluate 26 medical institutions. 16 Another survey of family medicine program directors 17 asked questions about discrimination complaints in the training environment.…”