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Increasing Resident Diversity in an Emergency Medicine Residency Program: A Pilot Intervention With Three Principal
Java Tunson1, Dowin Boatright, Stephanie Oberfoell
1J. Tunson is a fourth-year resident, Denver Health Residency in Emergency Medicine, Denver, Colorado. D. Boatright is a Robert Wood Johnson Clinical Scholar, Fellow for Veteran Affairs, and clinical instructor, Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut. S. Oberfoell is a third-year resident, Denver Health Residency in Emergency Medicine, Denver, Colorado. K. Bakes is associate professor of emergency medicine, University of Colorado School of Medicine, Aurora, Colorado, director, At-Risk Intervention and Mentoring Program, and physician liaison for community outreach, Denver Health, Denver, Colorado. C. Angerhofer is residency coordinator, Denver Health Residency in Emergency Medicine, Denver, Colorado. S. Lowenstein is professor of emergency medicine and medicine and associate dean for faculty affairs, University of Colorado School of Medicine, Aurora, Colorado. R. Zane is chair of emergency medicine and professor of emergency medicine, University of Colorado School of Medicine, Aurora, Colorado. R. King is assistant professor of emergency medicine, University of Colorado School of Medicine, Aurora, Colorado. J. Druck is associate professor of emergency medicine, University of Colorado School of Medicine, Aurora, Colorado, and associate residency director, Denver Health Residency in Emergency Medicine, Denver, Colorado.
Problem:
Much work remains to be done to align the diversity of the health care workforce with the changing racial and ethnic backgrounds of patients, especially in the field of emergency medicine.
Approach:
In academic year (AY) 2012-2013, to increase the number of underrepresented minority (URM) candidates who were interviewed and matched, the Denver Health Residency in Emergency Medicine program (DHREM) initiated a focused pilot intervention with three principal strategies: (1) a scholarship-based externship program, (2) a funded second-look event, and (3) increased involvement and visibility of URM faculty in the interview and recruitment process.
Outcomes:
One year after implementation of the pilot intervention, the percentage of URMs among all applicants invited to interview at the DHREM doubled (7.1% [20/282] in AY 2011-2012, 7.0% [24/344] in AY 2012-2013, and 14.8% [58/393] in AY 2013-2014) (95% confidence interval [CI] = 5-10, 4-11, and 11-19, respectively). Of all DHREM interviewees in AY 2013-2014, 17.6% (49/279) (95% CI = 12-23) were URMs, nearly a threefold increase from AY 2012-2013 (6.2% [14/226], 95% CI = 3-10). In AY 2013-2014, 23.5% (4/17) (95% CI = 7-50) of all new DHREM residents were URMs, compared with 5.9% (1/17) in AY 2011-2012 and 5.6% (1/18) in AY 2012-2013 (95% CI = 0-29 and 0-27, respectively).
Next Steps:
Additional studies are needed to determine whether these results are sustainable and generalizable to other residency programs in emergency medicine and other specialties.
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