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Increasing Pediatric Residency Class Diversity to Improve Patient Outcomes and Address Structural Racism
Enrique Escalante1, Yael Smiley2, Dewesh Agrawal3
1E. Escalante is assistant program director, Diversity, Equity, and Inclusion, Pediatric Residency Program, Children's National Hospital, and assistant professor, Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC. He was Director of Diversity, Recruitment, and Inclusion, Children's National Hospital, Washington, DC, at the time this work was completed.
Problem:
The racial and ethnic makeup of physicians in the United States does not reflect that of the communities they serve. Addressing this disparity may improve patient outcomes and combat structural racism.
Approach:
Starting in 2014, the pediatric residency program at Children's National Hospital deliberately worked to assemble residency classes with racial and ethnic diversity that was similar to that of the Washington, DC, community it served. This work consisted of 3 initiatives: the Minority Senior Scholarship Program (MSSP), a pipeline program for rising fourth-year underrepresented in medicine (UIM) medical students to expose them to careers in academic pediatrics; an enhanced applicant recruitment process for UIM applicants; and mechanisms like a diversity dinner series for UIM residents to find the support they need to succeed.
Outcomes:
Since its inception in 2015, 73 participants have completed the MSSP, with 26% (19/73) going on to match at Children's National Hospital. An additional 12 participants are completing the program during the 2022 Match cycle. The MSSP has also increased participants' self-reported interest in pursuing a career in academic pediatrics, from 70% (14/20) before participation to 95% (19/20) after participation. In addition, the enhanced recruitment efforts have proven fruitful. The percentage of UIM interns at Children's National Hospital has increased from 5% (2/40) in 2014 to 51% (21/41) in 2021.
Next Steps:
The dimensions of diversity included in these initiatives will be expanded to include individuals from other marginalized populations, such as certain individuals of Southeast Asian descent, those who identify as LGBTQ+, and those with disabilities. An antiracism initiative has also been implemented in the residency program in collaboration with the hospital and partner medical schools.
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