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Racial and Ethnic Differences in Internal Medicine Residency Assessments
Dowin Boatright1, Nientara Anderson2, Jung G Kim3
1Department of Emergency Medicine, New York University Grossman School of Medicine, New York, New York.
JAMA Network Open
|December 29, 2022
Summary
Internal medicine residents from underrepresented minority (URiM) and Asian backgrounds received lower performance scores than White residents in early training. These racial disparities in assessment narrowed by the final year, suggesting potential bias in graduate medical education.
Area of Science:
- Graduate Medical Education
- Health Equity
- Physician Workforce Diversity
Background:
- Racial and ethnic inequities are documented in medical student assessments and faculty promotions.
- Limited data exist on racial and ethnic disparities in graduate medical education (GME) performance assessments.
Purpose of the Study:
- To investigate the association between race/ethnicity and performance assessment scores among internal medicine residents nationwide.
- To identify potential racial biases in GME evaluations.
Main Methods:
- Retrospective cohort study of 9026 internal medicine residents from 2016-2017 graduating classes.
- Analysis of Accreditation Council of Graduate Medical Education (ACGME) Milestone scores, comparing underrepresented in medicine (URiM) and Asian residents with White residents.
- Evaluation of scores across 6 competency domains and postgraduate years (PGY).
Main Results:
- In PGY-1, Asian residents scored lower than White residents; no difference was found for URiM residents.
- Racial disparities in scores widened in PGY-2, with both URiM and Asian residents scoring lower than White residents.
- By PGY-3, score disparities narrowed, and parity was reached across all competency domains.
Conclusions:
- URiM and Asian residents received lower performance ratings than White peers in early training, potentially reflecting assessment bias.
- These disparities may impede career advancement for minoritized physicians and hinder workforce diversity.
- Further research is needed to address and mitigate racial bias in GME assessments.
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