Promoting Diversity and Health Equity: Recruitment and Best Practices in Education

Accreditation Council for Graduate Medical Education common requirements mandate that programs recruit and retain a diverse and inclusive workforce of residents. To achieve this aim and align with corresponding institutional equity goals, we developed a multifaceted intervention to recruit and train residents underrepresented in medicine (URiM) at a large academic residency program.

We implemented a holistic review of residency applications, including de-emphasizing board scores and recommendation letters, blinding academic information, and integrating behavioral-based interview questions. A departmental diversity, equity, and inclusion (DEI) committee member was added to the recruitment committee, all members of which underwent bias training. Updated curricula included DEI training across family medicine disciplines, integration of an advocacy and health equity curriculum, and quality improvement through a health equity lens, among other initiatives.

Over 4 years preintervention, self-identified URiM residents comprised only 6.25% of our program (3/48). Over 4 years postintervention, this percentage increased to 21.15% (11/52, P=.043). We also saw compliance above national specialty mean in ACGME resident surveys in nearly every DEI measurement.

Holistic changes to our recruitment and training efforts and structure had a direct impact on increasing the number of URiM applicants matching to our program. Curricular and institutional changes highlighting our commitment to DEI+ efforts improved our ability to match a diverse group of applicants. Limitations included self-reporting of Electronic Residency Application Service ethnic minority data and determining which of the several simultaneous interventions was most influential.