Evaluating Methodology for Increasing Diversity in US Residency Training Programs: A Scoping Review

Background There remains limited understanding of effective strategies to increase diversity, equity, and inclusion within residency programs-highlighting the need for a comprehensive review of current interventions. Objective To synthesize literature regarding interventions to increase the representation of populations underrepresented in medicine (URiM) within US residency programs. Methods A scoping review of studies published from January 2000 to July 2023 was conducted. Data were extracted from PubMed, Embase, Cochrane Library, and Scopus. URiM was defined by race, ethnicity, and gender. Studies were included if an intervention was implemented by a graduate medical education residency program but were excluded if they did not describe a defined intervention or if they were published outside of the United States. Study interventions were categorized into 5 areas: applicant factors, selection measures, application screening, interviews, and post-interview communication. Results Initial search captured 2683 titles and abstracts; 257 full-text articles were reviewed, with 27 eligible articles meeting inclusion criteria. Eligible articles were categorized as: applicant-12 (44%), selection-8 (30%), screening-17 (63%), interview-8 (30%), and post-interview-4 (15%). Many articles addressed multiple interventions that positively impacted URiM composition, making it difficult to isolate the effect of individual interventions. Common, effective interventions included holistic reviews, clerkships, and standardized interviews. Conclusions This review demonstrates that interventions aimed at increasing diversity in residency programs vary in their approaches, but consistent evaluation and evidence of effectiveness are lacking from the current literature.