Survey of equity, diversity, and inclusion in Canadian anesthesiology residency programs

Increased diversity in the healthcare workforce is associated with a higher quality of patient care, reduction in health disparities, and enhanced team performance. Women and individuals from minoritized groups continue to face underrepresentation in the medical workforce. Specifically, existing data has shown women and minoritized groups are underrepresented in the speciality of anesthesiology in the United States. To address this, increased diversity is needed within residency training programs to better address the widening healthcare inequities affecting marginalized populations. Currently, there are no studies describing either the demographics of Canadian anesthesiology residents or equity, diversity, and inclusion (EDI) initiatives within their training programs. This study aims to describe these in order to guide future EDI initiatives in Canada.

Ethics approval was obtained from the University of Alberta Research Ethics Board. An anonymous online survey focusing on demographics, perceptions of EDI, and existing EDI initiatives was distributed to resident trainees across the seventeen Canadian anesthesiology residency programs.

We analyzed 123 responses from 15 of 17 residency programs. For gender, 49% of respondents identified as male, 48% as female, and 1% as non-binary. For sexual identity, 84% of respondents identified as heterosexual, 8% as bisexual, and 7% as lesbian or gay. For ethnicity, 67% identified as White, 13% as East Asian, 6% as Arab, 4% as Black, 1% as Southeast Asian, 1% as Indigenous, and 0% as West Asian or Hispanic. Furthermore, 87% of respondents felt EDI was important, however 52% were unaware of any initiatives in their programs, and 43% reported receiving no EDI training. The overall gender representation seen in our data closely mirrors that of the Canadian 2021 census data. We saw a four times higher representation of LGBTQ individuals compared to Canadian demographic data. Indigenous, Hispanic, Southeast Asian, and West Asian individuals were underrepresented, while other ethnicities were well represented.

Our study used self-identification data of ethnicity, gender, and sexuality to reduce bias and provide a more accurate representation of the EDI landscape in Canadian anesthesiology residency programs. Our results showed that there is still underrepresentation of multiple ethnicities compared to Canadian demographics. Most residents believe EDI is important, however, the majority were unaware of any initiatives within their programs. Areas of future growth include better defining which EDI initiatives exist within training programs, studying how EDI programs are implemented in training programs, and examining perceived barriers to both having and implementing said initiatives. Through doing so, anesthesiology residency programs across Canada can best ensure their trainees reflect the diverse communities they serve and are educated to care for minoritized groups.