Barriers to Improving Diversity in Physical Medicine & Rehabilitation Residency Programs: A National Survey of...

Diversity within the Physician workforce is essential to improving patient outcomes, fostering cultural competence and advancing health equity, yet Physical Medicine & Rehabilitation (PM&R) continues to lag behind other specialties in representation of underrepresented in medicine (URiM) individuals and women. This study aimed to determine the extent to which perceived barriers prohibit residency programs from improving diversity in their programs. A cross-sectional, web-based survey was distributed to program directors at Physiatry '24 and via e-mail, collecting demographic and geographic data, as well as ratings of potential barriers on a 10-point scale. Sixty responses were obtained (~55% response rate). Visa-related challenges received the highest level of concern (median=6.0), followed by faculty diversity (mean=5.3), and Step 2CK scores (median=5.0). Subgroup analyses revealed notable variation: older directors showed greater concern about faculty and regional diversity, males expressed higher concerns over limited PM&R exposure among URiM applicants, and geographic regions differed significantly in perceptions of faculty and population diversity. These findings highlight persistent structural barriers that vary across demographic and regional contexts. Addressing them will require targeted, region-specific and data-informed approaches that strengthen recruitment pipelines, support URiM applicant exposure to PM&R and encourage institutional practices that promote a more inclusive and representative workforce.