Diversity Elements on Maternal Fetal Medicine (MFM) Fellowship Websites: Opportunity for Improvement in Recruitment and Representation.

Background: There has been a fundamental shift in recruitment of medical students and trainees into residency and fellowship programs during the Covid 19 pandemic.1 Historically, websites for medical trainees demonstrate a lack of explicit focus on diversity, equity, and inclusion. 2-7 Diversity has positive associations of improving healthcare team performance, patient care, and even financial goals.8 A lack of diversity may negatively impact patient care.9 Directed recruitment of underrepresented in medicine applicants has proven successful to increase diversity within training programs. Department websites have a more prominent role in virtual recruitment since the beginning of the COVID pandemic. Features on these websites may be utilized to attract underrepresented in medicine applicants and increase diversity in a field. Objective: To analyze Maternal Fetal Medicine fellowship websites for presence of diversity elements important to those people who are underrepresented in medicine. Study Design: Fellowship websites were accessed summer of 2021. They were analyzed for presence of twelve website elements that demonstrate commitment to diversity, including: 1) nondiscrimination statement; 2) diversity and inclusion message; 3) diversity specific language; 4) resources for trainees; 5) community demographics; 6-7) personalized biographies of faculty or fellows; 8-9) individual photographs of faculty or fellows; 10) photos or biographies of alumni; 11) diversity publications and; 12) department statistics. Program size, region, and location were collected. Self-reported underrepresented in medicine data on residency programs was extracted from the National Graduate Medical Education Survey from 2019. Programs were dichotomized into 6+ diversity elements. Nonparametric, chi-square and Fisher's exact were used for analysis. Results: Fellowship programs were analyzed (excluding military/fetal surgery, n = 91/94). Websites included a mean of 4.1± 2.5 diversity elements. Most featured fewer than 6 elements (n =75, 82.4%). When dichotomized to 6+ diversity elements, larger faculty size was the only significant factor (p=0.01). The majority of programs had fewer than 12 faculty members (n=54, 59.3%) and only 9.3% of those programs had 6 or more diversity elements. By contrast, among programs with more than 12 faculty, 29.7% had 6 or more diversity elements. Faculty photos, fellow photos, and diversity publications were the most commonly featured items (92.4%, 68.1%, and 49.5%, respectively). Mean rate of underrepresented in medicine was 18.8% ± 11.3% and no significant associations were noted. There was a non-significant difference in diversity elements in the West United States with a mean of 5.3±2.2 diversity elements, compared to 3.7±2 in the South. Conclusion: Fellowship websites convey information for trainees, especially in an era of virtual recruitment. This study highlights opportunities for directed improvements of websites for features which URIM medical trainees have identified as important.

In-Person, Remote, or Hybrid Instruction? A Quality Improvement Assessment of a Six Week Interprofessional Education Pathway Program for Undergraduate Pre-Health Students.

There is an emphasis on increasing the diversity of healthcare providers with the goal of reducing health disparities among racial/ethnic minorities. To support this initiative, pathway programs were designed to provide educational and career support to students belonging to racial/ethnic minorities or those who have challenges applying to or entering health professions. As a consequence of the COVID-19 pandemic, pathway programs have assumed various instructional delivery formats (e.g., face to face, virtual, hybrid) with little knowledge on the satisfaction of such methods. The current preliminary study examines whether in person, virtual, or hybrid learning is most effective for underrepresented pre-health undergraduate students who are engaged in a six-week interprofessional health pathway program. Quantitative and qualitative data was collected at one time point towards the end of the program when it was offered in person, virtually, and in hybrid format. Results revealed that the pre-health pathway program received highest satisfaction when presented in a hybrid format and least satisfaction when presented in virtual instruction. Qualitative data suggests that virtual instruction increases feelings of isolation and complicates educational information due to the limitations of virtual streaming. Implications for pathway design are discussed.

Perceptions of Otolaryngology Residency Among Students Underrepresented in Medicine.

OBJECTIVE: Otolaryngology-Head and Neck Surgery (OHNS) has historically been one of the least diverse surgical subspecialties. The objective of this study was to better understand perceptions of OHNS from underrepresented students in medicine (URiM) and identify factors affecting URiM application to the specialty. STUDY DESIGN: Survey via electronic questionnaire. METHODS: An anonymous, 22-question electronic survey was administered nationally to URiM medical students (N = 388) regarding factors that play a role in developing an interest in applying to OHNS. Responses to questions were compared between URiMs applying to OHNS and those applying to other fields. RESULTS: Thirty-six percent of respondents identified as African American and 26% as Latino. Students completed the survey in all years of medical school. Research opportunities (H(2) = 18.58, P < .001) and having a race-concordant role model were the most important factors for those pursing OHNS residency. Personality fit and interactions with OHNS faculty had the greatest influence on their decision to pursue OHNS residency. Board scores (e.g., USMLE Step 1/2CK Scores), competitiveness, lifestyle during residency, the influence of application costs, and racial/ethnic and gender distributions did not reach statistical significance or were noninfluential. CONCLUSION: URiMs applying to OHNS value race-concordant mentorship, are involved in research, and have meaningful relationships with their respective OHNS department. We found that establishing meaningful connections with URiM mentors significantly impacts URiM students considering OHNS. While this cohort was not influenced by overemphasis of board scores within the OHNS match process, the COVID-19 pandemic negatively impacted this aspect of their application, along with away rotations. LEVEL OF EVIDENCE: NA Laryngoscope, 132:2335-2343, 2022.

Virtual Summer Undergraduate Mentorship Program for Students Underrepresented in Medicine Yields Significant Increases in Self-Efficacy Measurements During COVID-19 Pandemic: A Mixed Methods Evaluation.

Purpose: The barriers that Black and Hispanic/Latinx students underrepresented in medicine (URiM) face while seeking biomedical careers have been identified, including lack of career preparation and social support. Yet it is unclear how the COVID-19 pandemic has impacted their decisions and progress toward their occupational goals. Methods: Adapting to the precautions necessitated by the COVID-19 pandemic, the authors conducted a mixed-methods evaluation of our 2020 virtual summer URiM biomedical mentoring program, using both quantitative and qualitative pre- and post-program questionnaires to measure the students' perceptions of their preparation and self-efficacy for applying to health professional schools. Results: Themes were extracted from qualitative data through thematic analysis. When students were asked how the COVID-19 pandemic affected them, two themes and subthemes emerged: (1) loss of supportive environment, (1.1) challenging learning environment, (2) derailed or uncertain future, and (2.2) COVID-19 hitting home. When students were surveyed about their online experience at the end of the program, the themes (3) supportive community and (4) inspired and reinforced goals appeared. In addition, quantitative data examined through statistical analysis revealed that the students' career self-efficacy improved significantly after program participation. Conclusion: Our results indicate that the COVID-19 pandemic has further challenged URiM students with pre-existing career obstacles. The outcomes also demonstrate that it is possible to virtually provide URiM students with socioemotional support and increase their career self-efficacy. Overall, frequent evaluations are encouraged to better understand the dynamic challenges of URiM students, improve the design of health career "pipeline" programs, and diversify the physician workforce to address racial health inequities.

Do Orthopedic Surgery Residency Program Web Sites Address Diversity and Inclusion?

Background: Orthopedic surgery is one of the least diverse medical specialties. Other medical specialties have employed diversity-related initiatives to increase the number of students underrepresented in medicine (URM). Furthermore, with the suspension of visiting student rotations during the COVID-19 pandemic, medical students used residency program Web sites as a main source of program-specific information. Aims/Purpose: The purpose of this study was to measure the extent to which orthopedic surgery residency program Web sites describe diversity and inclusion initiatives. Methods: The Electronic Residency Application Service (ERAS) was used to identify U.S. orthopedic surgery residency programs. The programs' Web sites were reviewed, and data on commitments to diversity and inclusion were collected. Descriptive statistics of these data were generated. Results: There were 192 residency programs identified and 3 were excluded from the analysis due to lack of Web sites. Of the remaining 189 residency program Web sites, only 55 (29.10%) contained information on diversity and inclusion. Information on a commitment to improving diversity and inclusion was the most prevalent data point found among program Web sites, although it was found on only 15% of program Web sites. Conclusion: Orthopedic surgery residency programs rarely address topics related to diversity and inclusion on their program Web sites. An emphasis on opportunities for URM students and initiatives related to diversity and inclusion on program Web sites may improve URM outreach and serve as one method for increasing URM matriculation into orthopedic surgery.

Dear White People.

We are living in unprecedented times. While the world is grappling with COVID-19, we find the horrors of racism looming equally large as we, yet again, confront lurid deaths in the center of the news cycle of Black and brown people from police bias and brutality. Those of us who have been championing antiracism and justice work and bearing the burden of the "minority tax" have been overwhelmed by sudden asks from our well-intentioned White colleagues of how to best respond. In the tone of the Netflix series, "Dear White People," we further emphasize that we are not alone in trying to reach out to you, our White colleagues and leaders. Please hear our story and heed our call to action.