Racial disparities in the selection of chief resident: A cross-sectional analysis of a national sample of senior residents in the United States.

INTRODUCTION: Part of the difficulty in recruiting and retaining a diverse physician workforce, as well as within medical leadership, is due to racial disparities in medical education. We investigated whether self-identified race-ethnicity is associated with the likelihood of selection as chief resident (CR). MATERIALS AND METHODS: We performed a cross sectional analysis using de-identified person-level data from the GME Track, a national resident database and tracking system, from 2015 through 2018. The exposure variable, self-identified race-ethnicity, was categorized as African American or Black, American Indian or Alaskan Native, Asian, Hispanic, Latino or of Spanish Origin, Native Hawaiian or Pacific Islander, White, and Multi-racial. The primary study outcome was CR selection among respondents in their final program year. Logistic regression was used to estimate the adjusted odds ratios (aOR) and 95% confidence intervals (CI) of CR selection for each racial group, as compared to the White referent group. RESULTS: Among the study population (N=121,247), Black, Asian and Hispanic race-ethnicity was associated with a significantly decreased odds of being selected as CR in unadjusted and adjusted analyses. Black, Asian and Hispanic residents had a 26% (aOR=0.74, 95% CI 0.66-0.83), 29% (aOR=0.71, 95% CI 0.66-0.76) and 28% (aOR=0.72, 95% CI 0.66-0.94) decreased likelihood of becoming CR, respectively. Multi-racial residents also had a decreased likelihood, but to a lesser degree (aOR=0.92, 95% CI 0.89-0.95). CONCLUSIONS: In as much as CR is an honor that sets one up for future opportunity, our findings suggest that residents of color are disproportionately disadvantaged compared to their White peers.

Evidence-based Best Practices in Recruitment of Diverse Residents: A Perspective From a Diversity Officer.

The recruitment of a diverse resident workforce is the immediate proximate step to growing a diverse physician workforce. This recruitment requires intentionality on the part of residency programs and institutional graduate medical education offices. This article describes evidence-based recruitment "best practices" and encourages programs to stay committed.

Postpartum vaginal agglutination: a case report.

BACKGROUND: Vaginal agglutination after spontaneous vaginal delivery has not been previously described in the medical literature. CASE: A healthy 35-year-old Gravida 2 Para 2002 had a normal, spontaneous vaginal delivery. At her 8-week postpartum visit, a speculum could not be inserted into her vagina secondary to significant foreshortening. She was breastfeeding at the time. She ultimately underwent scar tissue takedown in the operating room, with subsequent vaginal estrogen and dilator use. CONCLUSIONS: Postpartum vaginal agglutination after spontaneous delivery is rare, and this case highlights an interesting complication of vaginal delivery in a hypoestrogenic state.