Diversity, Equity, and Inclusion Milestones: Creation of a Tool to Evaluate Graduate Medical Education Programs.

Background: As the Accreditation Council for Graduate Medical Education (ACGME) began to ask programs to report their efforts surrounding diversity, equity, and inclusion (DEI), program directors felt ill prepared to evaluate their programs and measure change. Objective: To develop a tool that would allow graduate medical education (GME) programs to evaluate the current state of DEI within their residencies, identify areas of need, and track progress; to evaluate feasibility of using this assessment method within family medicine training programs; and to analyze and report pilot data from implementation of these milestones within family medicine residency programs. Methods: The Association of Family Medicine Residency Directors (AFMRD) Diversity and Health Equity (DHE) Task Force developed a tool for program DEI evaluation modeled after the ACGME Milestones. These milestones focus on DEI assessment in 5 key domains: Institution, Curriculum, Evaluation, Resident Personnel, and Faculty Personnel. After finalizing a draft, a pilot implementation of the milestones was conducted by a convenience sample of 10 AFMRD DHE Task Force members for their own programs. Results: Scores varied widely across surveyed programs for all milestones. Highest average scores were seen for the Curriculum milestone (2.65) and the lowest for the Faculty Personnel milestone (2.0). Milestone assessments were completed within 10 to 40 minutes using various methods. Conclusions: The AFMRD DEI Milestones were developed for program assessment, goal setting, and tracking of progress related to DEI within residency programs. The pilot implementation showed these milestones were easily used by family medicine faculty members in diverse settings.

Cellular telephone use and time trends for brain, head and neck tumours.

AIM: The objective of this study was to determine whether incidence rates of head and neck malignancies in New Zealand have varied since the introduction of cellular telephones in 1987. In particular, we sought to compare trends in tumour rates in anatomical sites that receive high, medium and low levels of cellular telephone radiation (based on dosimetry data). METHODS: We investigated whether trends in tumour incidence rates in New Zealand have varied since the introduction of cellular telephones in 1987. The exposure measure used was the proportion of cellular telephone subscribers within the national population, calculated using the number of subscribers over the study period. RESULTS: The graphs for high, medium and low exposure sites did not display any significant changes in trend patterns for either gender over the years 1986 to 1998. CONCLUSIONS: Incidence rates for malignancies arising in the head and neck, including those sites that hypothetically receive the highest levels of radio frequency radiation during cellular telephone use, have not changed materially since the introduction of cellular telephones to New Zealand. However, ecological studies of this nature are limited in many ways and a stronger study design is clearly needed to establish more exactly any elevation in risk.