Harris Rachel, Covington Kyle, Colford Cristin, Denizard-Thompson Nancy, Contarino Michael, Evans Kimberley, Zaas Aimee, Kraemer M Suzanne, McNeill Diana
is Adjunct Associate Professor, Morehouse School of Medicine.
is Associate Professor, Duke University School of Medicine.
J Grad Med Educ. 2021 Apr;13(2):181-188. doi: 10.4300/JGME-D-20-00729.1. Epub 2021 Apr 16.
While the overall percentage of residents who withdraw (2.7%) or take extended leave (1.0%) are low, subgroup analysis has found that minority physicians are approximately 30% more likely to withdraw from residency than their white counterparts and 8 times more likely to take extended leave of absence. With ongoing national efforts to support diversity in medical education through increased recruitment of underrepresented in medicine (UiM) students to residency programs, there is paucity of data identifying specific experiences challenging or contributing to their overall resiliency. Better understanding of the lived experience of UiM residents will allow residency programs to create successful curricular programing and support structures for residents to thrive.
We sought to understand UiM internal medicine residents' experiences during residency training.
We used a retrospective review of focus group transcripts of UiM internal medicine residents from 5 academic institutions in 2017 (4 in North Carolina and 1 in Georgia).
Of 100 self-identified UiM residents from 5 institutions, 59 participated in the focus groups. Using a consensus-based review of transcripts, 25 distinct codes in 8 parent code categories were determined. Two primary themes emerged: resilience and isolation. Three secondary themes-social support, mentorship, and external expectations and/or biases-served as mediators for the primary themes.
UiM residents who became or were already resilient commonly experienced isolation at some time in their medical career, specifically during residency. Moreover, they could be influenced and positively or negatively affected by social support, mentorship, and external expectations and biases.
虽然退出(2.7%)或休长假(1.0%)的住院医师总体比例较低,但亚组分析发现,少数族裔医生退出住院医师培训项目的可能性比白人医生高约30%,休长假的可能性则高出8倍。随着国家不断努力,通过增加招收医学领域代表性不足(UiM)的学生进入住院医师培训项目来支持医学教育的多样性,目前缺乏数据来确定对他们的整体适应能力构成挑战或有贡献的具体经历。更好地了解UiM住院医师的生活经历将使住院医师培训项目能够创建成功的课程规划和支持结构,让住院医师蓬勃发展。
我们试图了解UiM内科住院医师在住院医师培训期间的经历。
我们对2017年来自5个学术机构(北卡罗来纳州4个,佐治亚州1个)的UiM内科住院医师焦点小组记录进行了回顾性分析。
在来自5个机构的100名自我认定的UiM住院医师中,59人参加了焦点小组。通过基于共识的记录审查,确定了8个父代码类别中的25个不同代码。出现了两个主要主题:适应能力和孤立感。三个次要主题——社会支持、指导以及外部期望和/或偏见——作为主要主题的调节因素。
变得有适应能力或已经具备适应能力的UiM住院医师在其医疗职业生涯中的某些时候,特别是在住院医师培训期间,普遍经历过孤立感。此外,他们可能会受到社会支持、指导以及外部期望和偏见的影响,并产生积极或消极的作用。