Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA.
Department of Family Medicine and Community Health Mount Sinai Icahn School of Medicine, New York, NY.
Fam Med. 2021 Nov;53(10):871-877. doi: 10.22454/FamMed.2021.482291.
Increasing the number of underrepresented minorities in medicine (URM) has the potential to improve access and quality of care and reduce health inequities for diverse populations. Having a diverse workforce in residency programs necessitates structures in place for support, training, and addressing racism and discrimination. This study examines reports of discrimination and training initiatives to increase diversity and address discrimination and unconscious bias in family medicine residency programs nationally.
This survey was part of the Council of Academic Family Medicine Educational Research Alliance (CERA) 2018 national survey of family medicine residency program directors. Questions addressed the presence of reported discrimination, residency program training about discrimination and bias, and admissions practices concerning physician workforce diversity. We performed univariate and bivariate analyses on CERA survey response data.
We received 272 responses to the diversity survey items within the CERA program director survey from 522 possible residency director respondents, yielding a response rate of 52.1%. The majority of residency programs (78%) offer training for faculty and/or residents in unconscious/implicit bias and systemic/institutional racism. A minority of program directors report discrimination in the residency environment, most often reported by patients (13.2%) and staff (7.2%) and least often by faculty (3.3%), with most common reasons for discrimination noted as language or race/skin color.
Most family medicine residency program directors report initiatives to address diversity in the workforce. Research is needed to develop best practices to ensure continued improvement in workforce diversity and racial climate that will enhance the quality of care and access for underserved populations.
增加医学领域代表性不足少数群体（URM）的数量，有可能改善不同人群的医疗服务获取机会和质量，并减少健康不平等现象。居住计划中的多元化劳动力需要有支持、培训和解决种族主义和歧视的结构。本研究考察了全国家庭医学居住计划中报告的歧视和培训计划，以增加多样性，并解决歧视和无意识偏见问题。
这项调查是学术家庭医学教育研究联盟（CERA）2018 年全国家庭医学居住计划主任调查的一部分。这些问题涉及报告的歧视、居住计划关于歧视和偏见的培训以及有关医生劳动力多样性的招生实践。我们对 CERA 调查响应数据进行了单变量和双变量分析。
我们从 522 名可能的居住计划主任回复者中收到了 CERA 计划主任调查中多样性调查项目的 272 份回复，回复率为 52.1%。大多数居住计划（78%）为教师和/或居住者提供关于无意识/隐性偏见和系统性/制度性种族主义的培训。少数居住计划主任报告了居住环境中的歧视，最常见的是由患者（13.2%）和工作人员（7.2%）报告，而教师报告的最少（3.3%），最常见的歧视原因是语言或种族/肤色。
大多数家庭医学居住计划主任报告了解决劳动力多样性的举措。需要研究以制定最佳实践，以确保劳动力多样性和种族氛围的持续改善，从而提高医疗服务质量和获取机会，为服务不足的人群提供更好的服务。
