Watanabe Brooke L, Weston Robert A, Wyatt Christopher R, Brown Lawrence H
Division of Emergency Medicine, Department of Surgery and Perioperative Care Dell Medical School at the University of Texas-Austin Austin Texas USA.
U.S. Acute Care Solutions Canton Ohio USA.
AEM Educ Train. 2025 Apr 7;9(2):e70001. doi: 10.1002/aet2.70001. eCollection 2025 Apr.
There is limited understanding of factors influencing recruitment of emergency medicine (EM) residents identifying as races and ethnicities underrepresented in medicine (URM): Black/African American, Hispanic, American Indian/Alaskan Native, or Native Hawaiian/Pacific Islander. This study explored whether diversity of EM residents at the program level is associated with community diversity at the county level.
The proportion of URM residents in each EM residency program was determined using Association of American Medical Colleges academic year 2023-2024 data. We excluded newer programs without a full complement of residents and those not reporting race/ethnicity data. We used U.S. Census data to categorize each program's surrounding county as having lower diversity (<30% URM population), moderate diversity (≥30% to <49% URM population), or higher diversity (≥49% URM population). We used Kruskal-Wallis test with Dunn's procedure to determine whether the proportion of URM residents in a program was associated with the level of diversity in the surrounding county.
Among 247 included EM programs, 5% of residents were Black (range 0%-46% per program), 8% Hispanic (range 0%-43%), and 4% another URM race/ethnicity. The proportion of URM EM residents was significantly lower among programs in lower-diversity counties (median [IQR] 10% [6%-16%]) than among programs in moderate-diversity (median [IQR] 14% [8%-20%], < 0.001) or higher-diversity (median [IQR] 15% [9%-22%], < 0.001) counties. Similarly, programs in counties with higher Black populations had more Black EM residents, and programs in counties with higher Hispanic populations had more Hispanic EM residents.
EM residents at programs in lower-diversity counties are less likely to be URM than those in moderate- or higher-diversity counties. EM programs located in less diverse communities may require unique strategies to increase resident diversity.
对于影响医学中代表性不足的种族和族裔（URM）的急诊医学（EM）住院医师招募的因素，人们了解有限，这些种族和族裔包括黑人/非裔美国人、西班牙裔、美国印第安人/阿拉斯加原住民或夏威夷原住民/太平洋岛民。本研究探讨了项目层面的急诊医学住院医师多样性是否与县层面的社区多样性相关。
利用美国医学院协会2023 - 2024学年的数据确定每个急诊医学住院医师培训项目中URM住院医师的比例。我们排除了没有完整住院医师配备的新项目以及未报告种族/族裔数据的项目。我们使用美国人口普查数据将每个项目所在的县分类为多样性较低（URM人口<30%）、中等多样性（URM人口≥30%至<49%）或较高多样性（URM人口≥49%）。我们使用带有邓恩程序的克鲁斯卡尔 - 沃利斯检验来确定项目中URM住院医师的比例是否与周边县的多样性水平相关。
在纳入的247个急诊医学项目中，5%的住院医师为黑人（每个项目范围为0% - 46%），8%为西班牙裔（范围为0% - 43%），4%为其他URM种族/族裔。在多样性较低的县的项目中，URM急诊医学住院医师的比例（中位数[四分位间距]为10% [6% - 16%]）显著低于中等多样性（中位数[四分位间距]为14% [8% - 20%]，P < 0.001）或较高多样性（中位数[四分位间距]为15% [9% - 22%]，P < 0.001）县的项目。同样，黑人人口较多的县的项目有更多黑人急诊医学住院医师，西班牙裔人口较多的县的项目有更多西班牙裔急诊医学住院医师。
与中等或较高多样性县的项目相比，多样性较低县的项目中的急诊医学住院医师成为URM的可能性较小。位于多样性较低社区的急诊医学项目可能需要独特的策略来增加住院医师的多样性。
