Framing resident perceptions of diversity in GME: insights from a multi-specialty survey study.

BACKGROUND

Despite growing efforts to address diversity in healthcare, underrepresentation persists. While many studies about diversity focus on medical students, residents occupy a unique position as both learners and educators, influencing institutional culture from multiple levels.

OBJECTIVE

To characterize resident physician perceptions of diversity in medical training, identify differences in perceived importance of various diversity attributes, and examine how these perceptions and preferences differ between Underrepresented in Medicine (URiM) residents and non-URiM residents.

METHODS

We conducted a cross-sectional survey (October 2023-January 2024) via an anonymous online questionnaire distributed to residents across 55 ACGME-accredited programs within a multisite institution. Demographic and Likert-scale data on perceptions of diversity and various diversity categories (age, race, gender identity, socioeconomic status, etc.) were collected.

RESULTS

Of 1468 resident physicians surveyed, 520 responded (35.4% response rate). The majority were between the ages of 26 and 30 (n = 289, 55.6%). Women and individuals of the white or Caucasian race were more represented (n = 309, 59.4%, and n = 283, 54.4%, respectively). Most residents agreed on the importance of diversity across various dimensions, including race, age, socioeconomic background, geographic origin, gender identity, and sexual orientation. Religious identity, disability status, and premedical employment history were seen as less important. No diversity, equity, or inclusion (DEI) initiative was universally supported by URiM participants. URiM residents perceived less racial diversity than non-URiM residents (p = 0.04).

CONCLUSIONS

Residents value diversity across multiple dimensions but differ in perceptions and support needs based on identity. The variation in preferences and perceptions, particularly among URiM residents, highlights the limitations of uniform diversity interventions. Academic institutions should offer flexible, resident-informed support and address the daily experiences of exclusion that shape specialty-specific culture and career trajectories.