Diversity and Inclusion, Match

Developing a Diverse and Inclusive Pipeline in Emergency Medicine: Part 1

Part 1 of a 3-part series opens the conversation about how to build diversity, equity, and inclusion into the specialty.

Emergency medicine is a specialty that answers the call to serve, be on the frontlines, and step up to challenges. Due to deep inequities embedded within this country's history, we must address the deficiencies of diversity, equity, and inclusion (DEI) within our field.

Such a feat requires a multifaceted approach starting from eager medical students to attendings looking to push the envelope in DEI. In this three-part piece, we discuss how Baylor College of Medicine's (BCM) EM Program has targeted each stage of medical training to promote DEI within EM and beyond. On average, BCM EM is ~20% of the institution's Black composition and ~10% of the Latinx composition.

Residency and department DEI work are an important first step. Showcasing this effort to those that are unfamiliar with your program can be challenging. The most effective means of communicating DEI commitment is incorporating it before, during, and after the interview day.

Before the Interview
Participating in conferences hosted by underrepresented in medicine (URiM) student organizations such as underrepresented minority (URM), LGBTQ, and women in medicine groups showcases the program’s dedication to diversity early on. Programs can "show off" their diversity in person and "show up" by putting their time and money toward being accessible at events supporting URiM students. The candid conversations create memorable experiences for URiMs while allowing programs to grasp the breadth of diversity in the applicant pool. Additionally, applicants can see that a program has the ability to support their residents' attendance at these conferences and give them the opportunity to network with other URiM residents/faculty.

Another impactful indicator is scholarship to support URiM students interested in an away rotation. A scholarship reduces the financial burden of away rotations to allow URiM students an immersive experience not overshadowed or precluded by financial stresses.

Programs should assess what information is available to prospective applicants online. Make a dedicated webpage stating a program’s definition of and commitment to DEI work, with examples of projects and resident involvement. Consider the photos of the residents and faculty – are the visual representations proportionate to the makeup of the program and department? This is an opportunity for programs to be transparent about their current state of diversity, as well as describe goals for improvement. In the interview invitation, include a statement of the program’s commitment to DEI and emails of DEI advocates. Resident DEI committees can reach out independently to share goals, current projects, and contact information.

During the Interview
During the interview day, the introduction should include an overview of residency and department commitment to DEI. Standardized interview questions, such as one about implicit bias, allow programs to assess applicant commitment to DEI values and minimize bias in their own interviewing. Consider choosing interviewers who can speak to the DEI work being done. The interview day is more intimate than the website or emails – if there is a need for difficult and honest conversations, such as where the program has gone wrong in the past and how it is rectifying it, this is the time.

For programs early in their endeavors for DEI, consider a dedicated dinner or interview day for URiM applicants. This is helpful for programs with a small number of URiM residents/faculty, so they are not unduly burdened with participating in interview days and mixers more than their counterparts. For all mixers, choose each location with an inclusive lens, assuring that all cultural orientations and genders will feel welcome and accepted.

Play to your strengths.  BCM is located in the most diverse city in America, and we flaunt it. Our residents work at the county hospital known for taking care of marginalized patient populations, and we highlight it. We mention our community outreach to disadvantaged populations not only because we are proud, but also to recruit to our mission and vision.

After the Interview
After the interview day, consider a weekend for URiM applicants to take a second look. Travel funds and/or hotel accommodations are a meaningful way to demonstrate the program’s commitment. Send follow-up emails about more ways to learn about DEI work. Show these applicants that as they embark on residency, there will be a continued commitment to DEI efforts within the residency, department, and institution throughout the years to come.

Also in this series:
Part 2: Integrating DEI into training and curriculum
Part 3: Extending DEI beyond residency

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