Diversity and Inclusion, Match

Developing a Diverse and Inclusive Pipeline in Emergency Medicine: Part 2

Part 2 of a 3-part series on how to build diversity, equity, and inclusion into the specialty.

Commitment to Diversity, Inclusion, and Equity (DEI) is not only important to demonstrate to medical schools for successful recruitment, but it is also important to integrate into training and support for residents.

The prior multifaceted approach continues during residency, where the goal is to train, retain and support physicians who will continue to promote DEI. This second piece will showcase ways that these efforts continue as newly minted physicians start residency and are exposed to DEI efforts within the residency, department, and institution.

The most straightforward, but not always simple manner to include DEI efforts into the training of residents is to create a curriculum that promotes DEI at various levels. This should occur both formally and informally. In formal didactics, there should be lectures and/or workshops that address DEI issues on a regular basis, and not just in reaction to events happening in society. There are many critically acclaimed speakers that speak on these topics.  Investing the time, resources, and finances to bring them to didactics that are well-publicized should be part of the commitment. Consider collaborating with your institution, which could provide additional resources and avenues for advertisement. At the same time, introducing DIE efforts into bedside or other informal teaching is crucial. For example, if a patient presents with significant concern for neurosyphilis, this might be a good opportunity to discuss the complex racial history surrounding the progression and treatment of syphilis. With these topics seamlessly built into the curriculum, residents grow in their knowledge of social inequities and hopefully it translates into their care and collegiality. Last but not least, consider department-wide town halls as well as participation in institution-wide efforts, that allow the whole department to take stock of where things are and what steps need to be taken. This action demonstrates the prioritization of DEI efforts to trainees, who can take comfort in a supportive environment. 

Another important way to foster DEI amongst residents is through mentorship, both between faculty and residents as well as between residents on different levels of training. The most common and proven methodology is establishing mentors early in training, that can answer the non-clinical or advancement questions that inevitably arise during the course of training, as well as provide support during the expected challenges in residency. That being said, informal mentorship can also be incredibly effective, creating a cloud of support without any harsh expectations. This can be achieved by having faculty particularly interested in DEI hosting intimate events and gatherings for underrepresented minority (URM) groups. This can be a service event that promotes females in emergency medicine, or a barbecue for faculty and residents to discuss their experience as a Latinx in medicine. Last, is promoting a group chat or similar forum for URM individuals to find support. This can be divided in many ways, including amongst classes, amongst social groups, for special interests, etc. In this technological age of training, it can be a simple, yet effective manner to promote diversity, inclusion, and - probably most importantly - equity, as it relates to underrepresented groups and is available 24/7/365 for use. 

An additional way to promote DEI in residency is utilizing its most important assets: the residents. By recruiting diversely, equitably, and promoting DEI throughout residency, the result is usually DEI-minded residents. These residents often have buy-in in maintaining those efforts and promoting it for the future. During residency it is important to have time built in for socializing amongst residents. For example, a Sunday Funday, a reoccurring day when residents are not working, where residents can expose co-residents to their diverse backgrounds. In urban environments, this is relatively simple to do, whereas those in rural or more suburban environments may have to make an effort. Cultural potlucks are an example that can be utilized across environments. Secondly, residents also have buy-in in recruiting and choosing future residents. This happens with attendance at DEI-specific recruitment events as well as promoting DEI in all recruitment scenarios. Lastly, residents should be involved in the rank list process, allowing their perspectives to be a factor in creating future classes and replicating DEI efforts. Examples include involving residents in interviewing applicants, hosting social hours with applicants, and providing a forum to give resident input regarding applicants prior to rank lists due date.

Overall, using some of the tips above, residents will not only be exposed to efforts in DEI but also develop skills to further these efforts. This is something that they can take forward to their jobs after residency in efforts to promote DEI in the next step of their career.

Also in this series:
Part 1: Addressing DEI in emergency medicine
Part 3: Extending DEI beyond residency

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