Diversity in emergency medicine--a model program.

:Emergency medicine's (EM's) development as a specialty has spanned the last 25 years, with the first certifying examination administered by the American Board of Emergency Medicine in 1980. National census data project that the new millennium will bring a U.S. population that will be 40% minority. In the year 2000, the U.S. population had a projected minority population of 28%. The diversity of the patients we treat demonstrates the need for EM programs to diversify their faculty and residency staff. Strategies include expanding recruitment and supporting retention of underrepresented students, faculty, and trainees, addressing barriers that may exist for promotion of underrepresented women and minorities, mentoring underrepresented minority (URM) faculty in research and education, providing opportunities for URMs to advance in the field, and mentoring URMs at the junior high and high school levels in the sciences to expand the applicant pool in the field. The authors describe an academic EM program that is a model program for diversity within our specialty.

Heron S ，Haley L Jr 《ACADEMIC EMERGENCY MEDICINE》

The Impact of the 2008 Council of Emergency Residency Directors (CORD) Panel on Emergency Medicine Resident Diversity.

In 2008, the Council of Emergency Medicine Residency Directors (CORD) developed a set of recruitment strategies designed to increase the number of under-represented minorities (URMs) in Emergency Medicine (EM) residency. We conducted a survey of United States (US) EM residency program directors to: describe the racial and ethnic composition of residents; ascertain whether each program had instituted CORD recruitment strategies; and identify program characteristics associated with recruitment of a high proportion of URM residents. The survey was distributed to accredited, nonmilitary US EM residency programs during 2013. Programs were dichotomized into high URM and low URM by the percentage of URM residents. High- and low-URM programs were compared with respect to size, geography, percentage of URM faculty, importance assigned to common applicant selection criteria, and CORD recruitment strategies utilized. Odds ratios and 95% confidence limits were calculated. Of 154 residency programs, 72% responded. The median percentage of URM residents per program was 9%. Only 46% of EM programs engaged in at least two recruitment strategies. Factors associated with higher resident diversity (high-URM) included: diversity of EM faculty (high-URM) (odds ratio [OR] 5.3; 95% confidence interval [CI] 2.1-13.0); applicant's URM status considered important (OR 4.9; 95% CI 2.1-11.9); engaging in pipeline activities (OR 4.8; 95% CI 1.4-15.7); and extracurricular activities considered important (OR 2.6; 95% CI 1.2-6.0). Less than half of EM programs have instituted two or more recruitment strategies from the 2008 CORD diversity panel. EM faculty diversity, active pipeline programs, and attention paid to applicants' URM status and extracurricular activities were associated with higher resident diversity.

Boatright D ，Tunson J ，Caruso E ，Angerhofer C ，Baker B ，King R ，Bakes K ，Oberfoell S ，Lowenstein S ，Druck J ... -  《JOURNAL OF EMERGENCY MEDICINE》

Improving the retention of underrepresented minority faculty in academic medicine.

Although several studies have outlined the need for and benefits of diversity in academia, the number of underrepresented minority (URM) faculty in academic health centers remains low, and minority faculty are primarily concentrated at the rank of assistant professor. In order to increase the diversity of the faculty of the University of California, San Diego (UCSD) School of Medicine, the UCSD National Center for Leadership in Academic Medicine, in collaboration with the UCSD Hispanic Center of Excellence, implemented a junior faculty development program designed in part to overcome the differential disadvantage of minority faculty and to increase the academic success rate of all faculty. Junior faculty received counseling in career and research objectives; assistance with academic file preparation, introduction to the institutional culture; workshops on pedagogy and grant writing; and instrumental, proactive mentoring by senior faculty. After implementation of the program, the retention rate of URM junior faculty in the school of medicine increased from 58% to 80% and retention in academic medicine increased from 75% to 90%. A junior faculty development program that integrates professional skill development and focused academic career advising with instrumental mentoring is associated with an increase in the retention of URM faculty in a school of medicine.

Daley S ，Wingard DL ，Reznik V 《JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION》

Underrepresentation of underrepresented minorities in academic medicine: the need to enhance the pipeline and the pipe.

The number of underrepresented minorities (URMs; black or African American, Hispanic or Latino, American Indian or Alaska Native, Native Hawaiian or other Pacific Islander) among US medical school faculty is markedly low when compared with their respective percent representation of the US population. Women URMs are doubly underrepresented, particularly as the academic rank advances from the instructor to the professor level, and gender discrepancies occur more prominently among white female faculty. Although the percent of white faculty has decreased over the past 5 years, the low percentage of black and Hispanic faculty has not changed proportionately. Furthermore, the 2008-2009 pipeline of URM trainees is unlikely to reverse the current trends. Several measures are suggested for consideration by medical schools and the National Institutes of Health, and recommendations that URM faculty and students may wish to consider are also discussed. The major issues to address include increasing the pipeline of predoctoral URMs, promoting the success and retention of junior URM faculty, enhancing the support of senior URM faculty to serve as needed mentors, and building a pool of URM and non-URM mentors for URM trainees. Therefore, issues pertaining to both the pipeline and the pipe need to be overcome.

Merchant JL ，Omary MB 《-》

Increasing Resident Diversity in an Emergency Medicine Residency Program: A Pilot Intervention With Three Principal Strategies.

Much work remains to be done to align the diversity of the health care workforce with the changing racial and ethnic backgrounds of patients, especially in the field of emergency medicine. In academic year (AY) 2012-2013, to increase the number of underrepresented minority (URM) candidates who were interviewed and matched, the Denver Health Residency in Emergency Medicine program (DHREM) initiated a focused pilot intervention with three principal strategies: (1) a scholarship-based externship program, (2) a funded second-look event, and (3) increased involvement and visibility of URM faculty in the interview and recruitment process. One year after implementation of the pilot intervention, the percentage of URMs among all applicants invited to interview at the DHREM doubled (7.1% [20/282] in AY 2011-2012, 7.0% [24/344] in AY 2012-2013, and 14.8% [58/393] in AY 2013-2014) (95% confidence interval [CI] = 5-10, 4-11, and 11-19, respectively). Of all DHREM interviewees in AY 2013-2014, 17.6% (49/279) (95% CI = 12-23) were URMs, nearly a threefold increase from AY 2012-2013 (6.2% [14/226], 95% CI = 3-10). In AY 2013-2014, 23.5% (4/17) (95% CI = 7-50) of all new DHREM residents were URMs, compared with 5.9% (1/17) in AY 2011-2012 and 5.6% (1/18) in AY 2012-2013 (95% CI = 0-29 and 0-27, respectively). Additional studies are needed to determine whether these results are sustainable and generalizable to other residency programs in emergency medicine and other specialties.

Tunson J ，Boatright D ，Oberfoell S ，Bakes K ，Angerhofer C ，Lowenstein S ，Zane R ，King R ，Druck J ... -  《-》