One of the strongest signifiers of cultural validity, particularly in more liberal leaning circles, is when NPR covers your story. Which is to say, NPR posted a story today about racism in medical training, so it’s possible that these messages are filtering up to leadership in academic medicine.

To underscore the importance that Anthony Chin-Quee, MD, is far from alone, here is a short collection of evidence on graduate medical education (GME), i.e. residency and fellowship (recent articles, plus a few older to again remind ourselves that we are not discussing a new situation, but one that has been ongoing, i.e. how racism operates).

Martinez-Strengel A, Balasuriya L, Black A, Berg D, Genao I, Gross CP, Keene D, Latimore D, Sotto-Santiago S, Boatright D. Perspectives of internal medicine residency program directors on the Accreditation Council for Graduate Medical Education (ACGME) diversity standards. J Gen Intern Med. 2021 Sep;36(9):2539-2546.

de Bourmont SS, Burra A, Nouri SS, et al. Resident Physician Experiences With and Responses to Biased Patients. JAMA Netw Open. 2020;3(11):e2021769. doi:10.1001/jamanetworkopen.2020.21769

Jarman BT, Borgert AJ, Kallies KJ, et al. Underrepresented minorities in general surgery residency: Analysis of interviewed applicants, residents, and core teaching faculty. J Am Coll Surg. 2020;231(1):54-58. doi:10.1016/j.jamcollsurg.2020.02.042

Williams M, Kim EJ, Pappas K, et al. The impact of United States Medical Licensing Exam (USMLE) step 1 cutoff scores on recruitment of underrepresented minorities in medicine: A retrospective cross-sectional study. Health Sci Rep. 2020;3(2):e2161.

Yuce TK, Turner PL, Glass C, et al. National evaluation of racial/ethnic discrimination in US surgical residency programs. JAMA Surg. 2020;155(6):526-528. doi:10.1001/jamasurg.2020.0260

Dyrbye L, Herrin J, West CP, et al. Association of racial bias with burnout among resident physicians. JAMA Netw Open. 2019;2(7):e197457. doi:10.1001/jamanetworkopen.2019.7457

Jarman BT, Kallies KJ, Joshi ART, et al. Underrepresented minorities are underrepresented among general surgery applicants selected to interview. J Surg Educ. 2019;76(6):e15-e23. doi:10.1016/j.jsurg.2019.05.018 https://pubmed.ncbi.nlm.nih.gov/31175064/

Agawu A, Fahl C, Alexis D, et al. The influence of gender and underrepresented minority status on medical student ranking of residency programs. J Natl Med Assoc. 2019;111(6):665-673. doi:10.1016/j.jnma.2019.09.002

Khan NR, Taylor CM 2nd, Rialon KL. Resident perspectives on the current state of diversity in Graduate Medical Education. J Grad Med Educ. 2019;11(2):241-243. doi:10.4300/JGME-D-19-00062.1

Osseo-Asare A, Balasuriya L, Huot SJ, et al. Minority resident physicians’ views on the role of race/ethnicity in their training experiences in the workplace. JAMA Netw Open. 2018;1(5):e182723. doi:10.1001/jamanetworkopen.2018.2723

Lightfoote JB, Fielding JR, Deville C, et al. Improving diversity, inclusion, and representation in radiology and radiation oncology part 2: challenges and recommendations. J Am Coll Radiol. 2014;11(8):764-770. doi:10.1016/j.jacr.2014.03.008

Yehia BR, Cronholm PF, Wilson N, et al. Mentorship and pursuit of academic medicine careers: a mixed methods study of residents from diverse backgrounds. BMC Med Educ. 2014;14:26. doi:10.1186/1472-6920-14-26

Liebschutz JM, Darko GO, Finley EP, Cawse JM, Bharel M, Orlander JD. In the minority: black physicians in residency and their experiences. J Natl Med Assoc. 2006;98(9):1441-1448. https://pubmed.ncbi.nlm.nih.gov/17019911/

Edmond MB, Deschenes JL, Eckler M, Wenzel RP. Racial bias in using USMLE step 1 scores to grant internal medicine residency interviews. Acad Med. 2001;76(12):1253-1256. doi:10.1097/00001888-200112000-00021

Recommendations:

Gonzaga AMR, Appiah-Pippim J, Onumah C, Yialamas M. A framework for inclusive Graduate Medical Education recruitment strategies: Meeting the ACGME standard for a diverse and inclusive workforce. Acad Med. 2020; 95(5) 710-716 doi: 10.1097/ACM.0000000000003073

Castillo EG, Isom J, DeBonis KL, Jordan A, Braslow JT, Rohrbaugh R. Reconsidering systems-based practice: Advancing structural competency, health equity, and social responsibility in Graduate Medical Education. Acad Med. doi: 10.1097/ACM.0000000000003559

p.s. Check out this list for a brief review of undergraduate medical education (UME)