Born out of the Heersink School of Medicine’s strategic plan to improve the recruitment and retention of underrepresented minorities in medicine (URiM) in Graduate Medical Education (GME), The Dean’s Committee for Graduate Medical Education (DCGME) Subcommittee for Diversity and Inclusion was formed to help bring the school’s vision to life.
After gathering feedback from essential constituents and reviewing the current literature,10 key recommendations were developed for the Heersink School of Medicine. In the spirit of transparency and holding ourselves to a high standard of diversity and inclusion, we are sharing these recommendations with the UAB community, those looking to join us, or persons simply seeking more information.
1) Holistic Review of Applicants Interviewed
The basis behind holistic review is widening the lens through which we review candidates—recognizing and valuing the applicant’s experiences, attributes and academic metrics.
2) Step Score Cut-offs for URiM Applicants
It is recommended that programs expand minimum USMLE score cut-offs when screening applicants for interviews and in ranking considerations, as well as, consider blinding interviewers to this information to decrease bias during interviews. While USMLE step scores are frequently used as an objective measure to rate applicants, according to the literature, there is no conclusive relationship between USMLE scores and resident quality or performance at the time of graduation.
3) Effectively ranking URiM Applicants
It is recommended that GME programs review their best matches historically over the past five-years to have a better understanding of target ranges for strategic ranking of highly competitive URiM candidates for an overall goal of recruiting an intern class whose demographics are reflective of the patient population served at UAB.
4) Tailored Interviewers for URiM Applicants
It is recommended that programs have at least one interviewer with similar demographics to the applicant (if available). It was stated during interviews of current MS4 URiM medical students, current residents, and applicants in matchable positions, that structuring the interview day with URiM faculty and champions of diversity makes an impact to the candidate who reported diversity as a factor in their selection of residency programs.
5) Unconscious Biases Training for Interviewers
It is recommended that GME programs have their prospective interviewers receive unconscious bias training prior to interviewing applicants. As evident of the impact on unconscious biases in healthcare, in 2014 the AAMC and The Ohio State University Kirwan Institute for the Study of Race and Ethnicity convened a forum to discuss how unconscious bias affected academic medicine.
The article, Unconscious Bias in Academic Medicine: How the Prejudices We Don’t Know We Have Affect Medical Education, Medical Careers, and Patient Health, was a result of this meeting. It details how unconscious, or implicit, bias affects all aspects of academic medicine and contributes to the underrepresentation of racial and ethnic minorities at every level of the medical profession. This underscores the need to introduce such training within our interviewing faculty pool for all GME programs.
6) Engagement of highly competitive URiM applicants for Second Look
The Heersink School of Medicine Second look is designed to provide competitive URiM applicants an opportunity to learn more about the diversity and inclusion efforts of UAB.
It is recommended that programs strategically invite those applicants that will be considered competitive for the match process in their programs, with clear communication to all applicants that their attendance is not required nor will affect their ranking within the program.
7) Outreach after Interviews
It is recommended that GME programs provide outreach to URiM applicants after interviews. This outreach could be from residents, faculty (other than the departmental GME leadership) in your department or other departments that have diversity champions. It should be a goal to have outreach at multiple levels to emphasize to applicants our desire to recruit them here at UAB.
Note: This communication will abide by the National Resident’s Match Program code of conduct, in that it should not be disingenuous with the purpose of influencing an applicant’s rank process. This intentional communication is encouraged to allow applicants to learn more about UAB as well as our city and to answer questions applicants may have while on the interview trail.
8) Consider a Visiting Elective Program
It is recommended that programs consider sponsoring visiting elective programs. Many URiM applicants reported that they were not familiar with the excellent training and environment we have to offer at UAB prior to their interview. These visiting elective programs will require both institutional and departmental support to ensure success. This may include development of scholarships within Departments, with potential support by the Office of Diversity and Inclusion.
9) Attendance at Conferences Designed to Reach URiM Applicants
We recommend attendance at national programs that have conferences targeted for URiM applicants. This would include the The Student National Medical Association (SNMA) Annual Medical Education Conference (AMEC), the Latino Medical Student Association (LMSA) national conference, and the Association of Native American Medical Students (ANAMS). Attendance at these national and/or regional conferences may provide an opportunity to engage with multiple URiM students that may not be familiar with the UAB programs.
10) Initiatives to Improve Cultural Competency for all Residents and Faculty
It is recommended that all residents and faculty members be provided cultural awareness exposure, as well as formal implicit bias and cultural sensitivity training to minimize such experiences and to improve the overall environment for URiM applicants once they matriculate into our residency programs.