• J Gen Intern Med · Sep 2020

    Diversity Within the Most Competitive Internal Medicine Fellowships: Examining Trends from 2008 to 2018.

    • Praneet Mylavarapu, Nealansh E Gupta, Varun Gudi, Apoorva Mylavarapu, Lori B Daniels, and Mitul Patel.
    • Department of Cardiology, University of California, San Diego, CA, USA. pmylavarapu@health.ucsd.edu.
    • J Gen Intern Med. 2020 Sep 1; 35 (9): 2537-2544.

    BackgroundPrior studies have demonstrated the importance of diversity among physicians. Identifying trends in diversity within the most competitive internal medicine (IM) fellowships can guide focused efforts to address barriers to equal representation.ObjectiveTo examine the racial and gender composition of resident applicants and accepted fellows to the top five most competitive IM specialties.DesignSurvey data from the AAMC, JAMA, and NRMP were obtained. Fisher's exact tests were conducted to compare differences in representation between fellows in the most competitive specialties, resident applicants into those specialties, and categorical IM residents. Linear regression was used to analyze trends within each group.ParticipantsCategorical IM residents and fellows at ACGME-accredited M.D. programs in the USA.Main MeasuresProportion of each population by gender and race/ethnicity KEY RESULTS: Women saw an increase in representation among accepted fellows to the most competitive IM fellowships from 2008 to 2013 (+ 4.4%, p < 0.011), but the trend has since plateaued at a level (34%) significantly lower than their representation among IM residents (43%, p < 0.001). Black representation among accepted fellows (4.6%) has been increasing from 2008 to 2018 (+ 1.2%, p = 0.001), but is still significantly lower than their representation among IM residents (5.6%, p < 0.001). Hispanic resident applicant and fellow representation have seen minimal change.ConclusionDespite trends towards better representation among women and underrepresented minorities (URMs) among fellows in the most competitive IM specialties from 2008 to 2013, there has been a stagnation in both gender and racial diversity over the past 5 years. Further efforts must be undertaken to address barriers to entry and advocate for better representation of women and URMs in fellowship programs.

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