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J Pain Symptom Manage · May 2021
Lack of Exposure to Palliative Care Training for Black Residents: A Study of Schools with Highest and Lowest Percentages of Black Enrollment.
- Lindsay F Bell, Jessica Livingston, Robert M Arnold, Yael Schenker, Riba C Kelsey, Chinedu Ivonye, and Tessie W October.
- Division of General Internal Medicine, Section of Palliative Care and Medical Ethics and Palliative Research Center (PaRC), University of Pittsburgh, Pennsylvania, USA. Electronic address: Lfb8@pitt.edu.
- J Pain Symptom Manage. 2021 May 1; 61 (5): 1023-1027.
ContextThe palliative medicine workforce lacks racial diversity with <5% of specialty Hospice and Palliative Medicine (HPM) fellows identifying as black. Little is known about black trainees' exposure to palliative care during their medical education.ObjectivesTo describe palliative care training for black students during medical school, residency, and fellowship training.MethodsWe conducted a cross-sectional descriptive study using Internet searches and phone communication in September 2019. We evaluated 24 medical schools in three predetermined categories: historically black colleges and universities (HBCUs; N = 4) and non-under-represented minority-serving institutions with the highest (N = 10) and lowest (N = 10) percentages of black medical students. Training opportunities were determined based on the presence of a course, clerkship, or rotation in the medical school and residency curricula, a specialty HPM fellowship program, and specialty palliative care consult service at affiliated teaching hospitals.ResultsNone of the four HBCUs with a medical school offered a palliative care course or clerkship, rotation during residency, or specialty HPM fellowship program. Three of four HBCUs were affiliated with a hospital that had a palliative care consult service. Institutions with the highest black enrollment were less likely to offer palliative care rotations during internal medicine (P = 0.046) or family medicine (P = 0.019) residency training than those with the lowest black enrollment.ConclusionResidents at schools with the highest black medical student enrollment lack access to palliative care training opportunities. Efforts to reduce health disparities and underrepresentation in palliative care must begin with providing palliative-focused training to physicians from under-represented minority backgrounds.Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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