Fellowship Pipeline Program Named as an Educational Exhibit Awardee at the ASA

While diversity in healthcare improves patient outcomes, the number of fellows that identify with an under-represented in medicine group remains low. To address this, study authors Billy Nguyen, Marla Ferschl, MD, and Gabe Sarah, MD, conceived of a “Novel Pipeline Mentorship Program for Underrepresented in Medicine Residents Pursuing Fellowship Training.” Ten URIM residents from different anesthesiology residency programs from across the US were each paired with a mentor from UCSF. Meeting frequently during the year-long study period, mentees and mentors worked together to fine-tune personal statements and CVs, practice interview skills, and develop networks to help prepare mentees for the fellowship match. We are delighted to announce that the program was recognized as a Best Educational Exhibit awardee at the American Society of Anesthesiologists’ (ASA) annual meeting this October! Read more about the novel program below.

Background

• Anesthesiologists care for a diverse patient population
• Diversity in healthcare providers has been shown to improve productivity, clinical decision-making, patient outcomes, and safety1
• Over time, more anesthesia residents have entered fellowship, but the number of fellows that identify with underrepresented in medicine (URiM) groups remains low
• In pediatric anesthesiology, between 2000-2018, the proportion of black trainees decreased from 7% to 4.5% and other minority groups decreased from 12.3% to 10.9%2
• In 2019-2020 among 220 adult cardiothoracic anesthesia fellows, only 7 identified as Hispanic, 6 identified as Black, and 1 identified as Native Hawaiian/Pacific Islander3

Methods

• We created a novel URiM Mentorship Program to increase URiM representation in fellowship/subspecialty training.

Recruitment:

• Faculty mentors were recruited from UCSF based on interest and experience.
• URiM resident mentees were recruited from ACGME anesthesiology residency programs in the United States.
• Mentorship program coordinators paired each resident with a mentor from UCSF.

Mentorship Goals:

• Residents and their assigned mentees met at times and at frequencies that were accommodating to their schedules.
• Mentors facilitated networking opportunities, offered feedback on personal statements, reviewed CVs, and provided feedback on interviewing skills. Their focus was to help their resident mentee become more prepared and competitive for the fellowship match.

Program Evaluation:

• After one year, residents and faculty mentors were asked to complete survey to evaluate the utility of the mentorship program and to assess perceptions about potential barriers to fellowship training.

Results

• The inaugural cohort of mentees included 10 residents from different anesthesiology residency programs.
• Each level of training, PGY1-PGY3, was represented.
  • Self-reported resident identities
    • In total, 8 residents identified as Black, 1 identified as Hispanic, and 1 identified as Pacific Islander

Resident Perception About Applying to Fellowship

My level of indebtedness and/or other financial obligations (i.e. taking care of family) makes it less likely that I would choose to pursue fellowship training.

• More than 20% strongly disagreed
• More than 10% were neutral
• More than 40% somewhat agreed
• More than 10% strongly agreed

I feel that my sexual identity puts me at a disadvantage for applying to fellowship programs.

• Almost 60% strongly disagreed
• More than 10% somewhat disagreed
• More than 20% were neutral

I feel that my gender identity puts me at a disadvantage for applying to fellowship programs.

• Almost 60% strongly disagreed
• More than 20% somewhat disagreed
• More than 10% were neutral

I feel that a lack of URiM-identifying faculty in my subspecialty/fellowship of interest has discouraged me from applying to fellowship programs.

• More than 20% strongly disagreed
• More than 20% somewhat disagreed
• More than 20% were neutral
• More than 10% somewhat agreed

As a URiM-identifying resident, I feel that there is a place for me in subspecialty fellowship training.

• More than 10% were neutral
• More than 20% somewhat agreed
• Almost 60% strongly agreed

Mentor Perception About Applying to Fellowship

I feel that a resident’s sexual orientation can put them at a disadvantage when applying to fellowship programs.

• 40% somewhat disagreed
• 20% were neutral
• 40% somewhat agreed

I feel that a resident’s gender-identity can put them at a disadvantage when applying to fellowship programs.

• 20% somewhat disagreed
• 20% were neutral
• 60% somewhat agreed

I feel that a lack of URiM-identifying faculty within anesthesiology subspecialty/fellowship training discourages URiM-identifying residents from applying to fellowship programs.

• 20% strongly disagreed
• 20% were neutral
• 40% somewhat agreed
• 20% strongly agreed

Program Evaluation

Overall, I felt that my participation in the URiM mentorship program improved my chances of matching to a fellowship program.

• 20% somewhat disagreed
• 40% somewhat agreed
• 40% strongly agreed

Overall, I felt that my engagement with my mentor allowed me to submit a more competitive version of my fellowship application.

• 20% strongly disagreed
• 20% were neutral
• 40% somewhat agreed
• 20% strongly agreed

It was helpful to get interview practice and/or feedback from my mentor.

• 100% strongly agreed

It was helpful to get feedback on my CV/resume from my mentor.

• 100% strongly agreed

It was helpful to get personal statement feedback from my mentor.

• 100% strongly agreed

It was helpful to have my mentor facilitate networking opportunities with faculty from the fellowship programs I was interested in.

Discussion

• Results suggest that residents found the program helpful in terms of improving their fellowship application
• 60% indicated the mentorship they received through the program helped to create a more competitive application
• 80% stated that their participation improved their chances of matching
• We hope that the success of our URiM Mentorship Program will encourage other institutions to develop a similar program to improve URiM representation in fellowship training in anesthesiology

References

1. Gomez LE, Bernet P. Diversity improves performance and outcomes. J Natl Med Assoc. 2019 Aug;
2. Nafiu, Olubukola O. MD, FRCA, MS et.al,  Racial, Ethnic, and Gender Diversity in Pediatric Anesthesiology Fellowship and Anesthesiology Residency Programs in the United States: Small Reservoir, Leaky Pipeline, Anesthesia & Analgesia: October 2020
3. Sumler ML et.al A Call for Diversity: Underrepresented Minorities and Cardiothoracic Anesthesiology Fellowship Education. J Cardiothorac Vasc Anesth. 2022 Jan;