139 - Promoting Inclusivity and Belonging for Pediatric Residents from Backgrounds Underrepresented in Medicine

Poster Number: 139
Publication Number: 139.217

Aisha Barber, Children's National Medical Center, Washington, DC, United States; Judith Singletary, Howard University, Bowie, MD, United States; Stephen J. Teach, Children's National Hospital, Washington, DC, United States; Mark L. Batshaw, Children's National Health System, Washington, DC, United States; Jessica Hippolyte, Children's National Health System, Washington, DC, United States; Dewesh Agrawal, Children's National Hospital, Washingtpn, DC, United States

Background: Enhancing diversity and inclusion in pediatrics is essential to improving health outcomes, especially in minority populations. The pediatric residency program at Children’s National Hospital has significantly increased diversity from 15% to 46% as measured by the percentage of its 40+ interns self-identifying as members of racial/ethnic populations underrepresented in medicine (UIM) over the past 5 years. The program is now focused on ensuring the inclusivity and well-being of its diverse trainees.

Objective: Given the limited research on an inclusivity framework for medical trainees, the purpose of this qualitative study was to understand factors that promote inclusivity and feelings of belonging for UIM residents. 

Design/Methods: In May 2021, two online synchronous focus groups with UIM pediatric residents were conducted via Zoom, one with 6 first-year residents and the other with 4 senior residents.  All residents self-identifying as coming from backgrounds UIM were eligible to participate in this IRB-approved project. To protect the anonymity of participants an outside research consultant recruited the participants and collected and analyzed the data. All identifying information was removed from the focus group transcripts. Data were hand-coded for analysis by sorting and counting conceptual tags. Clusters of similar tags and codes were grouped into themes, and key themes were grouped and labeled as categories. Axial coding was used to confirm the accuracy of conceptual representations and explore interconnectedness.

Results: When asked if they felt that they fit in or belong, first-year residents answered that although they fit in more during residency than in medical school, they often feel marginalized by colleagues and patients because of their race, gender identity, or status as a resident. Senior residents similarly noted that, while they may feel close to a particular group or social circle, the large size of the program (120 residents) prevented personal connections on a wider scale. They noted that this issue has been exacerbated by the COVID-19 pandemic which has led to lost opportunities for mentorship and professional growth. Residents noted that, while their work environment was inclusive, they still experienced incidents of discrimination.Conclusion(s): UIM pediatric residents often felt marginalized by colleagues and patients. Pandemic-related social isolation and the large size of the program prevented opportunities for connection and professional growth. While there were no general concerns for lack of inclusivity, residents reported examples of discrimination in the workplace.