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Acad Med. 2019 Aug;94(8):1137-1141. doi: 10.1097/ACM.0000000000002779.

Bridging the Gap: Holistic Review to Increase Diversity in Graduate Medical Education.

Author information

1
O. Aibana is assistant professor of internal medicine, John P. and Kathrine G. McGovern Medical School at UT Health, Houston, Texas; ORCID: https://orcid.org/0000-0003-0665-5393. J.L. Swails is assistant professor of internal medicine and program director, Internal Medicine Residency, John P. and Kathrine G. McGovern Medical School at UT Health, Houston, Texas. R.J. Flores is assistant professor of internal medicine and associate program director, Internal Medicine Residency, John P. and Kathrine G. McGovern Medical School at UT Health, Houston, Texas. L. Love is associate professor of pediatrics and associate dean of diversity and inclusion, John P. and Kathrine G. McGovern Medical School at UT Health, Houston, Texas.

Abstract

PROBLEM:

Racial and ethnic disparities in health outcomes remain pervasive in the U.S. health care system. Increasing the diversity of the physician workforce is recognized as an important component of addressing these disparities. Holistic review, which gives balanced consideration to applicants' academic metrics, experiences, and attributes, has gained popularity in undergraduate medical education and led to improvement in student diversity. Limited research has investigated how holistic review and other strategies can be implemented in graduate medical education to enhance diversity.

APPROACH:

The internal medicine (IM) residency program of the John P. and Kathrine G. McGovern Medical School implemented a pilot intervention in academic years (AY) 2016-2017 and 2017-2018 aimed at increasing the number of matriculating residents who are underrepresented in medicine (URM). The intervention included (1) using holistic review in the process of selecting applicants for interview, (2) standardizing the interview encounters, and (3) explicitly highlighting the program's commitment to diversity on interview days.

OUTCOMES:

From AY 2015-2016 (preintervention) to AY 2017-2018, the percentage of URM applications reviewed increased from 14.1% (180/1,276) to 20.4% (183/897), the proportion of URM applicants interviewed rose from 16.0% (60/374) to 24.5% (95/388), and the proportion of URM residents matriculating increased from 12.5% (5/40) to 31.7% (13/41).

NEXT STEPS:

Further efforts are needed to expand the pool of URM applicants at McGovern and elsewhere and to identify how holistic review can be widely employed in other IM residency programs and in other specialties.

PMID:
31045603
DOI:
10.1097/ACM.0000000000002779
[Indexed for MEDLINE]

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