scholarly journals Diversity, Equity, and Inclusion in Hematology and Oncology Fellowship Programs

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2977-2977
Author(s):  
Michael Mankbadi ◽  
Lidet Alemu ◽  
Afiya Bey ◽  
Nathan T. Connell ◽  
Lisa Fanning ◽  
...  

Abstract Background The National Institutes of Health define African Americans or Blacks, American Indians, Alaska Natives, Hispanics or Latinos, Native Hawaiians, and other Pacific Islanders as being underrepresented in medicine. A number of studies have demonstrated that improving diversity of such underrepresented demographics within the medical profession improves patient outcomes, medical education and reduces health disparities in patients from vulnerable racial or socioeconomic groups. Despite this recognition, significant underrepresentation of various racial, ethnic, and sexual identities still exists within nearly all medical specialties. Aims The purpose of this study was to a gain a greater understanding of the current state of diversity, equity, and inclusion (DEI) efforts among U.S. hematology and medical oncology fellowship training programs. We explored the perspectives of adult and pediatric fellowship program directors regarding current recruitment strategies and suggestions for improvement to help mitigate the effects of implicit and explicit bias. Here, we present an interim analysis of the data using descriptive statistics. Methods: We convened a multi-institutional collaboration of fellowship program directors, teaching faculty, and staff members of the American Society of Hematology to develop a survey examining perceptions of DEI efforts among hematology and medical oncology fellowship program directors. The survey was pilot tested in a small group of program directors representing 6 different academic programs (5 adult, 1 pediatric). The final online survey was distributed via email to 224 fellowship program directors at U.S. adult and pediatric hematology and medical oncology fellowship programs. The survey included 29 questions regarding perspectives on bias within the fellowship selection process, current DEI initiatives, and current faculty and fellow demographics. Survey respondents were asked to rate the importance of numerous factors in determining which applicants to invite utilizing a scale of 0-10, with 0 and 10 representing lowest and highest importance, respectively. To measure program director perceptions of certain applicant groups, survey respondents were asked to rate applicant demographics as being advantaged/disadvantaged based on survey options ranging from 0-5, with 0 and 5 representing very disadvantaged and very advantaged, respectively. Results: At interim analysis, 41 of 224 program directors completed the survey for an interim response rate of 21%, including 25 adult program directors and 16 pediatric program directors, with representation from university and community programs. Of the program directors surveyed, 28 (68%) reported having access to a dedicated diversity committee or DEI policies in place to improve recruitment of underrepresented applicants. In determining which applicants to invite, respondents placed highest value on the applicant's program director letter (mean score ± standard deviation: 7.44±1.93), caliber of the applicant's residency program (7.28±2.06) and letters of recommendations (7.15±2.23). Survey respondents viewed white and male applicants as representing the most advantaged demographic group, while LGBTQI, age>40, and U.S. citizen and non-citizen international medical graduates were the most disadvantaged (Table 1). Suggestions regarding improving DEI in the fellowship selection process included implementing bias training, identifying potentially disadvantaged applicants in ERAS, increasing faculty diversity, and pairing underrepresented applicants with interviewers based on applicant preference. Conclusion: While the majority of hematology and medical oncology fellowship program directors report having DEI programs or policies to improve recruitment of underrepresented applicants, perceptions of advantaged/disadvantaged groups may extend beyond demographics traditionally viewed as being underrepresented in medicine. As our survey is ongoing, we plan to reanalyze our data when the survey has been finalized with a higher response rate utilizing multivariable regression to identify themes that may further improve DEI efforts within the fellowship selection process. Figure 1 Figure 1. Disclosures LaCasce: Bristol-Myers Squibb Company.: Other: Data Safetly and Monitoring. Murphy: North American Thrombosis Foundation: Honoraria. Naik: Rigel: Research Funding. Podoltsev: Pfizer: Honoraria; Blueprint Medicines: Honoraria; Incyte: Honoraria; Novartis: Honoraria; Celgene: Honoraria; PharmaEssentia: Honoraria; Bristol-Myers Squib: Honoraria; CTI BioPharma: Honoraria.

Author(s):  
Danica Rockney ◽  
Constance A Benson ◽  
Brian G Blackburn ◽  
Lisa M Chirch ◽  
Victoria J L Konold ◽  
...  

Abstract Background Graduate Medical Education training programs transitioned to all-virtual recruitment in 2020. Limited data have been published regarding the consequences of this transition. We aimed to understand (1) infectious diseases (ID) fellowship programs’ recruitment efforts and the effect of virtual recruitment on application and interview numbers, and (2) the number of programs to which matched applicants applied and interviewed, and their perspectives on virtual recruitment. Methods In 2020-21 we surveyed all United States ID fellowship program directors (PDs) and matched applicants. Descriptive data analysis was performed on quantitative survey items. Free-text responses were analyzed through a quantitative content analysis approach. Results PD response rate was 68/158 (43%); applicant response rate was at least 23% (85/365). PDs reported a 27% increase in mean number of applications received and a 45% increase in mean number of applicants interviewed compared to the previous year. Applicants especially valued online program structure information, PD program overview videos, didactic and curriculum content, and fellow testimonials and profiles. Most applicants preferred interviews lasting no more than 40 minutes and interview days lasting no more than 5 hours. Nearly all (60/64, 94%) PDs adequately learned about candidates; most (48/64, 75%) felt unable to showcase their program as well as when in-person. Most PDs (54/64, 84%) and applicants (56/73, 77%) want an option for virtual recruitment. Conclusions Virtual recruitment enabled programs to accommodate more applicants and highlighted applicants’ preferences for programs’ augmented online presences and time-limited interview days. Most programs and applicants want an option for virtual interviews.


Pain Medicine ◽  
2020 ◽  
Vol 21 (8) ◽  
pp. 1708-1717 ◽  
Author(s):  
Lynn Kohan ◽  
Susan Moeschler ◽  
Boris Spektor ◽  
Rene Przkora ◽  
Christopher Sobey ◽  
...  

Abstract Background Pain fellowship programs are facing unique challenges during the COVID-19 pandemic. Restrictions from state governments and the Centers for Disease Control and Prevention have resulted in a rapidly changing and evolving learning environment for todays’ fellows. Innovative solutions must be sought to guarantee that proper education is maintained and to ensure the well-being of our trainees. Methods We assembled a panel of pain program directors who serve as officers/board members of the Association of Pain Program Directors to provide guidance and formulate recommendations to pain fellowship directors nationally. This guidance is based on reviewing current changes to the Accreditation Council for Graduate Medical Education (ACGME) and American Board of Anesthesiology policies and best available evidence and expert opinion on the use of remote educational activities, research endeavors, and trainee wellness. Conclusions The country is in the midst of an unprecedented pandemic. The impact on pain management fellowships has been severe and will likely last for months, resulting in extraordinary challenges to the administration of pain fellowship programs and the education of our fellows. Understanding revisions to ACGME policies, using technology to promote remote learning opportunities, and providing trainees with opportunities to alleviate their anxiety and encourage mental health are beneficial strategies to implement. Together, we can implement innovative solutions to help overcome these challenges.


2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 87-87
Author(s):  
Emily Jean Martin ◽  
Joshua Adam Jones

87 Background: Educational deficiencies among hospice and palliative medicine (HPM) physicians are thought to contribute to sub-optimal utilization of palliative radiotherapy (PRT) for patients with advanced cancer. We conducted a national survey of HPM fellowship program directors and fellows to assess the need for increased PRT education in HPM fellowship. Methods: A 17-item, anonymous, electronic survey was distributed via email in May 2018 to the directors of all US Accreditation Council for Graduate Medical Education-accredited HPM fellowship programs with at least one enrolled fellow. A similar 19-item survey was emailed to the coordinators of these programs for distribution to enrolled fellows. Three reminder emails were sent over a one-month period. Results: Eighty-one (68%) of 120 eligible program directors and 114 (34%) of 338 eligible fellows completed the surveys. Nearly all respondents (98% of program directors and 99% of fellows) agreed that HPM physicians should be familiar with the principles of PRT and 95% of both groups agreed that this topic should be taught in HPM fellowship. Thirty percent of programs, however, lacked any PRT curriculum and 57% of programs provided only 1 or 2 hours of didactic PRT education. The minority of fellows felt confident in their ability to identify radiation oncology emergencies (43%) or to manage symptoms associated with radiotherapy toxicities (42%) and only 56% felt confident in their ability to assess which patients should be referred to radiation oncology for possible PRT. Notably, the majority of fellows reported that if they were more knowledgeable about PRT they would be more likely to consider referral to radiation oncology (78%), to collaborate with the radiation oncologists involved in their patients’ care (76%), and to advocate for shorter fractionation schedules or possible omission of radiation therapy altogether based on a patient’s prognosis or goals of care (78%). Conclusions: HPM fellowship program directors and fellows agree that that there is a need for increased education in PRT in HPM fellowship. Curricular interventions that address this need may result in more appropriate utilization of PRT.


2017 ◽  
Vol 9 (4) ◽  
pp. 523-526 ◽  
Author(s):  
Twinkle Patel ◽  
Katharina Schwan ◽  
Sara Hoover ◽  
Allison O'Hollaren ◽  
Suria Sadat ◽  
...  

ABSTRACT Background  Pediatrics fellowship programs typically are small, embedded in divisions, and vary in their approach to education. Program coordination usually falls to division administrators who operate in silos despite common requirements across programs, creating redundancy and inefficiency. Objective  We examined the feasibility, acceptability, and impact of a centralized administrative model for pediatrics fellowship support at a large university-based institution. Methods  In 2014, administrative support for the pediatrics fellowships at the University of California, San Francisco, was restructured from a model with division-level support to a centralized model. In the new model, a team of 6 full-time administrators supports 19 fellowship programs with a total of 80 fellows. The fellowship support team consists of 3 program coordinators, a data coordinator, a human resource coordinator, a team manager, and a faculty advisor. The team meets twice a month to discuss program issues and innovative ideas. Quarterly meetings are held with all coordinators and directors to discuss changes across fellowships and foster further collaboration. We surveyed program directors to examine the acceptability of the model and assessed its impact on finances and turnover. Results  Of 19 eligible fellowship program directors, 15 (79%) completed the survey. The majority indicated that the new administrative model was “better” or “much better” than the prior model. The new model resulted in decreased costs (an estimated $250,000 per year in salary support) and lower staff turnover. Conclusions  Centralization of fellowship administration is feasible and offers substantial benefits for all stakeholders involved.


2014 ◽  
Vol 6;17 (6;12) ◽  
pp. E681-E689
Author(s):  
Bassem O. Asaad

Background: Over the last decade ultrasound guidance (USG) has been utilized very successfully in acute pain procedures to confirm nerves’ anatomic location and obtain live images. Not only the utilization, but the teaching, of USG has become an essential part of anesthesiology residency training. Prior to the introduction of USG, chronic pain procedures were always done either under fluoroscopy or blindly. USG offers advantages over fluoroscopy for completion of chronic pain procedures. USG decreases radiation exposure and the expenses associated with operating a fluoroscopy machine and allows live visualization of soft tissues and blood flow, a feature that fluoroscopy does not directly offer. Even today, the utilization and teaching of the technique for chronic pain procedures has not been as widely accepted as in acute pain management. Objectives: To understand the current practices and the factors affecting the teaching of ultrasound guided chronic pain procedures in chronic pain fellowship programs throughout the United States. Study Design: Survey conducted by internet and mail. The survey was distributed to program directors of ACGME-accredited pain medicine fellowships. When the survey was distributed there were 92 accredited pain medicine fellowships. Methods: REDCap survey software was used for designing the questionnaire and sending email invitations. Also, paper questionnaires were sent to those who did not respond electronically. Additional copies of the survey were mailed or faxed upon request. We received 43 responses (a response rate of 46.7%). Statistical analyses included frequencies, crosstabs, and nonparametric Spearman rank-order correlations. Results: The majority of stellate ganglion blocks, occipital nerve blocks, and peripheral nerve blocks are currently being done under ultrasound guidance. Although interest among trainees is very high, only 48.8% of the fellowship programs require fellows to learn the technique before graduation and 32.6% of the program directors agree that teaching of USG should be an ACGME requirement for pain medicine fellowship training. Faculty training is considered to be the most important factor for teaching the technique by 62.8% of directors. In the opinion of the majority of program directors, the greatest factor that stands against teaching the technique is the fact that it is time consuming. Nearly half (44.2%) of program directors believe that the technique will never replace fluoroscopy; but one quarter (25.6%) think that the new 3D ultrasound technology, when available, will replace fluoroscopy. Limitations: A moderate response rate (46.7%) may limit the generalizability of the findings. However, our survey respondents seem to represent the study population quite well, although there was a bias towards the university-based programs. Training programs located at community-based hospitals and U.S. government installations were not as well represented. Conclusion: The teaching of ultrasound guided chronic pain procedures varies significantly between individual programs. Though many program directors do require that fellows demonstrate competency in the technique before graduation, as of today there is no ACGME guideline regarding this. The advancement in ultrasound technology and the increase in number of trained faculty may significantly impact the use of USG in training fellows to perform chronic pain procedures. Key words: Ultrasound guidance, fluoroscopy, chronic pain procedures, regional nerve blocks, musculoskeletal procedures, implantable devices, pain medicine, fellowship training, anesthesia residency training


Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3392-3392
Author(s):  
Rakhi P. Naik ◽  
Manuela Plazas Montana ◽  
Leslie S. Kersun ◽  
Srikanth Nagalla ◽  
Alfred I Lee

BACKGROUND: The American Board of Internal Medicine (ABIM) offers separate board examinations for adult hematology and medical oncology, yet the vast majority of fellowship training programs in the United States are structured as combined hematology/oncology programs. Single-board hematology tracks or programs may help increase recruitment and retention in non-malignant hematology; however, the barriers and attitudes toward hematology-only fellowship programs are unknown. We administered a survey to ACGME-accredited hematology/oncology program directors to explore their perceptions toward training in non-malignant hematology and their attitudes toward single-board hematology training. METHODS: In collaboration with the ASH Medical Educators Institute, we developed an anonymous online survey with 30 multiple-choice and open-ended questions to characterize attitudes toward specialization in non-malignant hematology and to assess program director interest and perceived barriers toward single-board hematology training. The survey was electronically administered to program directors of active hematology/oncology fellowship programs in the United States (n=139) in March/April 2019 using Qualtrics software. RESULTS: Of the 139 program directors who received the survey, 90 (65% response rate) completed the survey. The majority of program directors characterized their institutions as academic (87%), with only 9 (10%) describing their programs as community-based. Seventy-eight (87%) program directors believed that there is a shortage of exclusive non-malignant hematologists in the United States, and 59% felt that training more fellows to practice exclusive non-malignant hematology could help address the shortage (Table 1). Jobs for for exclusive non-malignant hematologists were perceived to exist only in academic settings by 47 (52%) respondents. In terms of fellowship training, program directors reported that an average of 5% of fellows per program pursued a career largely or exclusively focused on non-malignant hematology. In addition, 39 (43%) program directors felt that fellows were dissuaded from pursuing a career exclusively in non-malignant hematology. Regarding single-board hematology training, 73% of program directors believe that hematology-only training is both necessary and sufficient for fellows specializing in non-malignant hematology. The most commonly perceived barriers to single-board hematology fellowship programs were: 1) concerns for job availability for single-board hematology trainees, 2) concerns about limiting the training option to hematology only, and 3) lack of interested applicants to the program (Table 2). If barriers were addressed, 37% of programs directors reported that they would be interested in implementing a single-board hematology track at their institution. CONCLUSIONS: Combined hematology/oncology fellowship training is nearly exclusive to the United States. Our survey demonstrates that the percentage of fellows specializing in non-malignant hematology is significantly low (5%), a number that remains unchanged compared to a prior ASH program director survey in 2003. Our results also suggest that programs directors are interested in training fellows in non-malignant hematology and that single-board hematology training is generally acceptable among program directors. It will be important to address perceived barriers to hematology-only programs in order to promote implementation. Disclosures Naik: Elsevier: Other: Content Editor. Nagalla:Alnylam: Membership on an entity's Board of Directors or advisory committees.


2009 ◽  
Vol 27 (10) ◽  
pp. 1706-1711 ◽  
Author(s):  
Frances A. Collichio ◽  
Karen M. Kayoumi ◽  
Kenneth R. Hande ◽  
Richard E. Hawkins ◽  
Janine L. Hawley ◽  
...  

The American Society of Clinical Oncology (ASCO) developed its own test—the Medical Oncology In-Training Examination (MedOnc ITE)—as a tool to assess trainees' knowledge of the clinical oncology subspecialty, establish consistency in educational standards across training programs, identify areas of strength and weakness in individual programs, and stimulate intraprogrammatic reading and discussion. The Accreditation Council for Graduate Medical Education Outcome Project provided additional incentive for ASCO to develop an ITE. The examination was developed in 4 years. The concept of the examination and the budget were approved by the ASCO governing board. The National Board of Medical Examiners was selected to work with ASCO. Fellowship programs were contacted to determine if they had the information technology support to hold the examination. A blueprint for the examination was developed. The test format, including the number of questions and the selection of case-based single best answers, was determined. Physician volunteers to write the questions were solicited from among program directors, various ASCO committees, and disease experts. A workshop was held to teach volunteers how to write proper case-based questions. From this pool, a smaller group of physicians was selected to develop the test and review all test questions. The final examination was developed and administered in February 2008, with scores provided to fellows and program directors in April 2008. Feedback received after the examination will be helpful for developing future MedOnc ITEs. The process ASCO went through to develop the MedOnc ITE serves as a model for other subspecialties interested in developing their own ITEs.


2019 ◽  
pp. rapm-2019-100878
Author(s):  
Jonathan Michael Hagedorn ◽  
Thomas Pittelkow ◽  
Nafisseh Warner ◽  
Timothy Furnish ◽  
Scott Brancolini ◽  
...  

BackgroundWomen are entering medical school in record numbers, but multiple male-dominated medical specialties still exist, including pain medicine. It is not well-understood how gender diversity in academic pain medicine faculty affects fellow matriculation between female and male applicants.ObjectiveWe conducted a survey to ascertain whether gender diversity of those in leadership roles in pain medicine programs impacts the gender diversity of fellows in those programs.MethodsA questionnaire was delivered to all Accreditation Council for Graduate Medical Education-accredited pain medicine fellowships to assess their demographic data in 2018. Program characteristics are summarized using median (25th, 75th) for continuous variables and frequency counts and percentages for categorical variables. Analyses were then performed using a generalized linear mixed model with a logit link function and fellowship program included as a random effect. The gender of the fellow was the dependent variable and the program characteristics were the explanatory variables.ResultsData from 45 of 104 fellowship programs (43% response rate) are included. From univariate analysis, the odds of a fellow being female were higher in programs with a female program director (OR=2.17, 95% CI 1.29 to 3.65, p=0.004) and in programs with a higher percentage of female faculty (OR=1.02, 95% CI 1.00 to 1.04, p=0.027). From multivariable analysis, having a female program director was the only program characteristic found to be significantly associated with female fellows (OR=2.07, 95% CI 1.05 to 4.11, p=0.037).ConclusionsPain medicine fellowship programs with a female program director were significantly more likely to have female fellows.


2021 ◽  
Author(s):  
Danica Rockney ◽  
Constance A Benson ◽  
Brian G Blackburn ◽  
Lisa M Chirch ◽  
Victoria J. L. Konold ◽  
...  

Background: Graduate Medical Education training programs transitioned to all-virtual recruitment in 2020. Few data have been published regarding the consequences of this transition. We desired to understand (1) infectious diseases (ID) fellowship programs' recruitment efforts and the effect of virtual recruitment on application and interview numbers, and (2) the number of programs to which matched applicants applied and interviewed, and their perspectives on virtual recruitment. Methods: In 2020-21 we surveyed all United States ID fellowship program directors (PDs) and matched applicants. Descriptive data analysis was performed on quantitative survey items. Free-text responses were analyzed through a quantitative content analysis approach. Results: PD response rate was 68/158 (43%); applicant response rate was at least 23% (85/365). PDs reported a 27% increase in mean number of applications received and a 45% increase in mean number of applicants interviewed. Applicants especially valued online program structure information, PD program overview videos, fellow testimonials, didactic and curriculum content, and current fellow profiles. Most applicants preferred interviews lasting no more than 40 minutes and interview days lasting no more than 5 hours. Nearly all (60/64, 94%) PDs adequately learned about candidates; most (48/64, 75%) felt unable to showcase their program as well as when in-person. Most PDs (54/64, 84%) and applicants (56/73, 77%) want at least an option for virtual recruitment moving forward. Conclusions: Virtual recruitment enabled programs to accommodate more applicants and highlighted applicants' preferences for programs' augmented online presences and time-limited interview days. Most programs and applicants want the option for virtual interviews.


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