The State of Diversity and Inclusion in Regional Anesthesiology and Acute Pain Medicine (RA/APM) Fellowship Programs

Umeh UO.^1,2, Kalsi M.^1,2, Tailor M.¹, Zhong H.¹, Mehta S.³, Jain N.⁴, Pai P.⁵, Pulos B.⁶, Gabriel R.⁷, Joseph R.⁸, Lauzadis J.¹, Hargett MJ.¹, Rosenblatt MA.⁵

¹Department of Anesthesiology, Critical Care, & Pain Management, Hospital for Special Surgery; ²Department of Anesthesiology, Weill Cornell Medicine; ³Rutgers New Jersey Medical School; ⁴Department of Anesthesiology, Parkview Health; ⁵Department of Anesthesiology, Mount Sinai West and Morningside; ⁶Department of Anesthesiology and Perioperative Medicine, Mayo Clinic; ⁷Department of Anesthesiology, University of California San Diego; ⁸Department of Anesthesiology, Virginia Mason Franciscan Health

 

Introduction

• This cross-sectional survey-based study assessed the demographic characteristics of the 2023-2024 Regional Anesthesiology and Acute Pain Medicine (RA/APM) fellowship class.
• The number of underrepresented in medicine (URiM) racial/ ethnic groups and women in medical subspecialties such as anesthesiology is disproportionate to the diversity of the US population.^1,2,3
• Diversity in medicine is important to promote excellence in clinical practice and produce a workforce that can address widening inequities in US healthcare.⁴

Methods

1. Approved by Hospital for Special Surgery (HSS) Institutional Review Board (IRB #2023-1862).
2. REDCap survey emailed to 84 RA/APM fellowship directors in the US and Canada.
3. De-identified responses received from 39 US RA/APM fellowship directors.
4. Analyses were performed using SAS version 9.4 (SAS Institute, Cary, NC).

 

To increase underrepresented in medicine and LGBTQIA+ representation in RA/APM fellowship programs, we should increase early exposure to medical subspecialties, mentorship, and financial assistance.

 

Results

39 programs (120 total fellows) 21 URiM fellows 11 Black/African American 9 Hispanic/Latino/a/x or Spanish Origin 1 Native Hawaiian or Other Pacific Islander

24* programs (72 fellows) 6 LGBTQIA+ fellows

*15 responding fellowship directors were unsure of fellows’ LGTBQIA+ status

 

Discussion

• In the pipeline to medicine, we must address barriers to entry and retention for URiM students (limited resources, finances).^5,6
• We should provide early exposure to subspecialties, mentorship, and shadowing opportunities.
• Applicants who are sexual and gender minorities are less likely to apply to prestigious specialties due to lack of inclusivity.⁷
• Accreditation Council for Graduate Medical Education (ACGME) requires diversity training programs, but not all US RA/APM fellowship programs are ACGME accredited.
• This survey data represents the 2023-2024 RA/APM fellowship class. The majority of programs participated in the San Francisco Residency and Fellowship Matching Services (SF Match) to recruit the 2024-2025 RA/APM fellowship class.
• Repetition of this study in future years would identify how RA/APM fellowship class demographic characteristics vary year by year.