Thread by @MDSteeve

It's Martin Luther King Jr. day
In the essence of Dr. King, I'm going to keep it extra real with Twitter this evening. This is particularly aimed at the medical training programs in the Midwest and South. The performative mission statements really have to end. We're sick of it.

Soooooo many programs have these amazing mission statements of supporting diversity, fostering a community of diverse backgrounds, etc...then you look deeper and they've graduated one resident of color in the past decade. They have a homogeneous faculty but their patients aren't.

Another thing that needs to end is the courtesy interview. If you're not actually interested in ranking candidates of color, then don't invite them for an interview (or ask them to rotate at your hospital). It's a trend in medicine and applicants are aware; it's quite insulting.

I think one of the more infuriating things during the interview trail was traveling to an institution with a poor history of diversity, seeing very minimal POC faces at the interview (maybe 4 out of 30 interviewees), and then checking back and it's all White faces that matched.

Time and time again, programs claim it's hard to recruit diverse candidates. And yet, every year, overwhelmingly it's people of color who make up the unmatched candidate pool. It kinda defies logic. Some programs are notorious for it, and don't even pretend to want to change it.

On the flip side, there are programs where you can literally see when they made an actual effort to diversify, and the faces of those matched there shows it. The faculty also represents that change. The trainees have people they can count on that know their cultural background.

For some reason, this is a revolutionary idea still, in 2022. The obvious barriers being Step 1 score, which we know has no correlation to how good a doctor you'll be, and Step 2 which really only correlates well with FM/IM/EM, and OBGYN knowledge, and zero surgical specialties.

These are graduate medical education programs, emphasis on EDUCATION. Yet, to take the onus off themselves, they tend to over rely on these scores to pick candidates, rather than doing to hard work of....actually finding someone that fits their program AND actually educate them.

...but I digress. The good old boys club persists nonetheless. So many programs are filled with legacy residents who are related to some longtime faculty member. This is not to say all legacy residents are poor matches, but someone better suited may have been left out that spot.

Programs also underestimate how much applicants network with each other. If your program has a history of being malignant for POCs, then they're going to avoid it. If there's not a support system for marginalized people, they're going to avoid it. You should want to be better.

At EVERY interview I went on, one of the first things I did, was talk to POC residents & med students. Find out what the inner workings of the program was, and if they would recommend going there. For the most part, they were honest when they thought I should avoid a program.

I've also had attendings outright tell me that the diversity is lacking, the program isn't doing much about it and their own frustrations...now, why exactly would I want to rank that place high?
Programs clearly depend on the competitive nature of The Match and don't even try.

It's really disheartening to see. A hospital with a patient pool who are primarily minorities & immigrants, yet the entire teaching faculty is White....or their past 5 classes of graduates are all White.

What would make me want to train there? Who would I connect with?

A LOT of the people in power, in Medicine, dismiss the importance of shared cultural experiences in training. Yes, we're there to learn, but it shouldn't feel so isolating for so many people. Go on any forum, there are minority residents begging for a way out of their program.

So many minority residents end up feel less enamored with Medicine based off their experience at a particular program. Others feel trapped someplace where their needs are dismissed. Or worse, many are held back or dismissed disproportionately to their counterparts. It's a shame.

Change doesn't happen in a day, we get that. However, with so many other programs making successful and objectively measurable changes...ask yourself why your program lags behind. Is it by design or due to poor reputation. In either case, let's be better. Stop the performance.

#medtwitter
#Blackmeninmedicine
#MedStudentTwitter
#medicalresident
#diversifymedicine