Commentary

The ACGME Wants Residency Program Directors to Prove Their DEI Credentials

  • By Do No Harm Staff
  • January 28, 2023
  • Accreditation Council for Graduate Medical Education

The Accreditation Council for Graduate Medical Education (ACGME) in a non-profit organization that “sets and monitors” educational standards in medical residency and fellowship programs. Accreditation is granted by ACGME’s Institutional Review Committee, which evaluates the data provided by the graduate medical education programs it oversees.

One method the ACGME uses for collecting those data points is by sending questionnaires to the program directors of various residencies in the United States. We obtained a copy of the “Diversity in Emergency Medicine Questionnaire,” which aims to “identify the current state of gender, ethnic, and racial distribution” of residency programs across the country. It also wants to know what program directors are doing to “increase racial/ethnic and gender diversity” in their recruitment efforts. Those who received a link to the questionnaire were assured that the study was approved by the Baylor College of Medicine Institutional Review Board, and 25 participants had the chance to receive a $100 Amazon gift card.

For assistance with their responses, program directors were instructed to refer to their “ERAS data.” ERAS® is the Electronic Residency Application Service® from the Association for American Medical Colleges (AAMC) and is said to “support the transition to residency in a fair and equitable way.”

Figure 1. Introduction to the ACGME Diversity in Emergency Medicine Questionnaire.

After determining which region of the country the program is in, the survey asked for “the number of residents in your program who are each gender.” A choice of “non-binary/gender non-conforming” is included.

Figure 2. Question #4 of the Diversity in Emergency Medicine Questionnaire.

The next question inquires about the number of residents by race/ethnicity, including “American Indian or Alaska Native; Asian; Black or African-American; Hispanic/Latinx; Native Hawaiian or Other Pacific Islander; White; Bi-racial/Multiracial; Other.”

Figure 3. Question #5 of the Diversity in Emergency Medicine Questionnaire.

The ACGME seeks to further slice and dice the data by requesting the gender and race/ethnicity totals for the program’s chief residents.

In a series of required responses, the rest of the Diversity in Emergency Medicine Questionnaire focused on recruitment and initiatives to increase diversity. Program directors were asked to rank the importance of several elements of the “process of screening/interview selection of applicants” to the residency program, such as grades, test scores, “Underrepresented in Medicine (URiM) Status,” and “gender/gender identity.” Choices of strategies to promote DEI initiatives included:

  • Holistic review
  • Use of the ACGME DEI Curriculum
  • Scholarships for “underrepresented in medicine” students
  • Dedicated DEI budget
  • DEI council and/or designated DEI leader
  • Section of the residency program’s website “that specifically highlights Diversity, Equity, and Inclusion”

To complete and submit the questionnaire, the program manager was asked to provide an answer for his or her race/ethnicity and gender.

Figure 4. Final questions of the Diversity in Emergency Medicine Questionnaire.

Why is the ACGME so obsessed with conducting research on the demographic data of the residency programs it accredits? The Program Director Guide to the Common Program Requirements provides some context:

It is expected that programs, in partnership with their Sponsoring Institutions, have and implement policies and procedures related to recruitment and retention of individuals underrepresented in medicine and medical leadership in accordance with the Sponsoring Institution’s mission and aims. The population of individuals considered underrepresented in medicine will include racial and ethnic minority individuals reflective of the program’s service area but may also include others the program deems underrepresented in medicine in the service area or in the discipline in general. 

Further, the Guide directs readers to the ACGME Equity Matters™ initiative for “continuous learning and process improvement” in DEI and anti-racism. The resources in this program include “commitments to equity for making meaningful change,” and are intended to demonstrate “historical and current injustices in the medical education system.”

Figure 5. ACGME Equity Matters initiative.

Clearly, the ACGME seeks to impress upon its residency program directors that advancing DEI and anti-racism over merit is of greater importance than providing the best emergency medicine training experience to new doctors.

Are you seeing a greater emphasis on DEI than medical learning in your residency program? Let us know – anonymously and securely.