Multi-year Evaluation of Family Medicine Residency Programs for Diversity, Equity, and Inclusion Milestones

Context: As the Accreditation Council for Graduate Medical Education (ACGME) began to ask programs to report their efforts surrounding diversity, equity, and inclusion (DEI), program directors felt ill prepared to evaluate their programs and measure change. Objective: To this end, The Association of Family Medicine Residency Directors (AFMRD) Diversity and Health Equity (DHE) Committee developed and piloted a framework to measure DEI initiatives across 5 domains: Curriculum, Evaluation, Institution, Resident Pathway, and Faculty Pathway.

Study Design: A survey was developed to collect milestone and residency program characteristics data. Program directors were re-surveyed after implementation of the framework to gauge change and identify areas for resource development.

Population Studied: Program directors of ACGME-accredited family medicine residencies.

Instrument: The original survey instrument consists of 12 quantitative items capturing residency program characteristics and the 5 DEI milestone ratings. A follow-up survey instrument was administered 2 years following the baseline survey and included additional survey items assessing positions and program needs.

Outcome Measures: Descriptive statistics including item means, standard deviations, frequencies and cross-tabulations were generated. Analysis of variance was used for subgroup comparisons.

Results: Baseline milestone data were collected for n=194 family medicine residency programs (33% response rate). Respondents represented 48 states and US territories; n=113 represented community-based, university affiliated programs, n=52 represented community-based/non-affiliated, n=38 represented university-based programs, and n=5 represented military/other programs. Overall, the curriculum milestone was rated the highest (mean=2.54), whereas the faculty pathway (mean=1.94) and resident pathway milestones (mean=2.02) were rated lowest. n=140 program directors completed the follow-up survey; at this time the faculty and resident pathway milestones were again rated the lowest (mean= 1.91 and mean=2.12, respectively). The resident evaluation milestone was rated the highest at follow-up (mean= 2.60). Subgroup comparisons will be presented at the meeting.

Conclusions: DEI milestone data provides support to residency programs as they assess their institution’s developmental progress across 5 key domains. Additionally, the FM academic community can use this information to curate additional resources.