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Sunday Poster Session

Category: Practice Management

P1217 - Racial and Ethnicity-Related Barriers to Internal Medicine Residents Pursuing Fellowship Training in Gastroenterology

Sunday, October 22, 2023
3:30 PM – 7:00 PM PT
Location: Exhibit Hall
Naba Saeed, MD1, Hammad Qureshi, MD1, Rashmi R. Advani, MD2, Marta Arjonilla, MD3, Arcelia GuersonGil, MD3, Farah Monzur, MD, FACG4, Folasade P.. May, MD, PhD, MPhil5
1University of Kentucky, Lexington, KY; 2Cedars-Sinai Medical Center, Los Angeles, CA; 3Stony Brook University, Stony Brook, NY; 4Stony Brook University Hospital, Stony Brook, NY; 5UCLA Health, Los Angeles, CA

Introduction: Barriers related to race and ethnicity in the pursuit of GI fellowship have not been studied at the resident level. We aimed to determine specific barriers related to race and ethnicity that may prevent internal medicine (IM) residents from pursuing GI fellowship.

Methods: Our multicenter team distributed an IRB-approved electronic survey to residents in IM residency programs nationwide. Multiple rounds of emails with the survey description and link were sent to program directors and coordinators to forward to their residents. Four-point Likert barrier scales were used. Frequencies & Chi-square tests (p< 0.05) were used to compare barriers by race and ethnicity.

Results: There were 627 trainee respondents. Mean age was 29.9 year. Of 508 responses that were recorded for race, 51.2% residents were White, 32.9% were Asian, and 6.1% were Black/African American. Residents who identified as Black/African American did not perceive the degree of workload in GI to be a barrier compared to other races. However, a larger percentage of Black residents reported financial obligations as greater barriers to pursuing GI compared to their peers of other races. Compared to White residents, Black/African American, Asian, or mixed race residents, perceived a lack of supportive faculty, lack of access to GI-related research, & high degree of competitiveness as barriers. There were no differences in debt burden, length of training,compensation inequality,or lack of mentors (Table 1).









Of the 525 responses, 13.5% (n=71) residents identified as Hispanic. Residents who identified as Hispanic reported job availability, debt burden, financial obligations, family obligations, lack of exposure to GI, lack of supportive faculty and lack of access to GI-related research to be greater barriers compared to residents who identified as non-Hispanic in pursuing GI fellowship. Higher percentages of Hispanic residents also reported lack of mentors to be a greater barrier overall compared to non-Hispanic residents, however this was not statistically significant. There were no differences in perceptions related to length of training, degree of workload in GI, degree of potential stress, work life balance, or burnout

Discussion: Investment in racial and ethnic equity is crucial to the diversification of the current GI workforce. These efforts start at the resident level. This study highlights areas of improvement and focus in order to increase representation of physicians with diverse racial/ethnic backgrounds in GI.

Barrier

Asian (n = 167)

Black/African American (n = 31)

Multi-Racial/Other (n = 50)

White (n = 260)

Length of training

 

 

 

 

Not a Barrier

66 (39.5%)

10 (32.3%)

25 (50.0%)

101 (38.8%)

Somewhat of a Barrier

49 (29.3%)

10 (32.3%)

11 (22.0%)

90 (34.6%)

Moderate Barrier

43 (25.7%)

9 (29.0%)

13 (26.0%)

49 (18.8%)

Extreme Barrier

9 (5.4%)

2 (6.5%)

1 (2.0%)

20 (7.7%)

Degree of workload in GI

 

 

 

 

Not a Barrier

71 (42.5%)

19 (61.3%)

26 (52.0%)

107 (41.2%)

Somewhat of a Barrier

44 (26.3%)

6 (19.4%)

11 (22.0%)

102 (39.2%)

Moderate Barrier

36 (21.6%)

6 (19.4%)

10 (20.0%)

35 (13.5%)

Extreme Barrier

16 (9.6%)

0 (0.0%)

3 (6.0%)

16 (6.2%)

Financial obligations

 

 

 

 

Not a Barrier

91 (54.5%)

9 (29.0%)

26 (52.0%)

114 (43.8%)

Somewhat of a Barrier

53 (31.7%)

9 (29.0%)

12 (24.0%)

84 (32.3%)

Moderate Barrier

18 (10.8%)

9 (29.0%)

8 (16.0%)

40 (15.4%)

Extreme Barrier

5 (3.0%)

4 (12.9%)

4 (8.0%)

22 (8.5%)

Debt burden

 

 

 

 

Not a Barrier

101 (60.5%)

13 (41.9%)

24 (48.0%)

127 (48.8%)

Somewhat of a Barrier

42 (25.1%)

7 (22.6%)

14 (28.0%)

76 (29.2%)

Moderate Barrier

19 (11.4%)

6 (19.4%)

8 (16.0%)

38 (14.6%)

Extreme Barrier

5 (3.0%)

5 (16.1%)

4 (8.0%)

19 (7.3%)

Lack of mentors

 

 

 

 

Not a Barrier

54 (32.3%)

7 (22.6%)

16 (32.0%)

95 (36.5%)

Somewhat of a Barrier

62 (37.1%)

11 (35.5%)

11 (22.0%)

98 (37.7%)

Moderate Barrier

34 (20.4%)

7 (22.6%)

18 (36.0%)

51 (19.6%)

Extreme Barrier

17 (10.2%)

6 (19.4%)

5 (10.0%)

16 (6.2%)

Lack of supportive faculty

 

 

 

 

Not a Barrier

66 (39.5%)

14 (45.2%)

21 (42.0%)

135 (51.9%)

Somewhat of a Barrier

55 (32.9%)

6 (19.4%)

10 (20.0%)

64 (24.6%)

Moderate Barrier

31 (18.6%)

5 (16.1%)

16 (32.0%)

47 (18.1%)

Extreme Barrier

15 (9.0%)

6 (19.4%)

3 (6.0%)

14 (5.4%)

Lack of exposure to GI

 

 

 

 

Not a Barrier

70 (41.9%)

9 (29.0%)

18 (36.0%)

97 (37.3%)

Somewhat of a Barrier

44 (26.3%)

12 (38.7%)

20 (40.0%)

83 (31.9%)

Moderate Barrier

39 (23.4%)

6 (19.4%)

8 (16.0%)

62 (23.8%)

Extreme Barrier

14 (8.4%)

4 (12.9%)

4 (8.0%)

18 (6.9%)

Lack of access to GI-related research

 

 

 

 

Not a Barrier

54 (32.3%)

12 (38.7%)

19 (38.0%)

111 (42.7%)

Somewhat of a Barrier

35 (21.0%)

5 (16.1%)

15 (30.0%)

79 (30.4%)

Moderate Barrier

50 (29.9%)

8 (25.8%)

9 (18.0%)

42 (16.2%)

Extreme Barrier

28 (16.8%)

6 (19.4%)

7 (14.0%)

28 (10.8%)

High degree of competitiveness

 

 

 

 

Not a Barrier

19 (11.4%)

3 (9.7%)

5 (10.0%)

60 (23.1%)

Somewhat of a Barrier

25 (15.0%)

2 (6.5%)

10 (20.0%)

70 (26.9%)

Moderate Barrier

62 (37.1%)

17 (54.8%)

13 (26.0%)

66 (25.4%)

Extreme Barrier

61 (36.5%)

9 (29.0%)

22 (44.0%)

64 (24.6%)

Compensation inequality

 

 

 

 

Not a Barrier

94 (56.3%)

16 (51.6%)

28 (56.0%)

147 (56.5%)

Somewhat of a Barrier

51 (30.5%)

9 (29.0%)

18 (36.0%)

57 (21.9%)

Moderate Barrier

19 (11.4%)

4 (12.9%)

3 (6.0%)

46 (17.7%)

Extreme Barrier

3 (1.8%)

2 (6.5%)

1 (2.0%)

10 (3.8%)

 

 


Table: Table 1: Racial barriers for IM residents toward pursuing GI fellowship (n=508)


Disclosures:
Naba Saeed indicated no relevant financial relationships.
Hammad Qureshi indicated no relevant financial relationships.
Rashmi Advani indicated no relevant financial relationships.
Marta Arjonilla indicated no relevant financial relationships.
Arcelia GuersonGil indicated no relevant financial relationships.
Farah Monzur: Medtronic (Covidien) – Consultant.
Folasade May: Exact Sciences – Consultant, Grant/Research Support. Freenome – Consultant. Geneoscopy – Consultant.


Naba Saeed, MD1, Hammad Qureshi, MD1, Rashmi R. Advani, MD2, Marta Arjonilla, MD3, Arcelia GuersonGil, MD3, Farah Monzur, MD, FACG4, Folasade P.. May, MD, PhD, MPhil5. P1217 - Racial and Ethnicity-Related Barriers to Internal Medicine Residents Pursuing Fellowship Training in Gastroenterology, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.