Programs Can Improve the Diversity Workforce in Family Medicine

To the Editor: We were pleased to read the article entitled “People, Not Programs: Improving Diversity in the Family Medicine Workforce,” by Schiel et al,¹ which describes the factors that influence URiM medical students to choose family medicine residencies.

As women of color in academic Family Medicine, we are inspired by the increase in URiM students choosing Family Medicine as a career. However, we are requesting that the authors cast a wider net to explore and define the specific factors concerning racial concordance within mentoring that could account for these gains over the last few years. Exposure to URiM faculty in assigned clerkships or community preceptorships seemed to be a determining factor for URiM students choosing Family Medicine as a speciality. However, we believe that there are variables aside from identity alone that are not accounted for in the outcomes.

In addition, it is important to identify and investigate factors outside of identity alone that could have accounted for this trend.² Several other studies indicate that factors such as gender concordant professional relationships have been noted to have a positive effect on outcomes.³ It is imperative for the continued growth of Family Medicine that researchers correctly identify and link all associated factors that may be at play. Survey hesitancy and social desirability were listed as potential reasons for limitations to this study. An equally great limitation is the low numbers of minority clerkship directors nationwide, which limits how many URiM directors can respond.

As we focus on increasing the Family Medicine physician workforce, we should also focus on why only 14.8% of medical school applicants are URiM despite being 34.1% of the population.^4,5 To increase the number of URiM Family Medicine physicians we should support or create pathway programs that support and recruit URiM individuals into medical school.

Keeping in mind that education is not equitable in the United States, longitudinal pathway programs can close the gaps and increase opportunities for URiM students to learn about health care careers.⁶ Pathway programs allow schools to target barriers that are otherwise not addressed by the educational system. Having a combination of URiM faculty and pathway programs increases the prospect that we will see an increase in URiM individuals in Family Medicine and have a workforce that reflects the communities we serve.