Rudy Davis, MD, with his mentor Felipe Perez, MD, FAAP, at Stanford University Medical Center. Photo courtesy of Felipe Perez, MD, FAAP.

Rudy Davis, MD, with his mentor Felipe Perez, MD, FAAP, at Stanford University Medical Center. Photo courtesy of Felipe Perez, MD, FAAP.

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Building a diverse workforce of physician anesthesiologists should be paramount for hospitals and health care systems. More inclusive preoperative staff would better reflect current demographics nationwide, help address health care disparities, encourage minority patient participation in decision-making, improve patient outcomes and satisfaction, and foster greater innovation in medicine (JAMA Intern Med 2014;174:289-91; Proc Natl Acad Sci U S A 2020;117:9284-91). Despite these indisputable advantages of physician workforce diversity, the percentage of people identifying as belonging to racial/ethnic minority groups in medicine has continued to remain below that of the general U.S. population (JAMA Netw Open 2019;2:e1910490; N Engl J Med 2019;380:803-5). In anesthesiology, the percentage of under-represented minority (URM) physicians is around 11%. Medical schools are documenting upward trends in Black and brown female graduates (asamonitor.pub/3tLSg8M; JAMA Intern Med 2015;175:1706-8). As per the Association of American Medical Colleges (AAMC), between 1986 and 2015, the proportion of female graduates has increased to 53%, although male graduates declined to 39%. Nonetheless, the translation of similar trends among residency programs is lacking. This is likely multifactorial; lower numbers of URM applicants, lack of longitudinal mentorship throughout medical education and training, deficiencies in organizational diversity and inclusion practices compounded by workplace microaggressions, and, most importantly, bias in the recruitment and selection process (asamonitor.pub/3CFiUUH). There are various studies that demonstrate that bias (system, interpersonal, and implicit bias) greatly influences residency selection (Pers Psychol 1997;50:655-702; J Grad Med Educ 2015;7:539-48; Acad Med 2001;76:1253-6). Systems bias precludes otherwise qualified residency candidates based solely on pedigree and parameters, including medical school, USMLE scores, and AOA membership. Inherently, these metrics may reflect longstanding inequities in access to better education and preparatory materials for URM candidates (Acad Med 2001;76:1253-6; Teach Learn Med 2019;31:487-96). Further, these metrics do not wholly dictate candidates' abilities to be safe, sound, and compassionate trainees. Interpersonal bias may limit recruitment based on visual appearances. Finally, implicit bias or preconceived notions of the URM community, both conscious and subconscious, can negatively affect applicant interactions and rankings.

Traditionally we have assigned greater importance to these metrics than taking the personal attributes and circumstances of the applicant into account. This approach is likely to have negatively impacted our ability to support more diversity in our residency programs.

We hypothesized that a holistic review process along with interventions to address biases will improve diversity in our resident selection process. Some of the processes for this year's residency recruitment were changed as a pilot project to determine if we could increase the pool of URM applicants on our rank list by shifting the focus from standardized exam scores and medical school reputation to personal attributes and accomplishments. We instituted strategies to mitigate these biases in our recruitment process, and we have appraised all interviewers of this project and solicited their cooperation:

  • We blinded reviewers of the applicants' USMLE scores, details of medical school and any AOA membership. The personal statement of the applicant was highlighted and other personal achievements were noted from the MSPE.

  • We continued to provide the option of virtual interviews to offset the financial burden of travelling, boarding and lodging.

  • We blinded applicant photographs during the review process.

  • We recruited a more diverse group of residents and faculty to participate in the recruitment process to engage applicants of different backgrounds.

  • We planned to host an additional optional session led by a URM resident and faculty to encourage better engagement by the applicants.

  • We administered the IAT to all interviewers to make them aware of their implicit biases.

  • We required the interviewers to complete online training by the AAMC on implicit biases

We are honored and grateful to receive the ASA mentorship grant to start our project. Through this project, we hope to enhance diversity among residents training in anesthesiology at our institution. Once we recruit residents of diverse backgrounds, we would encourage their professional development through involvement in various committees at the state component and national levels of ASA. Through ASA participation, they would be provided with networking and career development opportunities. These trainees represent the next generation of a diverse group of anesthesiologists who will be able to continue contributing to recruiting and training a diverse workforce of physician anesthesiologists. We believe that this will improve overall job satisfaction as well. We look forward to contributing to the increase in diversity in the next generation of anesthesiologists.

The ASA Committee on Professional Diversity's annual call for proposals for the ASA Mentoring Grant Program is now open on a new online submission platform. The goal of this grant is to foster diversity within ASA through mentorship. The program provides funding of up to $5,000 to mentor/mentee pairs who submit a project that addresses the goals of the Committee on Professional Diversity. The project may be oriented to research, education, political advocacy, or an organized medicine endeavor that clearly speaks to the mission and duties of the committee.

The matched mentee/mentor pair should submit their application form, including:

  • A detailed description of the project's objective along with an explanation of how it will enhance the professional growth and leadership potential of the mentee.

  • A designation of length of time, required equipment/supplies, travel, meetings and requested funding; also include co-funding provided by the home institution of record in support of the project chosen by the mentee/mentor, if any.

  • Potential barriers to completion of the grant.

  • Description of how this project speaks to the mission and duties of the ASA Committee on Professional Diversity.

  • Both the mentor and mentee must be active members of ASA and their state component society at the time of submission of their application.

Mentors should be well-established clinicians, educators and researchers, as well as current ASA leaders who have an interest in and passion for mentoring a rising medical student, anesthesiology resident/fellow, junior faculty member, or new graduate in private practice. An ASA leader is defined as an individual who has the following experience:

  • Currently an ASA member and has been so at least two consecutive years

  • Has served on an ASA committee, editorial board, or House of Delegates (Board included)

  • Is a member of their state anesthesia component

The mentor will voluntarily provide guidance, direction, and counsel to the mentee on a mutually agreed-upon project. The one- to two-year project must have the goal of enhancing the professional career, leadership potential, and active involvement of the mentee within ASA. Mentors will be held responsible for submitting a half-year report on the progress of the grant by June 30, 2022, and ensuring their mentees are upholding the expectations of the grant, including advocacy.

Mentees should be ASA members of diverse racial, ethnic, or gender backgrounds who are interested in gaining experience in leadership, exposure to research, education, or political advocacy opportunities within ASA. Mentees may be medical students, anesthesiology residents/fellows, junior faculty members, or new graduates in private practice. In addition to facilitating their chosen project and maintaining regular interaction with their mentors, mentees are expected to:

  • Join their ASA state component society and attend at least one local meeting annually; volunteering for involvement within component activities and advocacy participation is encouraged.

  • Self-nominate for at least one ASA or subspecialty society committee and actively participate if selected.

  • Submit an educational, clinical or research abstract, or poster at the ASA annual meeting or subspecialty society meeting within 12 months of project completion.

  • Along with their mentor, briefly present their project at the annual ASA Committee on Professional Diversity meeting.

  • Submit a half-year progress report on the status of the grant. Last year's award-winning submissions can be found at asahq.org/about-asa/asa-awards-and-programs/asa-mentoring-program.

The application process opens May 1, 2022. For 2022 applicants, the committee will review all submissions and notify the mentor/mentee pairs of potential funding status and support of the project by August 5, 2022. Funding to grant recipients will be distributed via mailed check after the ANESTHESIOLOGY® 2022 annual meeting. A one-page written update of the progress of the project will be due June 30, 2023.

Mentees are expected to give a one-slide, two-minute presentation at the Committee on Professional Diversity reception upon completion of their project at the ANESTHESIOLOGY annual meeting. If attendance is possible, mentees are also encouraged to give a brief overview of their project at this same event at ANESTHESIOLOGY 2022. For questions or comments, please contact DiversityMentor@asahq.org to reach Lauren Keith or Aleah Alfadi, staff liaison for the committee. We look forward to seeing this year's projects.

Sujatha Ramachandran, MBBS, MACM, Vice Chair for Education and Residency Program Director, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Sujatha Ramachandran, MBBS, MACM, Vice Chair for Education and Residency Program Director, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

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Camille Fontaine, MD, Director of Wellness, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Camille Fontaine, MD, Director of Wellness, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

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Tracey Straker, MD, MS, MPH, CBA, FASA, ASA Committee on Professional Diversity, Director, ASA Mentoring Grant, Vice Chair, Clinical Operations, DEI Officer, Division Director, and Generalist, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Tracey Straker, MD, MS, MPH, CBA, FASA, ASA Committee on Professional Diversity, Director, ASA Mentoring Grant, Vice Chair, Clinical Operations, DEI Officer, Division Director, and Generalist, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

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