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

Has Audio

Presenting Author(s)

Marta Arjonilla, MD

Stony Brook University
Stony Brook, NY

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.