Continued Discussion And Engagement Are Essential To How Otolaryngologists Are Championing DEI Initiatives In Medicine

DEI Initiative Opportunities According to the Literature

Recruiting a Diverse Workforce

“While there may be improvements to increase the representation of otolaryngology applicants and residents, there continues [sic] to be inequalities and a lack of diversity,” noted researchers of a study published in 2024 in the Journal of Surgical Education (J Surg Educ. doi:10.1016/j.jsurg.2023.12.016).

The retrospective study examined the racial and ethnic representation of U.S. otolaryngology applicants and residents from 2016 to 2022 from the Association of American Medical Colleges and residents from 2011 to 2022 from the Accreditation Council for Graduate Medical Education. The researchers aimed to determine any improvements over time in recruiting a diverse medical team.

When comparing 2016-2017 and 2021-2022, the proportion of applicants by self-reported race or ethnicity did not differ. From 2011-2012 to 2018-2019, the proportion of White residents dropped from 58.1% to 54.5%. Over the years, the researchers found a higher proportion of White residents than applicants and a lower proportion of Black residents than applicants. For individuals self-reporting as Hispanic or Latino, the most recent period showed a higher proportion of residents than applicants.

“Further initiatives are needed to ensure diversity in the field improves moving forward,” the authors concluded.

Implementing Health Disparities Curricula

Researchers (including Dr. Malekzadeh) of a study published in OTO Open in 2024 found that “only a small proportion of otolaryngology residency programs have implemented a health disparities curriculum, and an even smaller percentage have utilized a consistent curriculum over time (OTO Open. doi:10.1002/oto2.148).”

For the study, a survey sent to U.S. otolaryngology residency program directors had a response rate of 23%. Of the 24 responders, 12 reported that their institution held a health disparities curriculum. All 12 institutions developed their own curriculum, of which nine changed annually. Moreover, only one institution measured its curriculum’s utility outcomes.

The researchers looked at barriers to the development and implementation of health disparities curricula. They found the most reported barriers included insufficient time, inadequate ability to teach health disparities, and teaching disinterest by faculty.

“There is a severe lack of outcome measures related to otolaryngology residency programs’ health disparities curricula to validate or refute their effectiveness,” the authors concluded.

“Otolaryngology residency programs are at a crossroads in compliance for new resident education expectations … Standardizing these curricula could enhance resident competency in addressing health disparities,” aligning with the Clinical Learning Environment Review (CLER) mandate and ACGME expectations (CLER Program: https://www.acgme.org/initiatives/clinical-learning-environment-review-cler/).