Hematology/oncology program director perspectives on recruitment and inclusion of a diverse workforce.

Ana I. Velazquez Manana University of California San Francisco, San Francisco, CA info_outline Ana I. Velazquez Manana, Dame Idossa, Idalid Ivy Franco, Gerald Hsu, Martina Cathryn Murphy, Evelin Trejo, Jenny Ruiz, Urshila Durani, Maria De Lourdes Garcia-Jimenez, Lachelle Dawn Weeks, Ariela Lucy Marshall, Narjust Florez, Vonetta Michelle Williams

Authors Ana I. Velazquez Manana University of California San Francisco, San Francisco, CA info_outline Ana I. Velazquez Manana, Dame Idossa, Idalid Ivy Franco, Gerald Hsu, Martina Cathryn Murphy, Evelin Trejo, Jenny Ruiz, Urshila Durani, Maria De Lourdes Garcia-Jimenez, Lachelle Dawn Weeks, Ariela Lucy Marshall, Narjust Florez, Vonetta Michelle Williams Organizations University of California San Francisco, San Francisco, CA, University of Minnesota, Minneapolis, MN, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, San Francisco VA Medical Center, San Francisco, CA, University of Florida Health Shands Hospital, Gainesville, FL, University of California, San Francisco, San Francisco, CA, Children's Hospital of Philadelphia, Philadelphia, PA, Mayo Clinic, Rochester, MN, Department of Medicine, Division of Hematology/Oncology, UCLA, Los Angeles, CA, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, University of Pennsylvania, Philadelphia, PA, Memorial Sloan Kettering Cancer Center, Middletown, NJ Abstract Disclosures Research Funding No funding received None. Background: Despite progress in the enrollment of underrepresented in medicine (UIM) individuals in medical schools, hematology/oncology (HO) remains one of the least diverse medical subspecialties. We evaluated current recruitment efforts and barriers to the inclusion of UIM individuals in HO fellowship programs. Methods: We conducted a national online survey of program directors (PDs) and associate PDs (reported in aggregate as PDs) of adult and pediatric HO fellowships. Each PD received a unique survey link via email and 4 email reminders over the 8-week study period. Interim results at 4-weeks are presented and summarized with descriptive statistics. Results: At a pre-defined interim time point of 4 weeks, 78 HO PDs participated (18% response rate) and 69 completed the survey (88% completion rate). Most self-identified as women (57%, n = 38) and White (55%, n = 37), were affiliated with an academic program (79%, n = 53), and led an adult HO fellowship (73%, n = 49). Most PDs reported under or no representation of UIM faculty in their divisions; 9% (n = 6) self-identified as UIM. PDs reported their HO fellowships matched a median of 3 UIM fellows over the last 5 years (IQR 2-5 over 5 years); 46% (n = 32) reported UIM recruitment was unchanged and 4% (n = 3) decreased during this period. About half of PDs (51%, n = 35), matched a UIM candidate in the 2023 match. Of the 21% (n = 14) of PDs whose programs had no UIM fellows, 0% matched a UIM applicant in the 2023 match. 52% (n = 36) of PDs endorsed an inability to match UIM applicants despite consistently ranking them highly. PDs perceive the top 3 barriers to UIM recruitment as: low number of UIM applicants (53%, n = 41), geographic program location (50%, n = 39), and lack of diverse faculty/fellows in their program (42%, n = 31). 10% (n = 7) also reported meeting resistance about DEI initiatives. While 53% (n = 41) of PDs believe fellow demographics should reflect the local population, 23% (n = 16) don’t know how to increase diversity and 11% (n = 8) do not believe their program’s diversity needs to increase. In answers to open ended questions, some PDs expressed disagreement with the definition of UIM and reported a perceived limited number of qualified UIM applicants. Almost all institutions provide DEI training (96%, n = 72) for faculty and most PDs believe it has improved recruitment and inclusion of diverse individuals (52% and 65%, respectively). Yet, 34% (n = 23) agree that UIM fellows in their program are treated differently because of their race/ethnicity and 22% (n = 15) agree that UIM fellows repress their identity or background to be respected by faculty, peers, and staff. Conclusions: Historically and currently excluded populations remain underrepresented in the HO workforce. PDs face multiple barriers to the recruitment of diverse fellows, including differing views on the definition of UIM and perception of the value of diversity in the physician workforce.