Lindsay F Bell1, Jessica Livingston2, Robert M Arnold3, Yael Schenker3, Riba C Kelsey4, Chinedu Ivonye5, Tessie W October6. 1. Division of General Internal Medicine, Section of Palliative Care and Medical Ethics and Palliative Research Center (PaRC), University of Pittsburgh, Pennsylvania, USA. Electronic address: Lfb8@pitt.edu. 2. Division of Critical Care Medicine, Children's National Hospital, Washington, District of Columbia, USA. 3. Division of General Internal Medicine, Section of Palliative Care and Medical Ethics and Palliative Research Center (PaRC), University of Pittsburgh, Pennsylvania, USA. 4. Department of Family Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA. 5. Department of Internal Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA. 6. Division of Critical Care Medicine, Children's National Hospital, Washington, District of Columbia, USA; The George Washington School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Abstract
CONTEXT: The palliative medicine workforce lacks racial diversity with <5% of specialty Hospice and Palliative Medicine (HPM) fellows identifying as black. Little is known about black trainees' exposure to palliative care during their medical education. OBJECTIVES: To describe palliative care training for black students during medical school, residency, and fellowship training. METHODS: We conducted a cross-sectional descriptive study using Internet searches and phone communication in September 2019. We evaluated 24 medical schools in three predetermined categories: historically black colleges and universities (HBCUs; N = 4) and non-under-represented minority-serving institutions with the highest (N = 10) and lowest (N = 10) percentages of black medical students. Training opportunities were determined based on the presence of a course, clerkship, or rotation in the medical school and residency curricula, a specialty HPM fellowship program, and specialty palliative care consult service at affiliated teaching hospitals. RESULTS: None of the four HBCUs with a medical school offered a palliative care course or clerkship, rotation during residency, or specialty HPM fellowship program. Three of four HBCUs were affiliated with a hospital that had a palliative care consult service. Institutions with the highest black enrollment were less likely to offer palliative care rotations during internal medicine (P = 0.046) or family medicine (P = 0.019) residency training than those with the lowest black enrollment. CONCLUSION: Residents at schools with the highest black medical student enrollment lack access to palliative care training opportunities. Efforts to reduce health disparities and underrepresentation in palliative care must begin with providing palliative-focused training to physicians from under-represented minority backgrounds.
CONTEXT: The palliative medicine workforce lacks racial diversity with <5% of specialty Hospice and Palliative Medicine (HPM) fellows identifying as black. Little is known about black trainees' exposure to palliative care during their medical education. OBJECTIVES: To describe palliative care training for black students during medical school, residency, and fellowship training. METHODS: We conducted a cross-sectional descriptive study using Internet searches and phone communication in September 2019. We evaluated 24 medical schools in three predetermined categories: historically black colleges and universities (HBCUs; N = 4) and non-under-represented minority-serving institutions with the highest (N = 10) and lowest (N = 10) percentages of black medical students. Training opportunities were determined based on the presence of a course, clerkship, or rotation in the medical school and residency curricula, a specialty HPM fellowship program, and specialty palliative care consult service at affiliated teaching hospitals. RESULTS: None of the four HBCUs with a medical school offered a palliative care course or clerkship, rotation during residency, or specialty HPM fellowship program. Three of four HBCUs were affiliated with a hospital that had a palliative care consult service. Institutions with the highest black enrollment were less likely to offer palliative care rotations during internal medicine (P = 0.046) or family medicine (P = 0.019) residency training than those with the lowest black enrollment. CONCLUSION: Residents at schools with the highest black medical student enrollment lack access to palliative care training opportunities. Efforts to reduce health disparities and underrepresentation in palliative care must begin with providing palliative-focused training to physicians from under-represented minority backgrounds.
Authors: Katie Fitzgerald Jones; Esther Laury; Justin J Sanders; Lauren T Starr; William E Rosa; Staja Q Booker; Melissa Wachterman; Christopher A Jones; Susan Hickman; Jessica S Merlin; Salimah H Meghani Journal: J Palliat Med Date: 2021-11-16 Impact factor: 2.947