Shifting the Paradigm in Workforce Diversity: Prioritizing an Inclusive Environment in Graduate Medical Education.

Abstract: A diverse physician workforce is important to achieving the goal of health equity. Recruitment efforts are often the focus of graduate medical education (GME) workforce diversity efforts. However, to achieve the goal of workforce diversity, a foundation of inclusivity is essential to address the experiences of trainees whose race and ethnicity are underrepresented in medicine (UIM).Professional identity formation (PIF) describes the process through which trainees integrate their personal and professional identities as they learn to not only act but feel like they belong in their professional role. The concept of PIF provides a framework to consider how GME leaders can intentionally address inclusivity in training programs. The process of PIF is influenced by many factors including trainees' clinical and non-clinical experiences, their treatment by others, as well as the training program's structure, policy, and physical environment. The authors describe these factors influencing PIF, then through the lens of PIF, describe approaches that programs and institutions have taken to address inclusivity by investing in the workforce, disrupting the hidden curriculum, revisiting policies and procedures, and examining the physical environment.The authors encourage programs, institutions, and the greater GME community to leverage each learning environment's unique strengths and root out challenges to enhance inclusivity for UIM trainees.