A cross-sectional study of diversity in regional anesthesia and acute pain medicine fellowships.

Purpose: The number of underrepresented in medicine (URiM) physicians is disproportionately low compared with the general population. Patient-physician racial concordance may increase patient satisfaction and therapeutic adherence. In this study, we evaluated diversity within 2023-2024 regional anesthesia and acute pain medicine (RA/APM) fellowship programs and discuss methods to increase diversity and inclusion.

Methods: The Hospital for Special Surgery Institutional Review Board (IRB no. 2023-1862) approved this cross-sectional survey study. We distributed a questionnaire to RA/APM fellowship directors (FDs) on 2 October 2023 and present responses as counts and percentages or medians and interquartile ranges.

Results: We sent questionnaires to 84 FDs with 44 responses (52%)-39 from the USA and five from Canada. Overall, 4/44 (9%) FDs identified as URiM. Many FDs reported no URiM (57%) or lesbian, gay, bisexual, transgender, queer, intersex, asexual, or other (LGBTQIA +) fellows (50%). We observed no differences regarding gender identity, with 46% cisgender female FDs and 46% female fellows reported. While 35 (80%) FDs considered themselves successful at having a diverse program, 27 (61%) reported no outreach programs targeted to underrepresented groups. Thirty-two (73%) programs reported Accreditation Council for Graduate Medical Education accreditation and 33 (75%) reported participation in the 2023 San Francisco Residency and Fellowship Match.

Conclusions: Organizational diversity offers several advantages; however, there is a discrepancy between the diversity of RA/APM FDs and fellows compared with the general US and Canadian population. Methods to further increase URiM representation at the trainee and FD levels should be further explored.