Recruiting diverse emergency medicine residents: The influence of community diversity.

Objective: There is limited understanding of factors influencing recruitment of emergency medicine (EM) residents identifying as races and ethnicities underrepresented in medicine (URM): Black/African American, Hispanic, American Indian/Alaskan Native, or Native Hawaiian/Pacific Islander. This study explored whether diversity of EM residents at the program level is associated with community diversity at the county level. Methods: The proportion of URM residents in each EM residency program was determined using Association of American Medical Colleges academic year 2023-2024 data. We excluded newer programs without a full complement of residents and those not reporting race/ethnicity data. We used U.S. Census data to categorize each program's surrounding county as having lower diversity (<30% URM population), moderate diversity (≥30% to <49% URM population), or higher diversity (≥49% URM population). We used Kruskal-Wallis test with Dunn's procedure to determine whether the proportion of URM residents in a program was associated with the level of diversity in the surrounding county. Results: Among 247 included EM programs, 5% of residents were Black (range 0%-46% per program), 8% Hispanic (range 0%-43%), and 4% another URM race/ethnicity. The proportion of URM EM residents was significantly lower among programs in lower-diversity counties (median [IQR] 10% [6%-16%]) than among programs in moderate-diversity (median [IQR] 14% [8%-20%], Conclusions: EM residents at programs in lower-diversity counties are less likely to be URM than those in moderate- or higher-diversity counties. EM programs located in less diverse communities may require unique strategies to increase resident diversity.