Evaluating the Impact of Gender, Race, and Training Year on Internal Medicine Residents' Experiences Across the United States

• Published in: Permanente journal 2024-09, Vol.28 (3), p.1-116
• Main Authors: Kim, Grace, Lodha, Shweta, Wein, Lulu, Fahs, Lily, Allen, Ariana, Rathinavelu, Jay, Sharma, Poonam, Fekrat, Sharon
• Format: Article
• Language: English
• Subjects: Original Research
• ISSN: 1552-5775; 1552-5767; 1552-5775
• DOI: 10.7812/TPP/24.085

Prior studies have highlighted experiences of bias within resident training based on trainees' gender and race and high rates of burnout. However, few studies have addressed the intersection between bias and wellness for residents in internal medicine (IM) programs. This study explores how race, gender, and training year affect IM residents' bias experiences and well-being. An anonymous survey with questions evaluating demographics and resident experiences of bias and perceptions of wellness and self-efficacy was distributed to 596 IM programs across the United States. Sixty-nine programs sent out the survey to their IM residents. Respondents to the survey included 176 residents. Descriptive analyses and χ tests were performed. Responses demonstrated that gender and race impacted residents' experiences with bias and misidentification. Eighty-eight percent of women compared to 1% of men, and 89% of Black residents compared to 3% of White residents reported being misidentified as a nonphysician due to gender and race, respectively. Degrees to which residents felt they were thriving in residency, experiencing burnout, and utilizing their strengths varied significantly by gender. Residents' self-perceived burnout levels were associated with being misidentified as not being a physician due to race. Experiences with bias also increased significantly with training year. This study provides important insights into the impact of gender, race/ethnicity, and training year on IM residents' experiences with bias and self-perception. The findings emphasize the need for structural changes within IM residency programs to reduce experiences of bias and to better cultivate the wellness of residents.