For more than two decades, medical schools have worked hard to diversify, expanding pipeline programs, scholarships, and recruitment strategies to increase representation among students from historically excluded groups. These efforts have produced measurable gains in medical school enrollment, with the proportion of Black and Latino students increasing over the past decade.
And yet, diversity in the physician workforce has remained relatively unchanged. Black and Latino physicians continue to comprise a disproportionately small share of practicing physicians.
There is a leak in the pipeline: residency.
Residency, a mandatory three- to seven-year apprenticeship, depending on specialty, is the sole gateway to board certification and independent medical practice in the United States. Failure to complete residency is not a temporary detour, but rather, a career-ending event for most people — one that is not uniformly experienced.
Unpublished 2015 data from the Accreditation Council for Graduate Medical Education showed that while only 5% of resident physicians are Black, they accounted for 20% of dismissals. Emerging national data reinforce that residency training not only shapes clinicians but also determines who is ultimately allowed to enter the physician workforce.
