The Relationship Between Attitudes about Research and Health Literacy among African American and White (Non-Hispanic) Community-dwelling Older Adults Anjali Shah, BS; Christiana Macauley, MPH; Liang Ni; Allison A. Bay, MPH; Madeleine E. Hackney, PhD

Background: Ethnic minority representation lacks in research. Understanding factors that promote minorities in research addresses this participation gap. This study investigates differences in beliefs regarding research and health literacy between White and African American (AA) participants.

Methods: Cross-sectional study comparing 46 AA vs. 60 White healthy older adults (n=106). Participants were assessed with Participant Attitudes and Beliefs towards Research Questionnaire (PABRQ) and health literacy measures, Rapid Estimate of Adult Literacy in Medicine (REALM) and Short Test of Functional Health Literacy for Adults.

Results: Controlled for age, sex and education, AA performed significantly worse on REALM. 83-85% participants reported being unfamiliar with informed consent, 90-95% had positive attitudes towards research involvement and 38-52% believed researchers wanted to promote their own careers.

Conclusion: This work links older adults' beliefs towards research, health literacy and their participation. Future research may help remove barriers to research participation for underserved, older adults.


A National Student-led Platform for International Pre-health Students: Mentee Feedback from a Year in Review Kalina Tenorio L. Machado, M1; Gopika Senthil Kumar, M3; Rachel Jaber Chehayeb, M3; Nicole Belliard Martuscelli, M3; Zezhou (Zach) Zhao, M2; Matheus M. S. Peraci, M3; Deepali Bhalla, M1

Purpose: International pre-health students face unique challenges in the U.S. and have limited availability of mentorship and resources. Doctors is a novel, national student-led peer mentorship platform created with the goals of providing personalized mentorship and community for international pre-health students. Mentee feedback following a year of the platform’s existence is described.

Methods: Open response survey asking “Best Part of Their Experience” and “Areas to Work On” was distributed through mailing lists and social media. Responses were de-identified and a thematic analysis was performed by two independent reviewers.

Results: 115 students responded. 73% sought out mentors for MD applications; 27% inquired about MD-PhD, residency, DO and dentistry. 57% felt there were no areas for improvement and 45% suggested resource topics for the website and strategies for increasing speed of mentor responses.

Conclusion: Doctors is a useful and well-received platform for proving personalized, relatable mentorship for international students pursuing graduate health programs.


Engaging Community and Developing DEI Awareness in a Basic Science Department Edward T Morgan, PhD; Claudia Espinosa-Garcia, PhD; Asheebo Rojas, PhD; Olga Rivera

First convened in December 2020, the DEI Committee of the Department of Pharmacology and Chemical Biology meets monthly to discuss and implement initiatives to promote ongoing discussions in the community regarding diversity, equity and inclusion. Our goal is to create a culture and climate of equity and inclusion, where diversity is nurtured, valued and celebrated. This is posted on the department’s web pages together with the committee members, upcoming events and committee meeting notes (password protected). Regular reports are given at faculty meetings. Initiatives to promote awareness and a sense of community include a Reading Club, Town Hall meetings and DEI seminars. Crucially, where possible these are all held in the regular departmental seminar time slot. Subcommittees have been formed to recruit speakers and to plan social events that promote DEI, including an annual event and monthly lunches. The latter have been delayed by the pandemic.


Diversity and Inclusion in Basic Dermatology Curriculum Cases Yiwen (Helen) Li, MS, M3; Devon Barrett, MD; Joseph Tran, MD; Klint Peebles, MD; Howa Yeung, MD, MSc

There is limited diversity in the American Academy of Dermatology’s (AAD) Basic Dermatology Curriculum (BDC). This study compared the demographics and photographs of cases in the AAD BDC modules pre- and post- a 2018 AAD-led diversity initiative.

Methods: Two reviewers analyzed the AAD’s BDC modules to assess the Fitzpatrick Skin Type (FST) and the New Immigrant Survey (NIS) Skin Color of photographs in the curriculum, as well as other demographic features of patients detailed in the text of module cases.

Results: Total number of photographs with FST IV-VI/NIS 6-10 increased from 798 to 961. Mean skin of color (SOC) photographs per module increased from 3.9 to 4.7. In the text of the 168 pre- and 192 post-initiative cases, there is an increase in the number of sexual minority patients.

Discussion: Implementation of the AAD BDC diversity initiative led to an increase in the number of SOC photographs and representation of sexual and gender minorities in module text.


Diversity and Professional Advancement in Medical Physics Jillian Rankin, BS; Brendan Whelan, PhD; Julianne Pollard-Larkin, PhD; Kelly C. Paradis, PhD; Matthew Scarpelli, PhD; Chenbo Sun, BS; Christina Mehta, PhD; Keyvan Farahani, PhD; Richard Castillo, PhD

While disparities in the inclusion and advancement of women and minorities in science, technology, engineering, mathematics and medical (STEMM) fields have been well-documented, less work has focused on medical physics specifically. In this study, we use American Association of Physicists in Medicine (AAPM) member data to evaluate the diversity of the medical physics workforce and in positions classically representative of professional advancement in the field, including early-career professional advancement and NIH-funded research activities. AAPM-member demographics data were analyzed to evaluate diversity in the medical physics workforce and professional advancement cohorts, while the AAPM-NIH Research Database was analyzed to evaluate equity in medical physics grant funding. Our results suggest that medical physics may be suffering from a costly lack of workforce and leadership diversity, although early-career professional advancement may be more equitable. Future work is required to further analyze trends, disparities and influences the medical physics professional advancement pipeline.


Sex Ed For Med (Students) Harrison Goodall M4; Charlie Fortin Leung PGY2; Kingsley Fortin Leung MPH, M4; Bryana Williams PGY1; Jason S Schneider, MD

Half of medical students report not receiving adequate training taking a sexual history in medical school. Additionally, medical students report feeling less comfortable taking histories from LGBTQ+ patients. To address the need for increased sexual education in medical school we created the first student-led online training to help medical students learn to take LGBTQ+ inclusive sexual histories. Our educational intervention consisted of an educational video which was integrated into the first-year curriculum with surveys before and after the video. The most substantial differences in pre- and post-survey responses occurred in the categories relating to feeling well-trained in taking a sexual history and knowledgeable on counseling patients on safer sex practices and feeling knowledgeable on counseling LGBTQ populations on safer sex practices. Our data suggests that the use of an educational video increased ratings of confidence and knowledge relating to sexual history taking, especially regarding counseling of LGBTQ+ populations.


Interactive Didactic Session for Residents and Medical Students on Dermatologic Care for LGBTQ Patients Ramoncito L Caleon, BA, M4; Krittin J Supapannachart, MPH, M4; Devon L Barrett, BA, M4; Laura Ragmanauskaite, MD; Patrick McCleskey, MD; Howa Yeung, MD, MSc

To address the lack of evidence-based training on Lesbian, Gay, Bisexual and Transgender (LGBT) patient care in dermatology, we designed and implemented an interactive didactic session for medical students and dermatology residents. We assessed the session’s effectiveness in improving participants’ capacity for LGBT patient care in dermatology by comparing baseline and follow-up mean survey scores on clinical preparedness, attitudinal awareness and basic knowledge of LGBT patients in a dermatological setting. Mean clinical skills scale scores, clinical preparedness and basic knowledge domain scores and correct answers on the knowledge assessment increased by 0.7 (p<0.001), 1.1 (p=0.001), 0.7 (<0.001), and 2.6 (p=.02) points from baseline to follow-up survey, respectively. This student-led online interactive didactic session on dermatological care of LGBT patients increased participants’ clinical preparedness and basic knowledge. Similar sessions at other institutions can potentially improve gaps in preparing residents and medical students in the dermatological care of LGBT patients.


This ongoing project aims to analyze the frequency, determinants and outcomes of gender-affirming surgery (GAS) in transgender and gender diverse (TGD) persons enrolled in the expanded Study of Transition, Outcomes & Gender (STRONG). This cohort includes nearly 50,000 TGD individuals identified from the electronic medical records (EMR) of four large integrated health care systems: Kaiser Permanente Georgia (KPGA), Kaiser Permanente Southern California (KPSC), Kaiser Permanente Northern California (KPNC) and Kaiser Permanente Mid-Atlantic States (KPMAS). Study members have index dates (first evidence of transgender status) ranging from 2006 to 2014 and funding has been secured for follow-up through 2026. This project addresses two specific aims: 1) the frequency and distribution of GAS among TGD individuals as a function of location and sociodemographic characteristics; and 2) the overall outcomes and incidence of surgical complications following GAS. Team members include experts in transgender health, gender-affirming surgery, electronic record-based data collection and epidemiology.


The Failing Safety-Net: Medicaid and Vision Services in Georgia Samuel Levant, BS; Alexandrea Williams, MPH; Jane Kuhlenbeck; Jacquelyn Jetton O'Banion, MD, MSc

Objective: To determine the role of under-insurance and location in access to vision services.

Methods: Data from CMS and Georgia’s Department of Community Health, Governor’s Office of Planning and Budget and Department of Labor from 12/2019 to 5/2021 was used to calculate the total providers, insurance acceptance and insurance loss.

Results: 49 of Georgia’s 159 counties have no vision providers, and providers disproportionately work in population centers. Rural residents have higher rates of Medicaid enrollment and visual impairment. Although 93.9% of providers accept Medicaid, only 46.6% accept new Medicaid patients. Unemployment reached 12.5% in 4/2020 with 238,403 to 365,479 Georgians losing health insurance.

Conclusions: Many counties lack adequate vision providers, especially in rural areas where services are most needed. Many Georgians lost insurance or shifted to care-limiting Medicaid plans because of COVID-19. The national situation is likely similar to Georgia because of absent rural practice incentivization and falling Medicaid acceptance due to reimbursement cuts.


Suturing the gender gap through sponsorship: The role of sponsorship in female entry and advancement through their surgical careers Geethanjeli Mahendran, MD, MPH; Elizabeth Reisinger Walker, PhD, MPH, MAT; Mackenzie Bennett, BS; Amy Chen, MD, MPH, FACS, FACE

Sponsorship promotes female entry and advancement through the surgical field, and can mitigate gender inequities that persist in the surgical field. 35 women in surgery, including 14 surgeons, 11 residents and 10 fourth-year medical students, were interviewed from July 30 to August 18, 2021 at a single institution. All participants had provided or received sponsorship. Main themes included: (1) Evolving needs of sponsorship, (2) Decreased Access to Sponsorship as Career Level Advances, (3) Evolving importance of sponsorship, (4) Perceived limitations of receiving sponsorship and (5) Perceived limitations of providing sponsorship. Faculty members most frequently reported barriers to both receiving and providing sponsorship. The lack of sponsorship for female faculty limits their ability to rise to organizational leadership, and consequently, their ability to sponsor others. Increasing access to sponsorship for female surgeons can help to bridge the gender gap in the surgical field.


This paper outlines the Healthcare Early Access for Diverse Students Underrepresented in Plastic Surgery (HEADSUP) program curriculum, a surgical pipeline program implemented by a group of residents, medical students and undergraduate students in the Atlanta area. Study findings emphasize the benefit of targeted mentorship programs for improving access to experiences in surgical subspecialties, particularly plastic and reconstructive surgery. These programs empower a traditionally underrepresented range of candidates to pursue these subspecialties. This study also suggests an approach for bridging the gap as competitive surgical subspecialties struggle to recruit racially underrepresented trainees to better mirror U.S. patient populations.


The Emory General Surgery Residency Longitudinal Anti-racism Curriculum Jeroson Williams, MD; Jerome Anyalebechi, MD; Rachel Niehuus, MD, PhD; Sara Kebede; Jahnavi Srinivasan, MD; Olamide Alabi, MD

Racism impacts every patient and physician operating within the American health care system. It is widely accepted that structural racism directly results in disparate health outcomes and inequitable training and hiring of able physicians. Until more recently, very little was done to address the policies that exist within graduate medical education that perpetuate current racist practices. Diversity, equity and inclusion efforts dedicated to the education, recruitment, and empowerment of marginalized groups in medicine have brought with them a new unique opportunity to train the next generation of clinicians to more competently treat diverse patient populations, fairly interact with diverse colleagues and champion causes that ameliorate discriminatory conventions. Herein, we discuss the implementation of an anti-racism surgical education curriculum within the Emory University General Surgery Residency Program.


Academic institutions recognize the need to enhance the curriculum of trainees and faculty to include topics addressing diversity, equity, inclusion and justice. Grand Rounds is a well-established forum that can be used to bridge this gap. The Department of Pediatrics Diversity and Inclusion (D&I) Committee, Children’s Healthcare of Atlanta (Children's) DEI Council, and Children's Continuing Medical Education leadership collaborated to create the “Egleston Grand Rounds: Diversity, Equity and Inclusion Series,” starting in February 2021. Attendance rates for this quarterly series averaged 100 participants compared to averages of 82 and 60 for all of 2021 and 2020, respectively. Additionally, faculty identified ways to improve their practices, such as with letter-writing and recruitment. Performance changes and increased attendance rates support further expansion of this offering. Starting 2022, this quarterly series will add a second site and time for each session.


Historically, it has been difficult to recruit underrepresented minority (URM) physicians to the dermatology workforce. This study examined barriers, facilitators and influential factors with regard to URM physicians pursuing careers in dermatology. A survey was created and distributed to the National Medical Association  dermatology section. The proportions of respondents identifying influential factors, barriers and facilitators in pursuing a career in dermatology were summarized and compared by sex, residency first-time match status and prior attendance of Historically Black Colleges and Universities using Fisher exact tests. Dermatology clinical rotations, shadowing in dermatology during pre-clinical years and lack of racial/ethnic diversity were the top influential factors among URM dermatologists. Lack of racial/ethnic diversity, step 1 score, and research experience were identified as the top barriers faced by those who successfully matched. Those who successfully matched cited mentorship from a dermatologist, institutional career guidance and shadowing opportunities in dermatology as top facilitators.


Utilization of Mohs Micrographic Surgery in Skin of Color Patients Treated at Emory University Dermatology Clinic Ameya Gangal, MS; Danielle Harlan, BS; Maher Alharthi, MD; Loren Kruegar, MD

Our demographic results suggest that SOC patients undergo MMS in similar body locations and at similar ages to White counterparts. Our results further suggest that BCC constitutes a smaller proportion of malignancies treated with MMS in SOC populations when compared to White counterparts. Future studies may aim to characterize these differences further and ensure equitable distribution of dermatologic care among SOC patients. We are currently finalizing statistical analysis of a data pull from the DataDerm national database and have investigated this in a larger national population of SOC patients.


Although several studies have elucidated the relationship between biased language and patient care outcomes, few have attempted to outline methods for reducing biased language in medical trainees or medical practice. A recent workshop at Stanford successfully implemented an anti-biased language curriculum for health care providers; however, attendance was optional and therefore attendees were likely more invested in the workshop objectives. The goal of this study is to determine whether a curriculum based on the Stanford workshop increases understanding of anti-biased language and its impact on patient care in a standard group of rising third-year medical students. To our knowledge, no similar study exists in the literature. We found that students’ understanding of anti-biased language and its impact on patient care increased because of the workshop. Students felt that the workshop was a valuable use of time, and several recommended it should be presented to attendings.


Adult cardiothoracic anesthesiology (ACTA) is a field committed to leadership, innovation and excellence. As leaders in the perioperative space, cardiac anesthesiologists have an opportunity to be leaders in recognizing and harnessing the power of diversity in their professional environment. While it is not yet a specialty that embodies diversity in its membership, cardiothoracic anesthesiology could serve as a model to other subspecialties for how to implement actionable change and successfully create a more equitable professional landscape. The demographic data for ACTA demonstrates a lack of racial and ethnic diversity in the subspecialty. The 2019-2020 Accreditation Council for Graduate Medical Education program data reported that of the 220 ACTA fellowship trainees in accredited programs, thirty-six identified as Asian, seven as Hispanic, six as Black, one as Native Hawaiian/Pacific Islander and zero as Native American/Native Alaskan. While discussions of the need for diversity are not new in the last ten years, the racial and ethnic demographics in ACTA largely have remained unchanged and may even have become slightly less diverse.


Novel Curriculum to Combat Health Care Disparities Nancy DeSousa, PhD, MPH; Altelisha Taylor; Antonio Graham

A 2017 report by the Accreditation Council for Graduate Medical Education (ACGME) evaluating 297 ACGME-accredited residency and fellowship programs reported that there is a deficiency in preparing residents and fellows to address health care disparities. To address this gap, we developed a DEI curriculum consisting of eight topic areas separated into 12 monthly 50-minute didactic sessions. Topics ranged from foundational implicit bias and social determinants of health sessions and more topical sessions on sub-populations such as LGBTQ+ health and racial disparities in maternal and child health. Sessions were evaluated via surveys. Intermittent data show that the majority of residents found the sessions informative and believe it will improve their medical practice in ways that decrease health disparities.


In response to recommendations from various national organizations and the Accrediting Council for Graduate Medical Education for institutions to create recruitment strategies targeting underrepresented in medicine (URiM) groups, we implemented a recommendation that all faculty, staff and trainees involved in GME recruitment receive Implicit Bias Training (IBT), in alignment with the strategic plan for diversity, equity and inclusion. Leadership from GME DEI and the School of Medicine DEI partnered to provide targeted IBT sessions which focused on GME recruitment and best practices as it relates to URiM recruitment. These sessions were offered to all at various times of day to accommodate physician schedules. Over the course of two years, over 200 participants were educated representing 20 departments. During these sessions, participants were able to share best practices and discuss common challenges in recruitment, interviewing and selection practices.


Hair has played a longstanding role in race relations in the United States and is particularly relevant as current U.S. legislation addresses discrimination on the basis of hair. Through the centuries black hair has represented the social status and plight of the Black race. Black hair and skin has evolved into an integral symbol of the Black culture, so understanding it and maintaining it extends beyond aesthetics. Dermatologists should be aware of this historical context to optimize communication with patients and advance inclusivity efforts in the field and society more broadly.


There is a paucity of examples of gender discrimination and sexual harassment in radiology. This lack of knowledge can limit radiologists' ability to relate to this topic, acknowledge its importance and impact and take actions toward improvement. We surveyed female radiologists and conducted a qualitative analysis. The narratives we collected provide relatable examples of gender discrimination and sexual harassment in radiology. These may spark discussions that raise awareness among radiologists and result in interventions geared toward improvement.


The Time Is Now: Racism and the Responsibility of Emergency Medicine to Be Antiracist Nicole Franks, MD; Katrina Gipson, MD; Anwar Osborne, MD; Sheryl Heron, MD, MPH

In response to Racism is a Public Health Crisis declarations made by emergency medicine professional organizations; a socio-ecological framework was developed that structures the intentional actions that emergency medicine must implement at the individual, organizational, community and policy levels to address this public health crisis and be antiracist. This framework can serve as a model for medical specialties to raise awareness about racism and adapt these strategies as a call to action.


Women and minorities are systematically under-represented in medicine, and this effect is pronounced in the field of radiology, across education, work-force and leadership. The proportion of women and minorities represented in radiology diminishes as their rank or job title elevates. Much of this is likely due to implicit biases, generational attitudes, and workplace cultures that can be discriminatory towards women and minorities. Steps that can be taken include closing the gender pay-gap, providing more opportunities for mentorship, addressing biases, and supporting the upward career mobility of women and minorities. The purpose of our presentation is to discuss the existing disparities in medicine and radiology, and to address potential mitigating solutions.


Are Disparities in Emergency Department Imaging Exacerbated during High-volume Periods? Camara Sharperson, Tarek Hanna, Roger Gerard, Shenise Gilyard, Jamalik-Omari Johnson

HCOP National Academy @ Emory: Building a Multi-Entry Pipeline to a Career in Healthcare Drew Kohlhorst, Kristin Gordon, Allen Lee, LaToya Rolle, NyThea Tolbert, Theodore A. Brzinski, Candice Chatman, Brian Crawford, Joanne McGriff, John Eley, Yolanda Hood

Emory University School of Medicine (EUSOM), in collaboration with Atlanta Metropolitan State College (AMSC), Atlanta Public Schools (APS), the Rollins School of Public Health, Emory College of Arts & Sciences, Southeastern Primary Care Consortium, Inc., Atlanta-area Health Education Center and the Urban Health Initiative, have developed an educational pipeline program focusing on providing programming, curriculum and activities to individuals from disadvantaged backgrounds in entering health professions. Collectively, this program, the National HCOP Academy at Emory, targets disadvantaged groups that have been historically under-represented in the health sciences field, partly due to a lack of exposure and access of minority communities to health sciences. The target population of the Emory Academy are students from the APS, AMSC, EUSOM and Rollins School of Public Health. These populations, Ambassadors, are carefully guided through curriculum and activities designed to increase self-efficacy, professional and academic development and mentorship helping the target population enter the health care educational pipeline.