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2021 residents

Incoming residency class at Children’s National three times more diverse than national average

2021 residents

The new class of residents arriving at Children’s National Hospital on June 9, will be the hospital’s most diverse class ever. 51% of the incoming intern class identify with races and ethnicities underrepresented in medicine (UIM) including Black, Latino and Southeast Asian, a percentage that is more than three times the national average for diversity within residency programs.

“We have worked hard to make our residency class more diverse because we know that diversity among academic pediatricians helps dismantle systemic health care inequities faced by children,” said Aisha Barber, M.D., M.Ed., director of the Pediatric Residency Program at Children’s National. “Studies show that when patients see someone they identify with, it enhances patient trust and satisfaction. Diversity within medical ranks has also been associated with improved health care outcomes for patients from underrepresented backgrounds.”

Children’s National created outreach and pipeline programs designed to reach a larger more diverse group of medical students and to increase diverse students’ interest in academic pediatrics at Children’s National. Program leaders reach out through various student medical association meetings, nationally and regionally.

In 2015, the hospital developed Advancing Diversity in Academic Pediatrics, a scholarship program for senior medical students from backgrounds UIM to experience what a career in academic pediatrics might look like for them. Since the start of the scholarship program, the diversity of incoming resident classes has grown from 12% to the current 51%.

“This scholarship program changed my career trajectory as it introduced me to the field of pediatric academic medicine,” said Jessica Hippolyte, M.D., M.P.H., pediatric chief resident at Children’s National and graduate of the scholarship program. “I was paired with minority resident and faculty mentors, networked with senior program leadership, received guidance on the application process and gained tremendous insight on all the opportunities available to Children’s National residents.”

Under the scholarship program, fourth year medical students are invited for a month-long clinical rotation and given a stipend funded by the CEO’s office at Children’s National. The program’s curriculum not only focuses on the clinical experience, but through relationships with mentors, focuses on the development of interview skills and the creation of a competitive curriculum vitae, or CV.

Since the program began, there have been over 70 participants and a 25% match rate to the pediatric residency program at Children’s National. Four members of the 2021 class are graduates of the scholarship program.

Every March, medical students learn which residency programs they will train with on what is known as ‘Match Day’. Children’s National receives over 2,000 applications per year for 41 residency positions. That’s more than half of medical student applications in the U.S. for pediatrics. Applicants were recruited from some of the top medical schools in the U.S. including the University of Pennsylvania, Columbia University, University of California, San Francisco and University of California, Los Angeles.

In addition to the increases in the racial and ethnic diversity of the incoming residents, at least 10% of the incoming class identify as LGBTQ, which mirrors the percentage of adults in D.C. who identify as LGBTQ.

“There are many factors that indicate to us that someone will make a great resident and a great doctor,” said Dr. Barber. “At Children’s National, we strive to be sure our residents understand that they’re appreciated not for how they add to diversity statistics, but for who they are as a whole person and all they have to contribute to our community.”

 

coronavirus

Higher COVID-19 rates seen in minority socioeconomically disadvantaged children

coronavirus

Minority and socioeconomically disadvantaged children have significantly higher rates of COVID-19 infection, a new study led by Children’s National Hospital researchers shows.

Minority and socioeconomically disadvantaged children have significantly higher rates of COVID-19 infection, a new study led by Children’s National Hospital researchers shows. These findings, reported online August 5 in Pediatrics, parallel similar health disparities for the novel coronavirus that have been found in adults, the authors state.

COVID-19, an infection caused by the novel coronavirus SARS-CoV-2 that emerged in late 2019, has infected more than 4.5 million Americans, including tens of thousands of children. Early in the pandemic, studies highlighted significant disparities in the rates of infection in the U.S., with minorities and socioeconomically disadvantaged adults bearing much higher burdens of infection. However, says Monika Goyal, M.D., M.S.C.E, a pediatric emergency medicine specialist and associate division chief in the Division of Emergency Medicine at Children’s National whose research focuses on health disparities, it’s been unclear whether these disproportionate rates of infection also extend to youth.

To investigate this question, she and her colleagues looked to data collected between March 21, 2020, and April 28, 2020, from a drive-through/walk-up COVID-19 testing site affiliated with Children’s National — one of the first exclusively pediatric testing sites for the virus in the U.S. To access this free testing site, funded by philanthropic support, patients between the ages of 0 and 22 years needed to meet specific criteria: mild symptoms and either known exposure, high-risk status, family member with high-risk status or required testing for work. Physicians referred patients through an online portal that collected basic demographic information, reported symptoms and the reason for referral.

When Dr. Goyal and her colleagues analyzed the data from the first 1,000 patients tested at this site, they found that infection rates differed dramatically among different racial and ethnic groups. While about 7% of non-Hispanic white children were positive for COVID-19, about 30% of non-Hispanic Black and 46% of Hispanic children were positive.

“You’re going from about one in 10 non-Hispanic white children to one in three non-Hispanic Black children and one in two Hispanic children. It’s striking,” says Dr. Goyal.

Using data from the American Families Survey, which uses five-year census estimates derived from home address to estimate median family income, the researchers separated the group of 1,000 patients into estimated family income quartiles. They found marked disparities in COVID-19 positivity rates by income levels: while those in the highest quartile had infection rates of about 9%, about 38% of those in the lowest quartile were infected.

There were additional disparities in exposure status, Dr. Goyal adds. Of the 10% of patients who reported known exposure to COVID-19, about 11% of these were non-Hispanic white. However, non-Hispanic Black children were triple this number.

Although these numbers show clear disparities in COVID-19 infection rates, the authors are now trying to understand why these disparities occur and how they can be mitigated.

“Some possible reasons may be socioeconomic factors that increase exposure, differences in access to health care and resources, as well as structural racism,” says Dr. Goyal.

She adds that Children’s National is working to address those factors that might increase risk for COVID-19 infection and poor outcomes by helping to identify unmet needs — such as food and/or housing insecurity — and steer patients toward resources when patients receive their test results.

“As clinicians and researchers at Children’s National, we pride ourselves on not only being a top-tier research institution that provides cutting-edge care to children, but by being a hospital that cares about the community we serve,” says Denice Cora-Bramble, M.D., M.B.A., chief medical officer of Ambulatory and Community Health Services at Children’s National and the research study’s senior author. “There’s still so much work to be done to achieve health equity for children.”

Other Children’s National researchers who contributed to this study include Joelle N. Simpson, M.D.; Meleah D. Boyle, M.P.H, Gia M. Badolato, M.P.H; Meghan Delaney, D.O,. M.P.H.; and Robert McCarter Jr., Sc.D.