Background Racism pervades the medical system, contributing to health inequities, lack of Black, Indigenous, and people of color (BIPOC) entering medical education, and poor retention of BIPOC physicians. Racial affinity caucusing (RAC) is a tool to address and dismantle cultural and institutional racism by providing space for individuals with shared racial identities to engage in conversations about their racialized identities and experiences. Little is published on RAC facilitation and training. Objective The authors aimed to evaluate an RAC facilitator training program. Methods Program directors from 32 residency programs nominated 12 faculty for RAC facilitation training, and all participated in virtual trainings and RAC sessions from September 2021 to March 2022. Training consisted of foundational concepts of anti-racism and RAC, and practice co-leading an RAC session. All 12 participated in semistructured interviews. Interview transcripts were evaluated for identified themes. This qualitative study used directed content analysis to discern patterns and cross-walked code categories with constructs from social cognitive theory. Results Interview transcripts for all 12 participants, who included 7 BIPOC faculty and 5 White faculty, were reviewed to discern patterns. Patterns were coded revealing themes for participants' motivations and perceived benefits of facilitator training, critical skills needed for successful facilitation, and resources necessary to implement RAC at home institutions. Conclusions In addition to identifying motivations for participation in training, key skills and resources for successful facilitation were identified, including small group facilitation, managing one's own emotions, understanding principles of anti-racism, and practice and debrief of RAC facilitation.

Context: Rural America has fewer physicians leading to poorer health outcomes. In an attempt to bolster the rural physician workforce, the Health Resources and Services Administration (HRSA) funded a series of Rural Residency Planning and Development (RRPD) awards to develop rural residency programs in needed specialties. These 3-year program start-up grants were awarded to the initial cohort of RRPD grantees in 2019. Objective: Explore early workforce outcomes of the RRPD grants program, using resident recruitment data Study Design & Analysis: cross-sectional, descriptive analysis of qualitative and quantitative evaluation data Setting: new rural residency training programs across the U.S. Intervention/instrument: grantee exit survey, administered at the conclusion of their RRPD award Population studied: Cohort 1 RRPD grantees: 25 newly developing residency programs in Family Medicine (n=20), Psychiatry (n=4) and Internal Medicine (n=1) across the US Outcome measures: Median total and eligible applications per available position; median interviews offered and completed per position; positions filled in the main residency Match vs the Supplemental Offer and Acceptance Program (SOAP); residents from the state where program is located Results: The 25 Cohort 1 RRPD programs range in size from 2 to 8 residents per year. Most programs (16 or 64%) were considered rural training tracks and anticipate that residents will spend on average 73% of their time at rural training sites (50% min to 100% max). Of the 25 sites, 17 (68%) were far enough along in development to participate in the 2022 Match. These programs received a median of 152 (range 25-349) total applications per position, 22 (range 5-122) of which were considered eligible. They offered a median of 15 (range 5-45) interviews per position and completed 15 (range 5-33) of these. Most of the 68 total positions were filled in the main NRMP Match (79% average) though some (19% average) were filled in the SOAP. Approximately 1 in 3 (34%) of residents currently enrolled in Cohort 1 RRPD programs are from the state in which the program is located, though this ranged from 0 to 79% by program. Conclusions: Early resident recruitment outcomes suggest the RRPD model is successful in creating and supporting new physician workforce training in rural communities. A strong main Match fill rate (79%) may indicate student interest in rural training, including those who are local to the area.

OBJECTIVES Residency programs must gather and track data on the diversity of their applicants, interviewees, and matched residents as part of the process of checking for bias in the interview and rank process. As such, the aims of this study were (1) to provide data from a large, regional network of family medicine residencies on who is applying, interviewing, and matching into our programs as a baseline for the family medicine residency community; and (2) to assess potential differences in the gender and racial diversity of the eligible applicants to programs across settings, including in rural and underserved communities. METHODS Survey of programs in Alaska, Idaho, Montana, Washington and Wyoming about their applicant pool in the 2020-2021 interview season. RESULTS Programs received a median of 100 applications per position, 57 of which were considered eligible. Programs offered 17 interviews per position and 15 of these were completed. Programs in rural and underserved communities did not have fewer eligible applicants per position, nor was there less diversity within that pool of applicants. Most programs are working to increase their program's diversity. CONCLUSION On average, the racial and gender diversity of eligible applicants to programs in rural and underserved settings is no different than other programs. What is important in terms of diversity varies across programs, based on community needs and program mission, but having a mechanism to extract and review data and to then be able to assess progress is a place to start.

BACKGROUND AND OBJECTIVE:The National Resident Matching Program's (NRMP) Supplemental Offer and Acceptance Program (SOAP) places unmatched applicants in residency programs. We examined the outcomes and experience of family medicine residency programs that matched with residents through SOAP.METHODS:In 2020, all program directors in a regional family medicine residency network whose programs had participated in SOAP (n=23) completed a survey on their experience with SOAP and characteristics of residents who were matched via SOAP (n=52) anytime between 2012 and 2020. Resident outcome measures included graduation, remediation, leadership, fit, and comparisons of Milestones areas. Experiences with the SOAP process included factors that may have led the program to SOAP and advice for other programs participating.RESULTS:Eighty-seven percent of residents matched via the SOAP graduated, and the majority compared favorably to other residents. Two-thirds of program directors were very likely to hire their residents matched via the SOAP. Rural programs had similar outcomes, although rural-track positions represented 30% of all residents matched via the SOAP in the study. More than half of all responding program directors reported being underprepared for the SOAP process. Program directors recommend getting familiar with the NRMP resources and setting aside time for key personnel in case a program needs to participate in SOAP.CONCLUSIONS:The vast majority of residents matched via the SOAP are well prepared for training, contribute to their programs, and perform as well as other residents. Rural programs are more likely to place residents via SOAP than nonrural programs.

BACKGROUND AND OBJECTIVES In 2020-2021, the Family Medicine Residency Network (FMRN) programs participated in virtual recruitment. We conducted a study to describe the recruitment activities utilized by programs and to identify which of these activities were most and least helpful to both students and the programs. METHODS In May 2021, we sent an electronic survey to the incoming interns (n=242) asking which recruitment activities they participated in, which were most and least helpful in deciding their rank list, and which most positively impacted their perception of the program. Simultaneously, we surveyed the 43 FMRN program directors (PDs), asking them which virtual recruitment activities they offered, which were most and least helpful in creating their rank list, and which they thought most positively impacted students' perception. RESULTS The 167 intern survey responses (69% response) indicated that virtual interviews and virtual get-togethers with residents were most helpful to deciding rank list order while receiving gifts and meals were least helpful. Websites, bios, and social media positively impacted perception of a program. PDs (79% response) overestimated the importance of the recruitment video and a prerecorded hospital/clinic tour and underestimated the importance of resident-only social interactions to the applicants. CONCLUSIONS Programs may improve the effectiveness of their virtual recruitment process by maximizing interactions with current residents and creating opportunities for interviews with individuals in different positions across the program. Reducing spending on gifts and meals frees up funds better spent on activities with greater impact such as website improvement and more events for student interaction with current residents.

Context: The Supplemental Offer and Acceptance Program (SOAP) is part of the National Resident Matching Program (NRMP) and is the process for matching unmatched student applicants with unfilled residency programs. Little research has been done on the SOAP, on how these students perform in residency or what factors may have led programs to go unfilled. Objective: The main objective of our study was to describe characteristics and outcomes of residents who went through SOAP; secondary objectives included identifying residency program factors that may contribute to SOAP and strategies for programs to prepare to SOAP. Study Design: survey Setting: Residency programs in the Family Medicine Residency Network (FMRN) Population studied: 23 programs and rural training tracks from the FMRN who participated in the SOAP since its inception in 2012 (of 39 total programs) and the residents who were matched to those programs in the SOAP (54 of 1658 total residents) Outcome Measures: Primary outcomes were resident performance, including graduation from residency, performance on key competency areas at the beginning and end of residency, likelihood to need remediation, likelihood to hold leadership positions, resident “fit” with program culture, and program director likelihood to recommend to a colleague for hiring. Secondary outcomes were around program experiences with SOAP, including program director perception of factors that led to the program SOAPing and suggestions for preparing other programs to participate in the SOAP process. Results: We had a 100% response rate. Program Directors reported a largely positive experience with their SOAP residents, viewing them as mostly equal or more favorable to the average resident. Respondents offered a number of factors that may have led them to SOAP including being ill prepared, being a new program, location (rural), program director turnover, low morale, and potential program weaknesses. Program Directors shared advice for preparing for SOAP including clearing schedules during Match week, understanding the process, screening applicants and communicating with applicants. Conclusions: Our findings help dissuade concerns programs may have about the quality of residents obtained through SOAP and confirm the assumption that rural training tracks are more likely to SOAP. Additionally, our findings offer guidance to programs for remediating potential issues that could lead them to SOAP and how to best prepare if they do SOAP.