Journal Club Podcast: Fostering Inclusivity in PM&R: A National Survey-Journal Club Podcast: Fostering Inclusivity in PM&R: A National Survey

Video Transcription

Welcome to the HAP MNR Journal Club, a podcast where we introduce you to thought leaders who are published in the American Journal of Physical Medicine and Rehabilitation.  This is a show about practices, research, and education that are shaping the field of physiatry in inspiring ways.  The Journal Club is brought to you by the Association of Academic Physiatrists, or AAP, an intimate and influential professional society that brings together leading minds at every  career level. Physiatrists and professors, directors and med students, researchers and residents, this  is your behind-the-scenes look at people and ideas that will influence your future. Your host is Dr. Eric Wasatsky, an AAP member with Georgetown University School of Medicine.  Welcome everyone. Thank you for joining the AAP's Journal Club podcast. I'm Dr. Eric Wasatsky, coming to you from the MedStar National Rehabilitation Hospital in Washington, DC.  Today I am joined by my co-host, Dr. Kenyatta Williams, who's one of our PGY3 residents interested in pain medicine. Dr. Williams, thank you so much for joining me today.  Thank you for having me. I'm happy to be here. Absolutely. This is going to be a great conversation.  So today we have a wonderful author of a recently published article in the American Journal of Physical Medicine Rehabilitation.  The article is titled, Fostering Inclusivity in PM&R, a National Survey. And the lead author is Dr. Deji Adeneyi, who was born in Lagos, Nigeria and raised in the United States.  Dr. Adeneyi attended Vanderbilt University as an undergrad and graduated from Columbia Medical School.  He's currently a prelim intern at Mount Sinai in New York City, and will be joining the PM&R residency at University of Washington next academic year.  Within PM&R, Dr. Adeneyi is passionate about medical education, was a former Fulbright scholar in Taiwan and speaks Chinese, and is the founder of the Columbia PM&R series,  which he pioneered as a medical student. And this PM&R series was a response to the research we're going to be discussing today.  And this PM&R series works to empower underrepresented students to explore medicine and PM&R through evidence-based initiatives. So very, very excited.  Thank you, Dr. Adeneyi, for joining us today on this podcast. No, I'm super excited to be here. Thank you so much for inviting me. Absolutely. This will be a nice discussion.  So again, we're discussing this article, Fostering Inclusivity in PM&R, a National Survey. And if we can just start, hopefully all of our listeners are going to open the journal  and read this article. But for anyone who has not looked at it yet, can you just provide us kind of a brief overview,  just so all of our listeners have an understanding of what the study is about? Yeah, absolutely.  So actually, my journey into PM&R actually started where I was watching a YouTube video. It was in my third and fourth year of medical school.  And I was wondering to myself, why is it that it wasn't until my later years of medical school did I not hear about this specialty?  So I was really passionate about reasons why the awareness about PM&R is not so high. And so that was one of the reasons I started this project.  So there was already a paper that was made by a group in Mount Sinai that had looked at medical students, but there wasn't any papers that had looked at early on, such as  high school students or pre-meds. And so I really wanted to understand reasons why awareness or interest in PM&R isn't as high as other specialties.  And so that's really where the work started. So it was really, I'm super excited that we got a lot of responses from it.  We were able to collect over 1000 responses from over 40 different states and over 200 different universities represented it.  But the results were really shocking and really promising, I think, kind of showcase ways in which we can increase awareness and interest in PM&R.  But we showed that only about a third of students knew what actually PM&R was. And that was coupled with the fact that a lot of them had never shadowed a PM&R doctor.  We have seen about only two to three percent of students have ever shadowed a PM&R doctor. But ways in which we saw that students were interested in PM&R was through like shadowing,  through workshops and through mentorships. And so we think those are avenues and ways to increase or address underrepresentation in PM&R.  And so actually one of the direct results of the study was actually I created the Columbia PM&R series based on the findings from the research. Fantastic. This is such great work.  And, you know, I think I often think to myself, you know, PM&R, I think, has a greater standing in the world than when I was a medical student in the early 2000s.  But your work here that we'll continue to discuss today shows us we still have a lot more work to do. So I'll pass the baton to Dr. Williams for our next set of questions.  Thank you. So I found your article really interesting. And even though I know this wasn't the focus of your article, in the beginning, you touched  on there being a lack of women representation in physical medicine rehabilitation. I'm wondering if during your research, you found that the lack of women applying to the  specialty stemmed from like pre-med exposure, or do you think it stemmed more from mentorship  from other women in PM&R for students to actually talk to, to shadow with and that sort of thing? Yeah, that's a great question. And yeah, you're right.  Unfortunately, our paper didn't directly looked at it. But some of the data that we did see from the paper revealed maybe some ways in which  to increase representation in female applicants. But one of the things that we noticed was about 40% of respondents has indicated that  mentorship was something that was very important to them. And so we also had noticed that very few students have ever had a PM&R doctor as a  mentor with 2% of students had ever shadowed a PM&R doctor before. So we definitely think there's definitely avenues to increase awareness in PM&R through that.  We also noticed from the manuscript in the paper that over 60% or nearly 60% of respondents, even though we didn't stratify by gender, over 60% of respondents were interested in  workshops that were related to topics that empowered women. And so I think those are definitely some ways in which we can try to work in trying to increase  representation for female applicants. But I think there is some promising news with I was looking through data with the AAMC.  I think there's now more female applicants than male applicants who apply into medical schools.  And that trend persists where within PM&R, we can now see an increase of applicants within going to PM&R and then training into PM&R.  I think PM&R, based on data that I saw earlier, had less than 40% of female trainees. I actually noticed that as well.  I think the trend overall in medical training with women physicians is almost trending toward even. It's almost 50%.  It's still hovering in the high 40s, but we're certainly getting there. So I do hope to see those changes in the specialty of PM&R also. Absolutely. I agree.  That sort of brings me to one of the other questions that I had with going through your study.  You mentioned a lot of really good resources like websites, podcasts, and different things like that that pre-med students have access to.  But I'm wondering if you put any thought into what would get students interested in seeking out those things to begin with in order for them to get the best utilization of it.  Because of course, if they don't know that our specialty exists, then they have no reason to seek those really good resources that are already available to them.  A lot of people don't know just how broad the specialty is. We were able to see that a lot of students were able to associate topics like sports  medicine with PM&R, but less than one third of students were able to associate cardiac patients or burn patients with PM&R. So I think there's avenues where we can work in that way.  But I also think that another way we can do so is working with collaborations with other specialties.  So we have done, within the Columbia PM&R series, we have collaborated with other specialties as well.  For example, we had collaborated with orthopedics, where a lot of students actually initially had a lot of interest within that specialty.  And I was actually talking to one of my mentees who was like, oh wait, I was actually interested  in orthopedics initially, but now that I've heard about PM&R, I think I'm a little bit more interested in PM&R.  So I think a lot of people just don't know about the specialty, and that could be a way as well where we can collaborate with other specialties.  But yeah, I agree, it could be really challenging to find ways to increase awareness in PM&R. I think that's a really interesting point.  Obviously, we always have work to do with awareness of the specialty. But I think that awareness of the broad diversity of the specialty could potentially be a conduit  to a more diverse pool of applicants and future residents, because in some ways, if many, many people are associating PM&R with, let's just say, sports medicine, which in some ways  can be orthopedic adjacent, which is probably a specialty that traditionally has been maybe  less diverse in people applying to that, that could potentially negatively impact the diversity  in our field, whereas if people see all the many different areas of our specialty, ranging from spinal cord, pediatrics, cancer rehab, the list goes on and on and on.  Maybe that could have a positive effect on the diversity of who we recruit. Yeah, I agree. And within PM&R, we were looking at what topics that students were interested in learning  about PM&R. I think the two top topics were cancer rehab, which a lot of students didn't associate with  PM&R, and then another was pain management, which a lot of students really didn't associate with PM&R.  So I think if we could find ways to talk about topics or introduce those topics within the scope of PM&R, I think lots of students would be more drawn into the specialties.  I think that's a really interesting point, and it kind of brings me to another part of the article where you mentioned institutions in New York sort of targeting high school  students actually for introductions to physical medicine rehabilitation. And I'm wondering with how broad our practice is with all the subspecialties that we have,  do you think it would be more beneficial across the board for us as a specialty to target more high school students for similar opportunities? Yeah, absolutely.  So with the Columbia PM&R series, which I founded earlier this year in April, our most attended workshop outside of the most recent workshop that we had did in collaboration  with General Surgery was our high school event. Over 200 students had initially signed up for it or were waist-listed, and then about 80 students had attended.  So it was definitely high turnout in terms of students. But for that one, we had partnered with the neurology department here at Columbia.  One of the themes was technological innovations within PM&R. So we had introduced them into things like virtual reality and training for gait or,  for example, exoskeletons and things like that. And then also because the age of AI, we also talked about how the field itself is evolving,  which I thought would be something that would be geared towards a younger audience. And so students really, really appreciated learning about that within the scope of PM&R.  And so our data is already back where we were able to see a statistical significant increase in students' interest in PM&R and awareness of PM&R-related topics.  And we ended up doing actually a three-month follow-up to see how much retention students have in terms of their interests and their knowledge about PM&R-related topics.  And although there was a decrease, there wasn't a statistical decrease. So there was definitely some persistent retention of information and interest within PM&R.  So that was really exciting news to see within PM&R, within the high school students, all the high school students.  So we do have a social media page and all the high school students keep like commenting or DMing us about when's the next workshop.  So we owe it out to them to start creating more workshops. And we've been doing more or less a lot of them for pre-meds, but it seems like high  school students are just as eager to learn about the specialty. That's great. I really, really appreciate those efforts.  So along those lines, as we kind of talk about this process of outreach, outreach on behalf of PM&R departments to medical students, undergrads, college students, et cetera, it  takes human power. It takes time for maybe the residents and certainly faculty members to go out and do that.  You did mention briefly in your article a little bit about what's called the diversity tax.  And for any listeners not familiar with that, that's often referred to when diverse members of a department are maybe asked to do more things to kind of represent their diversity  group in outreach efforts, which can be a rewarding activity, but also can be more time for those faculty members to be asked to do those things.  For me as a faculty member and a leader, I'm always trying to get faculty members to help us with different initiatives, but I'm also sensitive to all of our busy clinicians are  busy and only have so much time to engage in those things. So you talk in your article that institutional support can really help faculty members to  get engaged in these outreach efforts. I know you're a junior in your career, starting your PGY on intern year, but in your mind  as you went through this article, do you have any thoughts on how institutions may be able  to help their departments, their faculty members, get more engaged and involved in these outreach efforts? No, I agree.  I think it can definitely be challenging, especially for individual institutions or members. I can maybe only speak from the perspective of a institution where we do happen to have  a undergraduate and a medical school affiliated with our program. But I honestly do think that a lot of these initiatives and a lot of these efforts can actually be student-led.  And actually that's what a lot of the Columbia PM&R series is. Most of it is actually led by pre-meds themselves. So they help and run most of the logistics.  They create a lot of the planning and the day of the event in terms of things like passing out foods and things like that.  So I think having a stepwise mentorship where pre-meds are more or less organizing things and then medical students are overseeing it, and then you can sometimes have oversight  from residents and maybe faculties. I think that type of model works well, and that's the type of model that's worked well for me.  My intern year is, right now in New York City, I'm extremely busy with trying to keep up with just being a doctor.  Even though we have monthly workshops, a lot of them are actually led by the really great pre-meds who've been super eager to want to be a part of this mission and this initiative.  And a lot of them actually end up, I get text messages about, oh my gosh, when's the next workshop and how can I get more involved?  Because there's a research element to it, a lot of them also gain experience doing research as well. So I think that's one avenue.  Another avenue I think also is in the article about virtual resources, such as representation  and rehab, as well as I believe there's a podcast within AAP that also can be a resource for students.  So I think sometimes having resources that are virtual and maybe you can produce one in time could definitely also be helpful for students as well.  But I also do really believe that collaborating with other specialties can also be something that could be helpful as well.  We've done a number of different collaborative workshops with other specialties. With the orthopedic example, that one specifically was about sports medicine, but with emergency  medicine, which people often do not think emergency medicine, PM&R, how is that related? But we did one related to cardiac health.  So the emergency medicine team had talked about the acute aspect of having a myocardial refraction.  And then we talked about what that could look like for a patient after a heart attack and what cardiac rehab can look like.  So I definitely encourage, if there is limited resources or things like that, those are definitely avenues in which I think we can increase outreach. That's beautiful.  I think that's a great model and really presents something that's very feasible, as we discussed  with residents and faculty being very busy, having that sort of distance supervision model where the undergraduate college or medical school students are kind of running things  somewhat on their own with some supervision from those in practice. Sounds like a great way to do this and a very worthwhile initiative for the future of our specialty.  I think honestly also as well, if it's within, besides just individual institutions, I think  organizations such as the AAP can also have some, I don't know if they can be like a committee  where, I think there's already a medical student committee, but if the AAP was interested in  something like a pre-med committee, I know different organizations have pre-med committees.  I believe the AOC PM&R has a pre-med committee, but there are avenues outside of individuals  institutions that maybe outreach can be breast spread through like organizational assistance as well. That's an excellent point.  You know, many, many undergraduate students and even medical students, you know, don't have the advantage of having, you know, PM&R departments, you know, locally.  So, you know, being able to leverage those national organizations like AAP, which does do a great job with mentor programs, you know, can make a big difference.  So thanks for bringing up that point. Well that's great. We're going to be getting close to wrapping up here.  Dr. Odeni, were there any other last comments that you wanted to add in about your great work you've done here? I just wanted to say thank you so much for inviting me.  It's been really nice being able to talk to both of you. I'm going to be heading over to AAP. So super excited to talk about my work and some of the things that we've done in trying  to increase our awareness of PM&R during February, late February, where AAP rolls around and I can talk about things like that. That's a great plug to put in.  Yeah, for any of our listeners planning to attend the 2025 AAP Conference in Phoenix, make sure you connect with Dr. Odeni if you want to talk with him about his great work  here and maybe potential for future projects. So really want to thank you for joining us today to discuss your study.  Again, for our listeners, please open your Blue American Journal of Physical Medicine Rehab journal to again read the article titled Fostering Inclusivity in PM&R National Survey.  Thank you, Dr. Williams, for joining me as my co-host, Dr. Odeni as our guest today to talk about your research.  Thank you all for listening and hope you all will tune in next time for the AAP's Journal Club podcast. Thank you all very much.

Video Summary

The HAP MNR Journal Club podcast focuses on advancements in physiatry, an evolving field in medicine. Hosted by Dr. Eric Wasatsky from Georgetown University and resident Dr. Kenyatta Williams, this episode features Dr. Deji Adeneyi, whose work on inclusivity in PM&R highlights the lack of awareness about the specialty among students. Dr. Adeneyi's research revealed that only a third of students knew about PM&R, with only 2-3% having shadowed a PM&R doctor. His Columbia PM&R series aims to boost awareness and inclusivity by engaging high school and pre-med students through workshops and collaborations with other specialties. These initiatives emphasize the broad scope of PM&R, including areas like cancer rehab and pain management, potentially attracting a diverse group of future practitioners. Institutional support and leveraging national organizations are pivotal in fostering increased representation and awareness in PM&R.

Asset Caption

Host: Eric Wisotzky, MD (The MedStar Health—Georgetown/National Rehabilitation Hospital)
Co-Host: Kenaya Williams, MD (The MedStar Health—Georgetown/National Rehabilitation Hospital)
The AAP’s official medical journal, the American Journal of Physical Medicine & Rehabilitation (AJPM&R), publishes cutting-edge basic and clinical research, clinical case reports and in-depth topical reviews of interest to rehabilitation professionals.
As part of our ongoing effort to highlight significant contributions to the field, we host a monthly discussion featuring an esteemed author whose work has been recently published in AJPM&R. This month, we are pleased to feature the article "Fostering Inclusivity in PM&R: A National Survey," authored by Deji Adeniyi, MD (Mount Sinai Medical Center). This study examines the current landscape of diversity, equity, and inclusion within PM&R, offering valuable insights into the experiences and perspectives of professionals across the field.

Keywords

physiatry

inclusivity

PM&R

awareness

workshops