Assessing diversity, equity, and inclusion efforts and initiatives on Texas residency websites prior to Senate Bill 17 enactment

The 2023 National Resident Matching Program Applicant Survey revealed that 45% of applicants viewed an institution’s diversity as a factor when selecting a program. In light of Texas Senate Bill 17 (SB-17), which regulates institutions’ DEI efforts, becoming effective January 1st, 2024, we aim to assess the status of DEI-relevant information on residency websites before enactment. The purpose of this cross-sectional study is to assess the current (pre-SB-17) landscape of public-facing residency websites in Texas related to diversity, equity, and inclusion (DEI) content and to compare DEI content on websites for specialties with historically low diversity compared to more diverse specialties. A cross-sectional study was conducted to evaluate the presence or absence of 11 DEI elements on residency websites across the five most diverse and five least diverse specialties. All residency program-specific websites in Texas in specialties were included except for military programs and those who did not have at least 8 of 10 of the specialties of interest. Two authors independently extracted data. The overall range of positivity for the 76 evaluated websites was 19.78% (range 0%–90% across specialties). From lowest to highest in average positivity was Orthopedics (15.14%, 0%–36%), Physical Medicine and Rehabilitation (18.18%, 0%–70%), Dermatology (19.82%, 0%–54.4%), Radiology (20.80%, 0%–60%), Otolaryngology (20.82%, 0%–45.45%), Plastic Surgery (22.91%, 0%–22.22%), Vascular Surgery (23.72%, 0%–40%), Psychiatry (26.48%, 0%–90%), Family Medicine (29.43%, 9.09%–72.73%), and Obstetrics and Gynecology (30.03%, 0%–90%). Amongst reviewed institutions, the range of overall positivity was 3.14% to 41.89%. Our study found that a majority of residency websites contained limited information on many of the DEI factors we evaluated. There was significant variance in presence of DEI criteria across programs and specialties. Key limitations are that program websites may not reflect all ongoing DEI initiatives, and a lack of DEI efforts on public display may not correlate with program priorities.