Perceptions on navigating ACGME-accredited addiction psychiatry fellowship program websites: A thematic analysis across a race- and gender-diverse pool of potential applicants

Abstract

Background: There is an alarming shortage of addiction psychiatrists in the United States. To promote interest in addiction psychiatry (ADP), it is essential to maximize resources available through ADP fellowship websites. The aim of this study was to investigate the perceived adequacy and accessibility of content on ADP fellowship websites and discover what further information is considered important among trainees interested in becoming addiction specialists. Methods: Three virtual focus groups were conducted between January and February 2021 among medical students and residents in diverse geographic regions. Participants were asked about the availability of information on ADP fellowship program websites and other material they would like to see available. Focus groups were recorded, with data transcribed and coded using NVivo 11 and Dedoose. A coding scheme was deductively developed based on the core research questions. Results: The majority of participants (N = 27) identified areas of dissatisfaction with the content currently available on ADP websites. The sample was highly representative of racial and ethnic minoritized trainees (n = 12) and genderqueer/non-binary participants (n = 3). Three major themes were identified and durable across all focus groups: lack of emphasis on diversity/health equity, lack of portrayal of everyday life and activities of fellows, and inadequate representation of curricula. Overwhelmingly, participants identified a dedication to health equity (for example, working with minoritized populations) as a key deciding factor in whether to apply to a particular ADP fellowship. Conclusions: ADP fellowship websites are perceived to have considerable variability in the amount and quality of information. Many do not appear to provide the full spectrum of content desired by diverse potential applicants, such as information regarding current fellows and community-centered initiatives. This is concerning, as it suggests ADP fellowships may be interfacing poorly with burgeoning leaders, especially those from race and gender minoritized backgrounds, neglecting potential opportunities to develop future addiction specialists.

Keywords:

• Addiction psychiatry
• addiction medicine
• fellowship
• graduate medical education
• website
• equity
• diversity
• recruitment

Acknowledgments

The authors thank Angelina Wing for her professional transcription services and Melissa Yuan for her support during the early stages of the project. In addition, the authors wish to acknowledge the support of Yale School of Medicine and University of Central Florida College of Medicine, as well as the Psychiatry Student Interest Group Network, the Association of Gay & Lesbian Psychiatrists, and the Recognizing and Eliminating Disparities in Addiction through culturally-informed Healthcare (REACH) Program for helping to disseminate recruitment information to their members.

Disclosure statement

None of the authors report a conflict of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the University of Central Florida, Yale University, SAMSHA, or any of their academic affiliates.

Author contributions

M.P.A., D.J., and A.J. conceived the idea for the study. M.P.A., D.J., and A.A. managed and contributed to the operation of the focus groups with guidance from A.J. and N.M. A.K. led the qualitative analyses. M.P.A., D.J., and A.J. took the lead in writing this manuscript. M.P.A., D.J., A.A., A.K., N.M., and A.J. provided critical feedback and contributed to the writing of the manuscript.

Additional information

Funding

This material is based upon work supported by the Substance Abuse and Mental Health Services Administration grant#1H79SM080388-01 (APA SAMHSA Minority Fellowship). Supporting organizations had no further role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.