Health Equity. 2026 Jun 8;10:24731242261455433. doi: 10.1177/24731242261455433. eCollection 2026 Jan-Dec.
ABSTRACT
INTRODUCTION: Disparities in medical education are documented across the training continuum, yet little is known about how racial and socioeconomic factors shape disciplinary actions during residency.
METHODS: We conducted a cross-sectional anonymous survey of resident physicians affiliated with the Committee of Interns and Residents. The survey captured demographic characteristics and experiences with negative feedback, remediation, and discipline. We used descriptive statistics and logistic regression.
RESULTS: We analyzed 1,755 validated responses (9.2% completion). Compared with White participants, Black participants had higher odds of being asked to meet with program leadership (unadjusted odds ratio [OR] = 1.93, 95% confidence interval [CI]: 1.32-2.82), and this association strengthened after adjustment for gender, specialty type, and early-life socioeconomic indicators (adjusted OR [AOR] = 2.24, 95% CI: 1.48-3.38). Black participants were nearly three times as likely to report ever being on remediation (OR = 2.93, 95% CI: 1.51-5.72), although adjusted models were limited by small event counts. When disciplinary outcomes were combined, Black participants were 55% more likely than White participants to experience any disciplinary action in unadjusted analyses (OR = 1.55, 95% CI: 1.10-2.19), and this association strengthened after adjustment (AOR = 1.76, 95% CI: 1.21-2.57). Hispanic and Asian participants did not demonstrate higher odds of disciplinary action compared with White participants.
CONCLUSION: Racial and socioeconomic inequities in residency discipline challenge assumptions that discipline reflects merit alone. Programs should implement transparent, uniform disciplinary processes and create supportive training environments for all trainees.
PMID:42534758 | PMC:PMC13421930 | DOI:10.1177/24731242261455433
