Cytopathology in focus: The cytopathology workforce through a DEI lens

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The events of the past few years have renewed questions about whether medicine is making progress in reflecting the full diversity of communities that physicians are called on to serve. Unfortunately, the data are clearly suggesting we are regressing, with a longstanding diversity gap that is widening. There is no quick recipe to reverse the trend, but we can take dedicated and purposeful actions to create a diverse workforce for the betterment of health care.

The flow in the pipeline for our field is critically low. Every year fewer and fewer U.S. medical school graduates are entering pathology. Multiple factors may be leading to the declining interest in pathology, but the decrease in pathology materials in the medical school curriculum has surely contributed. The CAP Pathology Pipeline Champions initiative (https://tinyurl.com/PathPipeline), one of four priorities of the CAP Pathologist Pipeline Ad Hoc Committee, is a wonderful way to reach out to prospective pathology trainees. The American Society of Clinical Pathology mentorship program is another platform to use to educate students in middle schools, high schools, and undergraduate colleges about career opportunities in pathology, including cytotechnology. Underrepresented communities should be the intended audience, regardless of the preferred outreach program.

The recruiting process can be a hurdle in reaching diversity if it is not designed to prevent implicit and explicit biases. Once a workforce is diverse, retention is best achieved through mentorship and sponsorship. The crucial glues to keep a diverse group of people working collaboratively are equity and inclusion for all. All these ideas are likely not new to most readers. In fact, many readers may be supportive of the vision of DEI, but perhaps fewer know how to move from a being a supporter to an advocate and an ally.

In recent years, most academic centers have begun to offer DEI classes or certificates. Many academic and nonacademic departments have created committees tasked to promote DEI. As a member of the profession, one should take advantage of these opportunities by signing up for a class or by joining one of these committees. The most important characteristic of a DEI advocate and ally is not his or her background, race, or ethnicity. It is the willingness to be open-minded and proactive in promoting DEI.

The inequities in our society go beyond the health care system, and it would be naïve to think we can reverse them with a few strategies. However, it would be irresponsible not to create strategies that could begin to do so. Over time, our involvement and engagement in DEI initiatives would bear fruit. Reaching DEI is more than about fairness; it is essential for our profession, for medicine, and above all for our patients.

1. Swartz TH, Palermo AS, Masur SK, Aberg JA. The science and value of diversity: closing the gaps in our understanding of inclusion and diversity. J Infect Dis. 2019;220(suppl 2):S33–S41.
2. Morris DB, Gruppuso PA, McGee HA, Murillo AL, Grover A, Adashi EY. Diversity of the national medical study body—four decades of inequities. N Engl J Med. 2021;384(17):1661–1668.
3. White MJ, Wyse RJ, Ware AD, Deville C. Current and historical trends in diversity by race, ethnicity, and sex within the US pathology physician workforce. Am J Clin Pathol. 2020;154(4):450–458.
4. Krouse HJ. COVID-19 and the widening gap in health inequity. Otolaryngol Head Neck Surg. 2020;163(1):65–66.
5. Lett E, Orji WU, Sebro R. Declining racial and ethnic representation in clinical academic medicine: a longitudinal study of 16 US medical specialties. PLoS One. 2018;13(11):e0207274.
6. Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463.

Dr. Samedi, a member of the CAP Cytopathology Committee, is associate professor of pathology, University of Colorado Anschutz Medical Campus School of Medicine, Aurora.