Toward opportunities for inclusive GP-specialty training On building bridges over the unspoken undercurrents

Migration has led to rapidly increased diversity in population demographics, necessitating a healthcare system that addresses its population's varied cultural and social needs. Given primary care's central role, these developments require a GP-workforce that reflects and respects this diversity. However, despite this requirement, ethnic minority GP-trainees in the Netherlands seem more at risk of being assessed as underperforming than their majority peers.
This dissertation investigates barriers and facilitators faced by these trainees, examining the impact on their professional development and identifying strategies for fostering an inclusive training environment. The research comprises four complementary studies:

Quantitative Analysis of Underperformance Assessments: An analysis of 1,700 trainees revealed that those from minority backgrounds are at a significantly higher risk of being labeled as 'underperforming,' even after adjusting for age and gender.Lived Experiences of Minority GP-Trainees during their 'Educational Journey': In-depth interviews with 14 trainees highlighted experienced bias, microaggressions, and a lack of belonging within predominantly 'white' institutions.Coping Strategies of these trainees: Trainees reported various coping mechanisms, including emotional distancing, religious support, and peer networking, which may put them at risk for isolation and hinder professional growth.Intervention Development: Seven interventions were proposed and co-designed with trainees and faculty. These include mandatory DEI training for all stakeholders, DEI ambassadors, and a significant voice for minority trainees in their curriculum.

The researchers underscore the need for continuous evaluation and adjustment in GP-specialty training programs to ensure a genuinely inclusive educational environment that reflects the diversity of the broader society.