Thank you for the opportunity to respond to the letter written by Dr Forde and Dr Rodriguez addressing our article, “Common Factors Among Family Medicine Residents Who Encounter Difficulty.”1 Drs Forde and Rodriguez expressed interest in whether our study could have explored potential association between residents’ minority status, such as race or ethnicity, and the likelihood of encountering difficulty during residency training. The question of whether underrepresented minorities (URM, defined by Drs Forde and Rodriguez as those of black, Latino, and Native American ethnicity) are more likely to encounter difficulty in medical training is an important topic to examine.
There is a simple answer to the query raised about our findings: while we anecdotally know that our program includes residents from URM, we do not collect data on the race or ethnicity of residents at any point in the application process or during residency training. This is not unique to our residency program; unlike in the United States, where race and ethnicity demographics are routinely included in information gathered about applicants,2 in Canada, race and ethnicity data are not part of standard data collection.3 Additionally, although there are enough commonalities between the Canadian and American family medicine residency training curricula to argue that our findings are generalizable beyond Canadian family medicine residency training, it would be difficult to justify generalizing any findings about URM beyond the Canadian context due to large differences in the demographics of the Canadian population and that of the United States.
As highlighted by the letter from Drs Forde and Rodriguez, there are many potential factors that may contribute to the situation of a resident encountering difficulty during training. Further research is needed to both improve identification of residents who encounter difficulty, and to facilitate better interventions for those residents.
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