From leadership research to district action: Evaluating equity, diversity, and inclusion in Canadian Postgraduate Medical Education: A cross-sectional analysis of online content

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Abstract Background Medical graduates applying to Residency through the Canadian Resident Matching System (CaRMS) utilize the internet to gather information on programs and their overarching Postgraduate Medical Education (PGME) Office. This study aims to evaluate how PGME websites across Canada convey their commitment to equity, diversity, and inclusion (EDI) through their website features. Methods Cross-sectional analysis of the 17 Canadian PGME websites against 20 EDI criteria based on contemporary literature, across five domains: leadership and governance, recruitment, accommodations, community engagement, and pathways to entry. Non-parametric testing was conducted to explore the relationship between EDI performance and municipal population diversity and geographic region. Results The evaluation of PGME websites, policies, reports, and plans revealed a mean score of 8.65/20 (SD = 3.00), with scores ranging from a minimum of 4/20 to a maximum of 13/20, indicating variability in EDI representation. Specifically, the domain of leadership and governance demonstrated the highest mean proportion of completed criteria (51%), while community engagement had the lowest (24%). Notably, 9 out of 17 PGME websites (53%) met at least 10 EDI criteria. Analysis by geographic region demonstrates significant mean differences (p = 0.02), with Ontario (10.50, SD = 2.17) and Western Provinces (11.00, SD = 0.00) scoring notably higher than Quebec (4.50, SD = 0.58), the Prairies (8.50, SD = 2.12), and the Atlantic region (8.00, SD = 2.83). Conclusions The assessment of Canadian PGME websites reveals varying levels of commitment to EDI. While many programs exhibit strong EDI representation in mission statements, access to mental health services, and anti-discrimination policies, there are notable gaps in leadership messaging, diverse interview panels, family-friendly policies, and deliberate recruitment of underrepresented groups. Regional differences highlight the need for sharing best practices to promote inclusivity across the country. Improving EDI efforts on PGME websites can promote the recruitment and retention of a diverse resident population.

Study methods

A list of all Canadian Faculties of Medicine was compiled using the Royal College of Physicians and Surgeons of Canada website [21]. Each institution’s PGME website was identified and subsequently reviewed. All website data was collected in February 2023 by two independent reviewers. This study was exempt from requiring ethics by the Queen’s University Health Sciences and Affiliated Teaching Hospitals Research Ethics Board (HSREB) as it relied exclusively on publicly available information.

Limitations

Our study sample size was constrained by the number of Canadian Postgraduate Medical Education Offices, although it is representative of all medical schools in Canada. Data collection was restricted to publicly accessible websites, excluding alternative sources such as private forums, emails, or direct interaction with trainees or staff which prospective residents might utilize. Website assessments were conducted with a degree of subjectivity, employing a binary approach to evaluate the presence or absence of content. A comprehensive analysis and critique of available content fell beyond the scope of this study. This study focused on assessing PGME at an overarching level and did not delve into individual program activities, which may vary from the presented findings. It is important to note that more nuanced information may be available on individual residency program websites.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Select one recurring district decision. Publish the decision owner, evidence requirements, consultation process and appeal route; test the process on a bounded low-risk decision. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Track decision time, unresolved objections, documented reasons, appeals and access differences. Review whether the process changes who can participate and who carries the burden. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Mohamed Bondok; Mostafa Bondok; Liana Martel; Christine Law. Evaluating equity, diversity, and inclusion in Canadian Postgraduate Medical Education: A cross-sectional analysis of online content. PLOS ONE (2024-08-27). https://doi.org/10.1371/journal.pone.0307584

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.