Placement: University of California, San Francisco
Mentor: Patricia S. O’Sullivan, EdD, MS, Professor of Medicine and Surgery; Director, Research and Development in Medical Education, University of California, San Francisco, School of Medicine
Project: Planning for Health Workforce Diversity: A Case-Comparative Study of How Graduate Medical Education Organizations Operationalize Diversity, Equity, and Inclusion Workforce Policies to Advance Health Equity in the United States and Australia.
Sarah Aitken, MBBS (Hons), FRACS (Vascular), PhD, is the 2024–25 Australian Harkness Fellow in Health Care Policy and Practice. She is currently the Head of Surgery at the University of Sydney and a vascular surgeon at Concord Repatriation General Hospital. Aitken’s education and health service leadership roles have been highly influential in promoting diversity and equity across multiple domains, from the surgical workforce and care of patients to health systems and policies. Through implementing new selection and training pathways in vascular surgery, she has increased the diversity of vascular surgeons in Australia and Aotearoa New Zealand. Her clinical research into collaborative models of care, and age-related bias, have resulted in innovative approaches to older patients having surgery and have been implemented in national and international surgical guidelines and health policies. Aitken uses a range of methodologies to explore the role of gender and intersectionality in surgical outcomes, engaging with multiple organizations to support equitable perioperative care practice and policies.
Aitken earned her medical degree and Ph.D. from the University of Sydney, completing her surgical training in leading vascular units in Australia and Aotearoa New Zealand. She has been awarded over $3 million in research funding, has produced more than 40 publications in the past five years, and is recognized as an international influence in surgical research and education.
Project overview: Persistent health disparities exist in both the U.S. and Australia, driven by multilevel structural and systemic inequality. National health care strategies targeted toward reducing these inequalities include increasing the diversity of the medical workforce to be concordant with local communities. The divide between policy and practice is mediated by graduate medical education organizations (GMEOs), which are responsible for the recruitment and training of the current and future medical workforce. GMEOs employ a range of interventions, including “widening access” pathways to operationalize diversity, equity, and inclusion (DEI) policies to their local context. However, the slow pace of change in the diversity of the surgical workforce highlights the fact that substantial impediments remain in altering the status quo, and there is limited research on how DEI policies influence organizational change in GMEOs.
This project will examine three contemporary policy issues centered on the nexus between graduate education, workforce planning, and health equity. Using a comparative case study design, informed by realist methodology, I will explore how surgical GMEOs are responding to a dynamic policy context to address diversity, equity, and inclusion through workforce planning. An explanatory theoretical model with actionable messages will be derived, providing policymakers and educational organizations with practical solutions to recruit and train a diverse health care workforce. The overarching goal is to enrich and guide our understanding of how a diverse workforce can contribute to equitable health care delivery. Through cross-national partnerships and collaboration, it will also help shape the views, attitudes, and beliefs of leaders in medicine, prioritizing inclusive pedagogies in practice change.