Only 6.5 percent of practicing radiologists are underrepresented minorities (URMs) in medicine despite accounting for nearly 35 percent of the U.S. population. Of the 20 largest Accreditation Council for Graduate Medical Education (ACGME) training programs, radiology ranks 18th among trainees classified as underrepresented minorities. The American College of Radiology Commission for Women and Diversity identified several obstacles to diversification in radiology including inadequate exposure, relative lack of URM role models and mentors, and bias. Vanderbilt University Medical Center’s Diagnostic Radiology Residency Program noticed a similar trend in its training residency. As recently as the 2013-2014 academic year, the program had none in its ranks. In 2013, under the direction of chairman Dr. Reed Omary, the department committed itself to addressing the disparity. Professor of Radiology and Radiological Sciences Dr. Stephanie Spottswood was appointed as the associate vice chair of diversity, and the radiology office of diversity, equity, and inclusion was created. The new office allowed Spottswood, who was the vice chair, and her team to incorporate additional faculty and educational resources to create a more diverse program. Vanderbilt’s belief is that diversity, equity, and inclusion must be intentional. In the early years, the office made calls to perspective applicants, reached out to potential URM applicants at conferences, made sure interviewees preferably interviewed with or met URM faculty members during their time on campus, and followed up with interviews to thank them for visiting and to make sure that they didn’t have additional questions or concerns. The program’s strategy includes website development, advertising, social media, early exposure opportunities, recruiting visits to predominantly minority institutions and national meetings, and mentoring minority students. The team implemented activities to increase the number of those students, including holistic screening tools for residency application review, a diverse recruitment committee, a welcoming environment for visiting candidates, and “Second Look Weekend” follow-up visits for prospective residents. The efforts are producing results; minority representation has climbed to 24 percent with the current class. Spottswood has since retired and Drs. Andrea Birch and Marques Bradshaw are carrying on her important work. “Studies show that having increased diversity improves the cultural competence of learners and leads to better outcomes for patients,” said Bradshaw, an associate professor and associate vice chair who joined the department in 2017. “There is also interesting information detailing that until you reach a certain number of underrepresented minorities or women, individuals may be inherently scrutinized more just because they are subconsciously noticed more than others.” Prospective residents’ scrutiny of a program goes beyond the program’s offerings and reputation. They want to know that faculty and staff are creating an inclusive environment. “I hear from learners that I mentor or interview that one of the first things that they do is look over a program’s website to see how diverse the residents and faculty are,” Bradshaw said. “My learners express how thankful they are to have other residents that look like them and, just as importantly, have faculty that look like them. Residents have said that they feel a certain level of comfort when they walk into a reading room and know that there is also someone of a diverse background in the room.” Some of the most crucial activities happen outside the hospital. Residents have varied backgrounds and need to feel camaraderie in a program if they are to succeed and go on to help patients. “We want to make sure that we are not just attracting applicants, but that we create an environment where they can thrive,” Bradshaw said. “We mentor our URM residents while they are here, and now we are beginning to have more constant social outings with them as a group to make sure that they feel supported, not just academically but socially as well.” Bradshaw and the rest of the team serve as sounding boards for their residents, asking for feedback and ways that the program can be improved. Bradshaw’s experiences in his training programs at Vanderbilt Nuclear Medicine and Medical University of South Carolina Radiology were positive and he wants today’s residents to have the same advantage. “It has been my experience as an attending physician that residents may have struggles or concerns but won’t let you know until unfortunately in some instances it is too late,” he said. “This is why I try to create an environment that is not only welcoming but hopefully will allow my residents to know that it is OK to come to me with any problem so that we can work it out before things get out of hand. I specifically ask them how things are going and what we can do better.” Bradshaw said while the program has concentrated on improving its URM numbers, it will continue recruiting the best in the field regardless of background. “We encourage all who are interested in radiology to come and check out our program,” he said. “Our arms are always open to a new encounter.”