The University of Louisville Medical School's comprehensive programs to increase its percentage of underrepresented-minority students

Young Doctors Program-Colorado: An Elective Elementary School Program to Improve Health Literacy, Utilization of the Healthcare System, and Osteopathic Awareness

The Young Doctors Program (YDP) is a "mini medical school" series for fifth-grade elementary children. The YDP was designed and led by medical students in the Academic Medicine and Leadership Track at the Rocky Vista University College of Osteopathic Medicine in Colorado. The curriculum of the program was designed around the State of Colorado Learning Standards with the purpose of educating students about emergencies and common ailments in five body systems (cardiovascular, respiratory, gastrointestinal, musculoskeletal, and renal) while also providing exposure to healthcare as a profession. YDP provides children with insights into the healthcare system, an introduction to osteopathic medicine, and it enhances community outreach. This article provides a framework for the semester-long YDP curriculum as well as our final event which synthesizes learned information using standardized patients. We describe successes including community outreach and healthcare exposure in the elementary school, and challenges initiating connections with local schools and funding. Future goals include expanding outreach to other fifth-grade schools as well as growth to different age levels. Authors plan to pursue IRB approval for research to examine the benefits and efficacy of the YDP.

Seeking Equity; Pathway Programs in Liaison Committee on Medical Education Medical Schools for Minoritized Students

Objectives

There is a paucity of data on pathway programs that seek to increase underrepresented in medicine (URiM) students in medicine. Therefore, this investigation aimed to describe the status and associations of pathway programs at US medical schools.

Methods

From May to July 2021, the authors obtained information by (1) accessing pathway programs listed on the Association of American Medical Colleges (AAMC) website, (2) reviewing websites of US medical schools, (3) calling medical schools to obtain further information. The data retrieved from the medical school websites was compiled into a 27-item checklist based on the maximum number of different items that was extracted from any of the medical school websites. The data included program characteristics, curricula, activities, and outcomes. Each program was assessed on the number of categories of which information was available. Statistical analyses determined significant associations of URiM-focused pathways and other factors.

Results

The authors identified 658 pathway programs: 153 (23%) listed on AAMC website and 505 (77%) identified from medical school websites. Only 88 (13%) programs listed outcomes and 143 (22%) had adequate website information. URiM-focused programs (48%) were independently associated with AAMC website listing (adjusted odds ratio [aOR] = 2.62, P  =  .001), no fees requirement (aOR  =  3.33, P  =  .001), oversight by diversity departments (aOR  =  2.05, P  =  .012), Medical College Admission Test preparations (aOR  =  2.70, P  =  .001), research opportunities (aOR  =  1.51, P  =  .022), and mentoring (aOR  =  2.58., P < .001). Programs targeting K1-12 were less likely to offer mentoring, shadowing or research or include URiM students. Programs with outcomes were more likely to be college programs with longer durations and offer research, while programs listed on AAMC website provided more resources.

Conclusion

Although pathway programs are available for URiM students, accessibility issues due to inadequate websites information and early exposure are barriers. Most programs have insufficient data on their website, including a lack of outcome data which is detrimental in today's virtual climate. Medical schools should update their websites to ensure that students requiring support to matriculate into medical school have adequate and relevant information to make informed decisions regarding participation.

We are part of the problem: the role of children's hospitals in addressing health inequity

Racism is an ongoing public health crisis that undermines health equity for all children in hospitals across our nation. The presence and impact of institutionalized racism contributes to health inequity and is under described in the medical literature. In this review, we focus on key interdependent areas to foster inclusion, diversity, and equity in Children's Hospitals, including 1) promotion of workforce diversity 2) provision of anti-racist, equitable hospital patient care, and 3) prioritization of academic scholarship focused on health equity research, quality improvement, medical education, and advocacy. We discuss the implications for clinical and academic practice.Plain Language Summary: Racism in Children's Hospitals harms children. We as health-care providers and hospital systems are part of the problem. We reviewed the literature for the best ways to foster inclusion, diversity, and equity in hospitals. Hospitals can be leaders in improving child health equity by supporting a more diverse workforce, providing anti-racist patient care, and prioritizing health equity scholarship.

Personality assessments and outcomes in medical education and the practice of medicine: AMEE Guide No. 79

In a paradigm of physician performance we propose that both "cognitive" and "noncognitive" components contribute to the performance of physicians-in-training and in-practice. Our review of the relevant literature indicates that personality, as an important factor of the "noncognitive" component, plays a significant role in academic and professional performances. We describe findings on 14 selected personality instruments in predicting academic and professional performances. We question the contention that personality can be validly and reliably assessed from admission interviews, letters of recommendation, essays, and personal statements. Based on conceptual relevance and currently available empirical evidence, we propose that personality attributes such as conscientiousness and empathy should be considered among the measures of choice for the assessment of pertinent aspects of personality in academic and professional performance. Further exploration is needed to search for additional personality attributes pertinent to medical education and patient care. Implications for career counseling, assessments of professional development and medical education outcomes, and potential use as supplementary information for admission decisions are discussed.

Introduction to the medical professions through an innovative medical student-run pipeline program

Underrepresented minorities (URMs) make up a disproportionately small percentage of medical school applicants, matriculants, and physicians relative to the general US population. Preprofessional pipeline programs may help introduce URMs to careers in the medical field. MiniMeds was developed as a paracurricular enrichment program that targeted URM students. The curriculum was designed and administered by medical students, and 2 trials of this program were conducted. Data were collected pre and post program through a survey that assessed knowledge of medical concepts and knowledge of and interest in careers in medicine. Attendance at program sessions correlated with baseline knowledge about medical professions. Knowledge about medical concepts increased significantly from baseline to follow-up for boys, a group significantly represented by URMs in our cohort. Median scores for knowledge of medical careers increased significantly from baseline to followup for URMs as well as for boys and girls. Preprofessional pipeline programs such as MiniMeds are able to engage and develop medical knowledge in URM students at a critical developmental age. Further evaluation and implementation of programs that incorporate medical students to actively develop and lead pipeline programs are warranted.

Developing leadership interventions for black and minority ethnic staff: A case study of the National Health Service (NHS) in the U.K

PURPOSE

The National Health Service (NHS) is the largest employer in the U.K. but, despite decades of equal opportunities legislation, its senior management workforce does not reflect the diversity of either the wider NHS workforce or the U.K. population. The aim of the paper is to consider the range of management interventions available to organisations like the NHS to deliver change in the area of promotion of Black and minority ethnic staff.

DESIGN/METHODOLOGY/APPROACH

Intervention programmes in a range of public and private organisations are reviewed and the nature of barriers to promotion and the range of interventions to overcome these are explored. The paper uses the paradigm of institutional racism to examine the ways in which the NHS discriminates against certain sections of its workforce. The methods used include a literature review combined with key stakeholder interviews. A comparative dimension which involved a review of research on leadership initiatives in the U.S.A. was also undertaken.

FINDINGS

The literature review found that there were a range of initiatives which could be implemented by public organisations such as the NHS to increase the presence of Black and Minority Ethnic (BME) staff in senior management positions. Most of these interventions were largely focused on the individual. Much more progress on institutional or organisational change needed to be made before the NHS could be perceived as a model employer in this area. The literature review also indicated that there is little published research on such initiatives within other European Union countries.

ORIGINALITY/VALUE

The paper is targeted at both policy makers and human resource officers responsible for equality and diversity issues within large organisations, who have a remit to improve the career pathways of staff. The analysis provided offers a set of critical tools and interventions that have not hitherto been well examined in the U.K. context.

Impact of the Career Explorers program on high school students' perceptions of the pharmacy profession

OBJECTIVE

To determine the effect of a 5-week Career Explorers Program (CEP) on high school students' perceptions of pharmacists' characteristics, duties, and training.

METHODS

A 16-item survey instrument with attitudinal, frequency, and relative quantity response options was completed by all CEP students on the first and last day of the program. The survey assessed students' attitudes concerning pharmacist characteristics, duties, and training.

RESULTS

All students who participated in the CEP in 2003 completed the survey instrument (n = 50). Seventy percent of respondents' answers to the attitudinal subscale questions significantly changed from preassessment to postassessment.

CONCLUSION

A 5-week CEP provided high school students with more realistic perceptions of pharmacists' roles, duties, and training before the students entered the pharmacy program.

A multicenter study of burnout, depression, and quality of life in minority and nonminority US medical students

OBJECTIVE

To determine the well-being of minority medical students in a multicenter sample of US medical students.

PARTICIPANTS AND METHODS

All 1098 medical students at 3 medical schools in Minnesota were surveyed in April 2004. Validated instruments were used to assess burnout, depression, and quality of life (QOL). Students were also asked about the prevalence of significant personal life events in the previous 12 months and strategies used to cope with stress.

RESULTS

Although symptoms of depression and overall burnout were similar among minority and nonminority students, minority students were more likely to have a low sense of personal accomplishment (P=.02) and lower QOL In a number of domains (all P< or =.05). These differences persisted on multivariate analysis that controlled for demographic characteristics and recent life events. Minority students were also more likely to have a child (P=.01), originate from outside Minnesota (P<.001), and experience a major personal Illness in the last 12 months (P=.03).

CONCLUSION

As a group, the minority medical students in this survey had a lower sense of personal accomplishment and QOL than nonminority students. Additional studies are needed to provide insight regarding the causes of these inequities and the unique challenges faced by minority medical students. Efforts to improve minority students' well-being, QOL, and learning experience may help prevent attrition among minority medical students and promote diversification in the physician workforce.

Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students

PURPOSE

To systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students.

METHOD

Medline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and May 2005 reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Searches used combinations of the Medical Subject Heading terms medical student and depression, depressive disorder major, depressive disorder, professional burnout, mental health, depersonalization, distress, anxiety, or emotional exhaustion. Reference lists of retrieved articles were inspected to identify relevant additional articles. Demographic information, instruments used, prevalence data on student distress, and statistically significant associations were abstracted.

RESULTS

The search identified 40 articles on medical student psychological distress (i.e., depression, anxiety, burnout, and related mental health problems) that met the authors' criteria. No studies of burnout among medical students were identified. The studies suggest a high prevalence of depression and anxiety among medical students, with levels of overall psychological distress consistently higher than in the general population and age-matched peers by the later years of training. Overall, the studies suggest psychological distress may be higher among female students. Limited data were available regarding the causes of student distress and its impact on academic performance, dropout rates, and professional development.

CONCLUSIONS

Medical school is a time of significant psychological distress for physicians-in-training. Currently available information is insufficient to draw firm conclusions on the causes and consequences of student distress. Large, prospective, multicenter studies are needed to identify personal and training-related features that influence depression, anxiety, and burnout among students and explore relationships between distress and competency.

Recruitment and retention of students from minority groups

BACKGROUND AND PURPOSE

Studies have identified strategies used in physical therapist education to recruit and retain students from minority groups. However, physical therapist education has evolved since these studies were published. The purpose of this study was to examine current practice in recruiting and retaining students from minority groups.

SUBJECTS

Seventy program directors of programs offering master's or doctoral degrees in physical therapy responded to a survey.

METHODS

The survey questionnaire requested information on program demographics, numbers of applicants, students and graduates from minority groups, and recruitment and retention strategies utilized. The most frequently used strategies were identified. Wilcoxon rank sum tests were performed to determine which strategies were associated with better recruitment and retention of students from minority groups.

RESULTS

Fifty programs made a special effort to recruit and retain students from minority groups. Nine recruitment strategies and 3 retention activities were associated with programs having higher proportions of minority applicants, students, and graduates.

DISCUSSION AND CONCLUSION

The most frequently used strategies were incongruent with the strategies used by programs with higher proportions of applicants, students, and graduates from minority groups. This study provides information to help physical therapist educators determine which strategies help recruit and retain students from minority groups.

"Not a university type": focus group study of social class, ethnic, and sex differences in school pupils' perceptions about medical school

OBJECTIVE

To investigate what going to medical school means to academically able 14-16 year olds from different ethnic and socioeconomic backgrounds in order to understand the wide socioeconomic variation in applications to medical school.

DESIGN

Focus group study.

SETTING

Six London secondary schools.

PARTICIPANTS

68 academically able and scientifically oriented pupils aged 14-16 years from a wide range of social and ethnic backgrounds.

MAIN OUTCOME MEASURES

Pupils' perceptions of medical school, motivation to apply, confidence in ability to stay the course, expectations of medicine as a career, and perceived sources of information and support.

RESULTS

There were few differences by sex or ethnicity, but striking differences by socioeconomic status. Pupils from lower socioeconomic groups held stereotyped and superficial perceptions of doctors, saw medical school as culturally alien and geared towards "posh" students, and greatly underestimated their own chances of gaining a place and staying the course. They saw medicine as having extrinsic rewards (money) but requiring prohibitive personal sacrifices. Pupils from affluent backgrounds saw medicine as one of a menu of challenging career options with intrinsic rewards (fulfillment, achievement). All pupils had concerns about the costs of study, but only those from poor backgrounds saw costs as constraining their choices.

CONCLUSIONS

Underachievement by able pupils from poor backgrounds may be more to do with identity, motivation, and the cultural framing of career choices than with low levels of factual knowledge. Policies to widen participation in medical education must go beyond a knowledge deficit model and address the complex social and cultural environment within which individual life choices are embedded.