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Ardenghi DM, Grazziotin-Soares R, Papagerakis S, Papagerakis P. Equity-diversity-inclusion (EDI)-related strategies used by dental schools during the admission/selection process: a narrative review. BDJ Open 2024; 10:55. [PMID: 38961060 PMCID: PMC11222376 DOI: 10.1038/s41405-024-00233-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 05/06/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION Decades of evidence have demonstrated a lack of workforce diversity and sustaining disparities in academic dentistry and professional practice. Underrepresented minority students may face challenges and implicit bias during the dental schools' admission/selection process. This review collected papers from different countries to summarize the Equity-Diversity-Inclusion (EDI)-related strategies that dental schools worldwide have used in their admissions process to increase diversity. METHODS A comprehensive search using MEDLINE (via PubMed), ERIC, Cochrane Reviews, Cochrane Trials, American Psychological Association Psyc Info (EBSCO) and Scopus was done between January and March-2023. All types of articles-designs were included, except comments and editorials, and all articles selected were in English. Two independent investigators screened the articles. Extracted data were general characteristics, study objectives, and EDI-related strategies. RESULTS Sixteen publications were used to construct this manuscript. The year with the greatest number of publications was 2022. Type of studies were case studies/critical reviews (50%), cross-sectional (including survey and secondary data analysis) (n = 5, 31.25%), qualitative methods of analysis (n = 2, 12.5%), and retrospective/secondary data collection (n = 1, 6.25%). The strategies described in the articles were related to (1) considering the intersectionality of diversity, (2) using noncognitive indicators during the school admissions process to construct a holistic selection process, (3) diversifying, professionalizing, and providing training to admissions persons who had leadership roles with the support from the dental school and the university, and (4) allocating financial investments and analyzing current policies and procedures regarding EDI. CONCLUSIONS This review aggregated interesting findings, such as: some schools are considering the intersectionality of diversity as a way to include underrepresented minorities and to diversify the students-body. The recent growth in publications on EDI during dental admission/selection process might indicate a positive movement in this field.
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Myint MT, Yue H, Zalpuri I, Sharma N, Stewart C. Workforce Initiatives to Advance Health Equity and Diverse Representation. Child Adolesc Psychiatr Clin N Am 2024; 33:437-445. [PMID: 38823815 DOI: 10.1016/j.chc.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
The persistence of health inequity and the need for workforce diverse representation within child and adolescent psychiatry require systemic solutions. There are recommendations and strategies particularly for the training programs with "all of the above" approach to tackle these complex systemic issues. One of the ways is to think through existing and innovative training pipelines by making them less leaky, enhancing quality, expanding the type and size, and connecting them to reach children and adolescents in need.
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Affiliation(s)
- Myo Thwin Myint
- Tulane University, Children's Hospital New Orleans, 1430 Tulane Avenue, #8055, New Orleans, LA 70112, USA.
| | - Han Yue
- Tufts University, 800 Washington Street Pratt Building 2nd Floor, Boston, MA 02111, USA
| | - Isheeta Zalpuri
- Stanford University, 401 Quarry Road, Palo Alto, CA 94304, USA
| | - Neha Sharma
- Tufts University, 800 Washington Street Pratt Building 2nd Floor, Boston, MA 02111, USA
| | - Colin Stewart
- Georgetown University, 2115 Wisconsin Avenue Northwest, Washington, DC 20016, USA
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Tremonti G, Shah NR, Moreci R, Hooper RC, Gadepalli SK, Newman EA. Early Lessons From Implementation of Holistic Review for Pediatric Surgery Fellowship Applicants. J Pediatr Surg 2024:S0022-3468(24)00302-6. [PMID: 38811257 DOI: 10.1016/j.jpedsurg.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE Holistic review (HR) considers applicants' unique identities and experiences rather than focusing on academic metrics. Though several residency programs have demonstrated increases in women and those underrepresented in medicine (URiM), this is the first study to examine HR in pediatric surgery (PS). METHODS Using a retrospective review of applicants, demographic, academic, and non-academic metrics of traditional review (TR) [2015-2017] were compared to HR [2018-2022]. HR initiatives include expansion of faculty reviewers, implementation of a pre-screening rubric, and greater prioritization of non-academic factors. Chi-squared/Fisher's exact tests, Wilcoxon rank-sum tests, and two sample z-test for proportions were used where appropriate. RESULTS For 635 applicants (TR: 268, HR: 367), the proportion offered interviews in the TR and HR cohorts were similar (31.7 vs 36%, p = 0.30). Candidates selected for interview pre- and post-HR most commonly graduated from residency programs affiliated with PS fellowships (56.5 vs 50%, p = 0.65). After HR implementation, no change in proportion of women interviewees (TR: 52.9 vs HR: 54.5%, p = 0.93) was observed. Though URiM residents applying to PS remained consistently low (TR: 14.6 vs HR: 10.9%, p = 0.21), significantly more received interviews with HR (30.8 vs 42.5%, p = 0.001). The median number of peer-review publications per interviewee increased (17 vs 22, p = 0.02) as did non-academic achievements (leadership, service, athletic awards, etc.) per applicant (1.0 vs 1.5, p = 0.104), though the latter did not reach significance, demonstrating similar qualification of interviewees in HR and TR. CONCLUSION Holistic review of PS fellowship applications increased the proportion of URiM interviewees, despite a persistently low URiM proportion in the applicant pool. Furthermore, implementing HR did not sacrifice the caliber of interviewees, as publications and non-academic achievements increased by over 25% in the HR cohort. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Grace Tremonti
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Nikhil R Shah
- Section of Pediatric Surgery, Michigan Medicine, Ann Arbor, MI, USA
| | - Rebecca Moreci
- Center for Surgical Training and Research, Michigan Medicine, Ann Arbor, MI, USA
| | - Rachel C Hooper
- Section of Plastic Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, MI, USA
| | | | - Erika A Newman
- Section of Pediatric Surgery, Michigan Medicine, Ann Arbor, MI, USA.
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Rattani A, Mian Z, Farahani S, Ridge M, Uzamere T, Bajwa M. A systematic review of barriers to pursuing careers in medicine among Black premedical students. J Natl Med Assoc 2024; 116:95-118. [PMID: 38267334 DOI: 10.1016/j.jnma.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/26/2023] [Accepted: 09/30/2023] [Indexed: 01/26/2024]
Abstract
Among the various etiologies of the exclusion of Black male physicians from the healthcare workforce, it is critical to identify and examine the barriers in their trajectory. Given that most medical school matriculants graduate and pursue residency training, medical school admission has been identified as the primary impediment to a career in medicine. Thus, this work aims to identify barriers in the journey of primarily Black, and secondarily underrepresented minority, premedical students. A systematic review of the medical literature was conducted for articles pertaining to the undergraduate/premedical period, Black experiences, and the medical school application process. The search yielded 5336 results, and 13 articles were included. Most papers corroborated common barriers, such as financial/socioeconomic burdens, lack of access to preparatory materials and academic enrichment programs, lack of exposure to the medical field, poor mentorship/advising experiences, systemic and interpersonal racism, and limited support systems. Common facilitators of interest and interventions included increasing academic enrichment programs, improving mentorship and career guidance quality and availability, and improving access to and availability of resources as well as exposure opportunities. No article explicitly discussed addressing racism. There is a dearth of studies exploring the premedical stage-the penultimate point of entry into medicine. Though interest in becoming a physician may be present, multiple and disparate impediments restrict Black men's participation in medicine. Addressing the barriers Black and underrepresented minority premedical students face requires an awareness of how multiple systems work together to discriminate and restrict access to careers in medicine beyond the traditional pipeline understanding.
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Affiliation(s)
- Abbas Rattani
- Department of Radiation Oncology, Tufts Medical Center, 800 Washington St., Boston, MA 02111, United States of America.
| | - Zoha Mian
- University of Louisville School of Medicine, A Building, Suite 110, 500 S. Preston Street, Louisville, KY 40204, United States of America
| | | | - Margaret Ridge
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue Cincinnati, OH, 45229, United States of America
| | - Theodore Uzamere
- Division of Neonatology, Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, Suite W6104, Houston, TX, 77030, United States of America
| | - Moazzum Bajwa
- Department of Family Medicine at the University of California Riverside, 900 University Avenue Riverside, CA, 92521, United States of America
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Guan SSA, Ashcroft J, Horowitz B, Ie E, Vasquez-Salgado Y, Saetermoe C. Sociocultural and contextual determinants of science career goal at a community college and baccalaureate-granting institution. INTERNATIONAL JOURNAL FOR EDUCATIONAL AND VOCATIONAL GUIDANCE 2024; 24:59-75. [PMID: 38725969 PMCID: PMC11081598 DOI: 10.1007/s10775-022-09547-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 04/25/2022] [Indexed: 05/12/2024]
Abstract
Guided by social cognitive career theory (SCCT; Lent et al. in J Vocat Behav 45(1):79-122, 1994), we assessed sociocultural (e.g., home-school cultural value mismatch) and contextual barriers (e.g., institutional climate) in science education and career development at both a baccalaureate-granting institution (BGI) and community college (CC) among 263 students (72.4% female; Mage = 22.96, SD = 5.70) in the USA. For BGI students, path analyses suggest proximal factors such as in-class prejudice negatively predicted science self-efficacy and prejudice from faculty and staff predicted lower career outcome expectations. For CC students, home-school cultural value mismatch directly predicted science career goals. Implications for future research, intervention and policy are discussed.
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Affiliation(s)
- Shu-Sha Angie Guan
- Child and Adolescent Development, California State University, Northridge, 18111 Nordhoff Street, Northridge, CA 91330, USA
| | | | | | - Eileen Ie
- East Los Angeles College, Monterey Park, USA
| | - Yolanda Vasquez-Salgado
- Child and Adolescent Development, California State University, Northridge, 18111 Nordhoff Street, Northridge, CA 91330, USA
| | - Carrie Saetermoe
- Child and Adolescent Development, California State University, Northridge, 18111 Nordhoff Street, Northridge, CA 91330, USA
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Hemal K, Perez-Otero S, Boyd CJ, Weichman KE, Cohen OD, Thanik VD, Ceradini DJ. The Evolving Plastic Surgery Applicant: How Far Have We Come in 30 Years? Ann Plast Surg 2024; 92:S245-S250. [PMID: 38556682 DOI: 10.1097/sap.0000000000003905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
BACKGROUND Plastic surgery training has undergone tremendous change and transitioned through many models over the years, including independent, combined, and integrated. This study evaluates how these changes and others have affected plastic surgery applicants' demographics and academic qualifications over the last 30 years. METHODS Data on applicant demographics and academic qualifications were extracted from multiple sources including the National Resident Matching Program, the American Association of Medical Colleges, and cross-sectional surveys of plastic surgery applicants for the years 1992, 2005, 2011, and 2022. Data were compared using pairwise χ2 goodness of fit tests. RESULTS The sex distribution of plastic surgery applicants changed significantly over the last 30 years: whereas men predominated in 1992 (86% male vs 14% female), by 2011, the distribution was nearly equal (54% male vs 46% female in both 2011 and 2022, P < 0.001).The racial makeup of applicants also changed over time (P < 0.05). White applicants decreased from 73% in 1992 to 55% in 2011, and 53% in 2022. While there was an increase in Asian (7% to > 17% to > 20%) and other (13% to > 14% to > 21%) applicants over time, whereas the proportion of Black applicants remained stagnant (5% to > 6% to > 8%).Applicants with prior general surgery experience declined precipitously over the years: 96% in 1992, 64% in 2005, 37% in 2011, and 26% in 2022 (P < 0.001). When compared with 1992, Alpha Omega Alpha status increased significantly in 2011 (36% vs 12%, P < 0.05) but did not change considerably in 2005 (22%) and 2022 (23%). Research experience increased dramatically over the years, with the proportion of applicants with at least one publication going from 43% in 1992, to 75% in 2005, to 89% in 2011, and to 99% in 2022 (P < 0.001). Applicant interest in academic plastic surgery did not change considerably over the years at roughly ranging from 30% to 50% of applicants (P = ns). CONCLUSIONS There has been a shift in the demographics and academic qualifications of plastic surgery applicants over the last 3 decades. Understanding this evolution is critical for reviewing and evaluating the makeup of our specialty, and enacting changes to increase representation where necessary.
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Affiliation(s)
- Kshipra Hemal
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health
| | - Sofia Perez-Otero
- New York University Grossman School of Medicine, NYU Langone Health, New York, NY
| | - Carter J Boyd
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health
| | - Katie E Weichman
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health
| | - Oriana D Cohen
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health
| | - Vishal D Thanik
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health
| | - Daniel J Ceradini
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health
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Patel J, Anand D, Sayani C, Tam A, Green A, Katt BM. Early Exposure to Orthopaedic Surgery. Cureus 2024; 16:e57422. [PMID: 38699112 PMCID: PMC11062888 DOI: 10.7759/cureus.57422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2024] [Indexed: 05/05/2024] Open
Abstract
INTRODUCTION Disparities in early orthopaedic experiences among medical students prompt a critical examination of factors influencing the availability and nature of these exposures. While the current body of literature underscores the significance of early surgical exposure and mentorship in medical education, a notable gap exists in investigating early orthopaedic exposure and its specific impact on students from diverse backgrounds. METHODS A 16-item questionnaire, approved by our institutional review board, was administered to fourth-year medical students (MS4) and first-year orthopaedic residents (PGY-1) across U.S. orthopaedic surgery programs during the 2022-2023 application cycle. The questionnaire assessed participants' initial orthopaedic exposures and factors influencing interest in the field. Two-proportion Z-test analyses were conducted to analyze the data, and thematic analysis was used to assess qualitative data involving free-response questions. RESULTS Out of 72 total respondents, the study revealed that 83% of respondents encountered orthopaedics before medical school, with initial exposures stemming from various sources such as familial connections (28%), athletics (17%), and high school or college exposures (15%), including shadowing, athletics participation, and occupation-related exposure. Disparities were observed in the availability of orthopaedic mentors and early exposure opportunities between demographic groups. Statistical analyses highlighted significant differences in access to mentors who reflected students' identities between male and non-male participants (70% vs. 39%, p=0.02) and between white and non-white participants (69% vs. 36%, p=0.02). White participants were also more likely to first interact with a surgeon who treated them or their family members than non-white participants (35% vs 7%, p=0.04). Non-white participants were more likely than white participants to come by their first orthopaedic opportunity by searching for it independently (21% vs. 4%, p=0.03). Family and friend connections in orthopaedics were found to be influential in motivating students to pursue orthopaedics, with 40% of respondents indicating personal connections in medicine and 12% reporting family members who are orthopaedic surgeons. Research experiences were identified as important contributors to students' initial interest and motivation to ultimately pursue orthopaedics, especially those with diverse backgrounds. CONCLUSION The findings underscore the importance of early orthopaedic exposures in shaping students' interest in the field, highlighting the need for more immersive pre-clinical year opportunities and enhanced mentorship programs. Addressing disparities in mentorship access and early exposure opportunities requires systemic changes and increased support for underrepresented minorities in orthopaedics. Initiatives like mentorship programs and research opportunities can help bridge gaps in access to early orthopaedic experiences. Medical schools should prioritise targeted early access to orthopaedic exposures for all students, regardless of background. This initiative aims to promote inclusivity and cultivate a more diverse orthopaedic workforce capable of meeting the evolving healthcare needs of society.
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Affiliation(s)
- Jhillika Patel
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
| | - Divya Anand
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
| | - Chandravathi Sayani
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
| | - Alyanna Tam
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
| | - Anna Green
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
| | - Brian M Katt
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
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Levi BH, Ekpa N, Lin A, Smith CW, Volpe RL. The Experience of Medical Scribing: No Disparities Identified. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:153-160. [PMID: 38476633 PMCID: PMC10929157 DOI: 10.2147/amep.s439826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/20/2023] [Indexed: 03/14/2024]
Abstract
Introduction The chronic failure to significantly increase the number of underrepresented minorities (URM) in medicine requires that we look for new mechanisms for channelling URM students through pre-medical education and into medical school. One potential mechanism is medical scribing, which involves a person helping a physician engage in real-time documentation in the electronic medical record. Methods As a precursor to evaluating this mechanism, this survey pilot study explored individuals' experiences working as a medical scribe to look for any differences related to URM status. Of 248 scribes, 159 (64% response rate) completed an online survey. The survey was comprised of 11 items: demographics (4 items), role and length of time spent as a scribe (2 items), and experience working as a scribe (5 items). Results The vast majority (>80%) of participants reported that working as a medical scribe gave them useful insight into being a clinician, provided valuable mentoring, and reinforced their commitment to pursue a career in medicine. The experiences reported by scribes who identified as URM did not differ from those reported by their majority counterparts. Discussion It remains to be seen whether medical scribing can serve as an effective pipeline for URM individuals to matriculate into medical school. But the present findings suggest that the experience of working as a medical scribe is a positive one for URM.
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Affiliation(s)
- Benjamin H Levi
- Department of Humanities, Penn State College of Medicine, Hershey, PA, USA
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| | - Ndifreke Ekpa
- University of Houston, HCA Houston Healthcare Kingwood, Houston, TX, USA
| | - Andrea Lin
- Penn State College of Medicine, Hershey, PA, USA
| | | | - Rebecca L Volpe
- Department of Humanities, Penn State College of Medicine, Hershey, PA, USA
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Feeley AA, Feeley IH, Sheehan E, Carroll C, Queally J. Impact of Mentoring for Underrepresented Groups in Undergraduate Medical Education: A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2024; 81:353-366. [PMID: 38160117 DOI: 10.1016/j.jsurg.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/11/2023] [Accepted: 11/11/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES Despite efforts to mitigate challenges to advance underrepresented groups (URG) groups' representation in medical education, diversity remains underwhelming. In response to this several mentoring programs to increase diversification within medical education have been implemented. However, the impact of these programs on URG representation across disciplines is unknown. The aim of this review is to evaluate the impact of structured mentoring programs on URGs in undergraduate medical education. DESIGN Systematic review. METHODS A comprehensive search strategy was performed of electronic databases including PubMed, Ovid Medline, and EMBASE between January and September 2022 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Both qualitative and quantitative outcomes including characteristics of the mentoring structure explored within each study were collected, and differences in study outcomes analyzed. RESULTS In total 17 studies were included for analysis. Mentoring within URGs resulted in an increase in research opportunities, exam performance, medical specialty applications, and residency matching. Structured feedback yielded positive experiences by both mentors and mentees participating in programs, with both emotional and cultural competence issues explored across studies included for analysis. CONCLUSIONS Mentoring for medical students underrepresented in medicine across mentoring relationships including peer, senior, formal, and informal structures yield positive outcomes within research, academic modules, and career pathways. Future applications of mentoring programs should consider the use of tandem mentoring from both senior and peer mentors to optimize benefits URG students derive from each mentoring relationship.
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Affiliation(s)
- Aoife A Feeley
- Connolly Hospital Blanchardstown, Dublin, Ireland; Royal College Surgeons Ireland, Dublin, Ireland.
| | - Iain H Feeley
- Midlands Regional Hospital Tullamore, Offaly, Ireland
| | - Eoin Sheehan
- Midlands Regional Hospital Tullamore, Offaly, Ireland
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Paulson AE, Gu A, Dy CJ, Fufa DT, Wessel LE. Opportunities for Increasing Diversity in Orthopaedics Through Virtual Mentorship Programs. J Am Acad Orthop Surg 2024; 32:147-155. [PMID: 37994494 DOI: 10.5435/jaaos-d-23-00638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/15/2023] [Indexed: 11/24/2023] Open
Abstract
Orthopaedic surgery lags in recruiting women and under-represented minorities (URMs). In addition, women and URMs hold fewer leadership roles across orthopaedic subspecialties. This inequity is geographically heterogeneous, with female URM residents and attendings being more concentrated in some areas of the country. For instance, practicing female orthopaedic surgeons are more prevalent in Northeast and Pacific programs. Mentorship and representation in leadership positions play a notable role in trainee recruitment. Video communication platforms offer a novel mechanism to reach historically under-represented students across the country. We reviewed five established mentorship programs focused on women and URMs. Each program emphasized a longitudinal relationship between mentors and mentees. In reviewing these programs, we sought to identify the successful components of each program. Leveraging and integrating effective components already established by conventional mentorship programs into virtual programming will aid in optimizing those programs and improve geographic equity in access to mentorship resources. It is critical to extend the principles of successful mentorship programs to technology-enabled programs moving forward.
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Affiliation(s)
- Ambika E Paulson
- From the Georgetown University School of Medicine, Washington, DC (Paulson), the Department of Orthopaedic Surgery, George Washington School of Medicine and Health Sciences, Washington, DC (Gu), Department of Orthopaedic Surgery, Washington University School of Medicine, Washington, DC (Dy), the Department of Orthopaedic Surgery, Hospital for Special Surgery (Fufa), and the Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA (Wessel)
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Malvitz M, Khan N, Morgenstern LB. College preparation for a medical career in the United States. PLoS One 2024; 19:e0298203. [PMID: 38349896 PMCID: PMC10863898 DOI: 10.1371/journal.pone.0298203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/20/2024] [Indexed: 02/15/2024] Open
Abstract
PURPOSE A college degree is required to enter medical school in the United States. A remarkably high percentage of students entering college have pre-medical aspirations but relatively few end up as medical students. As an "applied science", education about medicine is usually thought to be beyond the purview of a liberal arts curriculum. Students therefore receive little education about a medical career, or information about the many alternative careers in health science. Instead, they take courses for Medical College Admission Test (MCAT) preparation and medical school application prerequisites in biology, chemistry, physics, and math. These classes give them little insight into a real medical career. The current report considers this mismatch between student needs in health science and available resources in colleges across the United States. METHODS A Collective Case Series framework was used to obtain qualitative data. Key informant interviews were requested from a convenience sample of representatives from 20 colleges, with six colleges providing extensive data. Three institutions collected data specifically on students who matriculated college interested in a career as a physician. RESULTS At these schools, one-half to one-quarter of students who said they were interested in medicine at the beginning of college ended up not applying to medical school. At each of the six schools, we saw a wide range of generally sparse academic and professional advising involvement and a very limited number of classes that discussed concepts directly related to careers in health science. CONCLUSIONS Looking at this data, we provide a novel conceptual model as a potential testable solution to the problem of an underexposed and unprepared student population interested in medicine. This includes a brief series of courses intended to inform students about what a career in medicine would fully entail to help foster core competencies of empathy, compassion and resilience.
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Affiliation(s)
- Madelyn Malvitz
- University of Michigan Medical School Department of Neurology, Ann Arbor, Michigan, United States of America
| | - Noreen Khan
- University of Michigan Medical School Department of Neurology, Ann Arbor, Michigan, United States of America
| | - Lewis B. Morgenstern
- University of Michigan Medical School Department of Neurology, Ann Arbor, Michigan, United States of America
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
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12
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Gonzalez CM, De Leon E. A Call to Promote Interventions for Increased Diversity in Health Professions Programs-Beyond Trends. JAMA Netw Open 2023; 6:e2347852. [PMID: 38153741 DOI: 10.1001/jamanetworkopen.2023.47852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2023] Open
Affiliation(s)
- Cristina M Gonzalez
- Institute for Excellence in Health Equity, New York University Grossman School of Medicine, New York
| | - Elaine De Leon
- Institute for Excellence in Health Equity, New York University Grossman School of Medicine, New York
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Majerczyk D, Behnen EM, Weldon DJ, Kanbar R, Hardy YM, Matsuda SK, Hardinger KL, Khalafalla FG. Racial, Ethnic, and Sex Diversity Trends in Health Professions Programs From Applicants to Graduates. JAMA Netw Open 2023; 6:e2347817. [PMID: 38153738 PMCID: PMC10755626 DOI: 10.1001/jamanetworkopen.2023.47817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/01/2023] [Indexed: 12/29/2023] Open
Abstract
Importance Diversity is an essential element of an effective health care system. A key to developing a diverse workforce is establishing a diverse student population in health professions programs. Objective To examine the diversity of students in Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), Doctor of Dental Surgery (DDS), Doctor of Dental Medicine (DMD), and Doctor of Pharmacy (PharmD) programs with emphasis on the trends of underrepresented minoritized groups (American Indian or Alaska Native, Black or African American, Hispanic or Latino, and Native Hawaiian or Other Pacific Islander) and sex relative to the overall age-adjusted US population. Design, Setting, and Participants This cross-sectional study used deidentified, self-reported data from 2003 to 2019 from the Association of American Medical Colleges, American Association of Colleges of Osteopathic Medicine, American Dental Education Association, American Dental Association, and American Association of Colleges of Pharmacy. Data analysis was performed from 2003 to 2004 and from 2018 to 2019. Exposures Data on the race, ethnicity, and sex of applicants, matriculants, and degrees conferred by health professions programs were collected and compared with the age-adjusted population in the US Census (aged 20-34 years) over time. Main Outcomes and Measures The main outcomes were trends in the proportions of underrepresented minoritized groups and sex diversity among applicants, matriculants, and degrees conferred relative to the overall age-adjusted US population. Trends were measured using the representation quotient, which is defined as the ratio of the proportion of each subgroup to the total population of applicants, matriculants, or graduates relative to the proportion for that subgroup within the US Census population of similar age. Regression analysis was used to evaluate the trend over time. Results A total of 594 352 applicants were analyzed across the examined programs. From 2003 to 2019, the proportions of individuals from underrepresented groups increased for DDS and DMD (applicants, from 1003 of 8176 to 1962 of 11 298 [5.1%]; matriculants, from 510 of 4528 to 966 of 6163 [4.2%]; degrees awarded, from 484 of 4350 to 878 of 6340 [2.7%]), PharmD (applicants, from 9045 of 71 966 to 11 653 of 50 482 [9.0%]; matriculants, from 5979 of 42 627 to 10 129 to 62 504 [6.3%]; degrees awarded, from 922 of 7770 to 2190 of 14 800 [3.0%]), and DO (applicants, from 740 of 6814 to 3478 of 21 090 [5.4%]; degrees awarded, 199 of 2713 to 582 of 6703 [1.4%]) programs, but decreased for MD programs (applicants, from 6066 of 34 791 to 7889 of 52 777 [-2.3%]; matriculants, 2506 of 16 541 to 2952 of 21 622 [-2.4%]; degrees awarded, from 2167 of 15 829 to 2349 of 19 937 [-0.1%]). Compared with age-adjusted US Census data, all programs had more Asian students and fewer male, American Indian or Alaska Native, Black or African American, Hispanic or Latino, and Native Hawaiian or Other Pacific Islander students (representation quotient <1). Conclusions and Relevance In this cross-sectional study, most of the health professions in the study saw increases in underrepresented minority applicants, matriculants, and degrees conferred from 2003 to 2019; however, all programs were below the age-adjusted US Census data. The increased racial, ethnic, and sex diversity in the programs illustrates progress, but additional strategies are needed to achieve a more representative health care workforce.
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Affiliation(s)
- Daniel Majerczyk
- Department of Family Medicine, Loyola Medicine–MacNeal Family Medicine Residency Program, Berwyn, Illinois
- College of Science, Health and Pharmacy, Roosevelt University, Schaumburg, Illinois
- Harvard Graduate School of Education, Harvard University, Cambridge, Massachusetts
| | - Erin M. Behnen
- College of Pharmacy, Belmont University, Nashville, Tennessee
| | - David J. Weldon
- School of Pharmacy, William Carey University, Biloxi, Mississippi
| | - Roy Kanbar
- School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Yolanda M. Hardy
- Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, Florida
| | | | | | - Farid G. Khalafalla
- College of Education and Health Sciences, Touro University California, Vallejo
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14
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Adkins SE, Dixon KS, Minchew HM, Vance D, Birney J, Berbel G, Kilgore LJ. Building Approachable Surgical Experiences (BASE) in High School Populations. JOURNAL OF SURGICAL EDUCATION 2023; 80:1189-1194. [PMID: 37460367 DOI: 10.1016/j.jsurg.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/16/2023] [Accepted: 06/17/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE Pipeline programs are often set up to bring more diverse candidates to medical schools with the goal of diversifying the physician workforce in the years to come. All too often, these programs begin in college, long after many students of diverse backgrounds have been left behind through a myriad of barriers that exist between entering high school and matriculating to medical school. The Building Approachable Surgical Experiences (BASE) outreach program was designed to showcase healthcare careers, with an emphasis on surgical subspecialties, to historically underserved high school students. This pilot program's goal was to increase high school students' interest and confidence in pursuing future medical and surgical careers and provide a platform to initiate mentorship. DESIGN Local high school students from underrepresented in medicine (URiM) populations or medically underserved communities were invited to spend the day at an academic medical school campus. These students engaged in hands-on clinical and basic operative skill workshops led by third- and fourth-year medical students. They also engaged in small group conversations centered on mentorship with surgical residents and faculty. SETTING Program implementation took place at an academic medical center school of medicine in an urban city. PARTICIPANTS Forty high school students, 16 medical students, and 2 surgery faculty participated in this pilot program. CONCLUSIONS This event allowed early exposure for high school students to surgical and medical specialties, clinical techniques, and surgical mentorship. From the connections made, students have developed mentorship relationships and have felt comfortable reaching out with questions regarding the steps required to seek entrance to medical school. Mentors are currently resident or attending physicians, which provides students from underrepresented populations an opportunity for direct insight and guidance to and through the path to becoming a physician. Based on qualitative feedback from students, their high school teachers, and administrators, this pilot program succeeded in providing a window into healthcare, using a format that was encouraging to students long beyond their time on the school of medicine campus.
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Affiliation(s)
- Sarah E Adkins
- Department of Surgery, The University of Kansas Medical Center, Kansas City, Kansas
| | - Katelyn Sanner Dixon
- Department of Surgery, The University of Kansas Medical Center, Kansas City, Kansas
| | - Heather M Minchew
- Department of Surgery, The University of Kansas Medical Center, Kansas City, Kansas
| | - Dylan Vance
- Department of Surgery, The University of Kansas Medical Center, Kansas City, Kansas
| | - Jalee Birney
- Department of Surgery, The University of Kansas Medical Center, Kansas City, Kansas
| | - German Berbel
- Department of Surgery, The University of Kansas Medical Center, Kansas City, Kansas
| | - Lyndsey J Kilgore
- Department of Surgery, The University of Kansas Medical Center, Kansas City, Kansas.
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15
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Ruiz Colón GD, Harris OA. Letter: A Call for Enhanced Diversity Efforts in the Physician Pipeline in the Face of Legal Threats. Neurosurgery 2023; 93:e65-e66. [PMID: 37345916 DOI: 10.1227/neu.0000000000002573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/01/2023] [Indexed: 06/23/2023] Open
Affiliation(s)
- Gabriela D Ruiz Colón
- Department of Neurosurgery, Stanford University School of Medicine, Stanford , California , USA
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16
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Bradley LJ, Meyer KE, Robertson TC, Kerr MS, Maddux SD, Heck AJ, Reeves RE, Handler EK. A mixed method analysis of student satisfaction with active learning techniques in an online graduate anatomy course: Consideration of demographics and previous course enrollment. ANATOMICAL SCIENCES EDUCATION 2023; 16:907-925. [PMID: 36949631 DOI: 10.1002/ase.2276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/28/2023] [Accepted: 03/17/2023] [Indexed: 06/18/2023]
Abstract
Online learning has become an essential part of mainstream higher education. With increasing enrollments in online anatomy courses, a better understanding of effective teaching techniques for the online learning environment is critical. Active learning has previously shown many benefits in face-to-face anatomy courses, including increases in student satisfaction. Currently, no research has measured student satisfaction with active learning techniques implemented in an online graduate anatomy course. This study compares student satisfaction across four different active learning techniques (jigsaw, team-learning module, concept mapping, and question constructing), with consideration of demographics and previous enrollment in anatomy and/or online courses. Survey questions consisted of Likert-style, multiple-choice, ranking, and open-ended questions that asked students to indicate their level of satisfaction with the active learning techniques. One hundred seventy Medical Science master's students completed the online anatomy course and all seven surveys. Results showed that students were significantly more satisfied with question constructing and jigsaw than with concept mapping and team-learning module. Additionally, historically excluded groups (underrepresented racial minorities) were generally more satisfied with active learning than non-minority groups. Age, gender, and previous experience with anatomy did not influence the level of satisfaction. However, students with a higher-grade point average (GPA), those with only a bachelor's degree, and those with no previous online course experience were more satisfied with active learning than students who had a lower GPA, those holding a graduate/professional degree, and those with previous online course experience. Cumulatively, these findings support the beneficial use of active learning in online anatomy courses.
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Affiliation(s)
- Libby J Bradley
- Department of Physiology and Anatomy, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, Texas, USA
| | - Kimberly E Meyer
- Department of Physician Assistant Studies and Executive Director of Division of Academic Innovation, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, Texas, USA
| | - Taylor C Robertson
- Department of Physiology and Anatomy, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, Texas, USA
| | - Marcel Satsky Kerr
- School of Biomedical Sciences, Assistant Dean for Undergraduate Education, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, Texas, USA
| | - Scott D Maddux
- Department of Physiology and Anatomy, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, Texas, USA
| | - Amber J Heck
- Microbiology, Immunology, & Genetics, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, Texas, USA
| | - Rustin E Reeves
- Department of Physiology and Anatomy, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, Texas, USA
| | - Emma K Handler
- Department of Anatomy and Cell Biology, The University of Iowa, 51 Newton Rd, Iowa City, Iowa, USA
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17
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Gajic E, Aleksa E, Dzioba A, Strychowsky JE, Hu A, Chan Y, Graham ME. Understanding Gender Differences in Research Productivity of Canadian Otolaryngologists-A Comprehensive National Audit. EAR, NOSE & THROAT JOURNAL 2023:1455613231190272. [PMID: 37534754 DOI: 10.1177/01455613231190272] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
Objective: To understand the factors contributing to gender disparities in the research productivity of Canadian academic otolaryngologist-head and neck surgeons. Methods: Publicly available sources including departmental websites, SCOPUS, and the Royal College of Physicians and Surgeons of Canada were accessed between February and April 2022 to analyze gender differences in the academic productivity of otolaryngologist-head and neck surgeons across Canada. Gender differences in research productivity metrics, including h-index, i10-index, publication number, and number of first and senior authorships were assessed. Demographic data, including gender, institution, years in practice, and leadership roles were assessed for correlation with increased research productivity. Subgroup analyses were used to evaluate gender differences in productivity metrics, and univariable and multivariable regression analyses were used to evaluate predictors of research productivity. Results: Data were collected for 316 academic otolaryngologists (252 men, 64 women, P < .001). Men had significantly more years of publishing [mean (standard deviation, SD), 15.64 (9.45) vs 12.44 (8.28), P = .014], higher h-indices [12.22 (11.47) vs 7.33 (5.36), P < .001], i10-indices [22.61 (37.88) vs 8.17 (9.14), P > .001], publication numbers [46.63 (65.18) vs 19.59 (23.40), P < .001], and first [8.18 (9.95) vs 4.89 (6.18), P = .001] and senior authorships [12.98 (22.72) vs 3.83 (6.89), P < .001]. Gender differences were most pronounced in head and neck oncology, pediatrics, and the late career stage. Gender disparities in productivity were absent in the early career stage. Multivariate analysis identified only the number publications and number of senior author publications as being significantly influenced by gender. Conclusion: Canadian female otolaryngologist-head and neck surgeons appear to have equivalent research productivity to their male counterparts in the early career stage. This mirrors the recent findings in the United States, and demonstrates progress compared to earlier studies that found women to have lower research productivity in the early career stage.
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Affiliation(s)
- Eva Gajic
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Emily Aleksa
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, London, Ontario, Canada
| | - Agnieszka Dzioba
- Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, London, Ontario, Canada
| | - Julie E Strychowsky
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, London, Ontario, Canada
| | - Amanda Hu
- Division of Otolaryngology, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yvonne Chan
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - M Elise Graham
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, London, Ontario, Canada
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18
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Spaans I, de Kleijn R, Seeleman C, Dilaver G. 'A role model is like a mosaic': reimagining URiM students' role models in medical school. BMC MEDICAL EDUCATION 2023; 23:396. [PMID: 37264380 DOI: 10.1186/s12909-023-04394-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/25/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Role modelling is a widely acknowledged element of medical education and it is associated with a range of beneficial outcomes for medical students, such as contributing to professional identity development and a sense of belonging. However, for students who are racially and ethnically underrepresented in medicine (URiM), identification with clinical role models may not be self-evident, as they have no shared ethnic background as a basis for social comparison. This study aims to learn more about the role models of URiM students during medical school and about the added value of representative role models. METHODS In this qualitative study we used a concept-guided approach to explore URiM alumni's experiences with role models during medical school. We conducted semi-structured interviews with ten URiM alumni about their perception of role models, who their own role models were during medical school and why they considered these figures as role models. Sensitizing concepts guided the topic list, interview questions and finally served as deductive codes in the first round of coding. RESULTS The participants needed time to think about what a role model is and who their own role models are. Having role models was not self-evident as they had never thought about it before, and participants appeared hesitant and uncomfortable discussing representative role models. Eventually, all participants identified not one, but multiple people as their role model. These role models served different functions: role models from outside medical school, such as parents, motivated them to work hard. Clinical role models were fewer and functioned primarily as examples of professional behaviour. The participants experienced a lack of representation rather than a lack of role models. CONCLUSIONS This study presents us with three ways to reimagine role models in medical education. First, as culturally embedded: having a role model is not as self-evident as it appears in existing role model literature, which is largely based on research conducted in the U.S. Second, as cognitive constructs: the participants engaged in selective imitation, where they did not have one archetypical clinical role model, but rather approach role models as a mosaic of elements from different people. Third, role models carry not only a behavioural but also a symbolical value, the latter of which is particularly important for URiM students because it relies heavier on social comparison.
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Affiliation(s)
- Isabella Spaans
- Educational Center, University Medical Center Utrecht, Postbus 85500 (HP: HB 4.05), Utrecht, 3508, GA, The Netherlands.
| | - Renske de Kleijn
- Educational Center, University Medical Center Utrecht, Postbus 85500 (HP: HB 4.05), Utrecht, 3508, GA, The Netherlands
| | - Conny Seeleman
- Educational Center, University Medical Center Utrecht, Postbus 85500 (HP: HB 4.05), Utrecht, 3508, GA, The Netherlands
| | - Gönül Dilaver
- Educational Center, University Medical Center Utrecht, Postbus 85500 (HP: HB 4.05), Utrecht, 3508, GA, The Netherlands
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19
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Amobi A. Applicant Flow Data: An Important Tool for Workforce Diversity. Med Care 2023; 61:349-350. [PMID: 37067991 DOI: 10.1097/mlr.0000000000001858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Affiliation(s)
- Adaugo Amobi
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
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20
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Tolson HC, Raikar DAH, Morris BE, Ferguson EMN, Shahriary E. Ethnic and Sex Diversity in Academic Plastic Surgery: A Cross-sectional Study. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4991. [PMID: 37396840 PMCID: PMC10313300 DOI: 10.1097/gox.0000000000004991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/22/2023] [Indexed: 07/04/2023]
Abstract
Ethnic, racial, and sex disparities continue to persist in medicine despite efforts to diversify the profession. In competitive surgical specialties such as plastic surgery, those disparities are particularly pronounced. This study aims to evaluate racial, ethnic, and sex diversity in academic plastic surgery. Methods We compiled a list of major plastic surgery professional societies, plastic surgery journal editorial boards, and plastic surgery accreditation boards to evaluate ethnic and sex diversity in society, research, and accreditation domains, respectively. Demographic data were collected and analyzed using the Mann-Whitney U test and the Kruskal-Wallis test. Results White individuals are significantly overrepresented across the professional and research domains, and Asian individuals are overrepresented in the professional domain when compared to non-white races. White individuals make up a total of 74% of the society domain, 67% of the research domain, and 86% of the accreditation domain when compared to all non-white surgeons. Male surgeons made up 79% of the society domain, 83% of the research domain, and 77% of the accreditation domain when compared to all non-male surgeons. Conclusions Ethnic, racial, and sex disparities persist in academic plastic surgery. This study, which looked at societies, editorial boards, and accreditation boards, demonstrated a persistent ethnic, racial, and sex homogeneity among leadership. Changes are required to continue to diversify the field and provide women and underrepresented minorities the tools needed to succeed.
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Affiliation(s)
- Hannah C. Tolson
- From the University of Arizona College of Medicine Phoenix, Phoenix, Ariz
| | | | - Bryn E. Morris
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Ariz
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21
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Tello C, Goode CA. Factors and barriers that influence the matriculation of underrepresented students in medicine. Front Psychol 2023; 14:1141045. [PMID: 37303920 PMCID: PMC10247986 DOI: 10.3389/fpsyg.2023.1141045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/27/2023] [Indexed: 06/13/2023] Open
Abstract
Despite many initiatives over more than 4 decades, the diversity of United States physicians still does not reflect the diversity of the United States population. The present study undertakes a literature review of the last 30 years to investigate barriers and protective factors underrepresented college students encounter as applicants for medical school. Known barriers that influence matriculation into medical school were analyzed such as academic metrics and test scores. Additionally, elements that are less well studied were investigated such as factors perceived as barriers by underrepresented applicants in addition to protective factors that allow them to persist in their journey in the face of difficulties and adversity.
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Affiliation(s)
- Cynthia Tello
- American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten
- Graduate College of Biomedical Sciences and College of Dental Medicine, Western University of Health Sciences, Pomona, CA, United States
| | - Christine A. Goode
- Graduate College of Biomedical Sciences and College of Dental Medicine, Western University of Health Sciences, Pomona, CA, United States
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22
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Jackson D, Greenfield S, Parry J, Agwu JC, Spruce A, Seyan G, Whalley N. Preparing for medical school selection: Exploring the complexity of disadvantage through applicant narratives. EDUCATION FOR HEALTH (ABINGDON, ENGLAND) 2023; 36:53-66. [PMID: 38047333 DOI: 10.4103/efh.efh_124_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background Despite a growing drive to improve diversity in medical schools, those from state schools and less-advantaged sociodemographic backgrounds remain underrepresented. We explore applicants' approaches to preparing for medical school selection, considering the complexity of sociodemographic disadvantage in this highly competitive process. Methods Narrative interviews were undertaken with applicants to a United Kingdom medical school, exploring experiences of preparation for selection (n = 23). Participants were purposively sampled based on involvement in widening participation schemes, school background, gender, and ethnicity. Transcribed data were analyzed using Labov and Waletzky's analytic framework. Bourdieu's concepts of cultural capital and habitus provided a lens to constraints faced and variable experiences. This informed a consideration of the ways applicants approached and navigated their preparation, in the face of various constraints. Results Constraints to resources and support were often apparent for those from state nonselective (SNS) schools. These applicants and those beginning their preparation later (12-18 months before application) appeared particularly vulnerable to myths and misunderstandings about the application process and appeared less confident and less discerning in their navigation of preparation. Some of the applicants, particularly those from independent and state selective schools, appeared confident and competent in navigating the complexities of the application process, while others (often from SNS schools) were more frequently lost or stressed by the process. Discussion Those who lack particular preparatory tools or resources (materially, culturally, or perceptually) must "make do" as they prepare for medical school selection, In doing so, they may risk a haphazard, ill-informed or ill-equipped approach. Constraints to opportunities, more typically experienced by those from SNS schools, appeared to motivate the process of bricolage for a number of the applicants. Perversely, medical schools have introduced nonacademic requirements to level the playing field of disadvantage, yet applicants in this group appear to experience challenges as they prepare for selection.
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Affiliation(s)
- Dawn Jackson
- College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Sutton Coldfield, UK
| | - Sheila Greenfield
- Public Health, Institute of Applied Health Research, Sutton Coldfield, UK
| | - Jayne Parry
- Public Health, Institute of Applied Health Research, Sutton Coldfield, UK
| | - Juliana Chizo Agwu
- College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Sutton Coldfield, UK
| | - Austen Spruce
- College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Sutton Coldfield, UK
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23
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Campbell KM, Bright CM, Corral I, Tumin D, Linares JLI. Increasing Underrepresented Minority Students in Medical School: a Single-Institution Experience. J Racial Ethn Health Disparities 2023; 10:521-525. [PMID: 35088390 DOI: 10.1007/s40615-022-01241-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE Underrepresented minority student recruitment initiatives from medical school admissions and diversity offices can bring equity for those learners underrepresented in medicine. Measuring growth of the applicant pool helps determine the impact of such initiatives in helping diversify the healthcare workforce. AIM The authors evaluated underrepresented minority applicant pool growth at the Brody School of Medicine to determine whether predominantly White institutions or historically Black colleges and universities have accounted for the most growth in minority applicants in recent years. METHODS Outreach outcomes across the state were obtained by comparing applicant and matriculant demographics. Data on all applicants and matriculants were retrieved from the school's institutional records and classified according to student self-identification as underrepresented minority. Using Chi-square tests, authors aimed to determine whether the proportion of minority students increased among applicants and matriculants since 2016, the year of restructuring outreach. In further analysis, the number of graduates from historically Black colleges and universities as compared to minority graduates from predominantly White schools was evaluated. RESULTS The authors identified 7,848 applicants and 654 matriculants over the evaluation period. The proportion of learners identifying as underrepresented minority increased from 17% before 2016 (622/3,672) to 20% after 2016 (835/4,176; p = 0.001). The proportion of applicants who did not graduate from a historically Black college or university increased slightly after 2016 (89% of underrepresented minority applicants before 2016 vs. 92% of underrepresented minority applicants after 2016), but this increase was not statistically significant (p = 0.097). CONCLUSION Applicant growth has been more significant for underrepresented minority applicants from predominantly White institutions. Graduates of targeted historically Black colleges and universities who applied to Brody School of Medicine were better prepared, resulting in increased chances of admission.
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Affiliation(s)
- Kendall M Campbell
- Department of Family Medicine, University of Texas Medical Branch, Galveston, TX, 77555, USA.
| | - Cedric M Bright
- Department of Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, 27858, USA
| | - Irma Corral
- Department of Psychiatry and Behavioral Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, 27858, USA
| | - Dmitry Tumin
- Department of Pediatrics, Assistant Dean of Clinical and Educational Scholarship, Division of Academic Affairs, Brody School of Medicine, East Carolina University, Greenville, NC, 27858, USA
| | - Jhojana L Infante Linares
- Office of Data Analysis and Strategy, Division of Academic Affairs, Brody School of Medicine, East Carolina University, Greenville, NC, 27858, USA
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Kishore A, DiGiovanni M, Sun KL, Kolevzon A, Benoit L, Martin A. Enhancing Child and Adolescent Psychiatry Recruitment Through a Medical Student Mentorship Network: A Qualitative Study. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:124-133. [PMID: 36123518 PMCID: PMC9484713 DOI: 10.1007/s40596-022-01700-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/15/2022] [Indexed: 05/25/2023]
Abstract
OBJECTIVE There is a shortage of psychiatrists necessary to meet the clinical needs of children and adolescents. Efforts over the past decade to enhance the workforce have had a limited impact. This study sought to identify the critical components of a medical student mentorship network designed to increase recruitment into the subspecialty. METHODS The authors conducted interviews via synchronized videoconferencing of network site leaders and medical students at 14 schools throughout the USA. In addition, they analyzed verbatim transcripts using a thematic-phenomenological qualitative approach. RESULTS The authors interviewed thirty-eight program participants during seven focus group sessions: nine program directors and 29 medical students or graduates, a median of five participants per session. They constructed a framework consisting of two overarching domains, comprised of three themes each: (1) life cycle of a subspecialty mentorship network (Origins, Initiation, and Continuity); and (2) next steps to improve the program (Refining goals, Increasing accessibility, and Defining a path forward). CONCLUSION Preliminary data have already documented the positive impact of participation in this mentorship program on medical student match rates into psychiatry. The qualitative model of this study provides a blueprint to develop, maintain, and optimize this and similar efforts aimed at increasing the child and adolescent psychiatry workforce.
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Affiliation(s)
| | | | | | | | - Laelia Benoit
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
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Soto E, Lewis M, Estrada CA, de la Torre JI, O'Beirne R, Martin C, Corey B. Barriers and Facilitators for Under-Represented in Medicine (URiM) Medical Students Interested in Surgical Sub-specialties. Am J Surg 2023; 225:660-666. [PMID: 37455798 PMCID: PMC10344418 DOI: 10.1016/j.amjsurg.2022.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Little is known on drivers and detractors underrepresented in medicine (URiM) medical students face. Methods Using the nominal group technique (NGT), we explored experiences that strengthen or weaken the enthusiasm to pursue a career in surgery among URiM medical students (October 2021- April 2022); participants voted on the three most important experiences (weight of 3= top rated, = 1 for the lowest rated). Responses from NGT with at least one vote were weighted, ranked, and categorized. Results Seventeen students participated. Experiences that strengthen enthusiasm (36 responses with at least one vote) involved mentorship and role models (weighted sum percentage, 35%), demonstrating grit (15%), lifestyle (15%), patient interactions (14%), technical skills (11%), community and team (10%), and intellectual stimulation (1%). Experiences that weaken enthusiasm (33 responses with at least one vote) include the minority experience (weighted sum percentage, 51%), quality of life (25%), toxic environment (13%), lack of information (7%), and finances (5%). Conclusions Mentorship, demonstrating grit, and feeling a sense of community were important positive experiences or attitudes. The minority experience, toxic environment, perceptions of self-worth, and lifestyle misconceptions perceived by URiM must be addressed to increase diversity, equity, and inclusion.
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Affiliation(s)
- Edgar Soto
- University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
| | - Marshall Lewis
- University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
| | - Carlos A Estrada
- Division of General Internal Medicine, Department of Medicine, University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
- Birmingham Veterans Affairs Medical Center; Birmingham, Alabama
| | - Jorge I de la Torre
- Birmingham Veterans Affairs Medical Center; Birmingham, Alabama
- Division of Plastic Surgery, Department of Surgery, University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
| | - Ronan O'Beirne
- Office of Continuing Medical Education, University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
| | - Colin Martin
- Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
| | - Britney Corey
- Birmingham Veterans Affairs Medical Center; Birmingham, Alabama
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
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Mmeje O, Perry M, Andreski P, Haggins A, Brown DJ. Creating opportunities to engage with prospective historically marginalized trainees with clinical simulation. J Natl Med Assoc 2023; 115:127-133. [PMID: 36707366 DOI: 10.1016/j.jnma.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/13/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND Recruiting a diverse group of medical students, house officers, and faculty in medicine is challenging-particularly for predominantly white, midwest institutions that may not be racially or ethnically diverse. PURPOSE To evaluate a novel clinical simulation program, SiMfest, for recruiting house officers from historically marginalized populations to our institution to demonstrate our leadership's commitment to high-quality education and recruitment of these students to enhance diversity in academic medicine. METHODS The Office for Health Equity and Inclusion, institutional leadership, and clinical department chairs developed a novel and engaging series of clinical simulations, SiMfest, to engage the pipeline of historically marginalized trainees and demonstrate our leadership's commitment to high-quality education. SiMfest is a two-hour simulation session presented annually (2017-2019) by our institution at the Student National Medical Association Annual Medical Education Conference. RESULTS Over 800 students participated in SiMfest sessions over three years. Of the 461 participants who completed a survey after participation, 301 identified as female, and 382 indicated a racial category considered as historically marginalized in medicine-91% of whom identified as African American or Black. Thirty percent (n = 125) of respondents identified as pre-medical (e.g., undergraduate, post-baccalaureate) students and 69% (n = 289) identified as current medical students. Over 80% of students would recommend SiMfest to others. Additionally, 73% (n = 87) of pre-medical and 54% (n = 143) of medical students reported exposure to a previously unknown specialty. Thirty-three department representatives reported their SiMfest experience revealed new information about historically marginalized applicants that they may not have engaged with through the traditional application process but would be more likely to engage with in future diversity, equity, and inclusion initiatives. CONCLUSION SiMfest harnessed our institution's high-quality training, personnel resources, and diversity, equity, and inclusion values to bring historically marginalized students in medicine and department leadership together to learn about one another and offer experiential learning. SiMfest may serve as a model for other institutions to draw on their strengths to develop innovative recruitment programs that promote the education and engagement of undergraduate and medical students from historically marginalized populations while simultaneously promoting diversity, equity, and inclusion culture change.
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Affiliation(s)
- Okeoma Mmeje
- Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109 USA.
| | - Marcia Perry
- Department of Emergency Medicine, University of Michigan, 1500 E. Medical Center Dr., Ann, Arbor, MI 48109 USA
| | - Patricia Andreski
- Michigan Medicine Office for Health Equity and Inclusion, 1150 W. Medical Center Dr., Ann Arbor, MI 48109 USA
| | - Adrianne Haggins
- Michigan Medicine Office for Health Equity and Inclusion, 1150 W. Medical Center Dr., Ann Arbor, MI 48109 USA
| | - David J Brown
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109 USA
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Williams MS, Myers AK, Finuf KD, Patel VH, Marrast LM, Pekmezaris R, Martinez J. Black Physicians' Experiences with Anti-Black Racism in Healthcare Systems Explored Through An Attraction-Selection-Attrition Lens. JOURNAL OF BUSINESS AND PSYCHOLOGY 2023; 38:75-88. [PMID: 35702386 PMCID: PMC9184355 DOI: 10.1007/s10869-022-09825-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 05/05/2023]
Abstract
Anti-Black racism is a specific form of racism directed at Black people. In healthcare, there are poignant examples of anti-Black racism in the recruitment, selection, and retention stages of the job cycle. Research shows that anti-Black racism is associated with inequitable work outcomes and the under-representation of Black physicians. However, empirical findings are scattered with no organizing framework to consolidate these findings. To add to the literature, in this paper we present the attraction-selection-attrition (ASA) model (Schneider, 1987) as an organizing framework to discuss Black physicians' experiences with anti-Black racism and discrimination throughout their careers. We draw from previous literature to highlight specific experiences of Black physicians at each stage of the job cycle (i.e., attraction, selection, retention), and we offer considerations on how practitioners can mitigate anti-Black racism throughout the job cycle. In the wake of COVID-19 and highly publicized social justice movements, healthcare systems are seeking ways to increase the recruitment, selection, and retention of Black physicians to ensure health equity. We believe this guide will be valuable to practitioners, leaders, researchers, and program directions seeking to advance diversity, equity, and inclusion of Black physicians in their healthcare systems. We conclude by providing practical implications and directions for future research.
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Affiliation(s)
- Myia S. Williams
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
- Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY USA
- Department of Medicine, Northwell Health, 600 Community Drive 4th Floor, Manhasset, NY 11030 USA
| | - Alyson K. Myers
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
- Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY USA
- Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY USA
| | - Kayla D. Finuf
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
| | - Vidhi H. Patel
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
| | - Lyndonna M. Marrast
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
- Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY USA
| | - Renee Pekmezaris
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
- Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY USA
| | - Johanna Martinez
- Department of Medicine, Northwell Health, Manhasset, NY USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
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Ogunyemi D, Westermeyer C, Eghbali M, Patel P, Struble S, Arogyaswamy S, Teixeira A, Raval N, Gentry M, Lee T, Arabian S. Seeking Equity; Pathway Programs in Liaison Committee on Medical Education Medical Schools for Minoritized Students. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231177181. [PMID: 37324048 PMCID: PMC10265357 DOI: 10.1177/23821205231177181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/04/2023] [Indexed: 06/17/2023]
Abstract
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.
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Affiliation(s)
- Dotun Ogunyemi
- Graduate Medical Education, Arrowhead Regional Medical Center, Colton, CA, USA
| | - Claire Westermeyer
- School of Medicine, California University of Science and Medicine, Colton, CA, USA
| | - Mason Eghbali
- School of Medicine, California University of Science and Medicine, Colton, CA, USA
| | - Priyesh Patel
- School of Medicine, California University of Science and Medicine, Colton, CA, USA
| | - Sarah Struble
- School of Medicine, California University of Science and Medicine, Colton, CA, USA
| | - Sagarika Arogyaswamy
- School of Medicine, California University of Science and Medicine, Colton, CA, USA
| | - Amir Teixeira
- School of Medicine, California University of Science and Medicine, Colton, CA, USA
| | - Niren Raval
- Department of Family Medicine, Arrowhead Regional Medical Center, Colton, CA, USA
| | - Michael Gentry
- Department of Radiology, Arrowhead Regional Medical Center, Colton, CA, USA
| | - Tommy Lee
- Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, USA
| | - Sarkis Arabian
- Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA, USA
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Bersted KA, Lockhart KM, Yarboi J, Wilkerson MK, Voigt BL, Leonard SR, Silvestri JM. A Path Toward Equity and Inclusion: Establishing a DEI Committee in a Department of Pediatrics. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09929-x. [PMID: 36462109 PMCID: PMC9735055 DOI: 10.1007/s10880-022-09929-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 12/05/2022]
Abstract
The Diversity, Equity, and Inclusion (DEI) committee was established in 2017 within the Department of Pediatrics at Rush University Medical Center (RUMC), an academic medical health center located on the near west side of Chicago, IL. Results from climate surveys highlighted the need for increased DEI initiatives within the department, and a renewed national reckoning on racial tensions sparked an additional sense of urgency for system-level change. This paper outlines the initial creation and ongoing efforts of the DEI committee. Information related to the structure of our committee, aims of our work, progress toward identified goals, as well as ongoing barriers is provided. Academic medical health centers are tasked not only with working and training together, but also to care for a diverse group of patients within a larger community. As such, academic medical health centers represent a unique backdrop and opportunity for individual and system-level change.
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Affiliation(s)
- Kyle A. Bersted
- Department of Pediatrics, Rush University Medical Center, 1620 W. Harrison Street, Chicago, IL 60612 USA
| | - Kerri M. Lockhart
- Department of Pediatrics, Rush University Medical Center, 1620 W. Harrison Street, Chicago, IL 60612 USA
| | - Janet Yarboi
- Department of Pediatrics, Rush University Medical Center, 1620 W. Harrison Street, Chicago, IL 60612 USA
| | - Marylouise K. Wilkerson
- Department of Pediatrics, Rush University Medical Center, 1620 W. Harrison Street, Chicago, IL 60612 USA
| | - Bridget L. Voigt
- Department of Pediatrics, Rush University Medical Center, 1620 W. Harrison Street, Chicago, IL 60612 USA
| | - Sherald R. Leonard
- Department of Pediatrics, Rush University Medical Center, 1620 W. Harrison Street, Chicago, IL 60612 USA
| | - Jean M. Silvestri
- Department of Pediatrics, Rush University Medical Center, 1620 W. Harrison Street, Chicago, IL 60612 USA
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Ruzycki SM, Roach P, Ahmed SB, Barnabe C, Holroyd-Leduc J. Diversity of physicians in leadership and academic positions in Alberta: a cross-sectional survey. BMJ LEADER 2022; 6:278-285. [PMID: 36794601 DOI: 10.1136/leader-2021-000554] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/10/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Efforts to reduce barriers and disparities faced by marginalised physicians are limited by a lack of data on the current diversity of the Canadian physician workforce. We aimed to characterise the diversity of the Albertan physician workforce. METHODS This cross-sectional survey, open to all Albertan physicians from 1 September 2020 to 6 October 2021, measured the proportion of physicians from traditionally under-represented groups, including those with diverse gender identities, disabilities and from racial minorities. RESULTS There were 1087 respondents (9.3% response rate); of whom 33.4% identified as cisgender men (n=363), 46.8% as cisgender women (n=509) and less than 3% as gender diverse. Fewer than 5% were members of the LGBTQI2S+community. Half were white (n=547), 4.6% were black (n=50) and fewer than 3% were Indigenous or Latinx. Over one-third reported a disability (n=368, 33.9%). There were 303 white cisgender women (27.9%), 189 white cisgender men (17.4%), 136 black, Indigenous or person of colour (BIPOC) cisgender men (12.5%) and 151 BIPOC cisgender women (13.9%). Compared with BIPOC physicians, white participants were over-represented in leadership positions (64.2% and 32.1%; p=0.06) and academic roles (78.7% and 66.9%; p<0.01). Cisgender women had less often applied for academic promotion than cisgender men (85.4% and 78.3%, respectively, p=0.01), and BIPOC physicians had been denied promotion more frequently (7.7% compared with 4.4%; p=0.47). CONCLUSION Many Albertan physicians may experience marginalisation through at least one protected characteristic. There were race-based and gender-based differences in experiences of medical leadership and academic promotion which may explain observed disparities in these positions. To increase diversity and representation in medicine, medical organisations should focus on inclusive cultures and environments. Universities should focus efforts on supporting BIPOC physicians, especially BIPOC cisgender women, in applying for promotion.
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Affiliation(s)
- Shannon M Ruzycki
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada .,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Pamela Roach
- Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sofia B Ahmed
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Cheryl Barnabe
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Jayna Holroyd-Leduc
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Armijo A, Eldeeb K, Fairley S, Groenen M, Montemayor JR, Myrick E, Robinson B, Rogers J, Schokking M, Sheakley M. IAMSE Meeting Report: Student Plenary at the 26th Annual Conference of the International Association of Medical Science Educators. MEDICAL SCIENCE EDUCATOR 2022; 32:15-19. [PMID: 36277268 PMCID: PMC9580428 DOI: 10.1007/s40670-022-01662-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Arthur Armijo
- Rocky Vista University College of Osteopathic Medicine, Greenwood Village, USA
| | - Khalil Eldeeb
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Buies Creek, Lillington, NC 27506 USA
| | - Stacie Fairley
- Philadelphia College of Osteopathic Medicine-South Georgia, Moultrie, USA
| | - Milou Groenen
- Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Erica Myrick
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA
| | - Benjamin Robinson
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Buies Creek, Lillington, NC 27506 USA
| | - Jasmine Rogers
- Philadelphia College of Osteopathic Medicine-South Georgia, Moultrie, USA
| | | | - Maria Sheakley
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA
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32
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Avila AH, Weixelbaum JH, Compton WM. The National Institute on Drug Abuse Summer Research Internship Program: Building a Diverse National Scientific Workforce. Neuropsychopharmacology 2022; 47:2184-2188. [PMID: 35902690 PMCID: PMC9330961 DOI: 10.1038/s41386-022-01377-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/22/2022] [Accepted: 06/25/2022] [Indexed: 12/05/2022]
Affiliation(s)
- Albert H. Avila
- grid.420090.f0000 0004 0533 7147National Institute on Drug Abuse, Bethesda, MD USA
| | | | - Wilson M. Compton
- grid.420090.f0000 0004 0533 7147National Institute on Drug Abuse, Bethesda, MD USA
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Martínez LE, Anaya YBM, Santizo Greenwood S, Diaz SFM, Wohlmuth CT, Hayes-Bautista DE. The Latino Resident Physician Shortage: A Challenge and Opportunity for Equity, Diversity, and Inclusion. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1673-1682. [PMID: 35731597 DOI: 10.1097/acm.0000000000004793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE The purpose of this study is to examine the number of Latino physicians in residency training and Latino resident physician trends in the nation's 10 largest medical specialties in the United States and in the 4 states with the largest Latino populations: California, Florida, New York, and Texas. METHOD The authors used data from the United States Census Bureau's American Community Survey to determine Latino populations and a special report from the Association of American Medical Colleges to determine rates of Latino resident physicians in the United States and in California, Florida, New York, and Texas from 2001 to 2017. Rates of Latino residents in the nation's 10 specialties with the largest number of residents were also determined. RESULTS From 2001 to 2017, the United States had an average of 37 resident physicians per 100,000 population. At the national level, however, Latino residents were underrepresented, with only 14 per 100,000 Latino population. At the state level, California and Texas, the 2 states with the largest Latino populations (39.4% and 39.7% of their population, respectively), had 5 and 9 Latino residents per 100,000 Latino population, respectively. Latino residents in California, Texas, Florida, and New York were also very underrepresented in the primary care specialties examined. CONCLUSIONS The findings show a severe shortage of Latino resident physicians. While a similar shortage also exists in primary care specialties, the majority of Latinos in states with large Latino populations are consistently choosing to train in primary care. Investment and greater improvement in the representation of certain population groups in medicine and for combating the inequities existing in the current educational system is needed. The authors offer recommendations to increase the number of Latinos in residency programs and for increasing the number of Spanish-speaking physicians and Latino international medical graduates in residency programs.
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Affiliation(s)
- Laura E Martínez
- L.E. Martínez is a postdoctoral fellow, Department of Obstetrics and Gynecology, and researcher, Center for the Study of Latino Health and Culture (CESLAC), David Geffen School of Medicine at UCLA, Los Angeles, California; ORCID: https://orcid.org/0000-0002-9804-6001
| | - Yohualli Balderas-Medina Anaya
- Y.B.-M. Anaya is assistant clinical professor, Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California; ORCID: https://orcid.org/0000-0002-3454-7667
| | - Seira Santizo Greenwood
- S. Santizo Greenwood is chief of staff, CESLAC, David Geffen School of Medicine at UCLA, Los Angeles, California; ORCID: https://orcid.org/0000-0003-3055-076X
| | - Sonja F M Diaz
- S.F.M. Diaz is founding director, Latino Policy and Politics Institute, Luskin School of Public Affairs at UCLA, Los Angeles, California; ORCID: https://orcid.org/0000-0001-9589-9837
| | - Cinna T Wohlmuth
- C.T. Wohlmuth is program director, Obstetrics and Gynecology Residency Program, Adventist Health White Memorial Medical Center, Los Angeles, California
| | - David E Hayes-Bautista
- D.E. Hayes-Bautista is distinguished professor of medicine and director, CESLAC, David Geffen School of Medicine at UCLA, Los Angeles, California; ORCID: https://orcid.org/0000-0001-8363-9034
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Mulder L, Wouters A, Fikrat-Wevers S, Koster AS, Ravesloot JH, Croiset G, Kusurkar RA. Influence of social networks in healthcare on preparation for selection procedures of health professions education: a Dutch interview study. BMJ Open 2022; 12:e062474. [PMID: 36316069 PMCID: PMC9628659 DOI: 10.1136/bmjopen-2022-062474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Health professions education (HPE) students are often not representative of the populations they will serve. The underrepresentation of non-traditional students is problematic because diversity is essential for promoting excellence in health education and care. This study aimed to understand the perceptions of traditional and non-traditional students regarding facilitators and barriers in preparing for HPE selection procedures, and to determine the role of social networks in their decision-making and preparations to apply. METHODS A qualitative study was conducted with 26 Dutch youth who were interested in university-level HPE programmes. Semistructured interviews and sociograms were analysed using thematic analysis, adopting a constructivist approach. RESULTS Twenty-six high school students participated, with traditional and non-traditional backgrounds, with and without social networks in healthcare and higher education. Two themes were constructed. First, four high-impact facilitators helped to overcome barriers to apply and in preparation for selection: access to a social network connection working or studying in healthcare, to correct information, to healthcare experience and to a social network connection in higher education. Lack of information was the main barrier while access to social network connections in healthcare was the main facilitator to overcome this barrier. However, this access was unevenly distributed. Second, access alone is not enough: the need for agency to make use of available facilitators is also essential. CONCLUSIONS The themes are discussed using intersectionality. Traditional students with access to facilitators develop their self-efficacy and agency within social structures that privilege them, whereas non-traditional students must develop those skills without such structures. Our findings provide recommendations for the ways in which universities can remove barriers that cause unequal opportunities to prepare for the selection of HPE programmes. Along with equitable admissions, these recommendations can help to achieve a more representative student population and subsequently a better quality of health education and care.
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Affiliation(s)
- Lianne Mulder
- Amsterdam UMC location Vrije Universiteit Amsterdam, Research in Education, De Boelelaan 1118, Amsterdam, The Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anouk Wouters
- Amsterdam UMC location Vrije Universiteit Amsterdam, Research in Education, De Boelelaan 1118, Amsterdam, The Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Suzanne Fikrat-Wevers
- Institute of Medical Education Research Rotterdam, Erasmus MC, Rotterdam, The Netherlands
| | - Andries S Koster
- Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jan Hindrik Ravesloot
- Amsterdam UMC location University of Amsterdam, Department of Medical Biology, Meibergdreef 9, Amsterdam, The Netherlands
| | - Gerda Croiset
- Wenckebach Institute for Education and Training, University Medical Centre Groningen, Groningen, The Netherlands
| | - Rashmi A Kusurkar
- Amsterdam UMC location Vrije Universiteit Amsterdam, Research in Education, De Boelelaan 1118, Amsterdam, The Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Woodruff JN, McDade WA, Nakae S, Vela MB. COVID-19 Has Exacerbated Inequities That Hamper Physician Workforce Diversification. JAMA Netw Open 2022; 5:e2238566. [PMID: 36269363 DOI: 10.1001/jamanetworkopen.2022.38566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- James N Woodruff
- Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - William A McDade
- Diversity, Equity, and Inclusion Office, Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Sunny Nakae
- Equity, Inclusion, Diversity and Community Partnerships, California University of Science and Medicine School of Medicine, Riverside
| | - Monica B Vela
- Department of Medicine, Hispanic Center for Excellence, University of Illinois College of Medicine, Chicago
- Department of Medical Education, Hispanic Center for Excellence, University of Illinois College of Medicine, Chicago
- Diversity, Equity, and Inclusion Associate Editor, JAMA Network Open
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Weiss J, Holaday L, Keene D, Akingbesote ND, Balasuriya L, Sharifi M, Latimore D, Genao I. Perspectives of Historically Black College and University Advisors to Premedical Students During the COVID-19 Pandemic: A Qualitative Study. JAMA Netw Open 2022; 5:e2238563. [PMID: 36269351 PMCID: PMC9587479 DOI: 10.1001/jamanetworkopen.2022.38563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
IMPORTANCE Black students remain underrepresented in medicine despite national efforts to increase diversity in the physician workforce. Historically Black College and University (HBCU) students play a vital role in increasing representation in the workforce. Currently, there is a paucity of literature understanding the impact of COVID-19 on premedical students from HBCUs. Understanding the adverse impact of the pandemic on HBCU students is essential to inform strategies that promote holistic medical school admissions and increased diversity, equity, and inclusion in the medical workforce. OBJECTIVE To explore premedical advisors' perspectives on the impact of the COVID-19 pandemic on HBCU premedical students pursuing admission to medical school. DESIGN, SETTING, AND PARTICIPANTS In this qualitative study, semistructured interviews of HBCU premedical advisors were performed from March 2020 to March 2021. One-on-one interviews were conducted with 21 advisors with a depth of experience as advisors, varied educational backgrounds, and diverse geographic representation. Data analysis was performed from March 2021 to December 2021. MAIN OUTCOMES AND MEASURES The experiences of HBCU premedical students during the COVID-19 pandemic from the perspective of the premedical advisor. RESULTS Among the 21 participants, 13 (62%) were female, 15 (71%) were Black or African American, 11 (52%) had a doctorate degree, and 7 (33%) had more than 10 years of experience as advisors. Participants described 3 major themes: (1) balancing academic responsibilities with family demands; (2) distraction, disruption, and isolation in the virtual learning environment; and (3) harmful impact of new stressors for HBCU applicants in the medical school admissions process. CONCLUSIONS AND RELEVANCE In this qualitative study of HBCU advisors to premedical students, advisors described how the COVID-19 pandemic adversely affected undergraduate HBCU premedical students; students faced family hardships, challenges with virtual learning, and uncertainty in the medical school admissions process. These findings suggest that medical schools should continue to create direct interventions to address the challenges that HBCU students faced during the height of the pandemic and as longitudinal consequences of the pandemic. Addressing these issues may improve physician workforce representation and promote more equitable patient care for underserved communities disproportionately affected by COVID-19 and other health disparities.
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Affiliation(s)
- Jasmine Weiss
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill
| | - Louisa Holaday
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
- Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Danya Keene
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Ngozi D. Akingbesote
- Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, Connecticut
- Department of Internal Medicine (Endocrinology), Yale University School of Medicine, New Haven, Connecticut
| | - Lilanthi Balasuriya
- Yale National Clinician Scholars Program, Yale University School of Medicine, New Haven, Connecticut
| | - Mona Sharifi
- Yale National Clinician Scholars Program, Yale University School of Medicine, New Haven, Connecticut
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
| | - Darin Latimore
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Inginia Genao
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania
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Sims LR. Into the Unknown: Experiences of Social Newcomers Entering Medical Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1528-1535. [PMID: 36198162 DOI: 10.1097/acm.0000000000004762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE Amid efforts to diversify the medical profession, research has yet to fully explore the role of early social ties to the field. This study examined diversity through the experiences of students without early ties to medicine through family members working in health care (i.e., "newcomers") in comparison with more-connected peers (i.e., "insiders"), examining how social newcomers to medicine negotiate challenges stemming from their outsider status. METHOD The author conducted an exploratory qualitative study from 2018 to 2021 using a constructivist grounded theory approach. Following a voluntary preliminary survey of 2 cohorts of first-year medical students about their social connections in health care, the author conducted interviews over the next 2 years with students who had indicated their willingness to participate. Interviews addressed how social context shaped-and continued to influence-their journeys into medicine. Eighty second- and third-year students participated in 94 interviews, including some follow-up interviews for longitudinal insight into outsider status. Interviews from the second year (58 new, 14 follow-up) provided the foundation of the qualitative results. RESULTS Students experienced outsider status primarily on the basis of being newcomers to medicine, often compounded by intersectional characteristics, including first-generation college status, rural or low-income background, race or ethnicity, and nontraditional status. For some, an early shortage of social capital became internalized, continuing to influence confidence and belonging well into training, in line with social reproduction theory. However, newcomers also experienced benefits associated with diverse backgrounds which helped them find a sense of belonging in medicine, as suggested by community cultural wealth and antideficit perspectives. CONCLUSIONS Newcomer status proved to be a central cause of outsiderness for students from all backgrounds and warrants greater attention from stakeholders, perhaps mirroring the undergraduate focus on first-generation college-goers. Findings suggest institutions that provide robust networking and community-building opportunities are best positioned to support newcomers.
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Affiliation(s)
- Lillian R Sims
- L.R. Sims is instructor, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, Kentucky; ORCID: https://orcid.org/0000-0003-1111-1649
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Hewlett ER, Lobo-Marwah E, Hishaw LB. Dental school pathway programs: Best practices for increasing workforce diversity. J Dent Educ 2022; 86:1098-1106. [PMID: 36165255 DOI: 10.1002/jdd.13033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/11/2022]
Abstract
The chronic underrepresentation of racial/ethnic minority practitioners in the U.S. health professions workforce is an oft-cited factor for disparities in health and health-care access affecting communities of color. As non-White providers are more likely to serve uninsured patients and practice in underserved areas, pathway/pipeline programs have been used for many years to increase the numbers racial/ethnic minorities in the health professions workforce. These programs target precollege, college, and postbaccalaureate students from historically underrepresented minority (HURM) groups (defined as African American/Black, Hispanic/Latino, and Native American students) to stimulate interest in health professions careers and provide academic support, mentoring, enrichment experiences, and other resources to facilitate their successful admission to and completion of health professions school and entry into the workforce. This article examines dental pathway programs to identify best practices for increasing enrollment of HURM students in dental school and their successful entry into the dental workforce-as evidenced in the academic literature.
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Affiliation(s)
- Edmond R Hewlett
- Restorative Dentistry, UCLA School of Dentistry, Los Angeles, California, USA
| | - Erin Lobo-Marwah
- Restorative Dentistry, UCLA School of Dentistry, Los Angeles, California, USA
| | - Laila B Hishaw
- Private Practice and Founder, Diversity in Dentistry Mentorships, Inc., Tucson, Arizona, USA
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Ogunyemi D, Lee T, Ma M, Osuma A, Eghbali M, Bouri N. Improving wellness: Defeating Impostor syndrome in medical education using an interactive reflective workshop. PLoS One 2022; 17:e0272496. [PMID: 35925925 PMCID: PMC9352101 DOI: 10.1371/journal.pone.0272496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 07/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Impostor syndrome is characterized by fraudulent self-doubt and correlates with burnout, and adverse mental health. Objective The objective was to investigate correlates of Impostor syndrome in a medical education cohort and determine if an interactive workshop can improve knowledge and perception of Impostor syndrome. Methods From June 2019 to February 2021 interactive educational workshops were conducted for medical education cohorts. Participants completed baseline knowledge and Impostor syndrome self-identification surveys, participated in interactive presentations and discussions, followed by post-intervention surveys. Results There were 198 participants including 19% residents, 10% medical students, 30% faculty and 41% Graduate Medical Education (GME) administrators. Overall, 57% were positive for Impostor syndrome. Participants classified as the following Impostor syndrome competence subtypes: Expert = 42%; Soloist = 34%; Super-person = 31%; Perfectionist = 25%; and Natural Genius = 21%. Self-identified contributors of IS included: parent expectations = 72%, female gender = 58%, and academic rat race = 37%. GME administrators compared to physicians/medical students had significantly higher number of self-identified contributors to Impostor syndrome. Knowledge survey scores increased from 4.94 (SD = 2.8) to 5.78 (2.48) post intervention (p = 0.045). Participants with Impostor syndrome competence subtypes had increased perceptions of Impostor syndrome as a cause of stress, failure to reach full potential, and negative relationships/teamwork (p = 0.032 -<0.001). Conclusion Impostor syndrome was common in this medical education cohort, and those with Impostor syndrome significantly attributed negative personal and professional outcomes to Impostor syndrome. An interactive workshop on Impostor syndrome can be used to increase perceptions and knowledge regarding Impostor syndrome. The materials can be adapted for relevance to various audiences.
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Affiliation(s)
- Dotun Ogunyemi
- Arrowhead Regional Medical Center, Colton, California, United States of America
- * E-mail:
| | - Tommy Lee
- Arrowhead Regional Medical Center, Colton, California, United States of America
| | - Melissa Ma
- California University of Science and Medicine, Colton, California, United States of America
| | - Ashley Osuma
- University of Illinois College of Medicine, Peoria, IL, United States of America
| | - Mason Eghbali
- California University of Science and Medicine, Colton, California, United States of America
| | - Natalie Bouri
- California University of Science and Medicine, Colton, California, United States of America
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Nguemeni Tiako MJ, Ray V, South EC. Medical Schools as Racialized Organizations: How Race-Neutral Structures Sustain Racial Inequality in Medical Education-a Narrative Review. J Gen Intern Med 2022; 37:2259-2266. [PMID: 35710658 PMCID: PMC9202970 DOI: 10.1007/s11606-022-07500-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
Abstract
In 2021, The American Association of Medical Colleges released a framework addressing structural racism in academic medicine, following the significant, nationwide Movement for Black Lives. The first step of this framework is to "begin self-reflection and educating ourselves." Indeed, ample evidence shows that medical schools have a long history of racially exclusionary practices. Drawing on racialized organizations theory from the field of sociology, we compile and examine scholarship on the role of race and racism in medical training, focusing on disparities in educational and career outcomes, experiences along racial lines in medical training, and long-term implications. From the entrance into medical school through the residency application process, organizational factors such as reliance on standardized tests to predict future success, a hostile learning climate, and racially biased performance metrics negatively impact the careers of trainees of color, particularly those underrepresented in medicine (URiM). Indeed, in addition to structural biases associated with otherwise "objective" metrics, there are racial disparities across subjective outcomes such as the language used in medical trainees' performance evaluations, even when adjusting for grades and board exam scores. These disadvantages contribute to URIM trainees' lower odds of matching, steering into less competitive and lucrative specialties, and burnout and attrition from academic careers. Additionally, hostile racial climates and less diverse medical schools negatively influence White trainees' interest in practicing in underserved communities, disproportionally racial and ethnic minorities. Trainees' mental health suffers along the way, as do medical schools' recruitment, retention, diversity, and inclusion efforts. Evidence shows that seemingly race-neutral processes and structures within medical education, in conjunction with individuals' biases and interpersonal discrimination, may reproduce and sustain racial inequality among medical trainees. Medical schools whose goals include training a more diverse physician workforce towards addressing racial health disparities require a new playbook.
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Affiliation(s)
- Max Jordan Nguemeni Tiako
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Urban Health Lab, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
| | - Victor Ray
- Department of Sociology, University of Iowa, Iowa City, IA, USA
| | - Eugenia C South
- Urban Health Lab, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Mulder L, Wouters A, Twisk JWR, Koster AS, Akwiwu EU, Ravesloot JH, Croiset G, Kusurkar RA. Selection for health professions education leads to increased inequality of opportunity and decreased student diversity in The Netherlands, but lottery is no solution: A retrospective multi-cohort study. MEDICAL TEACHER 2022; 44:790-799. [PMID: 35236235 DOI: 10.1080/0142159x.2022.2041189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Concerns exist about the role of selection in the lack of diversity in health professions education (HPE). In The Netherlands, the gradual transition from weighted lottery to selection allowed for investigating the variables associated with HPE admission, and whether the representativeness of HPE students has changed. METHOD We designed a retrospective multi-cohort study using Statistics Netherlands microdata of all 16-year-olds on 1 October 2008, 2012, and 2015 (age cohorts, N > 600,000) and investigated whether they were eligible students for HPE programs (n > 62,000), had applied (n > 14,000), and were HPE students at age 19 (n > 7500). We used multivariable logistic regression to investigate which background variables were associated with becoming an HPE student. RESULTS HPE students with ≥1 healthcare professional (HP) parent, ≥1 top-10% income/wealth parent, and women are overrepresented compared to all age cohorts. During hybrid lottery/selection (cohort-2008), applicants with ≥1 top-10% wealth parent and women had higher odds of admission. During 100% selection (cohort-2015) this remained the case. Additionally, applicants with ≥1 HP parent had higher odds, those with a migration background had lower odds. CONCLUSIONS Odds of admission are increasingly influenced by applicants' backgrounds. Targeted recruitment and equitable admissions procedures are required to increase matriculation of underrepresented students.
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Affiliation(s)
- Lianne Mulder
- Amsterdam UMC, Research in Education, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands
- LEARN! Faculty of Psychology and Education, Vrije Universiteit, Amsterdam, The Netherlands
| | - Anouk Wouters
- Amsterdam UMC, Research in Education, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands
- LEARN! Faculty of Psychology and Education, Vrije Universiteit, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Andries S Koster
- Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Eddymurphy U Akwiwu
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Jan H Ravesloot
- Department of Medical Biology, Amsterdam UMC, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Gerda Croiset
- Wenckebach Institute for Education and Training, University Medical Center Groningen, Groningen, The Netherlands
| | - Rashmi A Kusurkar
- Amsterdam UMC, Research in Education, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands
- LEARN! Faculty of Psychology and Education, Vrije Universiteit, Amsterdam, The Netherlands
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Baugh AD, Baugh RF. How Financial Aid Policy Shortchanges American Healthcare. TEACHING AND LEARNING IN MEDICINE 2022; 34:322-328. [PMID: 34672908 DOI: 10.1080/10401334.2021.1977135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
Issue: Medical school debt is increasing. This trend may reduce access to medical school at a time of historic recognition of the need for greater openness and diversity in medical education by disadvantaging candidates who are underrepresented in medicine. The effects of high education-related debt for medical school needs greater consideration. Evidence: The implementation staircase model is employed as lens for understanding the impact of debt on trainees who are underrepresented in medicine and the healthcare system overall. Higher debt burdens are associated with worse mental health outcomes and increased odds of attrition in medical school. Trainees cite debt as a concern in considering primary care careers. Those with greater debt are less likely to pursue or remain in academic careers. Implications: The current financial aid system's reliance on high debt burden undermines goals to improve the representation of underrepresented candidates in primary care and academic medicine. Alternative models requiring less debt could facilitate the creation of a more diverse workforce in healthcare.
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Affiliation(s)
- Aaron D Baugh
- Department of Medicine, University of California San Francisco, California, USA
| | - Reginald F Baugh
- Department of Surgery, University of Toledo College of Medicine, Toledo, Ohio, USA
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Identifying US Plastic Surgery Training Programs that Effectively Establish Gender and Ethnically Diverse Faculty. Plast Reconstr Surg Glob Open 2022; 10:e4303. [PMID: 35539297 PMCID: PMC9076441 DOI: 10.1097/gox.0000000000004303] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/22/2022] [Indexed: 12/03/2022]
Abstract
Background: Successful strategies to improve the representation of female and ethnically underrepresented in medicine (UIM) physicians among US plastic and reconstructive surgery (PRS) faculty have not been adequately explored. Accordingly, we aimed to identify programs that have had success, and in parallel gather PRS program directors’ and chiefs/chairs’ perspectives on diversity recruitment intentionality and strategies. Methods: We conducted a cross-sectional analysis of the demographic composition of female and UIM faculty of PRS residency training programs. Separate lists of programs in the top quartile for female and UIM faculty representation were collated. Additionally, a 14-question survey was administered to program directors and chiefs/chairs of all 99 Accreditation Council for Graduate Medical Education-accredited PRS residency programs. The questions comprised three domains: (1) demographic information; (2) perceptions about diversity; and (3) recruitment strategies utilized to diversify faculty. Results: Female and UIM faculty representation ranged from 0% to 63% and 0% to 50%, respectively. Survey responses were received from program directors and chiefs/chairs of 55 institutions (55% response rate). Twenty-five (43%) respondents felt their program was diverse. Fifty-one (80%) respondents felt diversity was important to the composition of PRS faculty. Active recruitment of diverse faculty and the implementation of a diversity, equity, and inclusion committee were among the most frequently cited strategies to establish a culturally sensitive and inclusive environment. Conclusions: These findings reveal that female and UIM representation among US PRS faculty remains insufficient; however, some programs have had success through deliberate and intentional implementation of diversity, equity, and inclusion strategies.
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Duma N, Velazquez AI, Franco I, Kiel L, Levit LA, Schenkel C, Kirkwood K, Green S, Rodriguez G. Dónde Están? Latinx/Hispanic Representation in the Oncology Workforce: Present and Future. JCO Oncol Pract 2022; 18:388-395. [PMID: 35544646 PMCID: PMC10166382 DOI: 10.1200/op.22.00153] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/24/2022] [Indexed: 11/20/2022] Open
Abstract
This manuscript reviews the status of Hispanic/Latinx physicians in oncology, the benefits and challenges to achieving equitable representation, and potential solutions and actions to increase diversity in the oncology workforce. Persons of Hispanic/Latinx origin comprise 18.7% of the population and 16.8% of the adult population in the United States but are only 4.7% of practicing oncologists. The reasons for the lack of representation of Hispanic/Latinx individuals in medicine are multifaceted and include discrimination and biases, exclusionary practices, financial barriers, and lack of role modeling. As a result, patients are deprived the benefits of a representative workforce, such as improved access, enhanced culturally and linguistically competent care, and minimization of health disparities. Solutions included in the manuscript include a description of efforts by ASCO to improve the representativeness of the oncology workforce through its awards programs and educational efforts, especially for Hispanic/Latinx clinicians. The manuscript also outlines individual actions that attending physicians, senior oncologists, oncology leaders, and hospital/cancer center leadership can take to improve the diversity of the oncology workforce and support our Latinx/Hispanic trainees and colleagues. Improving the representativeness of the oncology workforce will require collective action by institutions, medical societies, and individuals. Nevertheless, widespread commitment to creating an inclusive and supported workforce is necessary to ensure the quality of care for minority patients, reduce existing cancer care disparities, and advance innovation in oncology.
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Affiliation(s)
| | | | | | | | | | | | | | - Sybil Green
- American Society of Clinical Oncology, Alexandria, VA
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Highet A, Kendrick DE, Bandeh-Ahmadi H, Vitous A, Yang K, Ernst C, George BC. Pragmatic Mentoring Strategies for the Busy Surgeon Scientist. JOURNAL OF SURGICAL EDUCATION 2022; 79:695-707. [PMID: 35144902 DOI: 10.1016/j.jsurg.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/13/2021] [Accepted: 01/08/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The value of research mentorship in academic medicine is well-recognized, yet there is little practical advice for how to develop and sustain effective mentoring partnerships. Gaining research skill and mentorship is particularly critical to success in academic surgery, yet surgeon scientists are challenged in their mentorship efforts by time constraints and lack of education on how to mentor. To address this gap, this study explored the strategies that award-winning faculty mentors utilize in collaborating with their medical student mentees in research. DESIGN, SETTING, AND PARTICIPANTS For this qualitative study, the authors invited physician recipients of an institution-wide mentorship award to participate in individual, semi-structured interviews during July and August 2018. Following interview transcription, the authors independently coded the text and collaboratively identified common mentoring strategies and practices via a process of thematic analysis. RESULTS Nine physician mentors, representing a mix of genders, medical specialties and types of research (basic science, clinical, translational, and health services), participated in interviews. The authors identified 12 strategies and practices from the interview transcripts that fell into 5 categories: Initiating the partnership; Determining the research focus; Providing project oversight; Developing mentee research competence; and Supporting mentee self-efficacy. CONCLUSION Award-winning mentors employ a number of shared strategies when mentoring medical trainees in research. These strategies can serve as a guide for academic surgeons who wish to improve their research mentoring skills.
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Affiliation(s)
- Alexandra Highet
- Department of Surgery, University of California, San Francisco, San Francisco, California
| | - Daniel E Kendrick
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Hoda Bandeh-Ahmadi
- Center for Surgical Training and Research, Michigan Medicine, Ann Arbor, Michigan
| | - Ann Vitous
- Center for Health Outcomes and Policy, Michigan Medicine, Ann Arbor, Michigan
| | - Katherine Yang
- Center for Surgical Training and Research, Michigan Medicine, Ann Arbor, Michigan
| | - Caleb Ernst
- Center for Surgical Training and Research, Michigan Medicine, Ann Arbor, Michigan
| | - Brian C George
- Center for Surgical Training and Research, Michigan Medicine, Ann Arbor, Michigan; Center for Health Outcomes and Policy, Michigan Medicine, Ann Arbor, Michigan.
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Bradley AS, Adeleke IO, Estime SR. Healthcare disparities in trauma: why they exist and what we can do. Curr Opin Anaesthesiol 2022; 35:150-153. [PMID: 35045002 DOI: 10.1097/aco.0000000000001094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review will explore the underlying causes of healthcare disparities among trauma patients and offer considerations for reducing inequities to improve trauma care. RECENT FINDINGS Newly recognized racial disparities exist with respect to triaging trauma patients and in acute pain management. Social Determinants of Health offers a model to understand disparity in trauma care. SUMMARY Race, ethnicity, socioeconomic status, and access to healthcare drive outcome disparity among trauma patients. These disparities include reduced healthcare services, inadequate pain management, reduced postdischarge care, and increased mortality. Increasing workforce diversity may mitigate implicit bias and improve cultural competency. Social determinants of health impact the disparities in trauma care and offer a framework to address care through creative solutions.
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Affiliation(s)
- A Steven Bradley
- Department of Anesthesiology, Uniformed Services University of Health Sciences, Portsmouth, Virginia
| | - Ibukun O Adeleke
- Department of Anesthesiology, Northwestern University, Feinberg School of Medicine
| | - Stephen R Estime
- Department of Anesthesia and Critical Care, University of Chicago Medicine, Chicago, Illinois, USA
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Career advancement in academic surgery: A career development resource initiative for trainees. Am J Surg 2022; 224:1009-1012. [DOI: 10.1016/j.amjsurg.2022.03.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/27/2022] [Accepted: 03/31/2022] [Indexed: 11/17/2022]
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A disturbing trend: An analysis of the decline in surgical critical care (SCC) fellowship training of Black and Hispanic surgeons. J Trauma Acute Care Surg 2022; 93:84-90. [PMID: 35343928 DOI: 10.1097/ta.0000000000003621] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Underrepresented minorities in medicine (URiM) are disproportionally represented in surgery training programs. Rates of URiM applying to and completing General Surgery residency remain low. We hypothesized that the patterns of URiM disparities would persist into Surgical Critical Care (SCC) fellowship applicants, matriculants and graduates. METHODS We performed a retrospective analysis of SCC applicants, matriculants and graduates from 2005-2020 using the Graduate Medical Education (GME) resident survey and analyzed applicant characteristics using the Surgical critical care and Acute care surgery Fellowship Application Service (SAFAS) from 2018-2020. The data were stratified by race/ethnicity and gender. Indicator variables were created for Asian, Hispanic, White and Black trainees. Yearly proportions for each race/ethnicity and gender categories completing or enrolling in a program were calculated and plotted over time with Loess smoothing lines and overlying 95% confidence bands. The yearly rate and statistical significance of change over time were tested with linear regression models with race/ethnicity and gender proportion as the dependent variables and year as the explanatory variable. RESULTS From 2005-2020, there were a total of 2,481 graduates. Black men accounted for 4.7% of male graduates with a significant decline of 0.3% per year for the study period of those completing the fellowship (p = 0.02). Black women comprised 6.4% of female graduates and had a 0.6% decline each year (p < 0.01). A similar trend was seen with Hispanic men, who comprised 3.2% of male graduates and had a 0.3% annual decline (p = 0.02). White men had a significant increase in both matriculation to and graduation from SCC fellowships during the same interval. Similarly, Black and Hispanic applicants declined from 2019 to 2020, while the percentage of White applicants increased. CONCLUSIONS Disparities in URiM representation remain omnipresent in surgery and extend from residency training to SCC fellowship. Efforts to enhance the recruitment and retention of URiM in SCC training are warranted. LEVEL OF EVIDENCE Level IV - Therapeutic/Care Management.
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A Review of Underserved and Vulnerable Populations in Headache Medicine in the United States: Challenges and Opportunities. Curr Pain Headache Rep 2022; 26:415-422. [DOI: 10.1007/s11916-022-01042-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2022] [Indexed: 11/03/2022]
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Mahendra N, Kashinath S. Mentoring Underrepresented Students in Speech-Language Pathology: Effects of Didactic Training, Leadership Development, and Research Engagement. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:527-538. [PMID: 34731580 DOI: 10.1044/2021_ajslp-21-00018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The purpose of this study was to implement and track the outcomes of a yearlong, structured mentoring program aimed at enhancing the retention and success of underrepresented graduate and undergraduate students in speech-language pathology. METHOD Student participants were recruited following an open application process and based on meeting eligibility requirements and committing to program completion. The focus of this program was to provide didactic training on leadership development, culturally responsive practice, and research methods used in speech-language pathology. This program emphasized participant needs assessments and goal-setting, access to one-on-one and group mentoring by peers and professionals, and a culminating experience in which participant teams completed a supervised clinical research project or a community outreach and education project. RESULTS Forty-six participants in three cohorts completed the yearlong program in three consecutive years. Positive outcomes included program completion, degree completion, student perceptions of program benefit, completion of innovative community-engaged and research projects, and dissemination of scholarly work. CONCLUSION Our findings from implementing this program and tracking its outcomes have implications for using innovative, equity-minded, and evidence-based strategies for retaining and mentoring minoritized students in speech-language pathology.
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Affiliation(s)
- Nidhi Mahendra
- Department of Communicative Disorders & Sciences, San José State University, CA
| | - Shubha Kashinath
- Department of Speech, Language, & Hearing Sciences, California State University East Bay, Hayward
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