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Najmabadi S, Valentin V, Rolls J, Showstark M, Elrod L, Barry C, Broughton A, Bessette M, Honda T. Non-native English-speaking applicants and the likelihood of physician assistant program matriculation. MEDICAL EDUCATION ONLINE 2024; 29:2312713. [PMID: 38324669 PMCID: PMC10851801 DOI: 10.1080/10872981.2024.2312713] [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: 10/12/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE Effective communication is critical in patient care. Multilingual medical providers, including Physician Assistants (PAs) can contribute to improved health care among patients with limited English proficiency; however, this is contingent upon matriculating multilingual providers. In this study, the association between prospective applicants' self-reported English as second language (ESL) status and their likelihood of matriculation into a PA program was investigated. METHODS Participants included applicants to five admission cycles of the Centralized Application Service for Physician Assistant from 2012 to 2020. Logistic regression was utilized to investigate association between applicant ESL status and odds of program matriculation in both bivariate and multivariable regression models. Models were adjusted for citizenship status, undergraduate grade point average, gender, age, race/ethnicity, number of programs applied to, and patient care hours. RESULTS In unadjusted and adjusted models, ESL status was associated with a significantly lower odds of matriculation to a PA program across all study years. In adjusted multivariable models, associations were strongest for 2014-2015 where ESL status was associated with a 35% lower odds of matriculation (odds ratio 0.65, 95% confidence interval 0.56, 0.76) when controlling for demographics, citizenship status, patient care experience, and academic achievement. In sensitivity analyses restricting to (a) those with TOEFL scores ≥ 100, and (b) restricting to those ESL applicants without TOEFL scores, we did not observe important changes in our results. CONCLUSIONS Results indicated that non-native English-speaking applicants have lower odds of PA program matriculation. Decrements in matriculation odds were large magnitude, minimally impacted by adjustment for confounders and persistent across the years. These findings suggest that PA program admission processes may disadvantage non-native English-speaking applicants. While there are potential explanations for the observed findings, they are cause for concern. Matriculating and training PAs who have language concordance with underserved populations are important means of improving patient outcomes.
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Affiliation(s)
- Shahpar Najmabadi
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Virginia Valentin
- Department of PA Studies, College of Health Sciences, University of Kentucky, Lexington, KY, USA
| | - Joanne Rolls
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Mary Showstark
- Affiliate Faculty Yale Institute of Global Health, School of Medicine, Physician Assistant Online Program, Yale University, New Haven, CT, USA
| | - Leigh Elrod
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Carey Barry
- Department of Medical Sciences, Physician Assistant Program, Northeastern University, Boston, MA, USA
| | - Adam Broughton
- Department of Medical Sciences, Physician Assistant Program, Northeastern University, Boston, MA, USA
| | - Michael Bessette
- Department of Medical Sciences, Physician Assistant Program, Northeastern University, Boston, MA, USA
| | - Trenton Honda
- School of Clinical and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
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Bowens AN. A Systematic Review of Variables Used in Physical Therapist Education Program Admissions Part 2: Noncognitive Variables. JOURNAL, PHYSICAL THERAPY EDUCATION 2024; 38:192-204. [PMID: 39150256 DOI: 10.1097/jte.0000000000000329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/19/2023] [Indexed: 08/17/2024]
Abstract
BACKGROUND AND PURPOSE Physical therapist (PT) education professionals agree on promoting holistic admissions practices to increase student body diversity but lack consensus about what factors in an application should be part of this process. This systematic literature review aimed to understand the value of noncognitive variables in PT education admissions. METHODS The initial literature search identified 1,592 articles in databases and relevant journals. Of the 39 studies meeting the inclusion criteria, 29 reported on noncognitive variables. RESULTS Commonly used noncognitive variables (interviews, written essays, letters of recommendation, and clinical experiences) were insignificant or inconsistently associated with performance in the PT program or on the National Physical Therapy Examination. Sociodemographic variables appeared to negatively affect the academic qualifications of applicants who were older, identified with underrepresented racial/ethnic groups, and reported English as a second language. Finally, 5 studies identified personal attributes, such as emotional intelligence and grit, as having a significant relationship with successful student outcomes. DISCUSSION AND CONCLUSION Cognitive variables should serve as only one of several factors considered in admissions to achieve a more diverse class of students. Physical therapist education programs may use this evidence to reevaluate their admissions practices to include a balanced consideration of cognitive and noncognitive variables.
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Affiliation(s)
- Andrea N Bowens
- Andrea N. Bowens is an associate professor in the Department of Physical Therapy, School of Health Professions, Samford University, 800 Lakeshore Drive, CHS 2160, Birmingham, AL 35229 . Please address all correspondence to Andrea N. Bowens
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Cleland J, Blitz J, Amaral E, You Y, Alexander K. Medical school selection is a sociohistorical embedded activity: A comparison of five countries. MEDICAL EDUCATION 2024. [PMID: 39119835 DOI: 10.1111/medu.15492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 08/10/2024]
Abstract
INTRODUCTION The medical school selection literature comes mostly from a few countries in the Global North and offers little opportunity to consider different ways of thinking and doing. Our aim, therefore, was to critically consider selection practices and their sociohistorical influences in our respective countries (Brazil, China, Singapore, South Africa and the UK), including how any perceived inequalities are addressed. METHODS This paper summarises many constructive dialogues grounded in the idea of he er butong () (harmony with diversity), learning about and from each other. RESULTS Some practices were similar across the five countries, but there were differences in precise practices, attitudes and sociohistorical influences thereon. For example, in Brazil, South Africa and the UK, there is public and political acknowledgement that attainment is linked to systemic and social factors such as socio-economic status and/or race. Selecting for medical school solely on prior attainment is recognised as unfair to less privileged societal groups. Conversely, selection via examination performance is seen as fair and promoting equality in China and Singapore, although the historical context underpinning this value differs across the two countries. The five countries differ in respect of their actions towards addressing inequality. Quotas are used to ensure the representation of certain groups in Brazil and regional representation in China. Quotas are illegal in the UK, and South Africa does not impose them, leading to the use of various, compensatory 'workarounds' to address inequality. Singapore does not take action to address inequality because all people are considered equal constitutionally. DISCUSSION In conclusion, medical school selection practices are firmly embedded in history, values, societal expectations and stakeholder beliefs, which vary by context. More comparisons, working from the position of acknowledging and respecting differences, would extend knowledge further and enable consideration of what permits and hinders change in different contexts.
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Affiliation(s)
- Jennifer Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore and National Healthcare Group Singapore, Singapore
| | - Julia Blitz
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Eliana Amaral
- Faculdade de Ciências Médicas, UNICAMP (Universidade Estadual de Campinas), Campinas, São Paulo, Brazil
| | - You You
- Institute of Medical Education/National Center for Health Professions Education Development and Institute of Economics of Education, Peking University, Beijing, China
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Royal KD, Meyer C, Guercio E, Speicher M, Flamini J, Sandella JM, Tsai TH, Searcy CA. The predictive validity of MCAT scores and undergraduate GPA for COMLEX-USA licensure exam performance of students enrolled in osteopathic medical schools. J Osteopath Med 2024; 0:jom-2023-0265. [PMID: 39015097 DOI: 10.1515/jom-2023-0265] [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: 12/05/2023] [Accepted: 05/16/2024] [Indexed: 07/18/2024]
Abstract
CONTEXT Osteopathic (Doctor of Osteopathic Medicine [DO]) medical students account for more than 25 % of all medical students in the United States. OBJECTIVES This study examined the predictive validity of Medical College Admission Test (MCAT) total scores and cumulative undergraduate grade point averages (UGPAs) for performance on the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) Level 1 and Level 2-CE (Cognitive Evaluation) licensure examinations administered by the National Board of Osteopathic Medical Examiners (NBOME). Additionally, the study examined the degree to which MCAT total scores and UGPAs provide comparable prediction of student performance by key sociodemographic variables. METHODS This study involved a collaborative effort between the Association of American Medical Colleges (AAMC), the American Association of Colleges of Osteopathic Medicine (AACOM) and the NBOME. Data were examined for 39 accredited DO-granting medical schools in the United States during the 2017 application cycle. Researchers utilized three regression models that included MCAT total scores, cumulative UGPA, and combined MCAT total scores and cumulative UGPA to determine predictive validity. Researchers also examined the comparability of prediction for sociodemographic variables by examining the differences between observed and predicted error for both scores and pass/fail success rates. RESULTS Medium to large correlations were discernible between MCAT total scores, UGPA, and COMLEX-USA examination outcomes. For both COMLEX-USA Level 1 and Level 2-CE scores and pass/fail outcomes, MCAT scores alone provided superior predictive value to UGPA alone. However, MCAT scores and UGPA utilized in conjunction provided the best predictive value. When predicting both licensure examination scores and pass/fail outcomes by sociodemographic variables, all three models provided comparable predictive accuracy. CONCLUSIONS Findings from this comprehensive study of DO-granting medical schools provide evidence for the value-added benefit of taking MCAT scores and UGPA into consideration, particularly when these measures are utilized in conjunction. Further, findings provide evidence indicating that individuals from different sociodemographic backgrounds who enter medical school with similar MCAT scores and UGPA perform similarly on licensure examination outcome measures.
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Affiliation(s)
- Kenneth D Royal
- Director of MCAT Research and Data Science, 8352 Association of American Medical Colleges , Washington, DC, USA
| | - Christian Meyer
- Psychometric Intern, Association of American Medical Colleges, Washington, DC, USA
| | - Erik Guercio
- Senior Director of Research, American Association of Colleges of Osteopathic Medicine, Bethesda, MD, USA
| | - Mark Speicher
- Senior Vice President for Learning, Innovation and Research, American Association of Colleges of Osteopathic Medicine, Bethesda, MD, USA
| | - Joseph Flamini
- Vice President for Administration/Chief Operating Officer, National Board of Osteopathic Medical Examiners, Chicago, IL, USA
| | - Jeanne M Sandella
- Vice President for Professional Development Initiatives and Communications, National Board of Osteopathic Medical Examiners, Conshohocken, PA, USA
| | - Tsung-Hsun Tsai
- Associate Vice President for Assessment Services and Research, National Board of Osteopathic Medical Examiners, Chicago, IL, USA
| | - Cynthia A Searcy
- Senior Director of MCAT Science Strategy and Solutions, Association of American Medical Colleges, Washington, DC, USA
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Cummins S, Ray L, Nesheim J, Nasrazadani ZC. A framework for optimizing diversity, equity, inclusion, and belonging in pharmacy residency recruitment for underrepresented minorities. Am J Health Syst Pharm 2024; 81:390-400. [PMID: 38253043 DOI: 10.1093/ajhp/zxae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Indexed: 01/24/2024] Open
Affiliation(s)
- Sarah Cummins
- Pharmacy Department, University of California Davis Health, Sacramento, CA, USA
| | - Lance Ray
- Pharmacy Department, Denver Health Hospital Authority, Denver, CO
- Department of Emergency Medicine, University of Colorado, Denver, CO, USA
| | - Jessica Nesheim
- Inpatient Pharmacy, MercyOne Des Moines Medical Center, Des Moines, IA, USA
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Ventres WB, Stone LA, Wilson HJ, Sexton SM, Doukas DJ, Cerdeña JP, Kelley DM, Fetters MD, Haney JJ, Frey JJ. Storylines of family medicine XI: professional identity formation-nurturing one's own story. Fam Med Community Health 2024; 12:e002827. [PMID: 38609080 PMCID: PMC11029241 DOI: 10.1136/fmch-2024-002827] [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: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 04/14/2024] Open
Abstract
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'XI: professional identity formation-nurturing one's own story', authors address the following themes: 'The social construction of professional identity', 'On becoming a family physician', 'What's on the test?-professionalism for family physicians', 'The ugly doc-ling', 'Teachers-the essence of who we are', 'Family medicine research-it starts in the clinic', 'Socially accountability in medical education', 'Personal philosophy and how to find it' and 'Teaching and learning with Storylines of Family Medicine'. May these essays encourage readers to find their own creative spark in medicine.
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Affiliation(s)
- William B Ventres
- Family and Preventive Medicine, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA
| | - Leslie A Stone
- Family and Preventive Medicine, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA
| | - Hamish J Wilson
- General Practice and Rural Health, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
| | - Sumi M Sexton
- Family Medicine, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - David J Doukas
- Family and Community Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Jessica P Cerdeña
- Family Medicine Residency Program, Middlesex Health, Middletown, Connecticut, USA
| | - David M Kelley
- Family and Preventive Medicine, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA
| | - Michael D Fetters
- Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jeffrey J Haney
- Medical Education and Clinical Sciences, Washington State University, Spokane, Washington, USA
| | - John J Frey
- Family Medicine and Community Health, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
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Perez MA, Williams C, Henderson K, McGregor R, Vapiwala N, Shea JA, Dine CJ. Association of applicant demographic factors with medical school acceptance. BMC MEDICAL EDUCATION 2023; 23:960. [PMID: 38098006 PMCID: PMC10720109 DOI: 10.1186/s12909-023-04897-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Medical school acceptance rates in the United States (US) have been lower for applicants who identify as Underrepresented-in-Medicine (UiM) compared to non-UiM applicants. The gap between UiM and no-UiM groups is narrowing in recent years. Less well-studied are associations of acceptance decisions with family income and parental education. This study's purpose is to evaluate the relationships between medical school acceptance and family income, parental education status, racial/ethnic background, Grade Point Average (GPA), Medical College Admission Test (MCAT) score, and participation in extracurricular activities. METHODS This is a cross-sectional study of first-time US medical school applicants between 2017 and 2020. Acceptance rates for first-time applicants were calculated for first-generation (FG), low-income (LI), and UiM applicants. Associations of these attributes with MCAT scores, science GPAs, and seven categories of extracurricular activities were evaluated. Regression analyses estimated associations between acceptance to medical school with all variables with and without interaction terms (FG*URM, LI*URM, FG*LI). RESULTS The overall acceptance rate for first-time applicants from 2017-2020 was 45.3%. The acceptance rates among FG, LI and UiM applicants were 37.9%, 39.6% and 44.2%, respectively. In univariable logistic regression analyses, acceptance was negatively associated with being FG (OR: 0.68, CI: 0.67-0.70), LI (OR: 0.70, CI: 0.69-0.72), and UiM (OR: 0.95, CI: 0.93-0.97). In multivariable regression, acceptance was most strongly associated with science GPA (OR: 7.15, CI: 6.78-7.54 for the highest quintile) and UiM (OR: 5.56, CI: 5.48-5.93) status and MCAT score (OR: 1.19, CI: 1.18-1.19), FG (OR: 1.14, CI: 1.10-1.18), and most extracurricular activities. Including interaction terms revealed a negative association between acceptance and LI (OR:0.90, CI: 0.87-0.94) and FG was no longer significant (OR:1.10, CI:0.96-1.08). CONCLUSIONS Collectively these results suggest medical school admissions committees may be relying on holistic admission practices. While MCAT and GPA scores continue to predict acceptance, individuals from racially and ethnically UiM backgrounds have favorable odds of acceptance when controlling for MCAT and GPA. However, these positive associations were not seen for low-income and first-generation applicants. Additional preparation for college and the MCAT for these latter groups may help further diversify the medical profession.
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Affiliation(s)
- Michael A Perez
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, US
| | - Cheyenne Williams
- Department of Urology, Hospital of the University of Pennsylvania, Philadelphia, PA, US
| | - Korey Henderson
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, US
| | - Ryan McGregor
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, US
| | - Neha Vapiwala
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, US
- Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, US
| | - Judy A Shea
- Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, US
- Leonard Davis Institute of Economics, University of Pennsylvania, Philadelphia, PA, US
| | - C Jessica Dine
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, US.
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA, US.
- Leonard Davis Institute of Economics, University of Pennsylvania, Philadelphia, PA, US.
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Havemann C, Mason HRC, Russell RG, Casillas A, Nguyen M, Boatright D, Webber A, Parrilla JA, Gallegos A, Wyatt TR. Challenges Facing First-Generation College Graduates in Medical School: A Qualitative Analysis. JAMA Netw Open 2023; 6:e2347528. [PMID: 38091039 PMCID: PMC10719755 DOI: 10.1001/jamanetworkopen.2023.47528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/20/2023] [Indexed: 12/17/2023] Open
Abstract
Importance First-generation (FG) medical students remain underrepresented in medicine despite ongoing national efforts to increase diversity; understanding the challenges faced by this student population is essential to building holistic policies, practices, and learning environments that promote professional actualization. Although FG students have been extensively studied in the undergraduate literature, there is little research investigating how FG students experience medical education or opportunities for educators to intervene. Objective To explore challenges that FG students experience in undergraduate medical education and identify opportunities to improve foundational FG support. Design, Setting, and Participants This qualitative study was conducted using an online platform with 37 FG students enrolled in 27 US medical schools. An interprofessional team of medical educators and trainees conducted semistructured interviews from November 2021 through April 2022. Participants were recruited using a medical student listserv. Data were analyzed from April to November 2022. Main Outcomes and Measures After conducting a preliminary analysis using open coding, a codebook was created and used in a thematic analysis; the codebook used a combination of deductive and inductive coding. Results Among the 37 students recruited for this study, 21 (56.8%) were female; 23 (62.2%) were in the clinical phase of training; 1 (2.7%) was American Indian or Alaska Native, 7 (18.9%) were Hispanic, Latino, or of Spanish origin, 8 (21.6%) were non-Hispanic Asian or Asian American, 9 (24.3%) were non-Hispanic Black or African American, and 23 (32.4%) were non-Hispanic White; mean (SD) age was 27.3 (2.8) years. Participants described 4 major themes: (1) isolation and exclusion related to being a newcomer to medicine; (2) difficulty with access to basic resources (eg, food, rent, transportation) as well as educational (eg, books); (3) overall lack of faculty or institutional support to address these challenges; and (4) a sense of needing to rely on grit and resilience to survive. Conclusions and Relevance Although grit and resilience are desirable traits, results of this study suggest that FG medical students face increased adversity with inadequate institutional support, which forces them to excessively rely on grit and resilience as survival (rather than educational) strategies. By applying the holistic model often used in admissions to the postmatriculation educational process, targeted and flexible initiatives can be created for FG students so that all students, regardless of background, can achieve robust professional actualization.
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Affiliation(s)
| | | | | | - Alejandra Casillas
- Division of General Internal Medicine and Health Services Research, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California
| | | | - Dowin Boatright
- Ronald O. Perelman Department of Emergency Medicine, Emergency Medicine and Population Health, NYU Grossman School of Medicine, New York, New York
| | - Alexis Webber
- Department of General Surgery, Albany Medical Center, Albany, New York
| | | | - Abraham Gallegos
- Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, California
| | - Tasha R. Wyatt
- Center for Health Professions Education, Uniformed Services University, Bethesda, Maryland
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Grbic D, Gunter B, Poll-Hunter N, Youngclaus JA, Shader M, Addams AN, Young GH, Szenas PL. Association Between a Medical School Applicant's Community College Attendance and the Likelihood of Application Acceptance: An Investigation of Select Medical School Characteristics. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:1294-1303. [PMID: 37478136 PMCID: PMC10627549 DOI: 10.1097/acm.0000000000005332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
PURPOSE One-third of medical school applicants attend a community college (CC), and they represent a diverse group of applicants. However, they have a lower likelihood of being accepted to medical school. Using application-level data, this study examines how an applicant's CC attendance impacts the likelihood of application acceptance and how 3 medical school characteristics moderate this association. METHOD Data examined were from 2,179,483 applications submitted to at least one of 146 U.S. Liaison Committee on Medical Education-accredited medical schools by 124,862 applicants between 2018 and 2020. The outcome was application acceptance. The main measures were applicants' CC attendance (no, lower [> 0%-19% of college course hours], or higher [≥ 20%]) and 3 medical school characteristics: geographic region, private versus public control, and admissions policy regarding CC coursework. Multilevel logistic regression models estimated the association between CC attendance and the likelihood of application acceptance and how this association was moderated by school characteristics. RESULTS Among applicants, 23.8% (29,704/124,862) had lower CC attendance and 10.3% (12,819/124,862) had higher CC attendance. Regression results showed that, relative to no CC attendance, applications with lower (adjusted odds ratio [AOR] = .96; 95% confidence internal [CI], .94-.97) and higher (AOR = .78; 95% CI, .76-.81) CC attendance had significantly decreased odds of acceptance when the 3 school characteristics were included. Each of the 3 medical school characteristics significantly moderated the association between an applicant's CC attendance and the likelihood of application acceptance. CONCLUSIONS The negative association between CC attendance and medical school application acceptance varies by medical school characteristics. Professional development for admissions officers focused on understanding the CC pathway and potential biases related to CC attendance would likely be beneficial in terms of trying to attract and select a diverse cohort of medical students in a holistic and equitable manner.
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Affiliation(s)
- Douglas Grbic
- D. Grbic is manager, Medical Education Research, Association of American Medical Colleges, Washington, DC
| | - Brianna Gunter
- B. Gunter is lead research and data analyst, Strategic Operations and Data Services, Association of American Medical Colleges, Washington, DC
| | - Norma Poll-Hunter
- N. Poll-Hunter is senior director, Workforce Diversity, Association of American Medical Colleges, Washington, DC
| | - James A. Youngclaus
- J.A. Youngclaus is manager, Education Research, Association of American Medical Colleges, Washington, DC
| | - Michelle Shader
- M. Shader is director, Holistic Initiatives and Learning, Association of American Medicine Colleges, Washington, DC
| | - Amy N. Addams
- A.N. Addams is director, Student Affairs Alignment and Holistic Review, Association of American Medical Colleges, Washington, DC
| | - Geoffrey H. Young
- G.H. Young is senior director, Transforming Health Care Workforce, Association of American Medical Colleges, Washington, DC
| | - Philip L. Szenas
- P.L. Szenas is director, Business Intelligence, Association of American Medical Colleges, Washington, DC
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Schoenfeld D, Ingram J, Wiederhon J, Joice GA, Badalato GM. Perceived Barriers Among Underrepresented and Historically Marginalized Medical Students Pursuing a Career in Urology. Urology 2023; 180:59-65. [PMID: 37422135 DOI: 10.1016/j.urology.2023.05.043] [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: 02/22/2023] [Revised: 05/10/2023] [Accepted: 05/16/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE To assess perceived barriers to pursuing urology among medical students and to determine if marginalized groups identified greater challenges to entry. METHODS The Deans of all New York medical schools were asked to disseminate a survey to their students. The survey collected demographic information to identify underrepresented minorities, students of low socioeconomic background, and lesbian, gay, bisexual, transgender, queer, intersex, and asexual individuals. Students were asked to rate various survey items on a five-point Likert scale to determine which factors were perceived as barriers to applying to urology residency. Student t tests and ANOVA were used to compare mean Likert ratings between groups. RESULTS A total of 256 students responded to the survey from 47% of medical institutions. Underrepresented minorities students cited lack of evident diversity within the field as a more significant barrier than counterparts (3.2 vs 2.7, P= .025). Lesbian, gay, bisexual, transgender, queer, intersex, and asexual students perceived the lack of evident diversity within urology (3.1 vs 2.65, P = .01), exclusivity of the field (3.73 vs 3.29, P = .04), and fear that residency programs would have negative perceptions of them as students (3.0 vs 2.1, P < .0001) as substantial obstacles compared to peers. Students with childhood household incomes less than $40,000 cited socioeconomic concerns as a higher barrier compared to students with household incomes greater than $40,000 (3.2 vs 2.3, P = .001). CONCLUSION Underrepresented and historically marginalized students perceive more significant barriers to pursuing urology than their peers. Urology training programs must continue to foster an inclusive environment to recruit prospective students from already marginalized groups.
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Affiliation(s)
- Daniel Schoenfeld
- Department of Urology, Columbia University Irving Medical Center, New York, NY.
| | - Justin Ingram
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - Jo Wiederhon
- Associated Medical Schools of New York, New York, NY
| | - Gregory A Joice
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - Gina M Badalato
- Department of Urology, Columbia University Irving Medical Center, New York, NY
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Hashimoto DA, Johnson KB. The Use of Artificial Intelligence Tools to Prepare Medical School Applications. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:978-982. [PMID: 37369073 DOI: 10.1097/acm.0000000000005309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Advances in artificial intelligence (AI) have been changing the landscape in daily life and the practice of medicine. As these tools have evolved to become consumer-friendly, AI has become more accessible to many individuals, including applicants to medical school. With the rise of AI models capable of generating complex passages of text, questions have arisen regarding the appropriateness of using such tools to assist in the preparation of medical school applications. In this commentary, the authors offer a brief history of AI tools in medicine and describe large language models, a form of AI capable of generating natural language text passages. They question whether AI assistance should be considered inappropriate in preparing applications and compare it with the assistance some applicants receive from family, physician friends, or consultants. They call for clearer guidelines on what forms of assistance-human and technological-are permitted in the preparation of medical school applications. They recommend that medical schools steer away from blanket bans on AI tools in medical education and instead consider mechanisms for knowledge sharing about AI between students and faculty members, incorporation of AI tools into assignments, and the development of curricula to teach the use of AI tools as a competency.
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Affiliation(s)
- Daniel A Hashimoto
- D.A. Hashimoto is assistant professor of surgery and computer and information science, and affiliated faculty, General Robotics, Automation, Sensing, and Perception Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania; ORCID: http://orcid.org/0000-0003-4725-3104
| | - Kevin B Johnson
- K.B. Johnson is the David L. Cohen University Professor of Pediatrics, Biomedical Informatics, and Science Communication, University of Pennsylvania, Philadelphia, Pennsylvania
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Guevara JP, Aysola J, Wade R, Nfonoyim B, Qiu M, Reece M, Carroll KN. Diversity in the pediatric research workforce: a scoping review of the literature. Pediatr Res 2023; 94:904-914. [PMID: 37185966 PMCID: PMC10129297 DOI: 10.1038/s41390-023-02603-4] [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: 06/12/2021] [Revised: 12/22/2022] [Accepted: 03/30/2023] [Indexed: 05/17/2023]
Abstract
The purpose of this scoping review is to determine trends in racial and ethnic representation, identify barriers and facilitators to greater diversity, and assess strategies and interventions to advance diversity among those in the pediatric research workforce in the U.S. We conducted a scoping review of PubMed supplemented with the authors' personal library of papers published from January 1, 2010, to December 31, 2021. To be eligible, papers had to provide original data, be published in English, report information from a U.S. healthcare institution, and report on outcomes of interest relevant to the child health field. The diversity of faculty has modestly increased over the past decade but reflects a worsening representation compared to overall population trends. This slow increase reflects a loss of diverse faculty and has been referred to as a "leaky pipeline." Strategies to plug the "leaky pipeline" include greater investments in pipeline programs, implementation of holistic review and implicit bias training, development of mentoring and faculty programs targeted to diverse faculty and trainees, alleviation of burdensome administrative tasks, and creation of more inclusive institutional environments. Modest improvements in the racial and ethnic diversity of the pediatric research workforce were identified. However, this reflects worsening overall representation given changing U.S. population demographics. IMPACT: Racial and ethnic diversity in the pediatric research workforce has shown modest increases but worsening overall representation. This review identified barriers and facilitators at the intrapersonal, interpersonal, and institutional levels that impact BIPOC trainees and faculty career advancement. Strategies to improve the pathway for BIPOC individuals include greater investments in pipeline and educational programs, implementation of holistic review admissions and bias training, institution of mentoring and sponsorship, alleviation of burdensome administrative responsibilities, and creation of inclusive institutional climates. Future studies should rigorously test the effects of interventions and strategies designed to improve diversity in the pediatric research workforce.
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Affiliation(s)
- James P Guevara
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania & Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Biostatics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Jaya Aysola
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania & Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Roy Wade
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania & Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Bianca Nfonoyim
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania & Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Maylene Qiu
- Biotech Commons Library, University of Pennsylvania, Philadelphia, PA, USA
| | - Michelle Reece
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania & Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kecia N Carroll
- Department of Pediatrics, Mt Sinai School of Medicine, New York, NY, USA
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13
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Althans AR, Byrd T, Suppok R, Lee KK, Rosengart MR, Myers SP. Impact of holistic review on diversity of interviewed and matriculating residents in graduate medical education: a systematic review protocol. BMJ Open 2023; 13:e074118. [PMID: 37438073 PMCID: PMC10347482 DOI: 10.1136/bmjopen-2023-074118] [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] [Received: 03/29/2023] [Accepted: 06/20/2023] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION Diversity in the physician workforce improves patient-centred outcomes. Patients are more likely to trust in and comply with care when seeing gender/racially concordant providers. A current emphasis on standardised metrics in academic achievement often serves as a barrier to the recruitment and retention of gender and racial minorities in medicine. Holistic review of residency applicants has been supported as a means of encouraging diversification but is not yet standardised. The current body of evidence examining the effects of holistic review on the recruitment of racial and gender minorities in surgical residencies is small. We therefore propose a systematic review to summarise the state of holistic review in graduate medical education in the USA and its impact on diversification. METHODS AND ANALYSIS Our systematic review protocol has been designed with plans to report our review findings in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. PubMed and Embase will be searched with the assistance of a health sciences librarian with expertise in systematic review. We will include studies of graduate medical education programmes that describe the implementation of holistic review, outline the components of their holistic review process and compare proportions of under-represented minorities (URM) and women interviewed and matriculating before and after holistic review implementation. We will first report a summary of the findings regarding the operationalisation of holistic review as described by studies included. We will then pool the percentages of URM and women for interviewee and matriculant populations from each study and report the collective odds ratios of each for holistic review compared with traditional review as our primary outcome. ETHICS AND DISSEMINATION This study is a protocol for systematic review, and therefore does not involve any human subjects. Findings will be published in the form of a manuscript submitted to a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42023401389.
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Affiliation(s)
- Alison R Althans
- Department of Surgery, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
| | - Tamara Byrd
- Department of Surgery, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
| | - Rachel Suppok
- Health Sciences Library System, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kenneth K Lee
- Department of Surgery, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
| | - Matthew R Rosengart
- Department of Surgery, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
| | - Sara P Myers
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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14
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Broks VMA, Stegers-Jager KM, Fikrat-Wevers S, Van den Broek WW, Woltman AM. The association between how medical students were selected and their perceived stress levels in Year-1 of medical school. BMC MEDICAL EDUCATION 2023; 23:443. [PMID: 37328850 PMCID: PMC10276376 DOI: 10.1186/s12909-023-04411-0] [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: 02/23/2023] [Accepted: 05/30/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The prevalence of medical students' mental distress is high. While schools apply various methods to select a well-performing and diverse student population, little is known about the association between different selection methods and the well-being of these students during medical school. The present retrospective multi-cohort study assessed whether students selected by high grades, assessment, or weighted lottery showed different stress perception levels in Year-1 of medical school. METHODS Of 1144 Dutch Year-1 medical students, 650 (57%) of the cohorts 2013, 2014, and 2018 who were selected by high grades, assessment, or weighted lottery completed a stress perception questionnaire (PSS-14). A multilevel regression analysis assessed the association between selection method (independent variable) and stress perception levels (dependent variable) while controlling for gender and cohort. In a post-hoc analysis, academic performance (optimal vs. non-optimal) was included in the multilevel model. RESULTS Students selected by assessment (B = 2.25, p < .01, effect size (ES) = small) or weighted lottery (B = 3.95, p < .01, ES = medium) had higher stress perception levels than students selected by high grades. Extending the regression model with optimal academic performance (B=-4.38, p < .001, ES = medium), eliminated the statistically significant difference in stress perception between assessment and high grades and reduced the difference between weighted lottery and high grades from 3.95 to 2.45 (B = 2.45, p < .05, ES = small). CONCLUSIONS Selection methods intended to create a diverse student population - assessment and lottery - are associated with higher stress perception levels in Year-1 of medical school. These findings offer medical schools insights into fulfilling their responsibility to take care of their students' well-being.
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Affiliation(s)
- Vera M A Broks
- Institute of Medical Education Research Rotterdam, Erasmus MC University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Karen M Stegers-Jager
- Institute of Medical Education Research Rotterdam, Erasmus MC University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Suzanne Fikrat-Wevers
- Institute of Medical Education Research Rotterdam, Erasmus MC University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Walter W Van den Broek
- Institute of Medical Education Research Rotterdam, Erasmus MC University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Andrea M Woltman
- Institute of Medical Education Research Rotterdam, Erasmus MC University Medical Centre Rotterdam, Rotterdam, the Netherlands.
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15
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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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16
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Fikrat‐Wevers S, Stegers‐Jager K, Groenier M, Koster A, Ravesloot JH, Van Gestel R, Wouters A, van den Broek W, Woltman A. Applicant perceptions of selection methods for health professions education: Rationales and subgroup differences. MEDICAL EDUCATION 2023; 57:170-185. [PMID: 36215062 PMCID: PMC10092456 DOI: 10.1111/medu.14949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/26/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
CONTEXT Applicant perceptions of selection methods can affect motivation, performance and withdrawal and may therefore be of relevance in the context of widening access. However, it is unknown how applicant subgroups perceive different selection methods. OBJECTIVES Using organisational justice theory, the present multi-site study examined applicant perceptions of various selection methods, rationales behind perceptions and subgroup differences. METHODS Applicants to five Dutch undergraduate health professions programmes (N = 704) completed an online survey including demographics and a questionnaire on applicant perceptions applied to 11 commonly used selection methods. Applicants rated general favourability and justice dimensions (7-point Likert scale) and could add comments for each method. RESULTS Descriptive statistics revealed a preference for selection methods on which applicants feel more 'in control': General favourability ratings were highest for curriculum-sampling tests (mean [M] = 5.32) and skills tests (M = 5.13), while weighted lottery (M = 3.05) and unweighted lottery (M = 2.97) were perceived least favourable. Additionally, applicants preferred to distinguish themselves on methods that assess attributes beyond cognitive abilities. Qualitative content analysis of comments revealed several conflicting preferences, including a desire for multiple selection methods versus concerns of experiencing too much stress. Results from a linear mixed model of general favourability indicated some small subgroup differences in perceptions (based on gender, migration background, prior education and parental education), but practical meaning of these differences was negligible. Nevertheless, concerns were expressed that certain selection methods can hinder equitable admission due to inequal access to resources. CONCLUSIONS Our findings illustrate that applicants desire to demonstrate a variety of attributes on a combination of selection tools, but also observe that this can result in multiple drawbacks. The present study can help programmes in deciding which selection methods to include, which more negatively perceived methods should be better justified to applicants, and how to adapt methods to meet applicants' needs.
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Affiliation(s)
- Suzanne Fikrat‐Wevers
- Institute of Medical Education Research RotterdamErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Karen Stegers‐Jager
- Institute of Medical Education Research RotterdamErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Marleen Groenier
- Technical Medical Centre, Technical MedicineUniversity of TwenteEnschedeThe Netherlands
| | - Andries Koster
- Department of Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
| | - Jan Hindrik Ravesloot
- Department of Medical Biology, Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Renske Van Gestel
- Department of Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
| | - Anouk Wouters
- Faculty of Medicine VUAmsterdam UMC location Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and EducationVU University AmsterdamAmsterdamThe Netherlands
| | - Walter van den Broek
- Institute of Medical Education Research RotterdamErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Andrea Woltman
- Institute of Medical Education Research RotterdamErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
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Boyd C, Myers P, Gray MM, Johnston LC. Illuminating the path towards inclusivity: strategies to improve workforce diversity in neonatal-perinatal medicine. J Perinatol 2023; 43:415-416. [PMID: 36624305 DOI: 10.1038/s41372-023-01599-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/21/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023]
Affiliation(s)
- Cameron Boyd
- Department of Pediatrics, Northwestern University School of Medicine, Chicago, IL, USA
| | - Patrick Myers
- Department of Pediatrics, Northwestern University School of Medicine, Chicago, IL, USA
| | - Megan M Gray
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Lindsay C Johnston
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
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18
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Shulruf B, Velan GM, Kennedy SE. Medical student selection process enhanced by improving selection algorithms and changing the focus of interviews in Australia: a descriptive study. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2022; 19:31. [PMID: 36437628 PMCID: PMC10435329 DOI: 10.3352/jeehp.2022.19.31] [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: 08/25/2022] [Accepted: 11/20/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE The study investigates the efficacy of new features introduced to the selection process for medical school at the University of New South Wales, Australia: (1) considering the relative ranks rather than scores of the Undergraduate Medicine and Health Sciences Admission Test and Australian Tertiary Admission Rank; (2) structured interview focusing on interpersonal interaction and concerns should the applicants become students; and (3) embracing interviewers’ diverse perspectives. METHODS Data from 5 cohorts of students were analyzed, comparing outcomes of the second year in the medicine program of 4 cohorts of the old selection process and 1 of the new process. The main analysis comprised multiple linear regression models for predicting academic, clinical, and professional outcomes, by section tools and demographic variables. RESULTS Selection interview marks from the new interview (512 applicants, 2 interviewers each) were analyzed for inter-rater reliability, which identified a high level of agreement (kappa=0.639). No such analysis was possible for the old interview since it required interviewers to reach a consensus. Multivariate linear regression models utilizing outcomes for 5 cohorts (N=905) revealed that the new selection process was much more effective in predicting academic and clinical achievement in the program (R2=9.4%–17.8% vs. R2=1.5%–8.4%). CONCLUSION The results suggest that the medical student selection process can be significantly enhanced by employing a non-compensatory selection algorithm; and using a structured interview focusing on interpersonal interaction and concerns should the applicants become students; as well as embracing interviewers’ diverse perspectives.
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Affiliation(s)
- Boaz Shulruf
- Office of Medical and Health Education, Faculty of Medicine and Health, The University of New South Wales, Sydney, NSW, Australia
| | - Gary Mayer Velan
- Office of Medical and Health Education, Faculty of Medicine and Health, The University of New South Wales, Sydney, NSW, Australia
| | - Sean Edward Kennedy
- Office of Medical and Health Education, Faculty of Medicine and Health, The University of New South Wales, Sydney, NSW, Australia
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Levy J, Kausar H, Patel D, Andersen S, Simanton E. College competitiveness and medical school exam performance. BMC MEDICAL EDUCATION 2022; 22:780. [PMID: 36371170 PMCID: PMC9652795 DOI: 10.1186/s12909-022-03857-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND In medical school, students are tested through periodic USMLE Step 1 and 2 examinations before obtaining a medical license. Traditional predictors of medical school performance include MCAT scores, undergraduate grades, and undergraduate institutional selectivity. Prior studies indicate that admissions committees might unfairly discriminate against applicants who graduated from less competitive universities. However, there is limited literature to determine whether those who attended competitive colleges perform better on USMLE Step 1 and 2 examinations. OBJECTIVE The purpose of our study is to determine if students who attended competitive undergraduate colleges outperform those who did not on medical school benchmarks. METHODS We defined a Competitive College as having greater than 10% of its student body scoring 1400 or higher (on a 1600 scale) on the SAT. If this criteria was not met, colleges would be categorized as Non-Competitive. Descriptive statistics and unpaired t-tests were calculated to analyze average test scores on the MCAT, Phase 1 NBME, USMLE Step 1, Phase 2 NBME, and USMLE Step 2. RESULTS Our findings suggest there are no statistically significant differences between students who do or do not attend competitive undergraduate colleges on these medical school benchmark examinations following the MCAT. CONCLUSION Admissions committees should use this data to aid in their student selection as our research indicates that institutional selectivity accurately predicts MCAT scores, but not performance on standardized medical school examinations once admitted.
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Affiliation(s)
- Joshua Levy
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA.
| | - Hiba Kausar
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA
| | - Deepal Patel
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA
| | - Shaun Andersen
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA
| | - Edward Simanton
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA
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Grullon K, Hight RS, Goldberg EM, Rosenblatt AE. Impact of considering United States Medical Licensing Examination Step 1 pass/fail on diversity in dermatology residency recruitment. Clin Dermatol 2022:S0738-081X(22)00130-4. [PMID: 36257479 DOI: 10.1016/j.clindermatol.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The University of Chicago dermatology residency program considered the United States Medical Licensing Examination (USMLE) Step 1 pass/fail during the 2020-2021 application cycle with the goal of recruiting diverse dermatology residency candidates. We conducted a retrospective multiyear cross-sectional study among applicants to the dermatology residency program during the 2018-2019 and 2020-2021 application cycles, the latter excluding use of USMLE Step 1 cutoff scores as a screening tool. Of the applicants, 69.8% (n = 419) and 94.5% (n = 605) had their residency applications reviewed by our program during the 2018-2019 and 2020-2021 application cycles, respectively. There was a statistically significant upward trend in the number of underrepresented in medicine (URiM) applicants offered an interview from 10.4% (n = 5) to 37.7% (n = 20) across the application cycles. Multiple linear regression demonstrated there was a statistically significant decrease in the mean USMLE Step 1 score among applicants reviewed across application cycle and URiM status independently, and as a factor of their interaction (P = .016 and P = .001). By de-emphasizing the USMLE Step 1 score and using the test as originally intended, a marker for licensure, our program significantly increased the number of URiM applicants who were offered an interview and implemented a holistic review process focused on individual attributes and cultural competence.
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Affiliation(s)
- Karina Grullon
- University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.
| | - Robert S Hight
- University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| | - Ellen M Goldberg
- University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| | - Adena E Rosenblatt
- Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA; Department of Pediatrics, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
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Hanson JT, Busche K, Elks ML, Jackson-Williams LE, Liotta RA, Miller C, Morris CA, Thiessen B, Yuan K. The Validity of MCAT Scores in Predicting Students' Performance and Progress in Medical School: Results From a Multisite Study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1374-1384. [PMID: 35612915 DOI: 10.1097/acm.0000000000004754] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE This is the first multisite investigation of the validity of scores from the current version of the Medical College Admission Test (MCAT) in clerkship and licensure contexts. It examined the predictive validity of MCAT scores and undergraduate grade point averages (UGPAs) for performance in preclerkship and clerkship courses and on the United States Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge examinations. It also studied students' progress in medical school. METHOD Researchers examined data from 17 U.S. and Canadian MD-granting medical schools for 2016 and 2017 entrants who volunteered for the research and applied with scores from the current MCAT exam. They also examined data for all U.S. medical schools for 2016 and 2017 entrants to regular-MD programs who applied with scores from the current exam. Researchers conducted linear and logistic regression analyses to determine whether MCAT total scores added value beyond UGPAs in predicting medical students' performance and progress. Importantly, they examined the comparability of prediction by sex, race and ethnicity, and socioeconomic status. RESULTS Researchers reported medium to large correlations between MCAT total scores and medical student outcomes. Correlations between total UGPAs and medical student outcomes were similar but slightly lower. When MCAT scores and UGPAs were used together, they predicted student performance and progress better than either alone. Despite differences in average MCAT scores and UGPAs between students who self-identified as White or Asian and those from underrepresented racial and ethnic groups, predictive validity results were comparable. The same was true for students from different socioeconomic backgrounds, and for males and females. CONCLUSIONS These data demonstrate that MCAT scores add value to the prediction of medical student performance and progress and that applicants from different backgrounds who enter medical school with similar ranges of MCAT scores and UGPAs perform similarly in the curriculum.
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Affiliation(s)
- Joshua T Hanson
- J.T. Hanson is associate professor of medicine and associate dean for student affairs, University of Texas Health San Antonio, Joe R. and Teresa Lozano Long School of Medicine, San Antonio, Texas; ORCID: https://orcid.org/0000-0002-0591-9433
| | - Kevin Busche
- K. Busche is associate professor of neurology, Department of Clinical Neurosciences, and assistant dean, clerkship for undergraduate medical education, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Martha L Elks
- M.L. Elks is professor of medical education and senior associate dean of educational affairs, Morehouse School of Medicine, Atlanta, Georgia
| | - Loretta E Jackson-Williams
- L.E. Jackson-Williams is professor of emergency medicine and vice dean of medical education, University of Mississippi Medical Center School of Medicine, Jackson, Mississippi; ORCID: https://orcid.org/0000-0002-5732-6453
| | - Robert A Liotta
- R.A. Liotta is associate dean of recruitment and admissions, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, Maryland; ORCID: https://orcid.org/0000-0001-9217-5841
| | - Chad Miller
- C. Miller is professor of internal medicine and senior associate dean for undergraduate medical education, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Cindy A Morris
- C.A. Morris is professor of microbiology and immunology and associate dean for admissions, Tulane University School of Medicine, New Orleans, Louisiana
| | - Barton Thiessen
- B. Thiessen is associate professor of anesthesia and assistant dean for admissions, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Kun Yuan
- K. Yuan was director of MCAT research, Association of American Medical Colleges, Washington, DC, at the time this was written, and is now director of research and data science, Graduate Management Admission Council, Reston, Virginia
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Kennedy AB, Riyad CNY, Ellis R, Fleming PR, Gainey M, Templeton K, Nourse A, Hardaway V, Brown A, Evans P, Natafgi N. Evaluating a Global Assessment Measure Created by Standardized Patients for the Multiple Mini Interview in Medical School Admissions: Mixed Methods Study. J Particip Med 2022; 14:e38209. [PMID: 36040776 PMCID: PMC9472042 DOI: 10.2196/38209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/19/2022] [Accepted: 08/03/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Standardized patients (SPs) are essential stakeholders in the multiple mini interviews (MMIs) that are increasingly used to assess medical school applicants' interpersonal skills. However, there is little evidence for their inclusion in the development of instruments. OBJECTIVE This study aimed to describe the process and evaluate the impact of having SPs co-design and cocreate a global measurement question that assesses medical school applicants' readiness for medical school and acceptance status. METHODS This study used an exploratory, sequential, and mixed methods study design. First, we evaluated the initial MMI program and determined the next quality improvement steps. Second, we held a collaborative workshop with SPs to codevelop the assessment question and response options. Third, we evaluated the created question and the additional MMI rubric items through statistical tests based on 1084 applicants' data from 3 cohorts of applicants starting in the 2018-2019 academic year. The internal reliability of the MMI was measured using a Cronbach α test, and its prediction of admission status was tested using a forward stepwise binary logistic regression. RESULTS Program evaluation indicated the need for an additional quantitative question to assess applicant readiness for medical school. In total, 3 simulation specialists, 2 researchers, and 21 SPs participated in a workshop leading to a final global assessment question and responses. The Cronbach α's were >0.8 overall and in each cohort year. The final stepwise logistic model for all cohorts combined was statistically significant (P<.001), explained 9.2% (R2) of the variance in acceptance status, and correctly classified 65.5% (637/972) of cases. The final model consisted of 3 variables: empathy, rank of readiness, and opening the encounter. CONCLUSIONS The collaborative nature of this project between stakeholders, including nonacademics and researchers, was vital for the success of this project. The SP-created question had a significant impact on the final model predicting acceptance to medical school. This finding indicates that SPs bring a critical perspective that can improve the process of evaluating medical school applicants.
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Affiliation(s)
- Ann Blair Kennedy
- Biomedical Sciences Department, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
- Patient Engagement Studio, University of South Carolina, Greenville, SC, United States
- Family Medicine Department, Prisma Health, Greenville, SC, United States
| | - Cindy Nessim Youssef Riyad
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
- Hospital Based Accreditation, Accreditation Council of Graduate Medical Education, Chicago, IL, United States
| | - Ryan Ellis
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Perry R Fleming
- Patient Engagement Studio, University of South Carolina, Greenville, SC, United States
- School of Medicine Columbia, University of South Carolina, Columbia, SC, United States
| | - Mallorie Gainey
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Kara Templeton
- Prisma Health-Upstate Simulation Center, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Anna Nourse
- Patient Engagement Studio, University of South Carolina, Greenville, SC, United States
| | - Virginia Hardaway
- Admissions and Registration, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - April Brown
- Prisma Health-Upstate Simulation Center, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Pam Evans
- Patient Engagement Studio, University of South Carolina, Greenville, SC, United States
- Prisma Health-Upstate Simulation Center, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Nabil Natafgi
- Patient Engagement Studio, University of South Carolina, Greenville, SC, United States
- Health Services, Policy, Management Department, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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Abstract
There has been an increasing focus on the impact of racism both within pediatrics and throughout society as a whole. This focus has emerged as a result of the current sociopolitical climate in the United States coupled with the recent deaths of Black Americans by law enforcement and the maltreatment of Latina/o immigrants. In 2019, the American Academy of Pediatrics released the landmark policy statement "The Impact of Racism on Child and Adolescent Health," which describes the profound effects of racism on health, its function in perpetuating health disparities, and the potential role of child health professionals in addressing racism as a public health issue. (1) Foundational knowledge regarding race, racism, and their relation to health are not consistently included in standard medical education curricula. This leaves providers, including pediatricians, with varying levels of understanding regarding these concepts. This article seeks to provide an overview of the intersection of race, racism, and child/adolescent health in an effort to reduce knowledge gaps among pediatric providers with the ultimate goal of attenuating racial health disparities among children and adolescents. Please reference the Table for additional resources to reinforce concepts described throughout this article.
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Affiliation(s)
- Monique Jindal
- Department of Medicine, University of Illinois Chicago, Chicago, IL
| | - Maria Trent
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Division of Adolescent and Young Adult Medicine and
| | - Kamila B Mistry
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
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Looking Back on Graduate BME Admissions Data: Lessons Learned and Implications for Holistic Review and Diversity. BIOMEDICAL ENGINEERING EDUCATION 2022; 2:101-112. [PMID: 35856076 PMCID: PMC9275534 DOI: 10.1007/s43683-022-00080-5] [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: 01/21/2022] [Accepted: 06/19/2022] [Indexed: 11/05/2022]
Abstract
Graduate school applications in Biomedical Engineering (BME) are steadily rising, making competition stiffer, applications more complex, and reviews more resource intensive. Holistic reviews are being increasingly adopted to support increased diversity, equity, and inclusion in graduate student BME admissions, but which application metrics are the strongest predictors of admission and enrollment into BME programs remains unclear. In this perspectives article, we aim to shed light on some of the key predictors of student acceptance in graduate school. We share data from a three-year retrospective review of our own institution’s graduate BME applications and admission rates and review the influence of grade point averages (GPA), standardized test scores (e.g., GRE), and prior research experience on graduate school admission rates. We also examine how the waiver of GRE requirements has changed the landscape of BME graduate applications in recent years. Finally, we discuss efforts taken by our institution and others to develop and implement holistic reviews of graduate applications that encourage students from underrepresented backgrounds to apply and successfully gain admission to graduate school. We share five key lessons we learned by performing the retrospective review and encourage other institutions to “self-reflect” and examine their historical graduate admissions data and past practices. Efforts aimed at engaging faculty to overcome their own implicit biases, engaging with underrepresented students in hands-on, research-intensive programs, and networking with diverse student populations have strong potential to enhance the diversity of BME graduate programs and our STEM workforce.
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Minhas AMK, Sagheer S, Ijaz SH, Nazir S, Khan MS, Zaidi SH, Fudim M, Rodriguez F, Johnson HM, Virani SS. Persistent Racial/Ethnic Disparities in Cardiology Trainees in the United States. J Am Coll Cardiol 2022; 80:276-279. [PMID: 35835499 DOI: 10.1016/j.jacc.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 11/18/2022]
Affiliation(s)
| | - Shazib Sagheer
- Department of Cardiology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Sardar Hassan Ijaz
- Division of Cardiology, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, Massachusetts, USA
| | - Salik Nazir
- Division of Cardiovascular Medicine, University of Toledo Medical Center, Toledo, Ohio, USA
| | | | - Syeda Humna Zaidi
- Department of Medicine, Karachi Medical and Dental College, Karachi, Pakistan
| | - Marat Fudim
- Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Fatima Rodriguez
- Division of Cardiovascular Medicine, Stanford University, Stanford, California, USA
| | - Heather M Johnson
- Christine E. Lynn Women's Health and Wellness Institute, Boca Raton Regional Hospital/Baptist Health South Florida, Charles E. Schmidt College of Medicine, Boca Raton, Florida, USA
| | - Salim S Virani
- Michael E. DeBakey Veterans Affair Medical Center and Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
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Walker VP, Williams DR. Restitution Through Equity-Focused Mentoring: A Solution to Diversify the Physician Workforce. Front Public Health 2022; 10:879181. [PMID: 35719651 PMCID: PMC9199986 DOI: 10.3389/fpubh.2022.879181] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022] Open
Abstract
Minoritized and marginalized physicians who identify as Black, Latino/a/x and Native American (BLNA) remain unacceptably underrepresented in medicine. Multiple studies provide a compelling argument for prioritizing racial/ethnic diversification of the physician workforce to improve racial/ethnic physician-patient concordance and assist in achieving more equitable health outcomes. Despite a growing awareness for the tangible benefits of a diversified physician workforce, the number of physicians from minoritized and marginalized groups remains relatively stagnant or worsening in certain demographics. The 5:1 ratio of Black students and trainees to Black faculty exemplifies and exacerbates the increased risk for harmful isolation particularly experienced by many BLNA mentees. They too need and deserve the benefits produced by concordant racial/ethnic faculty mentoring and support. However, these demands on time, resources and bandwidth can lead to negative consequences for BLNA faculty engaged in these efforts by contributing to their emotional, mental and physical exhaustion. Given the perpetual paucity of BLNA physicians in academic medicine, immediate interventions to prevent attrition of BLNA faculty, trainees and students journeying along the physician career pathway are urgently needed. Requiring the implementation of mentoring programs explicitly focused on increasing the number of physicians from groups underrepresented in medicine must happen at every point of the education and training process.
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Affiliation(s)
- Valencia P Walker
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, United States.,Center for the Study of Racism, Social Justice and Health, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| | - Dominique R Williams
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, United States.,Division of Primary Care, Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, OH, United States
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Harris TB, Jacobs NN, Fuqua CF, Lyness JM, Smith PO, Poll-Hunter NI, Piggott C, Monroe AD. Advancing Equity in Academic Medicine Through Holistic Review for Faculty Recruitment and Retention. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:631-634. [PMID: 34935728 DOI: 10.1097/acm.0000000000004568] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The Association of American Medical Colleges (AAMC) in 2007 developed the Holistic Review Framework for medical school admissions to increase mission-aligned student diversity. This approach balances an applicant's experiences, attributes, and metrics during the screening, interview, and selection processes. Faculty recruitment provides its own set of challenges, and there is persistent underrepresentation of certain racial and ethnic minority groups and women in faculty and leadership positions in U.S. academic health centers (AHCs). In 2019, the AAMC initiated a pilot program to adapt and implement the framework for use in faculty recruitment at AHCs. In this Invited Commentary, the authors describe the pilot implementation of the Holistic Review Framework for Faculty Recruitment and Retention and share lessons learned to date. Although the pilot proceeded during 2020, institutional implementation was impacted by the COVID-19 pandemic and racial justice movement. Pilot institutions encountered hiring freezes, reductions in funding, and restrictions on in-person meetings due to COVID-19 that resulted in both barriers and opportunities in implementing the framework. Renewed commitment to racial justice was associated with increased momentum and urgency for the implementation of faculty holistic review at the majority of pilot institutions. Common themes from the pilot leads' experiences included the importance of achieving "buy in," having a dedicated implementation team, and being explicit about core values. Other themes included the importance of adaptability and flexibility to meet the needs of different institutions and mission areas. The faculty holistic review framework has shown promise as an approach to advancing faculty diversity goals. The pilot institutions will continue to share best practices, track outcomes, implement quality improvement, and disseminate findings to assist other institutions and health care communities with their endeavors to recruit and retain diverse faculty.
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Affiliation(s)
- Toi Blakley Harris
- T.B. Harris is associate provost of institutional diversity, equity, and inclusion, professor of psychiatry and behavioral sciences, and professor of pediatrics and family and community medicine, Baylor College of Medicine, Houston, Texas; ORCID: https://orcid.org/0000-0003-1976-5321
| | - Negar N Jacobs
- N.N. Jacobs is associate dean of diversity and inclusion and professor of psychiatry and behavioral sciences, University of Nevada, Reno School of Medicine, Reno, Nevada; ORCID: https://orcid.org/0000-0003-2697-3911
| | - Chantel F Fuqua
- C.F. Fuqua is director, Faculty and Education Initiatives, Equity, Diversity and Inclusion, Association of American Medical Colleges, Washington, DC; ORCID: https://orcid.org/0000-0002-9399-3931
| | - Jeffrey M Lyness
- J.M. Lyness is senior associate dean for academic affairs and professor of psychiatry and neurology, University of Rochester School of Medicine & Dentistry, Rochester, New York; ORCID: https://orcid.org/0000-0003-1618-5209
| | - Patrick O Smith
- P.O. Smith is chief faculty affairs officer and professor of family medicine, University of Mississippi Medical Center, Jackson, Mississippi; ORCID: https://orcid.org/0000-0001-9458-5422
| | - Norma I Poll-Hunter
- N.I. Poll-Hunter is senior director, Workforce Diversity, Equity, Diversity and Inclusion, Association of American Medical Colleges, Washington, DC; ORCID: https://orcid.org/0000-0003-1234-8197
| | - Cleveland Piggott
- C. Piggott is vice chair, Diversity, Equity, Inclusion for Family Medicine, and assistant professor of family medicine, University of Colorado, Aurora, Colorado; ORICID: https://orcid.org/0000-0002-3723-8720
| | - Alicia D Monroe
- A.D. Monroe is provost and senior vice president, Academic and Faculty Affairs, and professor of family and community medicine, Baylor College of Medicine, Houston, Texas; ORCID: https://orcid.org/0000-0003-2726-4615
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28
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Lund S, D'Angelo J, D'Angelo AL, Heller S, Stulak J, Rivera M. New Heuristics to Stratify Applicants: Predictors of General Surgery Residency Applicant Step 1 Scores. JOURNAL OF SURGICAL EDUCATION 2022; 79:349-354. [PMID: 34776371 DOI: 10.1016/j.jsurg.2021.10.007] [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: 07/19/2021] [Revised: 10/04/2021] [Accepted: 10/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE In 2022, United States Medical Licensing Examination (USMLE) Step 1 scores will become pass/fail. This may be problematic, as residency programs heavily rely on USMLE Step 1 scores as a metric when determining interview invitations. This study aimed to assess candidate application metrics associated with USMLE Step 1 scores to offer programs new cues for stratifying applicants. DESIGN Retrospective cohort study analyzing interviewed applicants to one general surgery residency program in 2019 and 2020. Applicant data analyzed included USMLE Step 1 scores, number of publications, clerkship scores, letter of recommendation scores (out of 2, scored by 0.25 interval), interview overall score (out of 5, scored by integer level), and standardized question score (out of 10). Each year, applicant's answers to one standardized behavioral question during their interview were scored by interviewers. SETTING Tertiary medical center, academic general surgery residency program. PARTICIPANTS Interviewed applicants at one general surgery residency program whose applications contained complete demographic information (203 out of 247). RESULTS Multiple Linear Regression revealed that higher surgical clerkship (β = 0.19, p = 0.006) and higher standardized interview question (β = 0.32, p < 0.001) scores were positively associated with applicant USMLE Step 1 score (F[7, 195] = 6.61, p < 0.001, R2 = 0.19). Letter of recommendation score, number of peer reviewed publications, gender, race, and applicant type (preliminary/categorical) were not associated with USMLE Step 1 scores. CONCLUSIONS With USMLE Step 1 scores transitioning to pass/fail, surgical residency programs need new selection heuristics. Surgery clerkship scores and standardized behavioral questions answered by applicants prior to the interview could provide a holistic view of applicants and help programs better stratify candidates without USMLE Step 1 scores.
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Affiliation(s)
- Sarah Lund
- Mayo Clinic Department of Surgery, Rochester, Minnesota.
| | | | | | - Stephanie Heller
- Mayo Clinic Division of Trauma, Critical Care, and General Surgery, Rochester, Minnesota
| | - John Stulak
- Mayo Clinic Department of Cardiovascular Surgery, Rochester, Minnesota
| | - Mariela Rivera
- Mayo Clinic Division of Trauma, Critical Care, and General Surgery, Rochester, Minnesota
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Michalec B, Hafferty FW. Examining the U.S. premed path as an example of discriminatory design & exploring the role(s) of capital. SOCIAL THEORY & HEALTH 2022; 21:70-97. [PMID: 35125969 PMCID: PMC8807955 DOI: 10.1057/s41285-022-00175-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 11/23/2022]
Abstract
The college-level pathway to medical school (i.e., the "premed path") includes all coursework, extra-curriculars, shadowing, volunteering, high-stakes examination (e.g., MCAT®), and application-related processes. Although medical school admission committees routinely insist their interest in diverse and "well-rounded" applicants, the premed path (PMP), through formal and informal mechanisms, is constructed to favor those from high in socioeconomic status (SES) privileged backgrounds, and those majoring in typical premed majors such as in the Biological Sciences. In these respects, the PMP is an example of Discriminatory Design-an entity constructed and sustained in a manner that (un)intentionally discriminates against certain groups of individuals. We begin this paper by providing a brief description of the PMP (within the U.S. specifically) and conceptual and theoretical overview of the discriminatory design framework. We then explore how the PMP is an example of discriminatory design through the distinct but related role(s) of financial, social, cultural, and (what we term) (extra)curricular capital. Using data gleaned from interviews with premedical students, content analyses of the curricular structure of particular majors and publicly available data on the various "costs" associated with the PMP, we detail how the PMP is reflective of discriminatory design, spotlighting specific barriers and hurdles for certain groups of students. Given the persistent lack of representation of students from minoritized groups as well as those from diverse academic backgrounds within medical schools, our goal is to spotlight key features and processes within the PMP that actively favor the pursuit of certain majors and students from more privileged backgrounds. In turn, we conclude by offering medical schools and undergraduate institutions specific recommendations for remediating these barriers and hurdles.
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Affiliation(s)
- Barret Michalec
- grid.215654.10000 0001 2151 2636Arizona State University, Phoenix, AZ USA
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30
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Bellaire CP, Fetherston TB, Chudow J, Maysonet J, Appel JM, Parkas V. All We Can Be: Innovations to Improve the Pipeline of Military Veterans in Medical Schools. TEACHING AND LEARNING IN MEDICINE 2022; 34:105-112. [PMID: 34284658 DOI: 10.1080/10401334.2021.1934474] [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: 01/19/2021] [Revised: 04/28/2021] [Accepted: 05/17/2021] [Indexed: 06/13/2023]
Abstract
ISSUE Medical schools are increasingly identifying military veteran applicants as a source of diversity, resiliency, and commitment-often derived from their personal experiences in the military. Yet, veterans remain significantly under-represented in entering classes; moreover, those veterans who do matriculate are not yet fully reflective of the diversity that the Armed Forces have to offer. Fortunately, specific measures have been shown to be effective at increasing both the number and diversity of student veterans in medical school. EVIDENCE In 2019, there were less than 60 military veterans who entered the 144 civilian medical schools in the United States, according to the Association of American Medical Colleges. We identify common barriers faced by military veterans and propose best practices for medical schools to recruit and sustain them. We draw on the existing medical education literature about veteran support systems, and we underscore the unique challenges of veterans in medicine. Finally, we highlight innovative programs currently in place at several US medical schools that seek to address the needs of student veterans. This article provides a guide for how to recruit, assess, and nurture student veterans, suggesting a new way of thinking about this population of nontraditional medical students. IMPLICATIONS This dearth of servicemembers significantly below what would be expected based on national demographic data is indicative of how medical schools offer few pathways to entry for military servicemembers-and far fewer for enlisted personnel and other populations traditionally under-represented in medicine. Should schools aim to recruit a veteran population that is truly representative of the military, additional measures need to be taken into consideration during the admissions review process.
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Affiliation(s)
- Christopher P Bellaire
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Thomas B Fetherston
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jacquelyn Chudow
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jessica Maysonet
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jacob M Appel
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Valerie Parkas
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Asaad M, Drolet BC, Janis JE, Giatsidis G. Applicant Familiarity Becomes Most Important Evaluation Factor in USMLE Step I Conversion to Pass/Fail: A Survey of Plastic Surgery Program Directors. JOURNAL OF SURGICAL EDUCATION 2021; 78:1406-1412. [PMID: 33487585 DOI: 10.1016/j.jsurg.2021.01.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 12/01/2020] [Accepted: 01/14/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In 2020, Step 1 of the United States Medical Licensing Examination (USMLE) changed to a pass/fail reporting. Step 1 has been one of the main factors for both inviting applicants for interviews and for ranking in Plastic Surgery. Due to this change, we hypothesize that Step 2 CK - currently the only remaining, universal quantitative metric - will become the main factor in the residency selection process. METHODS A survey-based cross-sectional study of United States (US) integrated plastic surgery program directors (PSPDs) investigated the factors that would assume importance following the change in the reporting pattern. RESULTS Respondents reported that personal prior knowledge of the applicant, Letters of recommendation (LORs), Step 2 CK scores, and away rotation at the institution of interest would become the most important factors (median ratings of 5, 4.5, 4.5, 4.5, respectively on a 5-point Likert scale). Eighty-three percent of respondents were strongly dissatisfied with the conversion to pass/fail reporting. LOR's received the highest ranking (median,1; IQR,1-2) as the component used for offering away rotations after the implementation of the pass/fail reporting, followed by the applicant's medical school (median, 3; IQR, 3-4), and grades obtained during medical school (median,3; IQR,1.75-4). Standardized assessment during rotations are recommended by 67% of PSPDs. CONCLUSIONS Future emphasis will be placed primarily on subjective metrics, including applicant familiarity. Step 2 CK, LORs, and away rotation at the institution of interest are other factors of importance. PSPDs welcome the adoption of objective assessments of patient care and medical knowledge to improve the current selection process.
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Affiliation(s)
- Malke Asaad
- Department of Plastic Surgery, MD Anderson Cancer Center, Houston, Texas
| | - Brian C Drolet
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jeffrey E Janis
- Department of Plastic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Giorgio Giatsidis
- Division of Plastic Surgery, University of Massachusetts, Worcester, Massachusetts.
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Lin CH, Chen MH, Tsai TC, Huang WJ. Difference in demographics and motivation to study medicine with respect to medical students' channel of admission: A national study. MEDICAL TEACHER 2021; 43:1025-1030. [PMID: 33784209 DOI: 10.1080/0142159x.2021.1902965] [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: 06/12/2023]
Abstract
INTRODUCTION Medical schools employ various tools to select suitable medical students (MS). This study investigated whether MS who were admitted through multiple mini-interviews (MMI) and MS who were admitted through Taiwan's Joint College Entrance Written Test (JCEWT) differed in their characteristics. METHODS AND SUBJECTS First-year MS from seven medical schools completed a semi-structured questionnaire that inquired into their channel of admission (MMI or JCEWT), gender, location (metropolitan or rural), high school type (public or private), parents' socioeconomic status (SES), and motivations to study medicine. RESULTS In total, 513 MS participated, 493 (96%) returned valid questionnaires, and 397 were enrolled in the study, (MMI group: 205 MS; JCEWT group: 192 MS). Irrespective of channel of admission, most MS came from metropolitan areas (80%-86%), belonged to high-SES families (73%-76%), and had mixed motivations (51%-96%). Female applicants, private school leavers, and those who were less motivated by the physician's SES were more likely to be selected through the MMI channel than the JCEWT channel. CONCLUSION Irrespective of the channels of entry, MS had similar demographics and motivations for studying medicine. MS selected through MMI had different characteristics than those selected through a JCEWT.
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Affiliation(s)
- Chyi-Her Lin
- Department of Pediatrics, E-Da Hospital, Kaohsiung, Taiwan, ROC
- Department of Pediatrics, College of Medicine, I-Shou University, Kaohsiung, Taiwan, ROC
- Department of Pediatrics, College of Medicine, National Cheng King University, Tainan, Taiwan, ROC
| | - Mei-Hua Chen
- Department of Pediatrics, College of Medicine, National Cheng King University, Tainan, Taiwan, ROC
| | - Tsuen-Chiuan Tsai
- Department of Humanities and Education, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC
| | - Williams J Huang
- Department of Urology, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Coming face to face with implicit bias, microagressions, and macroaggressions: Understanding the influence of structural racism and misogyny on physician wellness. J Vasc Surg 2021; 74:101S-110S. [PMID: 34303449 DOI: 10.1016/j.jvs.2021.04.021] [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: 11/28/2020] [Accepted: 04/15/2021] [Indexed: 11/24/2022]
Abstract
Implicit bias, microaggressions, and macroaggressions have a negative impact on physician and trainee wellness. In this article, we describe how structural racism, misogyny, and other social constructs have shaped the medical landscape. Increasing awareness in medical education, patient care, and research can help to dismantle the effects.
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Thatipelli S, Osude N, Youmans QR. Towards Inclusion: a Guidebook for Championing Diversity for Internal Medicine Chief Medical Residents. J Gen Intern Med 2021; 36:1761-1764. [PMID: 33846941 PMCID: PMC8175528 DOI: 10.1007/s11606-021-06782-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 03/30/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Sneha Thatipelli
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Nkiru Osude
- Department of Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Quentin R Youmans
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Nehemiah A, Roberts SE, Song Y, Kelz RR, Butler PD, Morris JB, Aarons CB. Looking Beyond the Numbers: Increasing Diversity and Inclusion Through Holistic Review in General Surgery Recruitment. JOURNAL OF SURGICAL EDUCATION 2021; 78:763-769. [PMID: 32950431 DOI: 10.1016/j.jsurg.2020.08.048] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/29/2020] [Accepted: 08/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The purpose of this study is the examine the effect of a holistic review process on the recruitment of women and students underrepresented in medicine (UIM) in a general surgery residency program. DESIGN A retrospective study comparing the proportion of women and UIM students ranked and matched into categorical positions from 2013 to 2020 before and after the implementation of the holistic application review process. United States Medical Licensing Exam (USMLE) scores and American Board of Surgery In-training Exam (ABSITE) scores were also compared between groups. SETTING General Surgery residency program at a tertiary, academic center. PARTICIPANTS Medical students applying for and matriculated to categorical positions. RESULTS After the implementation of holistic review in 2017, there was a statistically significant increase in the proportion of women (42% vs. 61%, p < 0.01) and UIM students (14% vs. 20%, p = 0.046) ranked in our program compared with the prior "traditional" approach. The proportion of matched female (33% vs. 54%, p = 0.11) and UIM applicants (14% vs. 21%, p = 0.48) also increased after holistic review, although the changes were not statistically significant. The median USMLE Step 1 scores were equivalent for both ranked (250 vs. 250, p = 0.81) and matched (250 vs. 249, p = 0.32) applicants before and after the intervention. The median ABSITE scores for the matched intern classes was lower after initiation of holistic review (519 vs. 483, p = 0.01). However, these scores were consistently above the national medians and subgroup analysis showed no difference between the median aggregate ABSITE scores for UIM and female categorical interns and non-UIM males (475 vs. 520, p = 0.09). CONCLUSIONS Increasing emphasis is being placed on the diversification of residency training to reflect an expanding, diverse patient population. The incorporation of a holistic review process, providing broader assessment of applicants, can play a pivotal role in increasing the proportion of women and UIM students represented in the general surgery recruitment process.
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Affiliation(s)
- Ariel Nehemiah
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Sanford E Roberts
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Yun Song
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Rachel R Kelz
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Surgery, Center for Surgery and Health Economics, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Paris D Butler
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Jon B Morris
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Cary B Aarons
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
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Henderson RI, Walker I, Myhre D, Ward R, Crowshoe L(L. An equity-oriented admissions model for Indigenous student recruitment in an undergraduate medical education program. CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:e94-e99. [PMID: 33995726 PMCID: PMC8105575 DOI: 10.36834/cmej.68215] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND With the 2015 publication of the Truth and Reconciliation Commission of Canada's calls to action, health professional schools are left grappling with how to increase the recruitment and success of Indigenous learners. Efforts to diversify trainee pools have long looked to quota-based approaches to recruit students from underserved communities, though such approaches pose dilemmas around meaningfully dismantling structural barriers to health professional education. Lessons shared here from developing one multi-layered admissions strategy highlight the importance of equity-rather than equality-in any recruitment for learners from medically underserved communities. SUMMARY The promotion of fairness in the recruitment of future practitioners is not just a question of equalizing access to, in this case, medical school; it involves recognizing the wider social and structural mechanisms that enable privileged access to the medical profession by members of dominant society. This recognition compels a shift in focus beyond merely giving the disadvantaged increased access to an unfair system, towards building tools to address deeper questions about what is meant by the kind of excellence expected of applicants, how it is to be measured, and to what extent these recruits may contribute to improved care for the communities from which they come. CONCLUSION Equity-based approaches to student recruitment move health professional schools beyond the dilemma of recruiting students from marginalized backgrounds who happen to be most similar to the dominant student population. Achieving this requires a complex view of the target population, recognizing that disadvantage is experienced in many diverse ways, that barriers are encountered along a spectrum of access, and that equity may only emerge when a critically, socially conscious approach is embedded throughout institutional practices.
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Affiliation(s)
- Rita Isabel Henderson
- Cumming School of Medicine, University of Calgary, Alberta, Canada
- Correspondence to: Rita Isabel Henderson, PhD; Family Medicine & Primary Care Research Office, Cumming School of Medicine, University of Calgary, G012, Health Sciences Centre, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1;
| | - Ian Walker
- Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Douglas Myhre
- Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Rachel Ward
- Cumming School of Medicine, University of Calgary, Alberta, Canada
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Schnapp BH, Alvarez A, Bianchi R, Caretta‐Weyer H, Jewell C, Kalantari A, Lee E, Miller D, Quinn A. Curated collection for clinician educators: Six key papers on residency recruitment. AEM EDUCATION AND TRAINING 2021; 5:e10597. [PMID: 33969251 PMCID: PMC8086575 DOI: 10.1002/aet2.10597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/19/2021] [Accepted: 03/08/2021] [Indexed: 05/23/2023]
Abstract
INTRODUCTION All emergency medicine (EM) residency programs must recruit new medical school graduates each year. The process is often overwhelming, with each program receiving far more applicants than available positions. We searched for evidence-based best practices to guide residency programs in screening, interviewing, and ranking applicants to ensure a high-performing and diverse residency class. METHODS A literature search was conducted on the topic of residency recruitment, utilizing a call on social media as well as multiple databases. After identifying relevant articles, we performed a modified Delphi process in three rounds, utilizing junior educators as well as more senior faculty. RESULTS We identified 51 relevant articles on the topic of residency recruitment. The Delphi process yielded six articles that were deemed most highly relevant over the three rounds. Transparency with selection criteria, holistic application review, standardized letters of evaluation, and blinding applicant files for interviewers were among noted best practices. CONCLUSIONS Well-supported evidence-based practices exist for residency recruitment, and programs may benefit from understanding which common recruitment practices offer the most value. The articles discussed here provide a foundation for faculty looking to improve their program's recruiting practices.
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Affiliation(s)
| | - Al’ai Alvarez
- Department of Emergency MedicineStanford UniversityStanfordCaliforniaUSA
| | - Riccardo Bianchi
- Department of Physiology and PharmacologySUNY Downstate Health Sciences UniversityNew YorkNew YorkUSA
| | | | - Corlin Jewell
- Department of Emergency MedicineUniversity of WisconsinMadisonWisconsinUSA
| | - Annahieta Kalantari
- Department of Emergency MedicineMilton S Hershey Medical CenterPenn State HealthHersheyPennsylvaniaUSA
| | - Eric Lee
- Department of Emergency MedicineMaimonides Medical CenterBrooklynNew YorkUSA
| | - Danielle Miller
- Department of Emergency MedicineStanford UniversityStanfordCaliforniaUSA
| | - Antonia Quinn
- SUNY Downstate Health SciencesUniversity College of MedicineNew YorkNew YorkUSA
- Department of Emergency MedicineSUNY DownstateBrooklynNew YorkUSA
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Capers Q, Johnson A, Berlacher K, Douglas PS. The Urgent and Ongoing Need for Diversity, Inclusion, and Equity in the Cardiology Workforce in the United States. J Am Heart Assoc 2021; 10:e018893. [PMID: 33686869 PMCID: PMC8174214 DOI: 10.1161/jaha.120.018893] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Quinn Capers
- Department of Medicine The Ohio State University Columbus OH.,Department of Internal Medicine University of Texas-Southwestern Dallas TX
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Is There Color or Sex Behind the Mask and Sterile Blue? Examining Sex and Racial Demographics Within Academic Surgery. Ann Surg 2021; 273:21-27. [PMID: 32956175 DOI: 10.1097/sla.0000000000004461] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The lack of underrepresented minorities has been a persistent issue within the surgical workforce. Equal sex representation has also been a problem in surgery. Underrepresented minorities females face the unique challenge of being a minority in both race and sex. OBJECTIVE The objective of this retrospective cross-sectional study is to determine the racial and sex demographics of medical trainees and faculty and determine the degree to which minority women are underrepresented at higher ranks and leadership. METHODS Race and sex demographic data for all medical students, surgical residents and faculty was extracted from the AAMC data files. This data was compared to the US population using chi squared tests. Race and sex breakdowns of the different surgical subspecialties was also analyzed using chi squared tests. Demographics of surgical faculty at various ranks are also reported. RESULTS White men made up 37% of all surgical residents. Black men made up only 1.9% of all surgical residents whereas Black women made up 2.6%. The subspecialty with the smallest percentage of Black women was Orthopedic Surgery with 0.6%. The specialty with the highest representation of Black women was Ob/Gyn with 6.2%. There was a decrease in representation of Black women with each increase in professional rank, with 2.8%, 1.6%, and 0.7% for assistant, associate, and full professor, respectively, as compared to Black men, who as a percentage, remained stable at the various ranks with 2.1%, 2.4%, and 2.1% for assistant, associate, and full professor, respectively. CONCLUSIONS There is a striking lack of minority women in surgery. This trend is amplified as surgeons progress from student, to resident, to attending, and then to leadership positions.
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Blamoun J, Hakemi A, Armstead T. Perspectives on Transitioning Step 1 of the United States Medical Licensing Examination to a Pass/Fail Scoring Model: Defining New Frameworks for Medical Students Applying for Residency. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:149-154. [PMID: 33603533 PMCID: PMC7886099 DOI: 10.2147/amep.s296286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/23/2021] [Indexed: 06/12/2023]
Abstract
For years, the USMLE Step 1 has acted as an unofficial "concours" for medical students applying to residency positions in the United States. The three-digit numeric score has been used to rank thousands of applicants without any evidence of validity. The USMLE will soon change score reporting to a pass/fail outcome. The main reason given was to address the concerns about its effects on the well-being of the students and medical education. It is argued that time for change has come. The authors discuss the various viewpoints of the stakeholders and the effects of this change on applicants and potential changes on the undergraduate medical curriculum. Furthermore, this article discusses several metrics that can be utilized in the application process in lieu of the USMLE Step 1. Additionally, some novel key metrics in the application process are identified, and their unique dynamic and adaptive characteristics are deliberated. Finally, the benefits of a transparent and holistic process are strongly advocated.
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Affiliation(s)
- John Blamoun
- Central Michigan University, College of Medicine, Mt Pleasant, MI, 48859, USA
- Physician Assistant Program, MidMichigan Health, Midland, MI, 48670, USA
| | - Ahmad Hakemi
- Central Michigan University, College of Health Professions, Mt Pleasant, MI, 48859, USA
| | - Teresa Armstead
- Central Michigan University, College of Education and Human Services, Mt Pleasant, MI, 48859, USA
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Hauer KE, Giang D, Kapp ME, Sterling R. Standardization in the MSPE: Key Tensions for Learners, Schools, and Residency Programs. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:44-49. [PMID: 32167965 DOI: 10.1097/acm.0000000000003290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The Medical Student Performance Evaluation (MSPE), which summarizes a medical student's academic and professional undergraduate medical education performance and provides salient information during the residency selection process, faces persistent criticisms regarding heterogeneity and obscurity. Specifically, MSPEs do not always provide the same type or amount of information about students, especially from diverse schools, and important information is not always easy to find or interpret. To address these concerns, a key guiding principle from the Recommendations for Revising the MSPE Task Force of the Association of American Medical Colleges (AAMC) was to achieve "a level of standardization and transparency that facilitates the residency selection process." Benefits of standardizing the MSPE format include clarification of performance benchmarks or metrics, consistency across schools to enhance readability, and improved quality. In medical education, standardization may be an important mechanism to ensure accountability of the system for all learners, including those with varied backgrounds and socioeconomic resources. In this article, members of the aforementioned AAMC MSPE task force explore 5 tensions inherent in the pursuit of standardizing the MSPE: (1) presenting each student's individual characteristics and strengths in a way that is relevant, while also working with a standard format and providing standard content; (2) showcasing school-specific curricular strengths while also demonstrating standard evidence of readiness for internship; (3) defining and achieving the right amount of standardization so that the MSPE provides useful information, adds value to the residency selection process, and is efficient to read and understand; (4) balancing reporting with advocacy; and (5) maintaining standardization over time, especially given the tendency for the MSPE format and content to drift. Ongoing efforts to promote collaboration and trust across the undergraduate to graduate medical education continuum offer promise to reconcile these tensions and promote successful educational outcomes.
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Affiliation(s)
- Karen E Hauer
- K.E. Hauer is associate dean, Assessment, and professor, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0002-8812-4045
| | - Daniel Giang
- D. Giang is associate dean, Graduate Medical Education, and professor, Department of Neurology, Loma Linda University, Loma Linda, California
| | - Meghan E Kapp
- M.E. Kapp is assistant professor, Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee; ORCID: https://orcid.org/0000-0002-0252-3919
| | - Robert Sterling
- R. Sterling is associate professor, Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; ORCID: https://orcid.org/0000-0003-2963-3162
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Daboub JA, Bergemann AD, Smith SR. Rethinking an Admissions Program to Align with the Mission of an Innovative Medical School. MEDICAL SCIENCE EDUCATOR 2020; 30:1655-1659. [PMID: 33052262 PMCID: PMC7544400 DOI: 10.1007/s40670-020-01084-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/21/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Joel A. Daboub
- Department of Medical Education, Dell Medical School, University of Texas at Austin, 1501 Red River Street, Austin, TX 78712 USA
| | - Andrew D. Bergemann
- Department of Medical Education, Dell Medical School, University of Texas at Austin, 1501 Red River Street, Austin, TX 78712 USA
| | - Stephen R. Smith
- Department of Medical Education, Dell Medical School, University of Texas at Austin, 1501 Red River Street, Austin, TX 78712 USA
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Lucey CR, Hauer KE, Boatright D, Fernandez A. Medical Education's Wicked Problem: Achieving Equity in Assessment for Medical Learners. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:S98-S108. [PMID: 32889943 DOI: 10.1097/acm.0000000000003717] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Despite a lack of intent to discriminate, physicians educated in U.S. medical schools and residency programs often take actions that systematically disadvantage minority patients. The approach to assessment of learner performance in medical education can similarly disadvantage minority learners. The adoption of holistic admissions strategies to increase the diversity of medical training programs has not been accompanied by increases in diversity in honor societies, selective residency programs, medical specialties, and medical school faculty. These observations prompt justified concerns about structural and interpersonal bias in assessment. This manuscript characterizes equity in assessment as a "wicked problem" with inherent conflicts, uncertainty, dynamic tensions, and susceptibility to contextual influences. The authors review the underlying individual and structural causes of inequity in assessment. Using an organizational model, they propose strategies to achieve equity in assessment and drive institutional and systemic improvement based on clearly articulated principles. This model addresses the culture, systems, and assessment tools necessary to achieve equitable results that reflect stated principles. Three components of equity in assessment that can be measured and evaluated to confirm success include intrinsic equity (selection and design of assessment tools), contextual equity (the learning environment in which assessment occurs), and instrumental equity (uses of assessment data for learner advancement and selection and program evaluation). A research agenda to address these challenges and controversies and demonstrate reduction in bias and discrimination in medical education is presented.
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Affiliation(s)
- Catherine R Lucey
- C.R. Lucey is executive vice dean/vice dean for education and professor of medicine, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Karen E Hauer
- K.E. Hauer is professor of medicine, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Dowin Boatright
- D. Boatright is assistant professor of emergency medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Alicia Fernandez
- A. Fernandez is professor of medicine, University of California, San Francisco, School of Medicine, San Francisco, California
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Jindal M, Heard-Garris N, Empey A, Perrin EC, Zuckerman KE, Johnson TJ. Getting "Our House" in Order: Re-Building Academic Pediatrics by Dismantling the Anti-Black Racist Foundation. Acad Pediatr 2020; 20:1044-1050. [PMID: 32891802 DOI: 10.1016/j.acap.2020.08.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/26/2020] [Accepted: 08/30/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Monique Jindal
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins School of Medicine (M Jindal), Baltimore, Md.
| | - Nia Heard-Garris
- Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine (N Heard-Garris), Chicago, Ill; Mary Ann & J. Milburn Smith Child Health Outreach, Research, and Advocacy Center, Stanley Manne Children's Research Institute, Ann and Robert H. Lurie Children's Hospital of Chicago (N Heard-Garris), Chicago, Ill
| | - Allison Empey
- Division of General Pediatrics, Department of Pediatrics, Oregon Health & Science University (A Empey and KE Zuckerman), Portland, Ore
| | - Ellen C Perrin
- Division of Developmental-Behavioral Pediatrics, Floating Hospital for Children, Tufts Medical Center (EC Perrin), Boston, Mass
| | - Katharine E Zuckerman
- Division of General Pediatrics, Department of Pediatrics, Oregon Health & Science University (A Empey and KE Zuckerman), Portland, Ore
| | - Tiffani J Johnson
- Department of Emergency Medicine, University of California, Davis (TJ Johnson), Sacramento, Calif
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Anderson N, Boatright D, Reisman A. Blackface in White Space: Using Admissions to Address Racism in Medical Education. J Gen Intern Med 2020; 35:3060-3062. [PMID: 32728961 PMCID: PMC7573045 DOI: 10.1007/s11606-020-06079-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/17/2020] [Indexed: 11/28/2022]
Abstract
Given the long history and pervasive nature of racism in medical culture, this essay argues that diversifying efforts alone cannot address systemic racism in medical education. Positive affirmation of anti-racist values and racial consciousness in the admissions process is necessary to create a truly inclusive culture in medical education and begin to undo centuries of racial prejudice in medicine. Drawing from historic examples, scholarship on the sociology of racialized space, recent research on race and medical education, and personal experience, we propose that medical educational institutions make a more concerted effort to consider racial attitudes and awareness as part of the admissions process as well as curricular reform efforts. We also provide examples of potential ways to practically implement this proposal in the admissions process.
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Affiliation(s)
- Nientara Anderson
- Yale School of Medicine Department of Psychiatry, , 300 George Street, Suite 901, New Haven, CT, 06511, USA.
| | - Dowin Boatright
- Yale School of Medicine Department of Psychiatry, , 300 George Street, Suite 901, New Haven, CT, 06511, USA
| | - Anna Reisman
- Yale School of Medicine Department of Psychiatry, , 300 George Street, Suite 901, New Haven, CT, 06511, USA
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Schreurs S, Cleutjens KB, Cleland J, oude Egbrink MG. Outcomes-Based Selection Into Medical School: Predicting Excellence in Multiple Competencies During the Clinical Years. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:1411-1420. [PMID: 32134790 PMCID: PMC7447174 DOI: 10.1097/acm.0000000000003279] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
PURPOSE Medical school selection committees aim to identify the best possible students and, ultimately, the best future doctors from a large, well-qualified, generally homogeneous pool of applicants. Constructive alignment of medical school selection, curricula, and assessment with the ultimate outcomes (e.g., CanMEDS roles) has been proposed as means to attain this goal. Whether this approach is effective has not yet been established. The authors addressed this gap by assessing the relationship between performance in an outcomes-based selection procedure and performance during the clinical years of medical school. METHOD Two groups of students were compared: (1) those admitted into Maastricht University Medical School via an outcomes-based selection procedure and (2) those rejected through this procedure who were admitted into the program through a national, grade-point-average-based lottery. The authors compared performance scores of students from the 2 groups on all 7 CanMEDS roles, using assessment data gathered during clinical rotations. The authors examined data from 3 cohorts (2011-2013). RESULTS Students admitted through the local, outcomes-based selection procedure significantly outperformed the initially rejected but lottery-admitted students in all years, and the differences between groups increased over time. The selected students performed significantly better in the CanMEDS roles of Communicator, Collaborator, and Professional in the first year of clinical rotations; in these 3 roles-plus Organizer-in the second year; and in 2 additional roles (Advocate and Scholar-all except Medical Expert) at the end of their clinical training. CONCLUSIONS A constructively aligned selection procedure has increasing predictive value across the clinical years of medical school compared with a GPA-based lottery procedure. The data reported here suggest that constructive alignment of selection, curricula, and assessment to ultimate outcomes is effective in creating a selection procedure predictive of clinical performance.
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Affiliation(s)
- Sanne Schreurs
- S. Schreurs is teacher/educational advisor, Department of Educational Development and Research, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0002-0233-9775
| | - Kitty B.J.M. Cleutjens
- K.B.J.M. Cleutjens is associate professor, Department of Pathology, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0002-7870-1670
| | - Jennifer Cleland
- J. Cleland is full professor and John Simpson Chair of Medical Education Research, Centre for Healthcare Education Research and Innovation (CHERI), University of Aberdeen, Aberdeen, Scotland; ORCID: http://orcid.org/0000-0003-1433-9323
| | - Mirjam G.A. oude Egbrink
- M.G.A. oude Egbrink is full professor, Implementation of Educational Innovations, Department of Physiology, School of Health Professions Education, and scientific director, Institute for Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0002-5530-6598
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Duvernoy CS, Capers Q. The Accreditation Council for Graduate Medical Education Mandates That You Attempt to Enhance Diversity in Your Cardiology Program: Great! (How Do We Do That?). Circ Cardiovasc Qual Outcomes 2020; 13:e006912. [PMID: 32552014 DOI: 10.1161/circoutcomes.120.006912] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Claire S Duvernoy
- VA Ann Arbor Healthcare System and University of Michigan Medical School Department of Internal Medicine, Division of Cardiovascular Medicine (C.S.D.)
| | - Quinn Capers
- VA Ann Arbor Healthcare System and University of Michigan Medical School Department of Internal Medicine, Division of Cardiovascular Medicine (C.S.D.)
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DeBenedectis CM, Heitkamp DE, England E, Gaviola GC, Hirsch JA, Ho CP, Jay AK, Kagetsu N, Kalia V, Milburn J, Ong S, Paladin AM, Patel MD, Swanson J, Sarkany DS. A Program Director's Guide to Cultivating Diversity and Inclusion in Radiology Residency Recruitment. Acad Radiol 2020; 27:864-867. [PMID: 31473056 DOI: 10.1016/j.acra.2019.07.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 07/22/2019] [Accepted: 07/29/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Carolynn M DeBenedectis
- Department of Radiology, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655.
| | | | - Eric England
- University of Cincinnati Medical Center, Cincinnati, Ohio
| | | | - Joshua A Hirsch
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Ann K Jay
- MedStar Georgetown University Hospital, Washington, District of Columbia
| | | | - Vivek Kalia
- Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
| | - James Milburn
- Department of Radiology, Ochsner Clinic Foundation, New Orleans, Louisiana
| | - Seng Ong
- University of Chicago/Comer Children's Hospital, Chicago, Illinois
| | | | - Maitray D Patel
- Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona
| | | | - David S Sarkany
- Department of Radiology, Zucker School of Medicine at Hofstra Northwell, Staten Island University Hospital Northwell Health, Staten Island, New York
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Piggott DA, Cariaga-Lo L. Promoting Inclusion, Diversity, Access, and Equity Through Enhanced Institutional Culture and Climate. J Infect Dis 2020; 220:S74-S81. [PMID: 31430385 DOI: 10.1093/infdis/jiz186] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Advancing the health of all members of the global community remains core to the mission of the infectious diseases profession. Training, research, healthcare-delivery, and other infectious diseases-related institutions play a central role in meeting this goal. The promotion of inclusion, diversity, access, and equity (IDA&E) is critical to harnessing the full range of human creativity, innovation, and talent necessary to realizing the education, research, patient care, and service missions that constitute the principal objectives of such institutions. Strong and positive institutional cultures and climates are essential to achieving these IDA&E goals. We discuss opportunity gaps that exist in leveraging institutional culture and climate to optimize IDA&E. We further identify effective strategies to address these gaps and achieve excellence in education, research, patient care, and service in infectious diseases and the broader healthcare and biomedical space. We discuss the importance of both local and global context in conceptualizing IDA&E to best achieve these aims.
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Affiliation(s)
- Damani A Piggott
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Liza Cariaga-Lo
- Department of Education, Brown University, Providence, Rhode Island
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Isaq NA, Bowers S, Chen ST. Taking a "step" toward diversity in dermatology: De-emphasizing USMLE Step 1 scores in residency applications. Int J Womens Dermatol 2020; 6:209-210. [PMID: 32637547 PMCID: PMC7330438 DOI: 10.1016/j.ijwd.2020.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/28/2020] [Accepted: 02/27/2020] [Indexed: 10/31/2022] Open
Affiliation(s)
- Nasro A Isaq
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Sacharitha Bowers
- Southern Illinois University School of Medicine, Department of Medicine, Division of Dermatology, Springfield, IL, United States
| | - Steven T Chen
- Harvard Medical School, Boston, MA, United States.,Massachusetts General Hospital, Department of Dermatology, 50 Staniford St, 2nd Floor, Boston, MA, United States
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