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Sechrist S, Margol V, Martinez A. Redefining the term "Disadvantaged student": A post baccalaureate program's role in underrepresented students' success and reclaiming of narratives. J Natl Med Assoc 2024; 116:309-319. [PMID: 38816265 DOI: 10.1016/j.jnma.2024.05.004] [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: 08/31/2023] [Revised: 01/31/2024] [Accepted: 05/08/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE Racial/ethnic minority groups and low-income students continue to be underrepresented in medicine (URiM) despite years of diversity and inclusion efforts. Post baccalaureate programs (PBP) are shown to prepare underrepresented students to successfully matriculate to medical school. However, identification of the aspects of a PBP that are key to future success in medicine from the student perspective is lacking. Therefore, this study was designed to answer the question, "What aspects of a post baccalaureate program do URiM students see as valuable to their future success?" METHODS This is a qualitative analysis of semi-structured interviews with alumni of the UCSF PBP who completed the program between 2015-2020. Interviews were conducted via phone or video call, audio recorded, and transcribed verbatim. Names and years of attendance were removed from the transcripts prior to review to protect confidentiality. Transcripts were coded following an inductive qualitative approach using methodology rooted in grounded theory. Demographic data was collected upon enrollment in the program. RESULTS Forty study participants were interviewed (58% of eligible subjects). Participants self-identified as Latinx (70%), African American (8%), Southeast Asian (10%), Native American (2%), Multiethnic (10%), and 60% female. The average age at enrollment was 24 years. Most participants (75%) were first-generation college students and 85% grew up with a family income <$49,999. Qualitative findings were categorized into five main themes: (1) Academic, Professional, and Personal Skills Development, (2) Supportive Student Cohort, (3) Resources, Personalized Advising, and Mentorship, (4) Gaining Confidence and a Sense of Belonging in Medicine, and (5) Redefining "Disadvantaged" Status. A novel finding was the importance of redefining the narrative of belonging to a "disadvantaged" community. During the program, the study participants reported gaining confidence and a sense of belonging in medicine as they recognized the unique qualifications and advantages they bring to medicine. CONCLUSIONS Our findings suggest that in addition to academic preparation, PBPs for students who are underrepresented in medicine should empower students to recognize their strengths and qualifications in the field of medicine. Our study participants rejected the term "disadvantaged" as they celebrated the value of their backgrounds and what they bring to medicine.
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Affiliation(s)
- Samantha Sechrist
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Valerie Margol
- Post Baccalaureate & Outreach Programs, University of California San Francisco, San Francisco, California, USA
| | - Alma Martinez
- Post Baccalaureate & Outreach Programs, University of California San Francisco, San Francisco, California, USA; Department of Pediatrics, University of California San Francisco, San Francisco, California, USA.
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Mason HRC, Ata A, Nguyen M, Nakae S, Chakraverty D, Eggan B, Martinez S, Jeffe DB. First-generation and continuing-generation college graduates' application, acceptance, and matriculation to U.S. medical schools: a national cohort study. MEDICAL EDUCATION ONLINE 2022; 27:2010291. [PMID: 34898403 PMCID: PMC8676688 DOI: 10.1080/10872981.2021.2010291] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/10/2021] [Accepted: 11/20/2021] [Indexed: 06/13/2023]
Abstract
Many U.S. medical schools conduct holistic review of applicants to enhance the socioeconomic and experiential diversity of the physician workforce. The authors examined the role of first-generation college-graduate status on U.S. medical school application, acceptance, and matriculation, hypothesizing that first-generation (vs. continuing-generation) college graduates would be less likely to apply and gain acceptance to medical school.Secondary analysis of de-identified data from a retrospective national-cohort study was conducted for individuals who completed the 2001-2006 Association of American Medical Colleges (AAMC) Pre-Medical College Admission Test Questionnaire (PMQ) and the Medical College Admissions Test (MCAT). AAMC provided medical school application, acceptance, and matriculation data through 06/09/2013. Multivariable logistic regression models identified demographic, academic, and experiential variables independently associated with each outcome and differences between first-generation and continuing-generation students. Of 262,813 PMQ respondents, 211,216 (80.4%) MCAT examinees had complete data for analysis and 24.8% self-identified as first-generation college graduates. Of these, 142,847 (67.6%) applied to U.S. MD-degree-granting medical schools, of whom 86,486 (60.5%) were accepted, including 14,708 (17.0%) first-generation graduates; 84,844 (98.1%) acceptees matriculated. Adjusting for all variables, first-generation (vs. continuing-generation) college graduates were less likely to apply (odds ratio [aOR] 0.84; 95% confidence interval [CI], 0.82-0.86) and be accepted (aOR 0.86; 95% CI, 0.83-0.88) to medical school; accepted first-generation college graduates were as likely as their continuing-generation peers to matriculate. Students with (vs. without) paid work experience outside hospitals/labs/clinics were less likely to apply, be accepted, and matriculate into medical school. Increased efforts to mitigate structural socioeconomic vulnerabilities that may prevent first-generation college students from applying to medical school are needed. Expanded use of holistic review admissions practices may help decision makers value the strengths first-generation college graduates and other underrepresented applicants bring to medical educationand the physician workforce.
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Affiliation(s)
- Hyacinth R. C. Mason
- Department of Medical Education Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Ashar Ata
- Department of Surgery and Emergency Medicine, Albany Medical Center, Albany, New York, USA
| | - Mytien Nguyen
- Yale University, School of Medicine, New Haven, Connecticut, USA
| | - Sunny Nakae
- Medical Education, California University of Science and Medicine, Colton, California, USA
| | - Devasmita Chakraverty
- Ravi J. Matthai Centre for Educational Innovation, Indian Institute of Management Ahmedabad, Ahmedabad, India
| | - Branden Eggan
- Department of Nursing, Siena College, Loudonville, New York, USA
| | | | - Donna B. Jeffe
- Department of Medicine, Director, Medical Education Research Unit, Office of Education, Washington University School of Medicine, St. Louis, Missouri, USA
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VanderMeulen S, Hills K, Snyder JA, Kohlhepp W, Alexander LM, Bowser J, Lane S. Reflections on a Physician Assistant Entrance Exam: Does the Profession Need One? J Physician Assist Educ 2021; 32:20-25. [PMID: 33605685 DOI: 10.1097/jpa.0000000000000343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Standardized entrance exams are used in many health professions as one way to objectively measure knowledge and facilitate comparisons across student groups. The physician assistant (PA) profession has historically not employed a profession-specific entrance exam, and the idea was never seriously explored until the Physician Assistant College Admissions Test was developed recently by a commercial assessment publisher, with field testing in some volunteer programs in 2018 and the exam's first administration in May of 2020. The 2020 Physician Assistant Education Association Presidents Commission chose to investigate the issues raised by a consensus-derived, PA-specific entrance exam to stimulate more informed discussion on the efficacy of such an exam. While it may have the potential to enhance efficiency in PA admissions and reduce variability in admissions requirements, a PA entrance exam would also likely introduce new challenges, including increased costs, impact on the diversity of the applicant pool, and incongruence with an increasingly holistic admissions process. The biggest barrier would likely be the lack of current consensus on the knowledge, skills, and attributes that matriculants need to be successful in the program and in clinical practice. Development of a consensus-derived PA entrance exam would be a complex, expensive, and time-consuming endeavor, requiring considerable attention to technical issues of psychometric quality, process transparency, and legal defensibility. Changes being made to health professions admissions practices due to the COVID-19 pandemic, including the dropping of test scores as a requirement by some institutions, may make some of the issues raised in this paper more timely than ever.
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Affiliation(s)
- Stephane VanderMeulen
- Stephane VanderMeulen, MPAS, PA-C, is an associate professor and program director for the Physician Assistant Program at the Creighton University School of Medicine, Omaha, Nebraska
- Karen Hills, MS, PA-C, is chief of educational development for the Physician Assistant Education Association, Washington, DC
- Jennifer A. Snyder, PhD, PA-C, is a professor in the College of Pharmacy and Health Sciences at Butler University, Indianapolis, Indiana
- William Kohlhepp, DHSc, MHA, PA-C, is a professor emeritus of Physician Assistant Studies at Quinnipiac University, Hamden, Connecticut
- Lisa Mustone Alexander, EdD, MPH, PA-C, is the program director for Physician Associate Studies at the Royal College of Surgeons, Dublin, Ireland
- Jonathan Bowser, MS, PA-C, is the program director for the Physician Assistant Program at the University of Colorado, Aurora, Colorado
- Steven Lane, MA, MPP, is senior director of strategic communications for the Physician Assistant Education Association, Washington, DC
| | - Karen Hills
- Stephane VanderMeulen, MPAS, PA-C, is an associate professor and program director for the Physician Assistant Program at the Creighton University School of Medicine, Omaha, Nebraska
- Karen Hills, MS, PA-C, is chief of educational development for the Physician Assistant Education Association, Washington, DC
- Jennifer A. Snyder, PhD, PA-C, is a professor in the College of Pharmacy and Health Sciences at Butler University, Indianapolis, Indiana
- William Kohlhepp, DHSc, MHA, PA-C, is a professor emeritus of Physician Assistant Studies at Quinnipiac University, Hamden, Connecticut
- Lisa Mustone Alexander, EdD, MPH, PA-C, is the program director for Physician Associate Studies at the Royal College of Surgeons, Dublin, Ireland
- Jonathan Bowser, MS, PA-C, is the program director for the Physician Assistant Program at the University of Colorado, Aurora, Colorado
- Steven Lane, MA, MPP, is senior director of strategic communications for the Physician Assistant Education Association, Washington, DC
| | - Jennifer A Snyder
- Stephane VanderMeulen, MPAS, PA-C, is an associate professor and program director for the Physician Assistant Program at the Creighton University School of Medicine, Omaha, Nebraska
- Karen Hills, MS, PA-C, is chief of educational development for the Physician Assistant Education Association, Washington, DC
- Jennifer A. Snyder, PhD, PA-C, is a professor in the College of Pharmacy and Health Sciences at Butler University, Indianapolis, Indiana
- William Kohlhepp, DHSc, MHA, PA-C, is a professor emeritus of Physician Assistant Studies at Quinnipiac University, Hamden, Connecticut
- Lisa Mustone Alexander, EdD, MPH, PA-C, is the program director for Physician Associate Studies at the Royal College of Surgeons, Dublin, Ireland
- Jonathan Bowser, MS, PA-C, is the program director for the Physician Assistant Program at the University of Colorado, Aurora, Colorado
- Steven Lane, MA, MPP, is senior director of strategic communications for the Physician Assistant Education Association, Washington, DC
| | - William Kohlhepp
- Stephane VanderMeulen, MPAS, PA-C, is an associate professor and program director for the Physician Assistant Program at the Creighton University School of Medicine, Omaha, Nebraska
- Karen Hills, MS, PA-C, is chief of educational development for the Physician Assistant Education Association, Washington, DC
- Jennifer A. Snyder, PhD, PA-C, is a professor in the College of Pharmacy and Health Sciences at Butler University, Indianapolis, Indiana
- William Kohlhepp, DHSc, MHA, PA-C, is a professor emeritus of Physician Assistant Studies at Quinnipiac University, Hamden, Connecticut
- Lisa Mustone Alexander, EdD, MPH, PA-C, is the program director for Physician Associate Studies at the Royal College of Surgeons, Dublin, Ireland
- Jonathan Bowser, MS, PA-C, is the program director for the Physician Assistant Program at the University of Colorado, Aurora, Colorado
- Steven Lane, MA, MPP, is senior director of strategic communications for the Physician Assistant Education Association, Washington, DC
| | - Lisa Mustone Alexander
- Stephane VanderMeulen, MPAS, PA-C, is an associate professor and program director for the Physician Assistant Program at the Creighton University School of Medicine, Omaha, Nebraska
- Karen Hills, MS, PA-C, is chief of educational development for the Physician Assistant Education Association, Washington, DC
- Jennifer A. Snyder, PhD, PA-C, is a professor in the College of Pharmacy and Health Sciences at Butler University, Indianapolis, Indiana
- William Kohlhepp, DHSc, MHA, PA-C, is a professor emeritus of Physician Assistant Studies at Quinnipiac University, Hamden, Connecticut
- Lisa Mustone Alexander, EdD, MPH, PA-C, is the program director for Physician Associate Studies at the Royal College of Surgeons, Dublin, Ireland
- Jonathan Bowser, MS, PA-C, is the program director for the Physician Assistant Program at the University of Colorado, Aurora, Colorado
- Steven Lane, MA, MPP, is senior director of strategic communications for the Physician Assistant Education Association, Washington, DC
| | - Jonathan Bowser
- Stephane VanderMeulen, MPAS, PA-C, is an associate professor and program director for the Physician Assistant Program at the Creighton University School of Medicine, Omaha, Nebraska
- Karen Hills, MS, PA-C, is chief of educational development for the Physician Assistant Education Association, Washington, DC
- Jennifer A. Snyder, PhD, PA-C, is a professor in the College of Pharmacy and Health Sciences at Butler University, Indianapolis, Indiana
- William Kohlhepp, DHSc, MHA, PA-C, is a professor emeritus of Physician Assistant Studies at Quinnipiac University, Hamden, Connecticut
- Lisa Mustone Alexander, EdD, MPH, PA-C, is the program director for Physician Associate Studies at the Royal College of Surgeons, Dublin, Ireland
- Jonathan Bowser, MS, PA-C, is the program director for the Physician Assistant Program at the University of Colorado, Aurora, Colorado
- Steven Lane, MA, MPP, is senior director of strategic communications for the Physician Assistant Education Association, Washington, DC
| | - Steven Lane
- Stephane VanderMeulen, MPAS, PA-C, is an associate professor and program director for the Physician Assistant Program at the Creighton University School of Medicine, Omaha, Nebraska
- Karen Hills, MS, PA-C, is chief of educational development for the Physician Assistant Education Association, Washington, DC
- Jennifer A. Snyder, PhD, PA-C, is a professor in the College of Pharmacy and Health Sciences at Butler University, Indianapolis, Indiana
- William Kohlhepp, DHSc, MHA, PA-C, is a professor emeritus of Physician Assistant Studies at Quinnipiac University, Hamden, Connecticut
- Lisa Mustone Alexander, EdD, MPH, PA-C, is the program director for Physician Associate Studies at the Royal College of Surgeons, Dublin, Ireland
- Jonathan Bowser, MS, PA-C, is the program director for the Physician Assistant Program at the University of Colorado, Aurora, Colorado
- Steven Lane, MA, MPP, is senior director of strategic communications for the Physician Assistant Education Association, Washington, DC
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