MEDPREP--30 years of making a difference.

The Medical/Dental Education Preparatory Program (MEDPREP) of Southern Illinois University School of Medicine has served over 1000 educationally or economically disadvantaged students since its inception in 1972. Seventy-eight percent of the former students (95% of the current students) are members of AAMC-defined underrepresented minority groups (URMs). Over the course of its 30-year history, 68% of the students have been accepted to professional schools, with 92% being accepted to medical schools and attending 90 different medical schools in the country. Of those accepted to professional schools, 87% have graduated or are expected to graduate. MEDPREP has had this impact on the profession by staying true to its original mission, assisting minority students and other students with disadvantaged backgrounds to prepare for admission and success in medical school. MEDPREP is an environment of high expectations, teamwork, personal growth, and opportunities to achieve goals. Students are served by an advisor who helps structure an individualized curriculum designed to develop a knowledge base and learning and reasoning skills. The success of the program is due to the school's commitment and support, the faculty who serve the students, and the sacrifice and hard work of the MEDPREP students.     

Blueprint for establishing an effective Postbaccalaureate medical school pre-entry program for educationally disadvantaged students.

The purpose of this article is to provide public and private medical schools with a pragmatic blueprint for the development and implementation of an effective medical school pre-entry program that increases the pool of students interested in returning to health care shortage areas. An ancillary benefit of this program is an increase in the number of underrepresented minority students to medical schools. The structure, experiences, and results of the University of California, Davis, School of Medicine's Postbaccalaureate Reapplicant Program are used as a case study to construct the blueprint for returning 85-90% of program participants to shortage areas while increasing minority student admissions. The UC Davis program has been in place since 1991 and post-program acceptance rates have varied from 57% to 100% with an overall acceptance rate of 90.4% through 1999-00. Of 115 participating students who had previously been rejected by medical schools, 104 were accepted to health professional programs: 95 students were accepted to major U.S. medical schools and nine were accepted to masters in public health programs, physician's assistant programs, and one international medical school. This success rate has been achieved through a combination of intense assistance in study skills and test-taking skills, academic course work, and academic and pre-professional counseling.     

Examining the Gap Between Medical School Matriculation and Graduation Rates Amongst Self-Identified Minorities

PurposeDespite increasing diversity, data indicates that there is a gap between the matriculation or admission of and graduation rates amongst medical students who identify with racial or ethnic minority groups. The purpose of this study was to identify barriers experienced by minority medical students that may account for this gap.MethodsAn IRB approved online survey was created, and distributed electronically to minority medical students, residents, and practicing physicians. Information on demographics, family dynamics, academic struggles, health issues, financial difficulties and faculty diversity was collected via self-report.ResultsParticipants (n = 167) who completed the survey identified as Black/African/African American (60%), Hispanic/Latinx (26%), Asian (8%), and as Other racial or ethnic minority (6%). The majority of survey participants graduated within the traditional 4 years of medical school (83%) and 17% did not. The most frequently reported reason was to pursue academic advancement (42%) which included completing a research year, dual degree, or PhD. The second reason was due to academic deficiencies (38%), either course failure or failure of a board exam. The majority of respondents (59%) also reported not having enough faculty members who were members of racial or ethnic minority groups at their medical school.ConclusionsOur data suggests the majority of racial and ethnic minority medical students graduate within the traditional 4 years of medical school. However, if they do not, it is either due to academic advancement to become a more successful residency applicant, or due to academic issues. The majority of respondents reported that they perceive a lack of racial and ethnic minority faculty members in academics.     

Effectiveness of a formal post-baccalaureate pre-medicine program for underrepresented minority students.

PURPOSE: To address the effectiveness of a formal postbaccalaureate (PB) experience for underrepresented minority (URM) students before medical school. The program provided an intense year-long experience of course work, research, and personal development. METHOD: There were 516 participants from one medical school: 15 URM medical students had completed the formal PB program, 58 students had done independent PB work before matriculation, and 443 students were traditional matriculants. Cognitive and academic indicators [college science and non-science grade-point averages (GPAs); biology, physics, and verbal MCAT scores; and percentage scores from first-year medical school courses] were compared for the three groups. RESULTS: Both groups of students with PB experience demonstrated competency in the first year of medical school consistent with traditional students even though the students who had completed the formal PB program had lower MCAT scores and lower college GPAs than did the traditional students. Traditional predictors of academic performance during the first year of medical school did not significantly contribute to actual academic performances of students from the formal PB program. CONCLUSION: The results support the use of a formal PB program to provide academic readiness and support for URM students prior to medical school. Such a program may also improve retention. Noncognitive variables, however, may be important to understanding the success of such students in medical school.     

Progress and pitfalls in underrepresented minority recruitment: perspectives from the medical schools

PURPOSE: To assess current initiatives at U.S. medical schools to recruit underrepresented minorities (URM) and to identify perceived barriers to enrollment of URM students. METHODS: We developed a survey that was mailed to the dean of Student Affairs of all U.S. allopathic and osteopathic medical schools in 2002. Respondents were asked to list their schools' URM recruitment programs and rate the effectiveness of these programs. They were also asked to indicate barriers to URM recruitment from a list of 37 potential barriers and rate their overall success with URM recruitment. RESULTS: The study had a 59% response rate. All schools reported a wide variety of initiatives for URM recruitment with > or =50% of all schools using each of the 11 strategies. The three most commonly listed barriers to URM recruitment were MCAT scores of applicants (90%), lack of minority faculty (71%) and lack of minority role models (71%). Most schools rated their recruitment efforts highly; on a scale of 1 to 10 (10 being very successful), the average score was an 8. CONCLUSION: While schools continue to invest tremendous efforts in recruiting minority applicants, admissions criteria, lack of URM faculty and the need for external evaluation remain important barriers to achieving a diverse physician workforce.     

A survey and analysis of student academic support programs in medical schools focus: underrepresented minority students.

This article describes an investigation that compiled information regarding academic support for medical students at 120 US medical schools. Specifically, the purpose of the study was to identify programs for underrepresented minority medical students and to review prospective applicant materials for photographic evidence that underrepresented minorities are involved in medical education. Eighty-three responses were returned and analyzed. Academic support services described most frequently were prematriculation, tutoring, and counseling and advising. Forty-one of the 83 schools indicated they offer prematriculation programs, 28 of which were required of under-represented minority freshmen entrants. Fifteen described offerings for undergraduate students and six for both undergraduate and secondary school students. Materials from the University of Iowa, the University of Medicine and Dentistry of New Jersey, and Stanford University revealed a variety of services and the largest numbers of photographs of under-represented minorities. These institutions are also among the leaders in underrepresented minority enrollment. Effective communication of academic support and minority presence appear to be contributory factors in enhancing diversity in medical education. Further investigation of academic support, evaluation of support services by participants, and dialogue about effective components of quality academic support are logical next steps to achieve the Association of American Medical College''s goal of 3000 by 2000.     

Recruitment and retention: the development of an action plan for African-American health professions students

This article presents results of a survey of African-American students enrolled in the colleges of medicine, dentistry, allied health, pharmacy, and nursing at the University of Kentucky. The survey was designed to determine the students' perceptions of factors that affect recruitment, enrollment, and academic progress of African-American students. Fifty-three of seventy students responded to survey questions addressing recruitment; admissions; and financial, social, personal, and academic support. Over 50% of medical students decided by junior high to enter a health career; only 15% of other students decided that early. The influence of a family member was more important in student decisions to enter nursing or medicine than in decisions by other students. Only 17% of medical students reported difficulty in locating sources of financial aid compared to 48% of those from other colleges. Perceptions regarding lack of social outlets were consistent among respondents from all colleges. Findings emphasize the importance of early exposure to the health professions, early outreach strategies, ongoing financial assistance, and the importance of establishing social networks for African-American students enrolled in a majority institution. The survey results were used to develop an action plan for the offices of minority affairs, student services, and academic affairs to address identified problems and concerns.     

Health science learning academy: a successful "pipeline" educational program for high school students.

OBJECTIVE: The objective of the Health Professions Partnership Initiative is to increase the number of underrepresented minority Georgia residents who become health care professionals by (1) creating a pipeline of well-qualified high school and college students interested in health care careers, (2) increasing the number of well-qualified applicants to medical and other health professions schools, and (3) increasing the number of underrepresented minority students at the Medical College of Georgia (MCG). DESCRIPTION: The Health Professions Partnership Initiative at MCG was created in 1996 by collaboration among the MCG Schools of Medicine and Nursing, two Augusta high schools attended primarily by underrepresented minority students, three historically black colleges and universities, the Fort Discovery National Science Center of Augusta, community service organizations, and MCG student organizations. The project was funded by the Association of American Medical Colleges and The Robert Wood Johnson Foundation. The high school component, the Health Science Learning Academy (HSLA), was designed to strengthen the students' educational backgrounds and interest in professional careers as evidenced by increased standardized test scores and numbers of students entering college and health professions schools. Additional goals included a system to track students' progress throughout the pipeline as well as professional development sessions to enrich faculty members' knowledge and enhance their teaching expertise. The HSLA began with ninth-grade students from the two high schools. During its second year, funding from the Health 1st Foundation allowed inclusion of another high school and expansion to ninth grade through twelfth grade. The HSLA's enrichment classes meet for three hours on 18 Saturday mornings during the academic year and include computer-interactive SAT preparation and English composition (tenth grade); biology, algebra, calculus, and English composition (eleventh grade); and advanced mathematics and biology (twelfth grade). DISCUSSION: The ultimate solution to the paucity of underrepresented minority physicians resides largely in successful pipeline programs that expand the pool of well-qualified applicants, matriculants, and graduates from medical schools. Intermediate results of the HSLA support the success of the program. Since its creation in the 1996-1997 academic year, 203 students have participated in the HSLA and all 38 (from the original two schools) who completed the four-year program have enrolled in college. The mean SAT score for students who completed the HSLA program was 1,066, compared with a mean of 923 for all college-bound students in the participating schools. The mean increases in SAT scores for students who completed the four-year program were.5% (1,100 to 1,105) for students attending a magnet high school and 18% (929 to 1,130) for students attending the comprehensive high school. The mean overall increases in SAT scores for students in the two high schools were 1% (1,044 to 1,048) and 9.1% (765 to 834), respectively. The HSLA is accomplishing its goals and, while it is too early to know if these students will participate in MCAT preparatory programs and apply to medical and other health professions schools, their sustained commitment and enthusiasm bode well for continued success.     

Student perspectives on diversity and the cultural climate at a U.S. medical school.

PURPOSE: To obtain the perspectives of medical students at one school on racial/ethnic campus diversity and cultural competence and to gain their perceptions of the institutional climate around diversity at their university and of reasons for minority underrepresentation at their medical school. METHOD: A student-driven survey of all medical students (N = 398) at a single medical school in the spring of 2003, supplemented by four focus groups from all racial and ethnic groups on the campus. RESULTS: A large majority of the responding students (n = 216; 54%) endorsed the value of campus diversity and the importance of cultural competence to the process of becoming a clinician. Most students felt their university had achieved a positive cultural climate, characterized by openness to diverse perspectives and attention to equity. Most students also felt that the university's programs and policies reflected a commitment to diversity, but fewer students--those from underrepresented minorities (URMs) in particular--felt that the university truly valued having a diverse student body and faculty. Most students felt that the lack of diversity on campus was a barrier to recruiting and retaining minority candidates. Some minority students also blamed the medical school's limited social, academic, and financial support, as well as inadequate efforts to recruit minority students. CONCLUSIONS: Medical students generally place a high value on campus diversity and cultural competence. URM students in particular felt that their university could do more to implement its commitment to diversity, including making greater efforts to recruit and retain URM students. These views constitute a barometer for medical schools to gauge and track their efforts to enhance campus diversity, incorporate cultural competence education, and create an inclusive and welcoming climate for students of all backgrounds.     

Examining Sedlacek's nontraditional variables of minority student success in a summer enrichment program for health careers

Nontraditional variables associated with minority student success in the health sciences have been identified by Sedlacek and his associates. These eight variables—positive self-concept, realistic self-appraisal, understanding and dealing with racism, long-range goals, availability of a strong support person, leadership, community service and medical interests—are examined with respect to their incorporation into the summer enrichment programs for talented minority students conducted at the University of Tennessee Center for the Health Sciences (UTCHS) during the years 1982-1984. Student comments and illustrations from the summer program''s curriculum are provided for five of Sedlacek''s variables to demonstrate how the UTCHS program is able to further the development of these nontraditional variables as well as to strengthen the cognitive abilities of students in basic science, mathematics, and communication. Evaluations of the summer program have revealed that the students have an increased academic self-concept, a more realistic view of the requirements to become a health professional, and an enhanced awareness of the health care environment.     

Diversifying the genomic data science research community

Over the past 20 years, the explosion of genomic data collection and the cloud computing revolution have made computational and data science research accessible to anyone with a web browser and an internet connection. However, students at institutions with limited resources have received relatively little exposure to curricula or professional development opportunities that lead to careers in genomic data science. To broaden participation in genomics research, the scientific community needs to support these programs in local education and research at underserved institutions (UIs). These include community colleges, historically Black colleges and universities, Hispanic-serving institutions, and tribal colleges and universities that support ethnically, racially, and socioeconomically underrepresented students in the United States. We have formed the Genomic Data Science Community Network to support students, faculty, and their networks to identify opportunities and broaden access to genomic data science. These opportunities include expanding access to infrastructure and data, providing UI faculty development opportunities, strengthening collaborations among faculty, recognizing UI teaching and research excellence, fostering student awareness, developing modular and open-source resources, expanding course-based undergraduate research experiences (CUREs), building curriculum, supporting student professional development and research, and removing financial barriers through funding programs and collaborator support.     

Preadmissions programs and enrollment of underrepresented minority students before and during successful challenges to affirmative action.

The association between the percent change in first-year and total underrepresented minority student enrollment and the presence of preadmission programs at Liaison Committee on Medical Education (LCME) accredited medical schools was assessed before and during successful legal and legislative challenges to affirmative action. The percent change in under-represented minority student enrollment was determined by comparing enrollment data for the academic years 1993-94 and 1996-97. Schools were categorized as having either a negative or positive percent change in their enrollment of underrepresented minority students. Logistic regression was used to determine the association of the percent change in under-represented minority student enrollment and the presence of a preadmission program while controlling for schools' financial support and the presence of postbaccalaureate programs. Fifty-six percent of the included medical schools had preadmission programs. Schools with a positive percent change were significantly more likely to have preadmission programs compared with schools with a negative percent change. There was no association between the presence of preadmission programs and the percent change in total enrollment. These results indicate that the presence of preadmission programs is positively associated with increases in first-year underrepresented minority student enrollment during the successful challenges to affirmative actions.     

Baylor's program to attract minority students and others to science and medicine

To attract minority students and others to careers in medical practice and biomedical research and to prepare them for such careers, Baylor College of Medicine conducts a variety of summer enrichment programs and other programs to improve how science is presented to students in their preprofessional years from elementary grades through college. These efforts aim to increase the number of competitive candidates for medical school, particularly those from minority groups underrepresented in medicine. They entail close collaboration between the Baylor administration and faculty from Texas public schools and two-year and four-year colleges and universities. The authors discuss the rationale for these programs and comment about the need for institutional commitments of faculty and financial support. They note that these programs are an investment in the future and that longitudinal assessment is needed to determine their ultimate success.     

Student's perspective of success in a postbaccalaureate program

ObjectiveTo identify contributors to the success of students in medical school that graduate from a 1-year postbaccalaureate bridge program.MethodIn 2010, using rigorous qualitative methodology, the principal investigator interviewed a random sample of 15 (23%) of current and past graduates of The Florida State University College of Medicine Bridge program. The investigators recorded and transcribed the interviews, utilized consensual qualitative research methodology to analyze the data, and identified an overarching theoretical construct.ResultsContent analysis of all 15 interviews yielded 73 themes, which were grouped into 6 broad categories/domains: The Florida State University College of Medicine Bridge Program attributes, personal attributes, proof of competence, support systems, exposure to medical programs, and faith/religion.ConclusionPostbaccalaureate programs prepare students for success in medical school. The Florida State University College of Medicine Bridge Program has been particularly successful in identifying and educating students who demonstrated promise upon application, despite noncompetitive grades and Medical College Admission Test scores. The authors identify the characteristics and individual experiences of the students and program that relate to success.     

Implementation of evidence-based PCOS lifestyle management guidelines: Perceived barriers and facilitators by consumers using the Theoretical Domains Framework and COM-B Model

BackgroundThe 2018 Evidence-Based Polycystic Ovary Syndrome (PCOS) Clinical Guidelines recommend lifestyle management as first-line treatment for PCOS, yet implementation of PCOS lifestyle programs into practice is not well understood.ObjectiveTo complete systematic intervention mapping by identifying the facilitators and barriers to lifestyle management in women with PCOS using the theoretical domains framework (TDF) and the Capacity, Opportunity, Motivation and Behaviour model (COM-B).Patient involvementWomen (N = 20) in Australian with PCOS were interviewed.MethodsTelephone semi-structured interviews.ResultsNine themes mapped onto seven TDF domains and the COM-B. Capability: psychological co-morbidities, knowledge and awareness of lifestyle change and ability to identify and resolve barriers. Opportunity: presence of other medical conditions, access to practical resources and availability of social support. Motivation: outcomes expectancies of lifestyle behaviour, personal values, enjoyment and readiness to change and the impact of stress on lifestyle choices.DiscussionThis is the first study to explore barriers and facilitators to lifestyle change from the perspectives of women with PCOS using the TDF and COM-B. Addressing these themes will facilitate patient-centred care and long-term behaviour change.Practical implicationsMay increase the efficacy and effectiveness of PCOS lifestyle programs and reduce the risk of PCOS-associated disease in this population.     

Do pre-admission programs make a difference in the enrollment of underrepresented-minority students at U.S. medical schools?

PURPOSE: To assess the association between the presence of pre-admission programs directed at underrepresented minority (URM) students at medical schools accredited by the Liaison Committee on Medical Education (LCME) and the first-year and total enrollments of URM students during the 1993-94 academic year. METHOD: The authors ranked 119 LCME-accredited medical schools by the percentages of their first-year classes and total enrollments made up of URM students. They then compared the schools in three ways: (1) schools ranking above versus below the median in terms of numbers of URM students; (2) the top 25% versus the lower 75%; and (3) the top 25% versus the lowest 25%. Logistic regression was used to determine the association between the presence of pre-admission programs and URM enrollment. RESULTS: Fifty-six percent of the medical schools had pre-admission programs. For both first-year and total enrollments, each comparison showed that schools ranked as having higher percentages of URM students (above the mean and in the top 25%) were more likely to have pre-admission programs than were the schools ranked lower (below the mean, lower 75%, and lowest 25%). CONCLUSION: This study suggests that the presence of pre-admission programs is positively associated with enrollment of URM students at U.S. medical schools.     

Social conditions in which medical students from the Faculty of Medicine of the National University of Mexico (UNAM) perform their Social Service in rural areas

The aim of this work is to describe the conditions in which medical students perform their Social Service, highlighting their experiences in areas such as: information before they move and the motivation to leave home; the perception of personal and environmental lack of safety; the institutional support that they receive during their work in the community and the financial support provided. The methodological design of the study included an exploratory phase, in which collective interviews were performed, using the focal group technique, with students who had been in rural areas. Three hundred sixty cases were considered, 72.8% corresponded to rural areas, and 27.7% to Mexico City. According to the findings, the following actions are proposed: give better information and improve the process of vacancy selection; increase the scholarship received by students in Social Service; establish legal, police, and community support mechanisms to guarantee the student's personal safety; pay attention to aspects such as the student's emotional and social situation, and design programs with gender perspective to enhance certainty and safety.     

Increasing women's leadership in academic medicine: report of the AAMC Project Implementation Committee.

The AAMC's Increasing Women's Leadership Project Implementation Committee examined four years of data on the advancement of women in academic medicine. With women comprising only 14% of tenured faculty and 12% of full professors, the committee concludes that the progress achieved is inadequate. Because academic medicine needs all the leaders it can develop to address accelerating institutional and societal needs, the waste of most women's potential is of growing importance. Only institutions able to recruit and retain women will be likely to maintain the best housestaff and faculty. The long-term success of academic health centers is thus inextricably linked to the development of women leaders. The committee therefore recommends that medical schools, teaching hospitals, and academic societies (1) emphasize faculty diversity in departmental reviews, evaluating department chairs on their development of women faculty; (2) target women's professional development needs within the context of helping all faculty maximize their faculty appointments, including helping men become more effective mentors of women; (3) assess which institutional practices tend to favor men's over women's professional development, such as defining "academic success" as largely an independent act and rewarding unrestricted availability to work (i.e., neglect of personal life); (4) enhance the effectiveness of search committees to attract women candidates, including assessment of group process and of how candidates' qualifications are defined and evaluated; and (5) financially support institutional Women in Medicine programs and the AAMC Women Liaison Officer and regularly monitor the representation of women at senior ranks.     

The Academic Support Program at the University of Michigan School of Medicine.

The University of Michigan has a support program aimed at early identification, remedial plans, and appropriate academic accommodations for at-risk students in under-graduate colleges and graduate and professional schools. Since 1994, the medical school has formally taken part in this program. Medical students at risk for academic failure (e.g., repeated failure in academic course work, licensure examinations, clinical examinations) are automatically referred to their academic counselors in the Student Programs Office of the medical school. Once a referral is made, the student is evaluated at the Office of Services for Students with Disabilities to identify problem areas. The office makes appropriate recommendations for interventions or accommodation. Tutoring, academic assistance, and other services are available through the medical school, specific divisions of the medical center, and the community. The Student Programs Office acts as a liaison between community and university assistance programs and between the student and the medical school. During the first four years of the program, 28 medical students were identified through it; of these, 24 (86%) were underrepresented minorities. Most (21) were referred during the first and third years of the curriculum. After a range of services for a variety of problems, 26 (93%) of the 28 students either graduated or continued to progress in their studies; the other two left the medical school for academic reasons.