Evaluation of an early medical school selection program for underrepresented minority students.

PURPOSE: To evaluate the academic performance in the first two years of medical school of underrepresented minority students (URMS) who participated in an early identification and admission program. METHOD: The study involved 39 early-selection URM students who entered one medical school from 1992 through 1999. Successful completion of the first two years of medical school and passing the United States Medical Licensure Examination (USMLE) Step 1 were correlated with Scholastic Aptitude Test I (SAT I) scores and Medical College Admission Test (MCAT) scores. The students were required to maintain an overall grade-point average of at least 3.0 on a 4.0 scale to remain in the program. RESULTS: Students who had combined scores of at least 900 on the SAT I and total scores of at least 18 on the three multiple-choice sections of the MCAT had more success completing the first two years of medical school and passed USMLE Step 1 with greater frequency than did those students who scored at lower levels on these tests. CONCLUSION: An early-selection program for URM students can identify early in their academic careers students who can complete the first two years of medical school and pass the USMLE Step 1.     

Effectiveness of a premedical postbaccalaureate program in improving medical college admission test scores of underrepresented minority and disadvantaged students

PURPOSE: The purpose of this article is to share the procedures used to strengthen the Medical Pathways (MEDPATH) premedical postbaccalaureate program (PBP) to increase the chances of its students successfully graduating from medical school in four years. METHODS: Subjects included students who matriculated into medical school between 1991-1999 (N = 72) following successful completion of the 12-month MEDPATH premedical PBP. Students who had passed the USMLE Step 1 on the first attempt were defined as successful and were compared to those who did not pass on their first attempt. Programmatic changes were implemented based on these findings, and outcomes were evaluated. RESULTS: There was a significant improvement in total MCAT scores between pre-2003 (PBP entry year) participants (Mn = 20.73, SD = 3.10, N = 117) and post-2003 (PBP entry year) participants (Mn = 25.27, SD = 2.96, N = 37) (t = 7.86, df = 152, p < 0.001). MEDPATH premedical PBP coursework grade-point averages improved from 3.48 to 3.67 over the same time intervals. Diversity of program participants was maintained. CONCLUSION: The enhanced MEDPATH premedical PBP appears to be producing underrepresented minority and disadvantaged medical students who are better prepared to succeed in medical school.     

The POD: a new model for mentoring underrepresented minority faculty.

Mentoring, long recognized as a catalyst for successful careers, is particularly important to the career development of underrepresented minority (URM) faculty. In academic medicine, mentor-protégé relationships are seriously threatened by increased clinical, research, and administrative demands and an emphasis on scholarship over citizenship. New mentoring models are needed, and they should be adaptable to a medical school's unique structure and mission. The Peer-Onsite-Distance (POD) model, developed in 2002 by the authors and introduced at the College of Medicine at the University of Arkansas for Medical Sciences, is a targeted, multilevel mentoring prototype that is built on a solid research foundation and tailored to the unique needs of URM medical school faculty. The mentee's individual needs for guidance related to career goals, resources, and the content and interaction skills that are known to be critical to successful academic careers are targeted for development. The multilevel approach provides a unique network of peer and faculty mentors who provide site-specific career guidance. Also in the network are leaders in their fields who can provide access to accurate information, cautions, predictions, and announcements of future resources or potential restrictions in academic medicine. Mentor commitments are clearly defined and time contributions are maximized. The POD model aims to promote retention and advance the careers of URM faculty by wrapping them in a protective cushion of interpersonal and intrapersonal support. The flexibility of the design allows for adaptation to any institution's unique structure and mission.     

Impostor syndrome among minority medical students who are underrepresented in medicine

ObjectivesImpostor syndrome (IS) is prevalent in medical professionals. However, little is known about the prevalence of IS among medical trainees and those who are underrepresented in medicine (UiM). Even less is known about the experiences of UiM students at predominantly white institutions (PWIs) and historically black colleges/universities (HBCUs) relative to their non-UiM peers. The purpose of this study is to investigate differences in impostor syndrome among UiM and non-UiM medical students at a PWI and a HBCU. We additionally explored gender differences in impostor syndrome among UiM and non-UiM students at both institutions.MethodMedical students (N = 278) at a PWI (N = 183, 107 (59%) women) and a HBCU (N = 95, 60 (63%) women), completed an anonymous, online two-part survey. In part one, students provided demographic information, and in part two, students completed the Clance Impostor Phenomenon Scale, a 20-item self-report questionnaire that assessed feelings of inadequacy and self-doubt surrounding intelligence, success, achievements, and one's inability to accept praise/recognition. Based on the student's score, the level of IS was measured and placed into one of two levels: few/moderate IS feelings, or frequent/intense IS feelings. We conducted a series of chi-square tests, binary logistic regression, independent sample t-tests, and analysis of variance to test the main aim of the study.ResultsThe response rate was 22% and 25% at the PWI and HBCU, respectively. Overall, 97% of students reported moderate to intense feelings of IS, and women were 1.7 times more likely than men to report frequent or intense feelings of IS (63.5% vs 50.5%, p = 0.03). Students at PWI were 2.7 times more likely to report frequent or intense IS than HBCU students (66.7% vs 42.1%, p< 0.01). In addition, UiM students at PWI were 3.0 times more likely to report frequent or intense IS compared to UiM students at HBCU (68.6 % vs 42.0%, p = 0.01). Computation of a three-way ANOVA with gender, minority status, and school type revealed a two-way interaction indicating that UiM women scored higher on impostor syndrome than UiM men at the PWI and HBCU. This trend was not observed among non-UiM students.ConclusionsImpostor syndrome is informed by gender, UiM status, as well as environmental context. Efforts to provide supportive professional development for medical students should be directed towards understanding and combatting this phenomenon at this critical juncture of their medical career.     

A pre-admission program for underrepresented minority and disadvantaged students: application, acceptance, graduation rates and timeliness of graduating from medical school.

PURPOSE: To determine whether students' performances in a pre-admission program predicted whether participants would (1) apply to medical school, (2) get accepted, and (3) graduate. METHOD: Using prospectively collected data from participants in the University of North Carolina at Chapel Hill's Medical Education Development Program (MEDP) and data from the Association of American Colleges Student and Applicant Information Management System, the author identified 371 underrepresented minority (URM) students who were full-time participants and completed the program between 1984 and 1989, prior to their acceptance into medical school. Logistic regression analysis was used to determine whether MEDP performance significantly predicted (after statistically controlling for traditional predictors of these outcomes) the proportions of URM participants who applied to medical school and were accepted, the timeliness of graduating, and the proportion graduating. Odds ratios with 95% confidence intervals were calculated to determine the associations between the independent and outcome variables. RESULTS: In separate logistic regression models, MEDP performance predicted the study's outcomes after statistically controlling for traditional predictors with 95% confidence intervals. CONCLUSIONS: Pre-admission programs with similar outcomes can improve the diversity of the physician workforce and the access to health care for underrepresented minority and economically disadvantaged populations.     

Proximal versus distal influences on underrepresented minority students pursuing health professional careers

The Health Careers Opportunities Program (HCOP) at Creighton University provides an important illustration of the short- and long-term successes of pipeline programming. The Pipeline to Success program at Creighton University provides exposure and enrichment activities to participants beginning in middle school and continuing through a one-year postbaccalaureate component in order to ensure that they are knowledgeable about health professional careers and competitive in applying for these training programs. This study hypothesized that the enrichment activities experienced by participants would have the additional benefit of providing indirect or distal influences to motivate participants to meet their career goals. In partial support of this hypothesis, a MANOVA demonstrated that the middle-school participants demonstrated a different pattern of influence from the other program components. Results indicate that as participants progressed through the Pipeline to Success HCOP at Creighton University, the program resources impacted their desire to pursue health professional careers in addition to positively preparing them for health professional training programs. We conclude that these findings have particular importance for planning and implementing student education programs.     

Recruitment of underrepresented minority students to medical school: minority medical student organizations, an untapped resource

Recruitment of more underrepresented minority students (black, Hispanic and native American) to increase racial diversity in the physician workforce is on the agenda for medical schools around the nation. The benefits of having a racially diverse class are indisputable. Minority physicians are more likely to provide care to minority, underserved, disadvantaged and low-income populations. Therefore, medical schools would benefit from diversity through utilizing strategies for recruitment of underrepresented minority (URM) students. Numerous recruitment strategies have been employed to increase the number of underrepresented minority students. However, formal collaboration with minority medical student organizations is an underutilized tool in the recruitment process. Many medical schools have informally used minority medical students and members of various minority organizations on campus in the recruitment process, but a formal collaboration which entails a strategic approach on using minority medical student organizations has yet to be included in the literature. This paper discusses the innovative collaboration between the University of Toledo College of Medicine (UTCOM) chapter of the Student National Medical Association (SNMA) and the college of medicine's admissions office to strategize a recruitment plan to increase the number of underrepresented minority students at the UTCOM. This paper suggests that minority medical student organizations, particularly the SNMA, can be used as a recruiting tool; hence, admissions offices cannot negate the usefulness of having formal involvement of minority medical student organizations as a recruiting tool. This approach may also be applicable to residency programs and other graduate professional fields with a severe shortage of URM students.     

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.     

Mentoring for women and underrepresented minority faculty and students: experience at two institutions of higher education

Women and minority faculty and students are seriously underrepresented in university and academic healthcare institutions. The role of mentoring has been identified as one of the significant factors in addressing this underrepresentation. We have described the mentoring efforts at two institutions of higher learning in assisting women and minority students and faculty in being accomplished in their academic pursuits. One-hundred-thirty students and >50 women and minority faculty have participated in the mentoring programs described. The number of participants has increased dramatically over the years and continues to evolve positively. These programs appear to be quite successful in the short term. Further evaluation of measurable outcomes will be necessary to fully determine their true impact. The mentoring models for women and underrepresented minority faculty and students at Creighton University Health Sciences Schools and Wake Forest University School of Medicine will serve as a guide for other Health Sciences Schools.     

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.     

Course selections and career plans of black participants in a summer intervention program for minority students

From 1985 through 1987, data were gathered on 151 participants in a summer program at the Bowman Gray School of Medicine of Wake Forest University. This program was designed for academically talented minority students to promote their awareness of medicine as a potential career and to strengthen their science and mathematics backgrounds. Among the findings were that the differences in the students' selections of courses in their schools were small, regardless of the occupational or educational levels of their parents, and that the gender of the students had little relation to their choices of advanced mathematics and science courses. The significance of the findings is discussed and the importance of continued support of such intervention programs is emphasized.     

Improving the retention of underrepresented minority faculty in academic medicine

BACKGROUND: Although several studies have outlined the need for and benefits of diversity in academia, the number of underrepresented minority (URM) faculty in academic health centers remains low, and minority faculty are primarily concentrated at the rank of assistant professor. In order to increase the diversity of the faculty of the University of California, San Diego (UCSD) School of Medicine, the UCSD National Center for Leadership in Academic Medicine, in collaboration with the UCSD Hispanic Center of Excellence, implemented a junior faculty development program designed in part to overcome the differential disadvantage of minority faculty and to increase the academic success rate of all faculty. METHODS: Junior faculty received counseling in career and research objectives; assistance with academic file preparation, introduction to the institutional culture; workshops on pedagogy and grant writing; and instrumental, proactive mentoring by senior faculty. RESULTS: After implementation of the program, the retention rate of URM junior faculty in the school of medicine increased from 58% to 80% and retention in academic medicine increased from 75% to 90%. CONCLUSION: A junior faculty development program that integrates professional skill development and focused academic career advising with instrumental mentoring is associated with an increase in the retention of URM faculty in a school of medicine.     

Predicting the medical school progress of minority students who participated in a preparatory program

The grade-point averages (GPAs), Medical College Admission Test (MCAT) scores, and Student Progress Committee (SPC) ratings of 75 minority students who had attended a preparatory program at Southern Illinois University School of Medicine at some period from 1976 through 1986 were analyzed to determine how these variables related to the retention and progress of these students in medical school. Although those retained had higher SPC ratings than those not retained, stepwise regression revealed that none of the variables predicted retention. The MCAT Reading score, however, was significantly higher for students who progressed on schedule; it was the only significant predictor of progress.     

Academic ranks and medical schools of underrepresented minority faculty in family medicine departments.

PURPOSE: To examine academic rankings and educational backgrounds of underrepresented minority (URM) family medicine faculty and compare their academic ranks with national trends. The authors also determined the extent to which international and historically black educational institutions contributed URM faculty to family medicine. METHOD: In 1999 questionnaires were sent to 129 family medicine departments asking for academic ranks and educational institutions attended by their URM faculty. Comparisons were made between URM faculty's academic ranks and all family medicine faculty, medical school minority faculty, and medical school faculty. RESULTS: A total of 80% of URM faculty were assistant professors or instructors, and 4.4% were professors. URM family medicine faculty had significantly lower rankings compared with medical school minority faculty and all family medicine faculty. URM family medicine faculty at historically black medical schools were more likely to have received their degrees from historically black undergraduate institutions and medical schools than were URM family medicine faculty at non-historically-black medical schools. CONCLUSIONS: URM family medicine faculty appear to experience a double disadvantage: being minority and working for family medicine departments. Their academic ranks remain far below those of both minority medical school faculty and family medicine faculty, a discouraging finding considering the current shortage of URM faculty in family medicine departments. Historically black medical schools cannot address the shortage alone, so non-historically-black medical schools need to both recruit URM faculty and follow up with appropriate mentoring of those faculty.     

Effectiveness of a communication skills training program for medical students to identify patients communicative clues

ObjectiveThis study explores whether an Experiential Training Programme (ETP) in communication skills (CS) improves students' ability to identify patients clues compared to those who follow a non-experiential training throughout their medical studies.MethodIntervention Group (IG): 85 4th-year medical students who received the ETP and Control Group (CG): 67 recently graduated students who did not receive it. Their immediate (written) response was requested to three expressions offered by patients containing communicative clues. The answers were grouped into 2 categories: Clue recognised and response patient-centred and the opposite. Three researchers analysed the answers.ResultsResponses 366 (65 from the CG and 77 from the IG): 280 did not recognise clues: 131 (62%) in IG and 149 (96%) in CG and 86 recognised them: 80 (37.9%) in IG and 6 (3.9%) in CG (p = 0.000). Some clues were more elusive than others (p = 0,003).ConclusionsThe students who received the ETP in CS showed greater ability to explore patients perspective taking advantage of different types of communicative clues than those who did not receive it in a non-relational context.Practice implicationsFurther research is needed to assess whether this ability is maintained in simulated or real clinical situations.     

WVU--community partnership that provides science and math enrichment for underrepresented high school students.

In response to the need to help West Virginia secondary school students overcome educational and economic barriers and to increase the number of health professionals in the state, the Health Sciences and Technology Academy (hereafter, "the Academy") was established in 1994. The Academy is a partnership between West Virginia University (WVU)--including the Robert C. Byrd Health Sciences Center, Eberly College of Arts and Sciences, and the College of Human Resources and Education--and members of the community, including secondary-school teachers, health care professionals, and other community leaders. The Academy targets students from underrepresented groups (mainly African Americans and financially disadvantaged whites) in grades nine through 12. By November 1997, 290 students (69% girls and 33% African American) from 17 counties were Academy participants. Funding is from the W. K. Kellogg Foundation, Howard Hughes Medical Institute, the National Institutes of Health, the Coca-Cola Foundation, and other sources. Academy programs are an on-campus summer institute and community-based clubs, where students engage in activities for science and math enrichment, leadership development, and health careers awareness. In the Academy's clubs, students carry out extended investigations of problems related to human health and local communities. Most students report that the Academy has increased their interest in health care careers, and almost all who have continued to participate in Academy programs through their senior year have been accepted into college.     

Premedical and predental enrichment program for minority students, 1969-1996, at Meharry Medical College.

From 1969 through 1996, Meharry Medical College offered the Biomedical Sciences Program, an eight-week summer premedical and predental enrichment program designed to increase the enrollment of minority students in health professions schools. The program focused on preparing undergraduates to pursue health professions careers by providing specially designed courses in biology, chemistry, mathematics, and scientific communications, as well as interactions with clinical faculty. The curriculum emphasized academic preparation, including structured course work in the classroom, assigned homework every night, and scheduled activities with clinicians. (The program merged with two other outreach programs in 1996 and is now part of the Health Careers Opportunity Pre-Baccalaureate Program.) From 1969 to 1996, 1,015 students participated in the program, and over the years 43% of them responded to tracking surveys. Of these 445 respondents, 70% (310) applied to professional schools, of whom 83% (257) applied to medical, 15% (46) to dental, and 2% (10) to graduate schools. Of the 257 who applied to medical schools, 70% (198) were admitted and all of them graduated. Of the 46 who applied to dental schools, all were admitted and graduated; and of the ten who applied to graduate schools, all were accepted and received PhD degrees in the biomedical sciences. Of particular note, 67% (172) of the applicants who were admitted to professional schools matriculated at Meharry Medical College. These data suggest that the Biomedical Sciences Program used effective strategies that increased the number of underrepresented-minority students entering health professions careers.