The Health Careers Opportunity Program: one influence on increasing the number of minority students in schools of health professions

Certain U.S. racial and ethnic minority groups traditionally have been underrepresented in the health professions. There have been significantly smaller proportions of health professionals who are blacks, Hispanics, and American Indians than members of those groups in the population at large. In the 1960s and 1970s various pieces of legislation were passed that were intended to increase the total number of health professionals and address the underrepresentation of minorities and other disadvantaged persons. The Special Health Careers Opportunity Grant (SHCOG) Program and its successor, the Health Careers Opportunity Program (HCOP) have had, as their specific charge, responsibility for awarding funds to undergraduate colleges, health professions schools, and other entities to increase the number of minority students admitted to, and graduated from, health professions schools. Since 1972, during the existence of the SHCOG and HCOP Programs, the number of black students in health professions schools has risen from 4,099 to nearly 6,000. The number of Hispanic students has doubled to more than 2,360 and that of American Indian health professions students has increased from 125 to 355. Minority student applicants to medical school have improved their scores on the medical college admission test (MCAT) and their mean grade point average (GPA) at a higher rate than nonminority students. Students from HCOP-supported schools had higher acceptance rates--even with lower MCAT and GPA scores--than students from schools lacking HCOP support.     

Factors affecting the supply of minority physicians in 2000

There was a substantial increase in the number of black and Hispanic physicians between 1970 and 1985. During the next 15 years, 1985 to 2000, the increase is projected to continue. The factors that will determine the size of the increase and the changes in physician to population ratios include black and Hispanic population increases, medical school costs, availability of student support, minority enrollment in undergraduate schools and the pool of these students who will be applicants to medical school, attrition during medical school, competition from other professions for talented minority students, and the effects of intervention programs such as the Health Careers Opportunity Program. The most likely outcome would seem to be that the increases in black and Hispanic physicians will continue to 2000 at 1985 levels because the data show neither strong positive nor strong negative net influences for the factors examined.     

Early identification of future medical students using initial undergraduate grades

This study assessed whether overall academic performance in undergraduate medical coursework can be predicted with reasonable accuracy by using grades from initial college-level courses rather than total premedical grade point averages (GPAs). Initial college grades from four areas, MCAT scores, and NBME I and II scores were recorded for students admitted to the University of Washington Medical School, for students admitted to other medical schools, and for students not admitted to any medical school. The results documented a high relationship between cumulative GPAs and initial grades, with differences found between those students admitted to medical school and those not admitted. The importance of this study is the documentation that little predictive utility is gained by waiting for overall college GPAs from medical school applicants. Initial GPAs are available 2 years earlier than overall GPAs and provide virtually the same information. Exploratory suggestions for medical school admission policies are made.     

An equivalence study of interview platform: Does videoconference technology impact medical school acceptance rates of different groups?

Web-based interviewing may be an effective element of a medical school’s larger approach to promotion of holistic review, as recommended by the Association of American Medical Colleges, by facilitating the feasibility of including rural and community physicians in the interview process. Only 10% of medical schools offer videoconference interviews to applicants and little is known about the impact of this interview modality on the admissions process. This study investigated the impact of overall acceptance rates using videoconference interviews and face-to-face interviews in the medical school selection process using an equivalence trial design. The University of New Mexico School of Medicine integrated a videoconferencing interview option for community and rural physician interviewers in a pseudo-random fashion during the 2014–2016 admissions cycles. Logistic regression was conducted to examine whether videoconference interviews impacted acceptance rates or the characteristics of accepted students. Demographic, admissions and diversity factors were analyzed that included applicant age, MCAT score, cumulative GPA, gender, underrepresented in medicine, socioeconomic status and geographic residency. Data from 752 interviews were analyzed. Adjusted rates of acceptance for face-to-face (37.0%; 95% CI 28.2, 46.7%) and videoconference (36.1%; 95% CI 17.8, 59.5%) interviews were within an a priori ± 5% margin of equivalence. Both interview conditions yielded highly diverse groups of admitted students. Having a higher medical college admission test score, grade point average, and self-identifying as disadvantaged increased odds of admission in both interview modalities. Integration of the videoconference interview did not impact the overall acceptance of a highly diverse and qualified group of applicants, and allowed rural and community physicians to participate in the medical school interview process as well as allowed campus faculty and medical student committee members to interview remotely.     

The Southern Rural Access Program and Alabama's Rural Health leaders Pipeline: A Partnership to Develop Needed Minority Health Care Professionals

ABSTRACT: Rural Health Leaders Pipeline programs are intended to increase the number of youth interested in and pursuing health professions in rural communities. This paper presents 2 complementary approaches to Rural Health Leaders Pipeline programs. Two different organizations in Alabama recruit students from 18 specified counties. One organization is a rural, community-based program with college freshmen and upperclassmen from rural communities. Students shadow health professionals for 6 weeks, attend classes, visit medical schools, complete and present health projects, and receive support from online tutors. The second organization is a university based program that supplements an existing 11th grade-medical school rural medicine pipeline with 10 minority students from rural communities who have graduated from high school and plan to enter college as premedical students in the following academic year. Students participate in classes, tutorials, seminars, and other activities, Students earn college credits during the 7-week program, maintain contact with program staff during the school year, and by performance and interest can continue in this pipeline program for a total of 4 consecutive summers, culminating in application to medical school. Each organization provides stipends for students. Early experiences have been positive, although Rural Health Leaders Pipeline programs are expensive and require long-term commitments.     

Allied health applicant pools and employment opportunities--1987

This study sought information relative to student capacity and enrollment, quality of applicants, numbers in the applicant pool, and program directors' estimates of the job market and salaries, as well as overall impressions of their respective professions in six allied health disciplines: medical technology, physical therapy, radiologic technology, occupational therapy, dietetics/nutrition, and medical record administration. Of 105 four-year colleges and universities surveyed, 252 programmatic responses were received from 83 institutions (79% response rate). Generally, the status of these six allied health professions appeared very good, with a 2 to 1 overall ratio of applicants to graduates, and an almost 6 to 1 ratio in physical therapy. The average GPA for incoming allied health students was 3.01. Job opportunities were considered plentiful, and 93% of program directors rated the overall outlook for their respective professions as good to excellent. However, there were four areas that program officials may wish to examine more closely: excessive length of some professional programs, numbers of minorities in the institutions surveyed, entry-level salaries for several professions, and a somewhat less positive atmosphere in medical technology as compared to the other five disciplines.     

Diversity of the allied health workforce: the unmet challenge

Although black and Hispanic people together constitute 25% of the American population, they represent only 18% of students enrolled in 4-year colleges and universities. The educational divide further widens within the health professions programs, where < 10% of enrolled students in the allied health professions are black or Hispanic. Health agencies have begun referring to the underrepresentation of minorities in the health professions as a public health crisis. Despite the increased focus that the national government is placing on underrepresented minorities, there has been little to no increase in the number of minorities enrolled in health professions programs. This report examines the roles of educational institutions, accrediting organizations, and the government in addressing diversification of the health workforce. The authors challenge stereotypes that reinforce the belief that the predominant reason for low enrollment by underrepresented minorities is inadequate numbers of qualified minorities.     

Factors influencing students' choice of medical schools

New entrants to four medical schools in Britain were questioned with regard to those factors which made them choose one medical school rather than another. Approximately 400 replies were obtained which indicated that acceptance of the student's personal qualifications for entry and the buildings and facilities of the medical school were attractive features and an emphasis on community medicine and the availability of living accommodation also exerted a positive effect on would-be medical students. The fact that relatives went to the school, that the school had a traditional approach or that they were advised to choose that particular institution by their school teacher appeared to be found unattractive by possible applicants.     

Premedical Education: The Contribution of Small Local Colleges

CONTEXT: Small local colleges may be sources of medical students with the gender, ethnicity, and background that promote identity with and empathy for underserved populations. PURPOSE: This study examined the impact of attendance at these premedical colleges on outcomes of medical education. METHODS: Data for 2508 matriculates to the University of Alabama School of Medicine, a state-supported medical school, were examined according to premedical colleges attended. FINDINGS: Medical students who had graduated from small local colleges were more diverse in gender, race, and rural background than other students. They had slightly lower academic performance in medical school, were more likely to drop out (10.6% versus 5.3% overall), and were more likely to locate in rural areas of the host state. CONCLUSIONS: Small local colleges may be rich sources of student diversity and medical students who choose rural practice, outcomes that are gained at a cost in terms of drop-out rate. Compared with other students, minor differences in performance and larger differences in the drop-out rate raise the question of cultural context and social support during medical school as points for intervention.     

Rural Medical School Applicants: Do Their Academic Credentials and Admission Decisions Differ From Those of Nonrural Applicants?

CONTEXT AND PURPOSE: Medical schools located in states with sizable rural areas are concerned about preparing physicians for practice in these areas; this is of particular concern for medical schools that are part of a state-owned university with a responsibility to educate physicians for rural areas. Because individuals from rural areas are most likely to return to practice medicine in rural areas at the conclusion of their training, it is important to recruit these individuals to medical schools to educate them for rural practice. METHODS: This study examines 7 years of admission data for students who applied and were accepted to the University of Missouri-Columbia School of Medicine, which has as a specific mandate to prepare physicians for rural practice. FINDINGS: The study indicates that rural applicants are more likely to be admitted to the medical school, and based on admissions criteria they are at least as academically qualified as nonrural applicants. CONCLUSIONS: The study demonstrates that a medical school can maintain competitive admission criteria while at the same time accepting those students more likely to enter rural practice. This is valuable information that medical schools with a similar mission to prepare physicians for rural practice might consider in their admissions decision-making process.     

Rural Health Leaders Pipeline, 1990–2005: Case Study of a Second-Generation Rural Medical Education Program

ABSTRACT

A pipeline model has been suggested to increase the rural physician supply. This study is an institutional case report used to describe the context, development, and in-house evaluation of the University of Alabama Rural Health Leaders Pipeline, 1990–2005. This program was developed at a University of Alabama School of Medicine branch campus to target rural students at multiple levels, elementary schools through residency, and includes a minority focus. Requirements to enter the medical program include living 8 years in rural Alabama, meeting admission requirements, and affinity for rural lifestyles. Twenty-six percent of 316 high school participants, all 40 students in the minority-focused college program, and 3% of 90 medical program students were African American. The program includes (1) puppet shows in elementary schools depicting different health professions, (2) Rural Health Scholars Program for 11th-grade students, (3) Minority Rural Health Pipeline Program for college students, (4) Rural Medical Scholars Program, a 5-year track of study in rural community health and medicine, and (5) assured admission to family medicine residency. Outcomes studied in this case report included medical school performance, graduation rate, selection of family medicine specialty, and rural practice location. Medical scholars were anticipated to experience academic difficulty, select family medicine specialty, and locate in rural practice more often than peers. Compared to peers, medical scholars showed lower scores on preclinical courses and USMLE steps 1 and 2, reflective of their lower MCAT and GPA scores, but had (1) similar graduation rates (95% vs peers 84%), (2) higher family medicine selection rate (47% vs Huntsville 27% vs Tuscaloosa 12% vs Birmingham 4% [OR compared to Birmingham 22.7, 95% CI 10.5–49.4]), and (3) higher rural practice rate (67% vs peers 14% vs national group 9%) in the first RMSP classes. Based on these important outcomes being better than or equal to the traditional student cohorts, the institution concluded that the Rural Health Leaders Pipeline demonstrates successful use of the rural pipeline model.     

Moral reasoning as a criterion for admission to medical school

To determine whether admission interviews could differentiate applicants on their personal qualities (such as integrity, empathy and commitment) 456 applicants from two medical schools were tested on the Defining Issues Test (DIT), which measures the amount of principled or post-conventional moral reasoning. No difference was found between the DIT scores of the accepted and the rejected applicants of the school in which the admission criteria are the traditional scholastic ones. On the other hand, a great difference was shown in the school which admits students for their personal characteristics as assessed by interviews. Yet only moderate correlation was shown between the DIT and the interview scores. Since moral reasoning is a key concept in medical professional behaviour and is correlated with clinical performance, the findings deserve special attention. A possible use of the DIT in the student selection process is discussed.     

Demographic and socio-economic associations with academic attainment (UCAS tariff scores) in applicants to medical school

BACKGROUND: In the United Kingdom medical students are selected predominantly on their academic merit. Their academic achievement marks are equated via the tariff point score structure administered by the Universities and Colleges Admissions Service (UCAS). We studied the applicant databases for 1998-2003 for one English medical school to determine the factors that predict high tariff point scores. METHODS: Complete demographic data and relative socio-economic status, educational institution attended and tariff point score was available for 8997 UK applicants aged 21 years or younger to the 5-year Bachelor of Medicine/Bachelor of Surgery (BM BS) course at Nottingham University medical school (and partially complete data for a further 1891 applicants). The data were subjected to standard univariate and multivariate analyses and to path analysis. RESULTS: In these samples, the independent predictors of a high tariff point score were being younger and male. The effect sizes were small, although significant. Higher tariff point scores were achieved by those from households less materially disadvantaged. Ethnicity was also a predictor with white, Chinese and those of mixed ethnic origin achieving higher tariff point scores than those from other groups. Finally, the type of school attended predicted academic achievement with applicants from further education colleges, independent schools and grant-maintained schools achieving higher tariff point scores. CONCLUSION: Notwithstanding the relatively homogeneous (predominantly young, white, high academic achievers) applicant pool to a single UK medical school we identified consistent significant predictors of high tariff point scores. As high tariff point scores are still the major entry criterion to UK medical schools, our findings will be of value in informing policy decisions concerning 'widening access' schemes being established at government request.     

Senior medical students' attitudes toward choosing residency programs in primary care

To investigate the associations between medical students' first choice for their graduate medical education specialty (primary care versus non-primary care) and both their sociodemographic characteristics and their perceptions of the importance of 44 factors related to that choice, we conducted a survey of the 1982 senior medical students at the three medical schools in Louisiana. The major differences that we found between the students choosing primary care residency programs and those choosing non-primary care programs included the following: the primary care group was much more likely to be married; to have resided in smaller communities during their childhood, high school, and premedical school years; to have made their decision on a specialty prior to medical school; and to place less importance on hospital reputation, quality of facilities, and up-to-date equipment in choosing a graduate medical program. No differences between the two groups were found for the following variables: whether or not they had children; whether or not they had resided in Louisiana during early childhood, high school, or premedical school; and whether or not they had resided in the South for those same time periods. Although the primary care group had a higher proportion of women than the non-primary care group, the difference was not statistically significant.     

Do UK Medical School Applicants Prefer Interviewing to Non-Interviewing Schools?

Medical schools select applicants; applicants who hold two or more offers also select medical schools. In this study we examine a large cohort of applicants applying for admission to UK medical schools in October 1991, and show that when presented with a choice, applicants are more likely to select an interviewing school over a non-interviewing school. Preferences for individual schools are examined in detail using the Bradley-Terry method for paired comparisons. The analysis shows that the preference for interviewing schools cannot be explained in terms of a preference for Oxford and Cambridge (which both interview), nor is it due to confounding by more non-interviewing schools being in the north of the UK. Nevertheless, interviewing status does not account for all the preferences expressed by applicants. The preference for interviewing schools is perhaps explained by applicants feeling closer and more involved with schools which they have visited, which have talked to them personally, and which have selected them individually, rather than on the basis of an impersonal application form. This revised version was published online in June 2006 with corrections to the Cover Date.     

中南四省高校学生医疗保障情况调研报告

目的了解高校学生医疗保障情况。方法对广东省内所有高校(包括公办和民办学校、部属和地方高校、高职院校等)以及广西自治区、福建省和海南省的8所高校发放了调查表。结果学生公费医疗覆盖面窄,只有公办大专院校学生有公费医疗,民办学校和大部分高职高专学校学生没有享受公费医疗。公办高校的公费医疗拨款基本不够学生医疗支出。所有学校都在学生自愿的基础上购买医疗保险,投保率在60%左右,学生患有重大疾病,就会给学生和学校带来很大压力。结论政府应加大对学生公费医疗拨款的数额,民办学校及高职高专院校应和公办学校一视同仁,所有学生同享医疗财政拨款。经测算学生公费医疗拨款在90~120元/(生.年)较为适宜,用来投入学生医疗保险体系,使投保率达到100%,这样才可以使学生医疗保健得到很好的保障。建议设立大学生救助基金,对患有重大疾病的贫困生给予救助。     

Some notes on the admission of graduate applicants to the medical schools

A survey of the admissions policy adopted by the medical schools towards older applicants, and in particular graduate applicants, has been carried out. Some 1000 graduates applied for places in 1976, of whom about one in six was successful (compared with one in four for all applicants). The academic requirements for this category of student are normally at least an upper second class degree, age maxima vary from 25 to around 30 years and, increasingly, schools require a financial guarantee from students not in receipt of a Local Education Authority grant. A minority of medical schools reserve a proportion of places for older applicants, but only a very small minority of schools will consider reducing the length of their course for graduate entrants.
These factors are tabulated for each of thirty-one of the medical schools in the United Kingdom and the Irish Republic.     

Effectiveness of medical school admissions criteria in predicting residency ranking four years later

BACKGROUND: Medical schools across Canada expend great effort in selecting students from a large pool of qualified applicants. Non-cognitive assessments are conducted by most schools in an effort to ensure that medical students have the personal characteristics of importance in the practice of Medicine. We reviewed the ability of University of Toronto academic and non-academic admission assessments to predict ranking by Internal Medicine and Family Medicine residency programmes. METHODS: The study sample consisted of students who had entered the University of Toronto between 1994 and 1998 inclusive, and had then applied through the Canadian resident matching programme to positions in Family or Internal Medicine at the University of Toronto in their graduating year. The value of admissions variables in predicting medical school performance and residency ranking was assessed. RESULTS: Ranking in Internal Medicine correlated significantly with undergraduate grade point average (GPA) and the admissions non-cognitive assessment. It also correlated with 2-year objective structured clinical examination (OSCE) score, clerkship grade in Internal Medicine, and final grade in medical school. Ranking in Family Medicine correlated with the admissions interview score. It also correlated with 2nd-year OSCE score, clerkship grade in Family Medicine, clerkship ward evaluation in Internal Medicine and final grade in medical school. DISCUSSION: The results of this study suggest that cognitive as well as non-cognitive factors evaluated during medical school admission are important in predicting future success in Medicine. The non-cognitive assessment provides additional value to standard academic criteria in predicting ranking by 2 residency programmes, and justifies its use as part of the admissions process.     

Evaluation of high-school health science careers program impact on student retention and careers

The purpose of this research was to longitudinally measure the impact of the University of Medicine and Dentistry of New Jersey-School of Health Related Professions high-school Health Science Careers program on student retention in health careers. Students (n = 1,218) who earned college credit in the program from 1996 to 2002 were surveyed. The response rate was 17% of the total and 21% of the deliverable surveys. Students were equally distributed between vocational, comprehensive, and academy-type schools. Ninety-seven percent of the students continued their education after high school, with 70% attending 4-year colleges. Forty-nine percent of those entering 2-year colleges and 57% of those entering 4-year colleges pursued health-related careers. Ninety-five percent perceived the Health Science Careers program as valuable. The findings suggest that the Health Science Careers program was helpful in guiding students toward health-related professions. The evaluation helped to understand the impact and to realize the positive and negative aspects of the program by the respondents.