Minorities In Medicine Research Articles

Factors Associated With Attrition Among Otolaryngology-Head and Neck Surgery Residents: A 10-Year Analysis.

To identify the risk factors for Otolaryngology-Head and Neck Surgery (OHNS) resident attrition. Retrospective cohort study. Annual Graduate Medical Education track survey. We conducted a retrospective analysis of OHNS residents who matriculated between 2006 and 2015. Variables analyzed included age at matriculation, sex, race/ethnicity, medical degree type, program location, attrition status, and matriculation year period (2006-2010, 2011-2015). A logistic regression model was used to determine factors predictive of attrition, with a significance level set at P < .05. A total of 3073 residents were analyzed. The overall attrition rate was 3.7%. Multivariable regression showed older residents (≥30 years) had a 2.1 times higher risk of attrition compared to younger residents (≤29 years) (adjusted odds ratio [aOR]: 2.1; 95% confidence interval, CI [1.383-3.316], P < .001). Underrepresented minorities in medicine (URiM) residents had a 3.5 times higher risk of attrition compared to whites (aOR: 3.5; 95% CI [1.823-6.806], P < .001). Southern US programs had a 2.5 times higher risk of attrition compared to northeastern programs (aOR: 2.5; 95% CI [1.480-4.315], P < .001). There was no statistically significant difference in attrition based on sex, medical degree type, or matriculation year period. A higher risk of attrition was found among OHNS trainees who were older, self-identified as URiM, and in the southern US programs. There was no significant difference in attrition risk based on gender, medical degree type, or matriculation period. Further research is needed to understand the reasons for attrition and to develop strategies to promote inclusion and diversity in OHNS.

Trends in gender and ethnic diversity among US psychiatry residents: A 5-year analysis.

This study aims to analyze trends in gender and ethnic diversity among incoming US psychiatry residents over the past 5 years. Physician diversity improves patient care as minority physicians often serve underserved communities and address health disparities. Increasing the representation of women and underrepresented minorities in medicine is essential for preparing a physician workforce that can effectively care for an increasingly diverse population. This study highlights the importance of efforts to enhance diversity within the field of psychiatry.

Analyzing diversity trends in dermatology: A comprehensive overview.

Dermatology lags behind other medical specialties in workforce diversity, particularly regarding gender, race, and ethnicity. This study aims to analyze the current demographics of dermatology physicians in the United States, comparing them with other medical specialties, the overall population of practicing U.S. physicians, and the U.S. population as a whole. Data from the Association of American Medical Colleges and the U.S. Census Bureau (2007-2022) were used to evaluate gender, racial, and ethnic diversity within dermatology. Demographic factors analyzed included gender, race, and ethnicity, with racial categories grouped as White, Asian, and underrepresented minorities in medicine (URiM). Chi-square tests assessed the fit of gender and age distributions with population proportions, while linear regression models examined trends over time. From 2007 to 2021, the number of dermatologists grew by 22.9%, with a corresponding decrease in population per dermatologist, indicating growth relative to the general population. The proportion of female dermatologists rose by 68.1% during this period, while the male proportion declined by 5.1%. From 2019 to 2022, a significant linear increase (p < 0.001) in URiM representation among dermatology residents was observed, with a model-predicted annual increase of 1.6%. The increasing diversity in dermatology may be attributed to initiatives such as scholarships and mentorship programs implemented by dermatology organizations and residency programs. By fostering a more diverse workforce, dermatology can better address the healthcare needs of a diverse population and promote health equity across all demographics.

Preparing for Virtual Interviews: A Pilot Study to Understand the Needs of Interviewees.

Virtual interviews play a crucial role in the ranking process. National Resident Matching Program (NRMP) data shows a median number of 23.5 interviews per applicant. Considering this volume of interviews, graduate medical education programs must leverage the virtual pre-interview materials to impact applicants' attitudes and perceptions of the interview beforehand. This study is a secondary data analysis of an anonymous cross-sectional survey collected during two orientation sessions held in June and July 2022. Responses from 123 residents and fellows rated the usefulness of available print and virtual pre-interview resources. Using a 5-point Likert scale, social media sites scored an average usefulness score of 4.0, while the information packet and program website scored 3.88 and 3.90, respectively. This article provides recommendations for restructuring virtual resources to aid residents and fellows, specifically under-represented minorities in medicine (UiM) applicants, in having a quality interview experience.

Mentoring for Admission and Retention of Black Socio-Ethnic Minorities in Medicine: A Scoping Review.

Despite numerous mentoring strategies to promote academic success and eligibility in medicine, Black students remain disproportionately underrepresented in medicine. Therefore, we conducted a scoping review to identify the mentoring practices available to Black pre-medical students, medical students and medical residents, specifically the mentoring strategies used, their application, and their evaluation. Between May 2023 and October 2023, the authors conducted a literature review. Studies that described a mentoring strategy applied among Black learners were eligible for inclusion, and all years of publication were included. Two reviewers screened each article using the Covidence tool, and conflicts were resolved by a third author. All reviewers extracted the data to summarize the various mentoring practices. After screening 6292 articles, 42 articles met the criteria for full review. Of these, 14 studies were included in the study. Mentoring practices for Black students included peer mentoring, dyad mentoring, and group mentoring. Mentoring was typically offered through discussion groups, educational internships, and didactic activities. Evaluation of mentoring programs took into account (1) pass rates on medical exams (eg, MCAT, Casper), (2) receipt of an invitation to a medical school admissions interview, (3) successful match to a competitive residency program, and (4) a mentee's report of the overall experience and effectiveness of the program. This review is the first, to our knowledge, to focus on mentoring strategies implemented among Black learners in medicine. The results will inform mentoring strategies adapted for Black learners and will therefore address the underrepresentation of Black students in medicine.

Development of a surgical skills course for preclinical medical students

BackgroundPreclinical students have limited exposure and training in surgical skills. As a result, many students report negative experiences during their surgery clerkship from a lack of confidence in their technical abilities and, thus, lower participation in cases. Moreover, in fields such as vascular surgery, where a shortage of physicians persists, the absence of surgery and field-specific exposure for medical students could limit recruitment. To address these gaps, we designed a surgical skills curriculum for preclinical medical students using surgical simulators to develop fundamental surgical skills, introduce students to vascular surgery early, and provide training on vascular surgery-specific procedures. We hypothesize that a surgical skills course can significantly enhance preclinical students' surgical abilities before they enter their surgical clerkship and increase interest in pursuing a surgical specialty. MethodsA total of 26 students took part in a structured surgical skills curriculum comprising three sections: fundamental surgical skills, application of skills in a clinical context, and a surgical skills competition. During the course of six workshops, the students received formative feedback from proctors using task-specific standardized rubrics and assessments through the Objective Standardized Assessment of Technical Skills. Additionally, students' attitudes and perceptions toward surgical training and vascular surgery were evaluated using the modified Vascular Surgery Interest Forum. The summative performance of the preclinical students enrolled in the surgical skills course was compared with their initial performance after the skills workshop and with that of third-year medical students who had completed surgical rotations. Differences in responses and attitudes were analyzed at the beginning and conclusion of the course using bivariate analysis. ResultsOf the 26 students, most were women (61.5%) and in their second year of medical school (76.9%). Also, 23.1% identified as underrepresented minorities in medicine, 7.7% had physician family members, and 19.2% reported they had decided on a specialty. Following the knot-tying and suturing workshops, students reported a statistically significant increase in their self-rated understanding, comfort, and knowledge of tasks. Third-year medical students outperformed the preclinical students in knot-tying and instrument-tying tasks. However, no difference was found in the performance of these tasks between the third-year medical students and the top three preclinical students who completed the course. Both groups performed similarly on the anastomosis challenge (29.25 vs 28.42; P = .9) and the vascular simulation challenge (27.25 vs 26.83; P = .6). At the program's conclusion, the students demonstrated an increased mean interest in vascular surgery (from 2.3 ± 1.1 to 2.9 ± 1.2; P = .39), an enhanced interest in surgery due to its hands-on nature (from 4.5 ± 0.8 to 4.7 ± 0.6; P = .06), a preference for surgical simulation in teaching fundamental skills (from 3.7 ± 1.0 to 3.9 ± 0.8; P = .31), and an increased awareness of radiation exposure in surgical practice (from 2.5 ± 1.0 to 3.0 ± 1.3; P = .11). Students cited personality fit, exposure during medical school, and identification of a mentor as the most influential factors for pursuing a surgical career. The competitiveness of a residency program and resident workload and lifestyle were least influential. ConclusionsA structured surgical skills curriculum for preclinical medical students increased students' technical skills and fostered a greater appreciation for the hands-on and technical nature of surgery. Moreover, early exposure to vascular surgery enhanced their interest and knowledge of the field. Notably, students believed that medical school does not adequately prepare them for success on surgical rotations and emphasized the importance of personality fit, early exposure, and mentorship in considering a surgical career.

Barriers to Entry: Socioeconomic Discrepancies Between Unmatched First-Time Applicants and Reapplicants in the Field of Orthopaedic Surgery.

Orthopaedic surgery remains a competitive surgical subspecialty with more applicants than spots each year. As a result, numerous students fail to match into these competitive positions each year with a growing number of reapplicants in consecutive application cycles. We sought to understand the socioeconomic factors at play between this growing reapplicant pool compared with first-time applicants to better understand potential discrepancies between these groups. Our hypothesis is that reapplicants would have higher socioeconomic status and have less underrepresented minority representation compared with successful first-time applicants. A retrospective review of deidentified individual orthopaedic surgery applicant data from the American Association of Medical Colleges was reviewed from 2011 to 2021. Individual demographic and application data as well as self-reported socioeconomic and parental data were analyzed using descriptive and advanced statistics. Of the 12,112 applicants included in this data set, 77% were first-time applicants (61% versus 17% successfully entered into an orthopaedic surgery residency vs versus unmatched, respectively), whereas 22% were reapplicants. In successful first-time applicants, 12% identified as underrepresented minorities in medicine. The proportion of underrepresented minorities was significantly higher among unmatched first-time applicants (20%) and reapplicants (25%) ( P < 0.001). Reapplicants (mean = $83,364) and unmatched first-time applicants (mean = $80,174) had less medical school debt compared with first time applicants (mean = $101,663) ( P < 0.001). More than 21% of reapplicants were found to have parents in healthcare fields, whereas only 16% of successful first-time applicants and 15% of unsuccessful first-applicants had parents in health care ( P < 0.001). Reapplicants to orthopaedic surgery residency have less educational debt and are more likely to have parental figures in a healthcare field compared with first-time applicants. This suggests the discrepancies in socioeconomic status between reapplicants and first-time applicants and the importance of providing resources for reapplicants.

Diversity Within the Field of Orthopedic Sports Medicine: A Systematic Review.

Orthopedic surgery is among the least diverse specialties in medicine. This systematic review analyzes gender, racial, and ethnic diversity within orthopedic sports medicine and aims to raise awareness and provide guidance for future strategies that support underrepresented minorities in medicine (URMs) and women in joining the orthopedic sports medicine workforce. We hypothesize that at all tiers of training, there is a lack of gender, racial, and ethnic parity in academic rank, leadership positions, and research productivity. A search of all published literature in the English language from PubMed, Embase, Cochrane, and Scopus databases, between January 1, 2010, and August 18, 2023, was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies presented demographics regarding diversity within orthopedic sports medicine and provided trends in applicants, attendings, leadership, and/or research. Bias was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) study checklist. Thirteen studies published between 2016 and 2023 with STROBE scores 15.5 to 21.5 (70.5% to 97.7%) met criteria, and pertinent data were extracted. The percent of female orthopedic sports medicine surgeons from 2010 to 2019 increased from 5% (n = 138) to 6% (n = 206) with a compound annual growth rate of 0.2% (r2 = 0.97; p < 0.001). Females and URMs are underrepresented at the highest levels of orthopedic sports medicine leadership including department chair (female: 0% [n = 0]), division chief (female: 4% [n = 4]; URM: 3% [n = 3]), and fellowship director (female: 3.3% [n = 3]; URM: 4.4% [n = 4]). Studies from prominent orthopedic sports medicine journals (American Journal of Sports Medicine, Arthroscopy, Journal of Shoulder and Elbow Surgery, and Sports Health) show a 12.1% increase in female involvement in orthopedic sports medicine research from 1972 to 2018; however, this increase captures 59.3% (n = 2,953) females with degrees other than an MD. Although increasingly more females and underrepresented minorities are joining orthopedic sports medicine, the rate of diversification remains slow and current involvement in leadership and research is minimal. Targeted efforts aimed at increasing research opportunities and inspiring interest through mentorship for URMs and females in orthopedics is essential to drive change toward parity. Level IV. Systematic Review. See Instructions for Authors for a complete description of levels of evidence.

Impact of holistic review on diversity of interviewed and matriculating residents in graduate medical education: a systematic review protocol

IntroductionDiversity in the physician workforce improves patient-centred outcomes. Patients are more likely to trust in and comply with care when seeing gender/racially concordant providers. A current emphasis on standardised metrics...

Gender and Racial Diversity Among Colon and Rectal Surgery Trainees and Leaders.

Despite recent changes in women and underrepresented minorities in medicine, there still exists large gender and racial gaps in surgical training and leadership. We hypothesize that gender and racial representation have improved among general and colorectal surgical trainees and leadership over the past 20 years. This cross-sectional study examines gender and racial representation of general and colorectal surgery residents, colorectal faculty members, and the American Society of Colon and Rectal Surgeons Executive Council. We extracted data from the Journal of the American Medical Association Graduate Medical Education yearly reports for information on surgical residents. We used the American Society of Colon and Rectal Surgeons website and publicly available practice websites to obtain information regarding colon and rectal surgery residents, faculty members, and the American Society of Colon and Rectal Surgeons Executive Council. We primarily focused on the gender and underrepresented minority breakdowns of general surgery residents, colorectal surgery residents, and the American Society of Colon and Rectal Surgeons Executive Council. We found that between 2001 and 2021, the number of women and people identifying as underrepresented minorities increased within general surgery programs. In addition, there has been a similar increase in underrepresented minorities and women entering colorectal surgery residency programs. Finally, there has been a steady, significant increase in women representation in the American Society of Colon and Rectal Surgeons Executive Council, with a slower increase in underrepresented minorities on the council. The study is limited by using previously collected data and relying on publicly available profiles for gender and race information. General and colon and rectal surgery have significantly increased gender and racial diversity at the training and leadership levels. ANTECEDENTES: A pesar de los cambios recientes en las mujeres y las minorías subrepresentadas en la medicina, todavía existen grandes brechas de género y raza en la capacitación y el liderazgo quirúrgico.OBJETIVO: Presumimos que la representación racial y de género ha mejorado entre los pasantes y el liderazgo en cirugía general y colorrectal en los últimos 20 años.DISEÑO: Este es un estudio transversal que examina la representación racial y de género de los residentes de cirugía general y colorrectal, miembros de la facultad colorrectal y el Consejo Ejecutivo de la Sociedad Estadounidense de Cirujanos de Colon y Recto.CONFIGURACIÓN: Extrajimos datos de los informes anuales de Educación Médica para Graduados del Journal of the American Medical Association para obtener información sobre los residentes quirúrgicos. Utilizamos el sitio web de la Sociedad Estadounidense de Cirujanos de Colon y Recto, así como los sitios web de práctica disponibles públicamente para obtener información sobre los residentes de cirugía de colon y recto, miembros de la facultad y el Consejo Ejecutivo de la Sociedad Estadounidense de Cirujanos de Colon y Recto.MEDIDAS PRINCIPALES DE RESULTADO: Nos enfocamos principalmente en los desgloses de género y minorías subrepresentadas de residentes de cirugía general, residentes de cirugía colorrectal y el Consejo Ejecutivo de la Sociedad Estadounidense de Cirujanos de Colon y Recto.RESULTADOS: Encontramos que entre 2001 y 2021, la cantidad de mujeres y personas que se identificaron como minorías subrepresentadas aumentó dentro de los programas de cirugía general. Además, ha habido un aumento similar en minorías subrepresentadas y mujeres que ingresan a programas de residencia en cirugía colorrectal. Finalmente, ha habido un aumento constante y significativo en la representación de mujeres en el Consejo Ejecutivo de la Sociedad Estadounidense de Cirujanos de Colon y Recto con un aumento más lento en las minorías subrepresentadas en el consejo.LIMITACIONES: El estudio está limitado por el uso de datos recopilados previamente y por confiar en perfiles disponibles públicamente para la información de género y raza.CONCLUSIONES: La cirugía general y de colon y recto han hecho algunos avances significativos en el aumento de la diversidad racial y de género en los niveles de formación y liderazgo. (Traducción-Yesenia.Rojas-Khalil ).

Promoting Women and Historically Excluded Minorities in Medicine as Essential Leaders of Research

Women and historically excluded minorities are underrepresented in clinical research. At the ASTRO 2021 annual meeting, the authors reviewed several strategies to improve on this issue. Implementation of such strategies should not only improve their visibility but also provide increased opportunities for their advancement and work in clinical research.

Improving the Experiences of Sexual and Gender Minority-Identifying Trainees in Gastroenterology and Hepatology

Improving the Experiences of Sexual and Gender Minority-Identifying Trainees in Gastroenterology and Hepatology

Representation of Women and Minority Faculty and Fellows in Academic Pediatric Cardiology Training Programs

BackgroundStudies have shown that diverse care teams optimize patient outcomes. Describing the current representation of women and minorities has been a critical step in improving diversity across several fields. ObjectivesTo address the lack of data specific to pediatric cardiology, the authors conducted a national survey. MethodsU.S. academic pediatric cardiology programs with fellowship training programs were surveyed. Division directors were invited (July 2021 to September 2021) to complete an e-survey of program composition. Underrepresented minorities in medicine (URMM) were characterized using standard definitions. Descriptive analyses at the hospital, faculty, and fellow level were performed. ResultsAltogether, 52 of 61 programs (85%) completed the survey, representing 1,570 total faculty and 438 fellows, with a wide range in program size (7-109 faculty, 1-32 fellows). Although women comprise approximately 60% of faculty in pediatrics overall, they made up 55% of fellows and 45% of faculty in pediatric cardiology. Representation of women in leadership roles was notably less, including 39% of clinical subspecialty directors, 25% of endowed chairs, and 16% of division directors. URMM comprise approximately 35% of the U.S. population; however, they made up only 14% of pediatric cardiology fellows and 10% of faculty, with very few in leadership roles. ConclusionsThese national data suggest a “leaky pipeline” for women in pediatric cardiology and very limited presence of URRM overall. Our findings can inform efforts to elucidate underlying mechanisms for persistent disparity and reduce barriers to improving diversity in the field.

The CASPER preparation program innovation: increasing self-perceived competence and confidence of underrepresented applicants on the novel CASPER Snapshot and CanMEDS roles

BackgroundUnderrepresented Minorities in Medicine (URMMs) may face financial and social limitations when matriculating into medical schools. Performance on situational judgment tests such as Computer-based Assessment for Sampling Personal Characteristics (CASPER) can be enhanced by coaching and mentorship. The CASPER Preparation Program (CPP) coaches URMMs to prepare for the CASPER test. During the coronavirus 2019 pandemic (COVID-19), CPP implemented novel curricula on the CASPER Snapshot and CanMEDS roles.MethodsPre and post-program questionnaires were completed by the students, which assessed their: 1) confidence in understanding the CanMEDS roles, and 2) perceived confidence in performing well and their familiarity and preparedness with the CASPER Snapshot. With a second post-program questionnaire, participants’ scores on the CASPER test as well as medical school application outcome were also assessed.ResultsParticipants reported a significant increase in the URMMs’ knowledge, self-perceived competency to complete the CASPER Snapshot, and their anxiety significantly decreased. The level of confidence in understanding CanMEDS roles for a career in healthcare increased as well. The majority (91%) agreed that the feedback received from tutors was adequate and the virtual component of the program was beneficial during COVID-19. 51% of students scored in the highest quartile on the CASPER test and 35% received an offer of admission from CASPER-requiring medical schools.ConclusionPathway coaching programs have the potential to increase confidence and familiarity amongst URMMs for the CASPER tests and CanMEDS roles. Similar programs should be developed with the aim to increase the chances of URMMs matriculating into medical schools.

National trends in distribution of underrepresented minorities within United States general surgery residency programs: A longitudinal panel study

BackgroundCultural affinity with a provider improves satisfactoriness of healthcare. We examined 2005–2019 trends in racial/ethnic diversity/inclusion within general surgery residency programs. MethodsWe triangulated 2005–2019 race/ethnicity data from Association of American Medical Colleges surveys of 4th-year medical students, the Electronic Residency Application Service, and Accreditation Council for Graduate Medical Education-affiliated general surgery residencies. Temporal trends in minority representation were tested for significance. ResultsUnderrepresented racial/ethnic minorities in medicine (URiMs) increased among graduating MDs from 7.6% in 2005 to 11.8% in 2019 (p < 0.0001), as did their proportion among surgery residency applicants during 2005–2019 (p < 0.0001). However, proportions of URiMs among general surgery residents (≈8.5%), and of programs without URiMs (≈18.8%), stagnated. ConclusionsGrowing URiM proportions among medical school graduates and surgery residency applicants did not improve URiM representation among surgery trainees nor shrink the percentage of programs without URiMs. Deeper research into motivators underlying URiMs’ residency program preferences is warranted.

Overcoming financial and social barriers during COVID-19: A medical student-led medical education innovation.

Underrepresented minorities in medicine (URMM) may face financial and social limitations when applying to medical schools. The computer-based assessment for sampling personal characteristics (CASPER) test is used by many medical schools to assess the nonacademic competencies of applicants. Performance on CASPER can be enhanced by coaching and mentorship, which URMMs often lack, for affordability reasons, when applying to medical schools. The CASPER Preparation Program (CPP) is a free, online, 4-week program to help URMM prepare for the CASPER test. CPP features free medical ethics resources, homework and practice tests, and feedback from tutors. Two of CPPs major objectives include relieving URMM of financial burdens and increasing their accessibility to mentorship during the COVID-19 pandemic. A program evaluation was conducted using anonymous, voluntary postprogram questionnaires to assess CPPs efficacy in achieving the aforementioned objectives. Sixty URMMs completed the survey. The majority of the respondents strongly agreed or agreed that CPP relieves students of financial burden (97%), is beneficial for applicants with low-socioeconomic statuses (98%), provides students with resources they could not afford (n = 55; 92%), and enables access to mentors during the pandemic (90%). Pathway coaching programs, such as the CASPER Preparation Program, have the potential to offer URMMs mentorship and financial relief, and increase their confidence and familiarity with standardized admission tests to help them matriculate into medical schools.

Exploring the Influence of an Interprofessional Student-Run Clinic on Matriculation to Health Professional School: A Retrospective Cross-Sectional Study

Background: Projected demographic trends in the United States suggest increasing racial and ethnic diversity. It is important that the healthcare workforce reflects these trends to reduce healthcare disparities among underserved populations. For example, concordant backgrounds between patients and providers improve communication and increase probability that patients seek and receive healthcare among marginalized populations. Building in curricular opportunities to connect with the underserved community is one way to recruit students from diverse backgrounds into this pipeline that will lead to a diverse workforce in healthcare. The objective of this study was to assess the influence of an interdisciplinary student-run clinic (SRC), which focuses on caring for underserved and vulnerable populations, on students’ decisions to matriculate in four health professional programs (medical, occupational therapy, pharmacy, and physician assistant) at a single institution.&#x0D; Methods: In this retrospective cross-sectional survey study, we examined factors influencing first-year students’ decisions to attend a private university in a large metropolitan area. The primary outcome was students’ self-reported ratings of the university’s SRC as a factor in their matriculation decisions. Two-tailed Mann-Whitney-U tests was applied to compare the relative importance of SRC on matriculation. Free response data were evaluated by a qualitative content approach.&#x0D; Results: A total of 419 students completed the survey (73% completion rate) across the 4 programs. We found that underrepresented minorities in medicine (URM) (p &lt; 0.05) and first-generation (p &lt; 0.01) students rated the importance of an SRC on their matriculation decision significantly higher than non-URM and non-first-generation students.&#x0D; Conclusions: Our findings suggest that the presence of an SRC may positively impact matriculation decisions and diversification of the student body across certain health professional disciplines.

Association Between Stress and Program Length in Underrepresented Minority Physician Assistant Students.

The purpose of this study was to determine if there was a relationship between physician assistant (PA) program length and stress measures in PA students, particularly PA students classified as underrepresented minorities in medicine. The stress measures included emotional and physical well-being. The 2019 End of Program survey data were analyzed using multiple regression to determine if emotional and physical well-being could be predicted by PA program length, age, gender, PA school debt, and UR minority in medicine status. Shorter PA programs were associated with higher physical well-being scores, although there was no difference between UR minority in medicine and non-UR minority in medicine students. Older students, males, and students with higher levels of PA school debt had lower scores for emotional and physical well-being. Shorter program lengths should be considered for optimal physical well-being in all students. Further research is needed to understand optimal program length and experiences of these students .

Associations between Faculty Vitality and Burnout in the COVID-19 Era: the Experience of One Institution

Introduction: Faculty vitality is the ideal synergy between engaged faculty and mission-driven institutions that generates a fruitful environment for academic productivity, career satisfaction, and fulfillment of shared goals. The COVID-19 pandemic has introduced unprecedented disruptions to faculty vitality, with profound perturbations to individual and institutional support networks. However, the extent of this impact is unclear, as are strategies to mitigate loss of faculty vitality and prevent burnout. Methods: We developed a survey instrument to evaluate the impact of COVID-19 on faculty vitality and burnout at a mid-sized, Midwestern academic institution affiliated with a university hospital. Survey items focused on individual and institutional factors that are predictive of faculty vitality, organized around themes of work-life integration, professional engagement, and institutional support. The survey also evaluated the impact of interventions implemented in response to the pandemic on faculty burnout. Results: One hundred and thirty-eight clinical and basic science faculty participated in the survey. Female faculty are less satisfied with work-life integration since the onset of the pandemic. Almost all (98.2%) faculty respondents experienced detriments to their professional development, and 38% believed their research was affected. Faculty of color experienced more detrimental effects on their professional development. Self-reported burnout increased from 23.6% before to 44.8% after the pandemic. Burnout was associated with lack of career development opportunities, whereas career satisfaction and utilization of university support efforts were protective. Conclusion: Faculty vitality has decreased since the pandemic began, but institutional support can mitigate these detrimental effects. Additional research on the efficacy of interventions to support female faculty, early-career researchers, and under-represented minorities in medicine is needed.

Factors Associated with Office-Based, Primary-Care Practice Among U.S. Medical Graduates: A National Cohort Study.

Purpose: Primary care (PC) career choice has been declining among U.S. medical graduates and residents since the 1990s. 1,2 By 2034, an estimated shortage of 17,800–48,000 PC physicians is expected. 2 Some medical schools have developed programs to increase students’ interest in PC specialties and practice in underserved areas. 3,4 To our knowledge, the durability of early PC-specialty preference for long-term PC practice has not been reported. Method: The Association of American Medical Colleges provided linked, deidentified data for a national cohort of 48,533 U.S. MD-granting medical school matriculants from 1998–1999 through 2000–2001. Data from the Student Records System (sex, race/ethnicity, and graduation year), Matriculating Student Questionnaire (MSQ; specialty board certification plans and attitudinal variables: importance of prestige and social responsibility in choosing a medical career), Graduation Questionnaire (GQ; total debt, plans to practice in underserved areas, and student ratings [excellent vs not excellent] of PC and non-PC clerkship experiences), and American Medical Association (AMA) Physician Masterfile practice data through May 2020 were used. The outcome was office-based practice in a specialty from the AMA Physician Masterfile, categorized as follows: (1) general-PC (i.e., internal medicine, pediatrics, family practice, general practice, internal medicine/pediatrics, or internal medicine/family practice as primary specialty, with another general-PC or unspecified secondary specialty), (2) PC-subspecialty (i.e., general-PC primary and PC-subspecialty secondary specialty, or PC-subspecialty as primary specialty), and (3) non-PC specialties (i.e., non-PC primary specialty). Multivariable logistic regression models identified variables independently associated with general-PC vs each of PC-subspecialty and non-PC-specialty practice. Results: Of 46,698 graduates in 2002–2013, 30,435 (65.2%) had complete data for analysis (7,700 [25.3%] general-PC physicians, 5,327 [17.5%] PC subspecialists, and 17,408 [57.2%] non-PC specialists). Female (vs male) students, and students with plans to practice in underserved areas (vs no plans) were more likely to report general-PC (vs PC-subspecialty) practice. Underrepresented racial/ethnic minorities in medicine (URiM), Asian/Pacific Islander (Asian/PI) students (each vs White), and students planning to pursue non-PC specialties or no board certification (each vs PC board certification plans) on the MSQ were each less likely to report general-PC (vs PC-subspecialty) practice. In the second model, female students and students reporting plans to practice in underserved areas (vs no plans), endorsing higher importance of social responsibility, or rating only PC clerkships excellent (vs rating both PC and non-PC clerkships excellent) were each more likely to report general-PC (vs non-PC-specialty) practice. URiM, Asian/PI students, students planning to pursue non-PC or no board certification, and students endorsing higher importance of prestige were each less likely to report general-PC (vs non-PC-specialty) practice. Discussion: Several factors were associated with future PC practice. The greater likelihood of women and lower likelihood of URiM graduating students to choose PC specialties on the GQ has been reported. 1 We extend this work, finding lower likelihood of URiM and A/PI physicians to be in general-PC practice. Importantly, early preference for PC specialties was positively associated with general-PC practice in both models. This may reassure medical schools considering early specialty preferences for admissions or entry into early, PC-pathway programs. Although clerkship experiences might influence students to change specialty interests, 5 to our knowledge, associations between clerkship experiences and PC practice have not been examined. We observed that students reporting excellent PC-clerkship experiences were more likely to report general-PC (vs non-PC) practice. Greater importance of social responsibility in choosing medicine also was positively associated with general-PC (vs non-PC) practice. Significance: Medical school experiences that are amenable to intervention were associated with greater odds of general-PC practice. Admitting students with early interest in PC specialties or who highly value social responsibility, fostering students’ plans to practice in underserved areas, 3,4 and improving PC-clerkship experiences may help mitigate the PC-physician shortage. Acknowledgments: The authors thank Hershel Alexander, PhD, Marie Caulfield, PhD (retired), David Matthew, PhD, and Lindsay Roskovensky, at the Association of American Medical Colleges (AAMC), for their efforts to obtain and prepare the deidentified datasets from various sources and their assistance with data coding; the National Board of Medical Examiners (NBME) Office for Research Strategy for permission to use Step 1 licensing examination data; Kristy Vanderplow at MMS, Inc., for provision of the American Medical Association (AMA) Physician Masterfile data; and Maria Pérez, MA, at Washington University School of Medicine, for data management and preparation of the data for analysis.