Pipeline Program Research Articles

123. Expanding The Health Professions Pipeline: A Qualitative Analysis of the Stanford Medical Youth Science Program

The underrepresentation of individuals from minority and low-income backgrounds is a pressing and persistent issue in medicine. High school biomedical pipeline programs offer a promising strategy to diversify the medical pipeline by supporting underrepresented students towards successful transition into college and health careers. One of the most established university-based pipeline programs is the Stanford Medical Youth Science Program (SMYSP). For over thirty years, SMYSP has fostered the potential of low-income and under-represented high school students interested in careers in health and medicine through a 5-week summer program.

Factors Influencing the Decision to Practice Medicine in West Virginia: Training Experiences

INTRODUCTION The study describes pipeline, training, and contextual experiences and factors that influence the decision to practice medicine in West Virginia (WV). METHODS The cross-sectional study using descriptive statistics was conducted between November 2019 and March 2020 using an online link to an anonymous survey sent to all physicians licensed to practice medicine in WV with an e-mail address on file with the WV Board of Medicine or WV Osteopathic Medical Association at the time of the study. RESULTS More WV medical school graduates identifying as a WV native practiced primary care than non-native WV medical graduates in this sample. More native WV medical graduates practiced primary care than non-native peers; however, both groups chose primary care at a greater rate than out-of-state medical school graduates. Returning to home communities and an established network of family and friends were influential factors for WV medical graduates. More WV natives completed residency in-state (n = 127) compared to out-of-state (n = 55). More than half of the sample (69.4%) participated in at least one pipeline program during medical school (n=153), residency (n = 86), undergraduate (n = 50), other graduate training (n = 18), or K-12 (n = 16). Approximately 24% of all respondents' primary practice was in a rural area, and 60% of respondents practiced in a primary health profession shortage area. DISCUSSION More native WV respondents are currently providing primary care and completed residency in-state compared to non-native respondents. The choice of primary care practice was similar across graduates of WV's three medical schools. A majority of respondents participated in pipeline programming though the effect on career and practice location decisions are unclear. CONCLUSIONS Continued recruitment of WV medical school graduates into in-state residency programs, concurrently with expanded primary care training placements and promotion, may increase the number and retention of WV primary care physicians in the coming years. Further study should examine factors that influence physician choice not to return to WV to practice after residency or fellowship training.

Racial Bias in the Assessment of Pain

<h3>Research Objectives</h3> To assess whether U.S. medical students and resident physicians (trainees) at Historically Black Colleges & Universities (HBCUs) displayed any racial bias in the assessment of pain or treatment recommendations; if they held any false beliefs about biological differences between Blacks and Whites, and if they were equally, more, or less accurate in their treatment recommendations for pain in Black vs White patients as a result of their beliefs and/or biases. <h3>Design</h3> This was a descriptive cross-sectional study. Each trainee was asked to read 2 mock-medical cases about a Black patient and a White patient, asked to estimate each patient's pain in each of 2 scenarios which are generally known by medical trainees to be significantly painful in nature, and then asked for their treatment recommendations based on this estimate. They were then given a 15-question survey to measure their preexisting beliefs about biological differences between Black and White people. <h3>Setting</h3> The study took place among U.S. medical students and resident physicians (trainees) at Howard University. <h3>Participants</h3> 96 medical students & residents. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> The presence of false beliefs between races; the impact of false beliefs on treatment recommendations, and treatment recommendations based on the patient's race. <h3>Results</h3> When compared to the landmark 2016 UVA study, significantly less HBCU-affiliated (predominantly BIPOC) students and residents held any false beliefs about biological differences between Blacks and Whites; their false beliefs (if any) did not impact the treatment of the sample patients, and their assessment of pain was not impacted by the patient's race. Interestingly, the White respondents at Howard also did not exhibit any racial bias in pain assessment or treatment recommendations, indicating that perhaps active teaching and implicit bias training by HBCUs counteracts racial bias in these individuals. <h3>Conclusions</h3> These findings strongly support the need for pipeline programs to improve exposure, recruitment, development, and retention of Black students in medicine, as well as continued support of HBCU medical schools. <h3>Author(s) Disclosures</h3> The authors have no conflicts to disclose.

Accountability Committee Tracks APA’s Progress on Structural Racism

Accountability Committee Tracks APA’s Progress on Structural Racism

Impact of summer healthcare diversity camp on students' interest and pursuit of healthcare careers

IntroductionThe diversity of the United States population has increased drastically, yet minority enrollment in healthcare schools continues to be low. The annual Healthcare Diversity Summer Camp for underserved minority high school students with an interest in a future healthcare career was created to expose students to pharmacy, nursing, and dental medicine. MethodsCamp participants completed pre- and post-surveys before and after attending the summer camp over four years to assess students' knowledge and confidence in pursuing a career in the healthcare field. Additionally, past participants were surveyed to assess academic progression following the completion of the camp. ResultsA total of 70 students completed both pre- and post-surveys during camp participation. Results were analyzed using descriptive statistics and paired t-test analysis. Post-survey results showed statistically significant improvement in comparison to pre-survey results. Of the past participants contacted, all except two are pursuing a healthcare-related degree. ConclusionsThis camp was effective in increasing students' interest and awareness of nursing, pharmacy, and dental careers. The profound majority of participants that declared the intention of pursuing a career in healthcare showcases its impact. This interdisciplinary program can serve as a model pipeline program for healthcare institutions nationwide.

Affirming and Nurturing Students’ Cultural Wealth to Enhance Self-efficacy: Examination of Urban High School Students’ Lived Experiences in a STEM-Medicine Pipeline Program

Embracing students’ cultural assets is critical in facilitating self-growth and development at the secondary level, especially among minoritized students interested in science, technology, engineering, mathematics, and medicine/health (STEM-M) careers. Using sociocultural and community cultural wealth (CCW) lenses, longitudinal data among 23 students or 53 semi-structured interviews were analyzed to understand how their participation in an extramural academic program stimulated their self-efficacy. Findings revealed how the program nurtured students’ cultural wealth while promoting their learning, engagement, persistence, and empowerment. Strengthening self-efficacy through the affirmation of cultural assets and through asset-based frameworks can enhance students’ academic and career goals.

NMA, NextGenU.org, and Enhancing Diversity in Medical Education Through Pipeline and Parallel Programs

NMA, NextGenU.org, and Enhancing Diversity in Medical Education Through Pipeline and Parallel Programs

Addressing geographic disparities in dermatology through virtual educational outreach

Purpose: Rural areas face significant shortage of dermatologists. Rural origin is a strong indicator of eventual rural practice for physicians, however students of rural background account for less than 5% of all incoming medical students. Increasing representation of students with rural backgrounds is important to increase the supply of dermatologists in rural areas, which have higher skin cancer mortality rates compared to urban populations. We created a virtual educational outreach program for high school students in Maine, a predominately rural state, to create interest amongst high school students in pursuing a career in health care.&#x0D; Methods: We developed a virtual pipeline program called the Inside Medicine Program that provides monthly educational workshops to high school students in Maine. For one of the sessions, we conducted a dermatology workshop teaching various topics in Dermatology. Pre- and post-curriculum surveys were sent to 33 students, which used a 10-point Likert scale to rate interest and perceived knowledge levels in these topics.&#x0D; Results: After the workshop, 100% of respondents endorsed a greater understanding of the path to a dermatology career and 94.12% stated that they were interested in learning more about dermatology. Moreover, students endorsed greater interest in pursuing a career in dermatology and reported a significant increase in knowledge about various dermatologic topics.&#x0D; Conclusions: Our results suggest that our program has improved these students’ interest and perceived knowledge in dermatology. We hope that this will promote their subsequent entry into the medical field to address shortages in subspecialty care in rural areas.

A Survey to Assess and Delineate Approaches to Medical Student Outreach to Promote Diversity at Academic Radiation Oncology Programs

The aim of this study was to assess how academic radiation oncology departments engage medical students who are either female and/or from racial and ethnic demographic groups that are underrepresented in medicine. An electronic survey was sent to all 83 radiation oncology residency program directors (or if applicable medical student directors) whose department is affiliated with an on-site medical school. Questions assessed whether any faculty in the participants' department offer exposure in radiation oncology specifically to medical and premedical student groups whose members are typically women and others underrepresented in medicine, or promote the American Society for Radiation Oncology's Minority Summer Fellowship Award. Barriers to these types of involvement were also assessed. A representative from 54 out of 83 programs responded (response rate 65%). Faculty from 83% of departments had given a presentation to an oncology or radiation oncology medical student interest group. However, faculty from only 18% of departments had given a presentation to a Student National Medical Association chapter, 9% to a Latino Medical Student Association chapter, and 11% to an American Medical Women's Association chapter. Faculty from 15% of departments actively promote the Minority Summer Fellowship to the general student body, and 24% promote it to any minority students who express interest in radiation oncology. Faculty from 22% of departments had given a presentation to a premedical student group, 10% to an undergraduate student group focused on minority or female students, and 20% to a pipeline program for high school (or younger) women or other students who are underrepresented in medicine. Lack of awareness of the existence of such programs, or not being invited, were the most common barriers to participation. Most academic radiation oncology departments do not offer educational outreach specifically targeting women or minority students or promote the Minority Summer Fellowship. Further efforts are needed to break from the status quo and attract a more diverse workforce.

Student Perspective of Pipeline Programs, an Essential Tool in Diversifying Radiology.

Radiology is in need of physicians who are demographically diverse to holistically treat the needs of an increasingly diverse US population. An important tool in increasing diversity is the pipeline programs that support medical students pursuing a career in radiology. A lack of diversity is seen in all radiologic specialties including diagnostic radiology, interventional radiology, radiation oncology, and radiation physics. According to the 2010 US census, Black and Hispanic Americans comprise 12.6% and 16.3% of the population, respectively.

Stalled Progress: Medical School Dean Demographics.

Medical schools have an important directive: to train the next generation of physicians. Faced with a primary care physician shortage, increasing numbers of under-represented faculty leaving academic medicine, low representation of women in leadership positions, and an ongoing pandemic, medical schools have a duty to implement solutions to alleviate these issues. Efforts have been made to create more diverse medical school classes, but those efforts are not mirrored in senior faculty demographics. In this medical students' perspective piece, the authors analyzed the demographics of medical school deans in comparison with the United States' demographics and the current composition of active physicians. The authors looked at the specialty, race/ethnicity, and gender of medical school deans in 2019. Based on the analysis, in 2019 only 11% of deans were under-represented minorities, 16% of deans were primary care physicians, and 18% of deans were women. When compared with the makeup of physicians in the United States and the population as a whole, these numbers are unrepresentative of national demographics. By hiring deans with a variety of race/ethnicities, specialties, and genders, schools set an important precedent that could lead to more pipeline programs, increased under-represented faculty retention, and more primary care physicians.

Brain Camp: A Summer Pipeline Program to Increase Diversity in Neurosciences.

Despite calls to increase diversity in the health care workforce, most medical fields including neurology have seen minimal advances, owing in part to the lack of developing a robust pipeline for trainees from underrepresented backgrounds. We sought to create an immersive, replicable neurology-themed summer camp and longitudinal mentorship program for underrepresented-in-medicine (URM) high-school students to encourage them to enter the training pipeline in neuroscience-related fields. We established an annual, no-cost 1-week camp for local URM students with the goals of exposing them to different health care professions within neuroscience while providing them with college application resources and long-term mentorship. A postprogram survey was distributed to assess the students' attitudes towards the camp and their desires to pursue health care careers. Over the 4 years since the founding of the camp (2016-2020), a total of 96 students participated, of whom 53% were URM, 74% came from very low-income households, and 61% had parents who did not attend college. In total, 87 students (91%) completed the postcamp survey. Nearly all (97%) of the respondents were likely to recommend the camp to their peers, and the vast majority (85%) felt that Brain Camp made them more likely to pursue careers in health care. Brain Camp seeks to address the unmet need for low barrier-to-entry programs designed for URM high-school students interested in health care careers. We envision that our camp may serve as a blueprint for other similar programs across the nation with the goal of addressing the URM pipeline in neuroscience.

The Scope of Social Mission Content in Health Professions Education Accreditation Standards.

Health professions education accreditation standards influence institutional practices and policies and ensure high-quality education that meets the needs of patients and society. Social mission is the contribution of a school in its mission, programs, and the performance of its graduates, faculty, and leadership to advancing health equity and addressing the health disparities of the society in which it exists. This study examined the scope of social mission content in major U.S. and Canadian health professions education accreditation standards. The authors analyzed publicly available accreditation standards documents from 9 accreditors across 5 disciplines-dental, medical, nursing, pharmacy, and physician assistant schools-with effective years from 2016 to 2020. They created a codebook from the previously published social mission metrics survey, which includes 18 social mission activity areas and 79 indicators within those areas. The authors then conducted detailed document reviews to identify the presence of the social mission areas and indicators within the accreditation standards. Across all 18 activity areas and 9 accreditors, the authors identified 93 instances of social mission. Curriculum was the most well-represented area with 34 instances. Interprofessional education in curriculum was the most prevalent indicator with 17 instances. The Committee on Accreditation of Canadian Medical Schools included more social mission areas and indicators than the other accreditors. There is substantial variability in the social mission content in accreditation standards across accreditors and disciplines. The authors found little representation of key aspects of social mission, including community collaborations, faculty training, and pipeline programs. These findings highlight areas of potential interdisciplinary collaboration to enhance the social mission content of health professions education.

Improving Youth COVID-19 Knowledge, Attitudes, and Practices Through a Novel Medical Student Driven Curriculum.

Despite widespread media coverage and public health messaging, many high school students lacked formal education about COVID-19 during the pandemic. Providing this education, particularly to underserved communities, may reduce health disparities and encourage youth to engage in the sciences. Twenty-five medical students at Emory University School of Medicine created a virtual, synchronous, COVID-19 curriculum. Learners included 25 students enrolled in a pipeline program from five high schools in metro-Atlanta. The five lesson topics included virus epidemiology, COVID-19 testing and mask-wearing, vaccine fundamentals, COVID-19 risk in communities, and mental health and wellness. Lessons were standardized through medical student-teacher practice presentations to faculty. The curriculum was evaluated with a 23-item pre- and postsurvey assessing learners' COVID-19 knowledge, attitudes, and practices. Pre- and postsurvey scores were compared using descriptive statistics and paired-samples t test. After the curriculum, learners' (N = 9) COVID-19 knowledge scores increased from 67% correct to 90% correct. Participants were better able to identify risk factors for severe COVID-19 infection, define "herd immunity," and describe how socioeconomic status can influence infection risk. In addition, after the curriculum implementation, more learners thought vaccines were safe, with 67% responding that vaccines are "very safe," compared with 0% at pretest. This initiative increased learners' COVID-19 knowledge and established bridges between medical students and underserved communities. These connections are essential to combat misinformation surrounding COVID-19, encourage participation in the sciences from underrepresented areas, and empower students to be health advocates within their communities.

Strategies for Developing an Inclusive Geriatric Physician Workforce for Older Adults in the U.S.

The “geriatric imperative” has been part of the aging discourse for more than 30 years but neither geriatric practice nor older adults are homogenous. As the U.S. population ages, elders will become more racially and ethnically diverse; and, their health outcomes will be shaped by lifetime experiences with systemic discrimination and racism. Already, COVID-19 has made clear that older adults and non-Whites, particularly African Americans and Hispanics, disproportionately bear the burden of disease and illness. Research suggests health disparities will continue unless there is change within the health care system. The Institute of Medicine (2001) reported on the problematic nature of the stark contrast between the diversity of patients and the physicians caring for them, including issues with patient trust and communication, yet no significant movement has been made to diversify the physician workforce. Despite being 13% and 16% of the U.S. population, respectively, African Americans and Hispanics make up just 5% and 6% of the practicing physician workforce. Further, practicing geriatricians represent less than 1% of physicians with very few physicians of color. There is a need for more African American and Hispanic geriatricians. In this systematic review, we examine recruitment and retention efforts targeting students of color, and curricula of geriatric medical programs in the U.S. We offer recommendations toward incentivizing physicians of color to enter geriatrics, strategies to support decolonization of geriatric medical curricula in undergraduate medical education programs, and the development of mentorship and pipeline programs to increase diversity in the geriatric physician workforce.

Tailoring Recruitment and Outreach Strategies for Underrepresented Students in Public Health Pipeline Programs

Studies have shown that racial and ethnic minority health professionals are more likely than those in the majority to work in predominantly underserved, largely minority communities. Increasing the pool of underrepresented racial and ethnic professionals could help reduce health disparities. Summer programs giving minority students public health training and experiences can increase the number who enter the health professions. This article describes recruitment strategies for obtaining a diverse pool of applicants for such a program as part of a Centers for Disease Control and Prevention funded multisite undergraduate training program intended to increase the diversity of the public health workforce. The recruitment strategies used included institutional linkages, collaborative partnerships, and interpersonal contacts. No one strategy was more effective; however, Hispanic/Latinas were more likely to be recruited through institutional linkages, but less likely to be recruited through interpersonal contacts than other female groups. Understanding successful recruitment strategies to achieve a diverse application pool for public health training programs is vital to achieve health equity.

An Evaluation of a Pipeline Program to Support Diversity in the Public Health Workforce: CDC Undergraduate Public Health Scholars (CUPS) Program

Established by the Centers for Disease Control and Prevention (CDC), the goal of the CDC Undergraduate Public Health Scholars (CUPS) program is to expose students underrepresented in public health and medicine to careers in public health; ultimately, increasing the membership of these groups in these fields including biomedical sciences. CDC implemented a retrospective outcome evaluation of 1,047 students who participated in the program from 2012 to 2017. Seventy-four percent (775) of students responded to the survey that captures their academic attainment and employment status, as well as their perception of the program’s and mentors’ influence on their career path. As of 2020, 639 (83.4%) of 775 participants have enrolled in an advanced degree program, with over 80% of 639 participants pursuing degrees in biomedical sciences, public health, or health care (BSPHHC)–related fields. Two thirds (374/566) of participants who reported they had ever been employed in a career position are working/have worked in BSPHHC-related fields. Overall, 77.4% (600) of 775 participants reported either the program or the mentors, or both were extremely or very influential to their career path. Students claimed the CUPS program had “opened their eyes,” inspired their interest, cultivated their passion for the field of public health, and fueled their drive to find solutions to and in social determinants of health and contribute to health equity. The opportunity to gain work and research experience through internship placements in CUPS has “opened doors” to first jobs and advanced education and training opportunities for many students.

Next Steps: Advocating for Women in Orthopaedic Surgery.

Orthopaedic surgery is the least diverse of all medical specialties, by both sex and race. Diversity among orthopaedic trainees is the lowest in medicine, and growth in percentage representation is the lowest of all surgical subspecialties. Women comprise only 6% of orthopaedic surgeons and 16% of orthopaedic surgery trainees. This extreme lack of diversity in orthopaedics limits creative problem-solving and the potential of our profession. Women in orthopaedics encounter sexual harassment, overt discrimination, and implicit bias, which create barriers to training, career satisfaction, and success. Women are underrepresented in leadership positions, perpetuating the lack of diversity through poor visibility to potential candidates, which impedes recruitment. Correction will require a concerted effort, as acknowledged by the American Academy of Orthopaedic Surgeons leadership who included a goal and plan to increase diversity in the 2019 to 2023 Strategic Plan. Recommended initiatives include support for pipeline programs that increase diversity of the candidate pool; sexual harassment and implicit bias acknowledgement, education, and corrective action; and the active sponsorship of qualified, capable women by organizational leaders. To follow, women will lend insight from their diverse viewpoints to research questions, practice problems, and clinical conundrums of our specialty, augmenting the profession and improving patient outcomes.

American Heart Association's 2024 Impact Goal: Every Person Deserves the Opportunity for a Full, Healthy Life.

American Heart Association's 2024 Impact Goal: Every Person Deserves the Opportunity for a Full, Healthy Life.

Diversity, equity, and inclusion in pathology: Some progress, but room for improvement: Amid a troubling backslide in diversifying medicine, pathologists point to recent successes and remaining challenges in promoting diversity, equity, and inclusion (DEI). In part 1 of a 2-part series, we investigate what has and has not worked in efforts to diversify workforces.

Diversity, equity, and inclusion in pathology: Some progress, but room for improvement: Amid a troubling backslide in diversifying medicine, pathologists point to recent successes and remaining challenges in promoting diversity, equity, and inclusion (DEI). In part 1 of a 2-part series, we investigate what has and has not worked in efforts to diversify workforces.