The Educational Pipeline for Health Care Professionals (original) (raw)
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Journal of Human Resources, 2010
While the representation of black students in medical schools rose dramatically from approximately 2 percent in 1965 to more than 7 percent in 1975, gains in the representation of blacks among health professionals have slowed, with blacks currently representing slightly more than 8 percent of first year medical students in the U.S. The underrepresentation of black Americans in the healthcare professions may have direct implications for the health outcomes of minority patients, underscoring the importance of understanding how individual characteristics, student achievement, and undergraduate experience differentially affect the completion of graduate training in the health sciences by race. We specify a model of individuals' postsecondary decisions including college enrollment, college type, and baccalaureate degree completion, jointly with the decision to enter a health care occupation that requires an advanced degree. We estimate the parameters of the model with maximum likelihood using data from the National Longitudinal Study class of 1972. Our estimates highlight the importance of factors operating prior to post-baccalaureate study, such as pre-collegiate achievement, in explaining the differential representation by race in the health professions. Without accounting for the impact of college type on the likelihood of completing a bachelor's degree, blacks appear to be somewhat more likely to pursue a career in the health professions. In contrast, blacks are less likely to pursue a career in the health professions once we account for the impact of college type on the race-specific likelihood of baccalaureate degree completion. Our results emphasize the importance of jointly examining the full chain of educational decisions in understanding racial differences in representation within professional healthcare occupations.
BMC Medical Education, 2021
Background: Physician Assistants (PA) are important members of the medical team, and increasing diversity in healthcare professionals has been consistently associated with improved health outcomes for underrepresented minority patients. In this study of a national cohort of PA program applicants, we investigated whether the number of programs a student applied to (Application Number, AN) was significantly associated with increased likelihood of matriculation into a PA program. Methods: We examined all applications (n = 27,282) to the 2017-2018 admissions cycle of the Central Application Service for Physician Assistants, which is utilized by over 90% of accredited PA programs in the US. As we a priori hypothesized that associations would be non-linear, we used natural cubic splines to estimate the associations between matriculation and AN, controlling for multiple metrics of academic achievement, experience, and applicant demographics. We subsequently used segmented regression analyses (modified poisson regression with robust error variance) to investigate log-linear associations above and below inflection points identified in the spline analyses. Additionally, we explored for effect modification by race/ethnicity. Results: The strongest associations were observed between application number 2-7, and a threshold effect was observed at > 16 applications, beyond which there was no significant, incremental benefit in matriculation likelihood. Associations differed by race, particularly for application number 2-7, wherein the incremental benefit from each additional application was highest for Black applicants (Likelihood Ratio [LR]: 1.243, 95% CI: 1.136 to 1.360) vs non-Latinx White (LR: 1.098, 95% CI: 1.072 to 1.125), with no additional, incremental benefit beyond 7 program applications. For all other races, significant increased likelihoods of matriculation were observed until 16 program applications.
American Journal of Pharmaceutical Education, 2021
Promoting equity and diversity in health care must include increasing the prevalence of minority health care professionals. The purpose of this study was to: (1) evaluate changes in Black student enrollment in colleges of pharmacy, medicine, and dentistry; (2) determine if significant differences exist in Black student enrollment among these colleges; and (3) grade colleges on how well Black student enrollment reflects state populations and compare failing grades between 2010 and 2019. Methods. Enrollment data were obtained through the American Association of Colleges of Pharmacy, Association of American Medical Colleges, and American Dental Association for Fall 2010 through Fall 2019. Average percentage of Black students and rate change was determined. Colleges were graded on their percentage of Black students relative to Black residents in their state. Kruskal-Wallis H test, Wilcoxon signed rank tests, and Chi square tests were performed to quantify differences in enrollment and college grades. Results. Colleges of pharmacy and medicine experienced a significant increase in Black student enrollment between 2010 and 2019, but colleges of dentistry did not. Pharmacy and medicine also had significantly greater Black student enrollment in 2019 compared to dentistry. Proportion of colleges of pharmacy and medicine with failing grades decreased between 2010 and 2019. Conclusion. To facilitate improved access and limit health and health care disparities, it is important health professions colleges reflect the diversity of the patient populations they serve. Serious and intentional efforts toward diversification, inclusivity, and equity are necessary to improve Black student enrollment.
Journal of Underrepresented & Minority Progress
The purpose of this study was to conduct the largest (2002-2018) longitudinal analysis and comparison of Black and White college student 6-year graduation rates. Data were obtained from the U.S. Department of Education, National Center for Education Statistics, Integrated Postsecondary Education Data System (IPEDS) for 17 cohorts (1996-2002 to 2012-2018) of Black and White students. Regression analyses confirmed: (1) a statistically significant negative linear trend for Black students, (2) a statistically significant positive linear trend for White Students, and (3) statistically significant differences between the Black and White student regression lines for both the y-intercepts and slopes. In addition, adverse impact, using the EEOC’s “4/5ths rule” was documented for Black students, as compared to White students, in all 17 cohorts.
JAMA: The Journal of the American Medical Association, 1994
Objective.\p=m-\Toinvestigate the performance of men and women from various racial and ethnic backgrounds on the National Board of Medical Examiners Part I examination, controlling for any differences in measures of educational background and academic performance before entering medical school. Design.\p=m-\Aretrospective analysis of existing records from the National Board of Medical Examiners and the Association of American Medical Colleges. Setting.\p=m-\National Board of Medical Examiners. Participants.\p=m-\All students taking the June administration of Part I for the first time in 1986, 1987, or 1988 and who were 2 years from graduation from an accredited medical school. Methods.\p=m-\Multipleregression methods were used to estimate Part I examination group differences in performance that would be expected if all students entered medical school with similar Medical College Admission Test scores, undergraduate grade point averages, and other prematriculation measures. Main Outcome Measure.\p=m-\Performanceon the Part I examination. Results.\p=m-\Therewere substantial differences in performance, with white students scoring highest, followed by Asian/Pacific Islanders, Hispanics, and blacks; within all racial and ethnic categories, women scored lower than men. Controlling for dissimilarities in academic background greatly reduced Part I differences among most racial and ethnic groups, except Asian/Pacific Islander men; unexplained differences remained between men and women. Results were consistent for the 3 years examined. Conclusions.\p=m-\Theresults of this study do not imply that physician performance varies among racial and ethnic groups or between men and women; no written examination can measure all the abilities that may be desirable to assess. Validity research investigating reasons for the reported gender and racial and ethnic differences in performance on the National Board examinations should be continued.
BMC Medical Education
Entry from secondary school to Australian and New Zealand undergraduate medical schools has since the late 1990's increasingly relied on the Undergraduate Medicine and Health Sciences Admission Test (UMAT) as one of the selection factors. The UMAT consists of 3 sections -- logical reasoning and problem solving (UMAT-1), understanding people (UMAT-2) and non-verbal reasoning (UMAT-3). One of the goals of using this test has been to enhance equity in the selection of students with the anticipation of an increase in the socioeconomic diversity in student cohorts. However there has been limited assessment as to whether UMAT performance itself might be influenced by socioeconomic background. Between 2000 and 2012, 158,909 UMAT assessments were completed. From these, 118,085 cases have been identified where an Australian candidate was sitting for the first time during that period. Predictors of the total UMAT score, UMAT-1, UMAT-2 and UMAT-3 scores were entered into regression models ...
Academic Performance of African American College Applicants / 63
2000
The implications of different potential affirmative action policies depend on three factors: selection rate from the applicant pool, base rate of qualified applicants, and accuracy of performance predictions. A series of analyses was conducted under vari- ous assumptions concerning affirmative action plans, causes of racial differences in average college admissions test scores, and racial differences in accuracy of per- formance