Medical School Admissions: Defining the Future of Healthcare Delivery in the United States (original) (raw)
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Increasing Diversity in the Health Professions: Reflections on Student Pipeline Programs
Journal of healthcare, science and the humanities, 2016
Despite major advances and technological improvements in public health and medicine, health disparities persist by race and ethnicity, income and educational attainment, and in some cases are increasing (Jackson & Garcia, 2014). These health disparities among these populations have even worsened or remained about the same since the landmark 1985 Report of the Secretary's Task Force on Black & Minority Health released by then Secretary Margaret M. Heckler. Ensuring diverse public health and healthcare workforces to provide services to diverse populations, in combination with other strategies, can increase access to and quality of healthcare for vulnerable populations and decrease healthcare disparities. One mechanism for achieving a diverse public health and healthcare workforce is to establish, promote, and conduct student training programs in public health. The Office of Minority Health and Health Equity, Centers for Disease Control and Prevention (CDC), has partnered with inst...
Diversity in medical school admission: insights from personnel recruitment and selection
health care it requires. To this end, and to best serve its people, it should provide enough medical school positions, and residency training positions in the right number, mix and distribution, as well as access to licensure. This should occur in an equitable manner that ensures diversity that is appropriate to best serving the society in question. Then we will be walking the talk. REFERENCES 1 Razack S, Hodges B, Steinert Y, Maguire M. Seeking inclusion in an exclusive process: discourses of medical school student selection.
How Should Medical Schools Foster Equity and Inclusion in Admissions?
AMA Journal of Ethics, 2021
This commentary in response to a case considers how merit and features of medical school applicants' dossiers should be drawn upon in admissions processes to promote equity and inclusion in medicine. It is argued that medical schools should incentivize inclusion by redefining merit in their admissions goals and processes, promote meaningful inclusion, and show institutional leadership in addressing social justice. Case UMed is a public institution in a state with limited racial and ethnic diversity. Its largest funder is the state, and its mission is to train physicians to serve its residents. UMed's recently appointed admissions dean has made new scholarships available to members of groups underrepresented in medicine (URiM). A primary funding source for these new scholarships is a pool of money that has traditionally supported only need-and meritbased scholarships. Decisions about which scholarships are offered to incentivize selected applicants to matriculate at UMed are made by its admissions committee. Few in-state applicants from groups URiM reside in the state, so many new scholarships are awarded to out-of-state applicants. Some UMed deans and faculty oppose this trend, suggesting it's unfair to reduce numbers of need-and merit-based scholarships and supposing that "they won't stay here after they're licensed." Commentary Traditional medical school merit-based criteria largely consist of applicants' grades, Medical College Admission Test ® (MCAT) scores, research engagement, scholarly article publications, mission trips, and clinical shadowing opportunities. 1 However, traditional merit-based criteria do not measure students' structural competency. 1 These metrics often reflect better access to preparatory resources and the wherewithal to allocate time and energy to academic pursuits rather than competing psychosocial demands. As Ziegelstein et al note, schools pursuing merit scholarships often favor the affluent, which may be subverting our desire to bring in a broader socioeconomic and diverse class. 2 This article argues that medical schools should redefine merit in their admissions goals and processes to promote meaningful inclusion.
Prioritizing Health Disparities in Medical Education to Improve Care
Academic Medicine, 2011
Despite yearly advances in life-saving and preventive medicine, as well as strategic approaches by governmental and social agencies and groups, significant disparities remain in health, health quality, and access to health care within the United States. The determinants of these disparities include baseline health status, race and ethnicity, culture, gender identity and expression, socioeconomic status, region or geography, sexual orientation, and age. In order to renew the commitment of the medical community to address health disparities, particularly at the medical school level, we must remind ourselves of the roles of doctors and medical schools as the gatekeepers and the value setters for medicine. Within those roles are responsibilities toward the social mission of working to eliminate health disparities. This effort will require partnerships with communities as well as with academic centers to actively develop and to implement diversity and inclusion strategies. Besides improving the diversity of trainees in the pipeline, access to health care can be improved, and awareness can be raised regarding population-based health inequalities.
Ensuring a fair and equitable selection of students to serve society's health care needs
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This study aimed to evaluate a selection and programmatic intervention designated 'Conditional Admissions' (CA), which is intended to expand access to medical education for individuals from under-represented ethnic, racial and rural groups. Further aims were to establish principles of practice designed to increase access for under-represented groups based on an empirical comparison of programmatic changes made to CA in 2005, and to quantify the costs associated with its implementation. Data for all students admitted between 1999 and 2009 (n = 3227) were compiled; these included demographic data, undergraduate college performance grades, medical school performance indicators, and information on honours, residency placement and md degree completion. To examine the outcomes of the CA intervention, students were divided into two cohorts of those admitted through the CA initiative during 1999-2004 and 2005-2009, respectively, and analysed for differences. Costs associated with CA...
Academic Medicine, 2019
American Medical Colleges (AAMC) has advocated for a more diverse physician workforce in the United States. 1-4 Increasingly, research has linked a diverse educational context to improved learning environments for trainees, increased access to and quality of care for patients, and an expanded medical research agenda, to name just a few of the benefits. 5 However, there are numerous challenges to educating and training a quality, compassionate physician workforce that both reflects and competently cares for our diverse nation. Some of these include shifting legal challenges to how trainees are selected and unequal access to educational opportunities among potential applicants. To address this evolving and uneven landscape, medical schools have begun to reconsider and revolutionize their admissions practices, policies, and processes, supported by two Supreme Court decisions. In his 1978 Regents of the University of California v. Bakke decision, Justice Powell remarked: Physicians serve a heterogeneous population. An otherwise qualified medical student with a particular background-whether it be ethnic, geographic, culturally advantaged or disadvantaged-may bring to a professional school of medicine experiences, outlooks, and ideas that enrich the training of its student body and better equip its graduates to render with understanding their vital service to humanity. 6
Improving Underrepresented Minority Medical Student Recruitment with Health Disparities Curriculum
Journal of General Internal Medicine, 2010
BACKGROUND: Diversity improves all students' academic experiences and their abilities to work with patients from differing backgrounds. Little is known about what makes minority students select one medical school over another. PURPOSE: To measure the impact of the existence of a health disparities course in the medical school curriculum on recruitment of underrepresented minority (URM) college students to the University of Chicago Pritzker School of Medicine.
Academic Medicine, 2018
Current challenges to affirmative action policies are cause for concern for medical schools that employ holistic admissions processes, which consider an applicant’s race, ethnicity, gender, status as a first-generation college student, educational and socioeconomic status, geographical location, past experiences with minority and underserved populations, social capital, and immigration status. Students from minority and underserved communities bring with them experiences and perspectives that may enhance the care they provide to underserved patients, improving patient outcomes. Student body diversity is also associated with increases in students’ academic performance, retention, community engagement, cooperation, and openness to different ideas and perspectives, and institutions that foster diversity tend to be nurturing places where all students and faculty can thrive. The use of race as a factor in admissions has been upheld in three Supreme Court decisions. Yet, the Supreme Court...
Annals of the American Thoracic Society, 2014
Despite the 2002 Institute of Medicine report that described the moral and financial impact of health care disparities and the need to address them, it is evident that health care disparities persist. Recommendations for addressing disparities include collecting and reporting data on patient race and ethnicity, supporting language interpretation services, increasing awareness of health care disparities through education, requiring cultural competency training for all health care professionals, and increasing diversity among those delivering health care. The Accreditation Council on Graduate Medical Education places strong emphasis on graduate medical education's role in eliminating health care disparities by asking medical educators to objectively evaluate and report on their trainees' ability to practice patient-centered, culturally competent care. Moreover, one of the objectives of the Accreditation Council on Graduate Medical Education Clinical Learning Environment Review visits as part of the Next Accreditation System is to identify how sponsoring institutions engage residents and fellows in the use of data to improve systems of care, reduce health care disparities, and improve patient outcomes. Residency and fellowship programs should ensure the delivery of meaningful curricula on cultural competency and health care disparities, for which there are numerous resources, and ensure resident assessment of culturally competent care. Moreover, training programs and institutional leadership need to collaborate on ensuring data collection on patient satisfaction, outcomes, and quality measures that are broken down by patient race, cultural identification, and language. A diverse physician workforce is another strategy for mitigating health care disparities, and using strategies to enhance faculty diversity should also be a priority of graduate medical education. Transparent data about institutional diversity efforts should be provided to interested medical students, residents, and faculty. Graduate medical education has a clear charge to ensure a generation of physicians who are firmly grounded in the principles of practicing culturally competent care and committed to the reduction of health care disparities.
Exceeding Expectations: Students Underrepresented in Medicine at University of Utah Health
Family Medicine, 2019
BACKGROUND AND OBJECTIVES: The University of Utah (UU) serves an in- creasingly diverse state and houses the only public medical school, dental school, and college of pharmacy in the state. Utah’s diversity in the health professions lags behind the diversity of its general population, and the nation. METHODS: The Health Sciences Learning, Engagement, Achievement, and Prog- ress (HS-LEAP) Program is a 4-year undergraduate pipeline program intended to increase racial and ethnic diversity in the health professions, specifically focused on students underrepresented in medicine (URM). Each student self- identified and submitted demographics at the time of enrollment. We followed students to successful engagement in their profession of choice; we compared graduation and postgraduation outcomes to non-HS-LEAP students at UU from 2005-2016. RESULTS: Almost 80% of HS-LEAP students are from communities underrep- resented in medicine: 41% Latinx, 28% Asian, 7% Black, 2% American Indi- an/Alaskan Native, and 1% Pacific Islander. HS-LEAP students had lower ACT scores upon undergraduate enrollment, higher grade point averages in their first semester of college, higher fall-to-fall first-year retention rates, and higher 6-year graduation rates when compared to non-HS-LEAP UU students. Students who completed HS-LEAP attended graduate school at twice the rate of students who participated in HS-LEAP, the majority in the health professions. CONCLUSIONS: The HS-LEAP program is associated with increased URM suc- cess in undergraduate programs and elevated participation in graduate pro- grams in medicine, dentistry, pharmacy, physician assistant, nursing, and public health. Similar programs, with continuous assessment and evaluation, could be adopted in other locations to improve the representation of these groups in health professions.