Making Merit Just in Medical School Admissions

Díaz, Tomás; Huerto, Ryan; Weiss, Jasmine

doi:10.1001/amajethics.2021.223

Cited by 7 publications

(3 citation statements)

References 21 publications

(25 reference statements)

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“…By expanding our holistic lens, we can build student-centered frameworks such as the Integrated Holistic Student Affairs (IHSA) model. The IHSA model, developed by leadership of the AAMC’s Group on Student Affairs, provides a road map to shift “from reactive, deficit-oriented practices to proactive, empowering, equitable practices.” 27 Accordingly, we suggest a holistic reimagining of merit, 28 where merit encompasses not only apex academic achievement, but “distance traveled,” structural competency, advocacy, service, and mentorship. With these frameworks in mind, the Figure outlines strategies for educational equity derived from participant observations.…”

Section: Discussionmentioning

confidence: 99%

Challenges Facing First-Generation College Graduates in Medical School

Havemann,

Mason,

Russell

et al. 2023

JAMA Netw Open

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ImportanceFirst-generation (FG) medical students remain underrepresented in medicine despite ongoing national efforts to increase diversity; understanding the challenges faced by this student population is essential to building holistic policies, practices, and learning environments that promote professional actualization. Although FG students have been extensively studied in the undergraduate literature, there is little research investigating how FG students experience medical education or opportunities for educators to intervene.ObjectiveTo explore challenges that FG students experience in undergraduate medical education and identify opportunities to improve foundational FG support.Design, Setting, and ParticipantsThis qualitative study was conducted using an online platform with 37 FG students enrolled in 27 US medical schools. An interprofessional team of medical educators and trainees conducted semistructured interviews from November 2021 through April 2022. Participants were recruited using a medical student listserv. Data were analyzed from April to November 2022.Main Outcomes and MeasuresAfter conducting a preliminary analysis using open coding, a codebook was created and used in a thematic analysis; the codebook used a combination of deductive and inductive coding.ResultsAmong the 37 students recruited for this study, 21 (56.8%) were female; 23 (62.2%) were in the clinical phase of training; 1 (2.7%) was American Indian or Alaska Native, 7 (18.9%) were Hispanic, Latino, or of Spanish origin, 8 (21.6%) were non-Hispanic Asian or Asian American, 9 (24.3%) were non-Hispanic Black or African American, and 23 (32.4%) were non-Hispanic White; mean (SD) age was 27.3 (2.8) years. Participants described 4 major themes: (1) isolation and exclusion related to being a newcomer to medicine; (2) difficulty with access to basic resources (eg, food, rent, transportation) as well as educational (eg, books); (3) overall lack of faculty or institutional support to address these challenges; and (4) a sense of needing to rely on grit and resilience to survive.Conclusions and RelevanceAlthough grit and resilience are desirable traits, results of this study suggest that FG medical students face increased adversity with inadequate institutional support, which forces them to excessively rely on grit and resilience as survival (rather than educational) strategies. By applying the holistic model often used in admissions to the postmatriculation educational process, targeted and flexible initiatives can be created for FG students so that all students, regardless of background, can achieve robust professional actualization.

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Section: Discussionmentioning

confidence: 99%

Challenges Facing First-Generation College Graduates in Medical School

Havemann,

Mason,

Russell

et al. 2023

JAMA Netw Open

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“…Some advisors raised concern that individualized challenges associated with the pandemic may be overlooked in evaluating a student’s medical school application. These concerns support the need for medical schools to continue to use a holistic review process to ensure that academic and nonacademic experiences are strongly considered along with standardized test scores . Medical schools should be proactive in considering the effects of the pandemic for HBCU students during current and future admission cycles.…”

Section: Discussionmentioning

confidence: 99%

Perspectives of Historically Black College and University Advisors to Premedical Students During the COVID-19 Pandemic

et al. 2022

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ImportanceBlack students remain underrepresented in medicine despite national efforts to increase diversity in the physician workforce. Historically Black College and University (HBCU) students play a vital role in increasing representation in the workforce. Currently, there is a paucity of literature understanding the impact of COVID-19 on premedical students from HBCUs. Understanding the adverse impact of the pandemic on HBCU students is essential to inform strategies that promote holistic medical school admissions and increased diversity, equity, and inclusion in the medical workforce.ObjectiveTo explore premedical advisors' perspectives on the impact of the COVID-19 pandemic on HBCU premedical students pursuing admission to medical school.Design, Setting, and ParticipantsIn this qualitative study, semistructured interviews of HBCU premedical advisors were performed from March 2020 to March 2021. One-on-one interviews were conducted with 21 advisors with a depth of experience as advisors, varied educational backgrounds, and diverse geographic representation. Data analysis was performed from March 2021 to December 2021.Main Outcomes and MeasuresThe experiences of HBCU premedical students during the COVID-19 pandemic from the perspective of the premedical advisor.ResultsAmong the 21 participants, 13 (62%) were female, 15 (71%) were Black or African American, 11 (52%) had a doctorate degree, and 7 (33%) had more than 10 years of experience as advisors. Participants described 3 major themes: (1) balancing academic responsibilities with family demands; (2) distraction, disruption, and isolation in the virtual learning environment; and (3) harmful impact of new stressors for HBCU applicants in the medical school admissions process.Conclusions and RelevanceIn this qualitative study of HBCU advisors to premedical students, advisors described how the COVID-19 pandemic adversely affected undergraduate HBCU premedical students; students faced family hardships, challenges with virtual learning, and uncertainty in the medical school admissions process. These findings suggest that medical schools should continue to create direct interventions to address the challenges that HBCU students faced during the height of the pandemic and as longitudinal consequences of the pandemic. Addressing these issues may improve physician workforce representation and promote more equitable patient care for underserved communities disproportionately affected by COVID-19 and other health disparities.

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“…Common DEI efforts, such as establishing new administrative positions, departmental committees, or implementation of health equity curricula, are not inherently flawed approaches (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). However, when institutions adopt initiatives in the absence of evidence-based strategic planning or structural reinforcement, their potential impact is severely limited.…”

Section: The Dei Landscape Todaymentioning

confidence: 99%

Doing the Work—or Not: The Promise and Limitations of Diversity, Equity, and Inclusion in US Medical Schools and Academic Medical Centers

Esparza

Simon²,

Bath

et al. 2022

Front. Public Health

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While the number of positions, committees, and projects described as “Diversity, Equity, and Inclusion (DEI)” work has grown rapidly in recent years, there has been little attention to the theory, praxis, or lived experience of this work. In this perspective, we briefly summarize the research and concepts put forth by DEI leaders in higher education more broadly, followed by an analysis of the literature's application to academic medicine. We then discuss the ways in which language obscures the nature of DEI and the necessity of scholarship to evaluate the extensive range of practices, policies, statements, and programs the label is given to.

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Making Merit Just in Medical School Admissions

Cited by 7 publications

References 21 publications

Challenges Facing First-Generation College Graduates in Medical School

Challenges Facing First-Generation College Graduates in Medical School

Perspectives of Historically Black College and University Advisors to Premedical Students During the COVID-19 Pandemic

Doing the Work—or Not: The Promise and Limitations of Diversity, Equity, and Inclusion in US Medical Schools and Academic Medical Centers

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