Levers of change: a review of contemporary interventions to enhance diversity in medical schools in the USA

Abstract

A growing body of research illustrates the importance of aligning efforts across the operational continuum to achieve diversity goals. This alignment begins with the institutional mission and the message it conveys about the priorities of the institution to potential applicants, community, staff, and faculty. The traditional themes of education, research, and service dominate most medical school mission statements. The emerging themes of physician maldistribution, overall primary-care physician shortage, diversity, and cost control are cited less frequently. The importance and salience of having administrative leaders with an explicit commitment to workforce and student diversity is a prominent and pivotal factor in the medical literature on the subject. Organizational leadership shapes the general work climate and expectations concerning diversity, recruitment, and retention. Following the Bakke decision, individual medical schools, supported by the Association of American Medical Colleges, worked to expand the frame of reference for evaluating applicants for medical school. These efforts have come together under the rubric of “holistic review”, permitted by the US Supreme Court in 2003. A large diverse-applicant pool is needed to ensure the appropriate candidates can be chosen for the incoming medical school class. Understanding the optimal rationale and components for a successful recruitment program is important. Benchmarking with other schools regionally and nationally will identify what should be the relative size of a pool. Diversity is of compelling interest to us all, and should pervade all aspects of higher education, including admissions, the curriculum, student services and activities, and our faculties. The aim of medical education is to cultivate a workforce with the perspectives, aptitudes, and skills needed to fuel community-responsive health-care institutions. A commitment toward diversity needs to be made.

Black Students’ Perception of Belonging: A Focus Group Approach with Black Students at the Uniformed Services University of the Health Sciences

“…[12][13][14][15][16] Collaboration with local HBCUs and increased recruitment of Black students, faculty, and staff will provide students more sense of belonging and contribute to the critical mass that is needed to make meaningful change. 17,18 Programs, such as the medical school pipelines at Wayne State University as well as Southern Illinois University Schools of Medicine, have been successful in matriculating and supporting diverse students. 19,20 A cascading mentorship program can promote an inclusive climate by providing academic and social support to students at different levels of education and from a variety of backgrounds.…”

A Review of Differential Attainment in Recruitment in the UK Medical Profession

“…A piecemeal approach results in an ineffective, siloed approach (67). Married with this, is the extension of accountability in order to encourage intentional support (68).…”

“…Greary et al showed how sharing postgraduate medical (residency) diversity recruitment data with training program directors led to significant annual improvements in applicant and selection diversity (70). National dissemination of HEE recruitment data and individual Trust recruitment data, can also allow for benchmarking (68) and identification of specialities and organisations most in need of peer review and reform.…”

“…national and organisational level (73), and free language classes to support NHS employees. (74) Meso level -organisational practices 1) Comprehensive, multifaceted and strategic diversity recruitment plans These are preferred over plans that offer short-term purely economic incentives such as relying solely on scholarships in undergraduate medical training, as they create an environment that diversity can be purchased (68). Deas et al show that by adopting South Carolina's multifaceted, strategic diversity plan, a university hospital was successfully able to recruit and retain more minority group medical students, postgraduate doctors, and faculty members over 10 years (67).…”

“…towards a diverse workforce This is a pivotal factor to being able to successfully shape organisational expectations surrounding recruitment and foster a culture of inclusivity. It also conveys this as a priority message to applicants and the wider community, thus attracting minority group applicants and widening the recruitment pool (68). A key requirement is also the recruitment of organisational leaders who espouse these values(77).…”