Understanding the Leaky Pipeline: Perceived Barriers to Pursuing a Career in Medicine or Dentistry Among Underrepresented-in-Medicine Undergraduate Students

Freeman, Brandi K.; Landry, Alden; Trevino, Robert L.; Grande, David; Shea, Judy A.

doi:10.1097/acm.0000000000001020

Cited by 121 publications

(68 citation statements)

References 28 publications

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“…Previous research has shown the negative impact of the lack of connections to physicians and the misconceptions of both students and parents about the medical field on under-represented students’ pursuit of a medical career 57 58 and there seems to be a desire for more information about the medical profession and study, and the admission processes. 32 58 Exposure to healthcare seems crucial in this respect.…”

Section: Discussionmentioning

confidence: 99%

“…Under-represented students’ concerns about the complexity of the admissions process 58 and not being able to compete with other applicants have been reported previously. 57 When medical schools wish to incorporate healthcare experiences as one of their selection criteria, they should acknowledge the unequal access to such experiences among high school students. For those who lack the opportunity of gaining healthcare experiences through their own network, medical schools could facilitate this.…”

Section: Discussionmentioning

confidence: 99%

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Motivation of Dutch high school students from various backgrounds for applying to study medicine: a qualitative study

et al. 2017

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ObjectiveTo explore high school students’ motivation for applying to study medicine and the factors that influence this. To find explanations for under-representation of minority students in medical education, descriptions of motivation of students with different background characteristics were compared.DesignQualitative phenomenological study using semistructured one-on-one interviews.SettingOne predominantly white and one mixed high school in a large multicultural city in the Netherlands. The study was conducted in March–December 2015.ParticipantsTwenty-four high school students, purposively sampled for demographic characteristics.MethodsThe analysis consisted of the coding of data using a template based on the motivation types (autonomous and controlled motivation) described by self-determination theory and open coding for factors that influence motivation.ResultsThe main reasons for pursuing a medical career pertained to autonomous motivation (interest in science and helping people), but controlled motivation (eg, parental pressure, prestige) was also mentioned. Experiences with healthcare and patients positively influenced students’ autonomous motivation and served as a reality check for students’ expectations. Having to go through a selection process was an important demotivating factor, but did not prevent most students from applying. Having medical professionals in their network also sparked students’ interest, while facilitating easier access to healthcare experiences.ConclusionsThe findings showed a complex interplay between healthcare experiences, growing up in a medical family, selection processes and motivation. Healthcare experiences, often one of the selection criteria, help students to form autonomous motivation for studying medicine. However, such experiences as well as support in the selection process seem unequally accessible to students. As a result, under-represented students’ motivation decreases. Medical schools should be aware of this and could create opportunities to acquire healthcare experiences. High schools could incorporate internships as part of their study counselling programmes and offer tailor-made guidance to each individual student.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Motivation of Dutch high school students from various backgrounds for applying to study medicine: a qualitative study

et al. 2017

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“…Studies cite negative experiences such as gender bias, negative psychological sequelae secondary to overt mistreatment and lack of role models as reasons for the ‘leakiness of the pipeline’—i. e., the departure of students from the path to academia and leadership [ 3 – 5 ]. While overt racism, bullying, and mistreatment of students may be relatively easier to identify, it is harder to identify everyday subtle put-downs or microaggressions.…”

Section: Introductionmentioning

confidence: 99%

An exploratory study on microaggressions in medical school: What are they and why should we care?

Espaillat¹,

Panna²,

Goede³

et al. 2019

Perspect Med Educ

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Introduction Microaggressions and their impact have been documented in minority college students; however, little is known about the experience of medical students. This study reports the prevalence and understanding of microaggressions among medical students at the University of Florida College of Medicine (UFCOM), while gaining insights into experiences of medical students dealing with microaggressions. Method A nine-question survey was sent out to all medical students at the UFCOM in the spring of 2017 to understand their experiences with microaggressions. The authors used simple statistics and chi-test to analyze the demographic data and an inductive thematic qualitative analysis was performed on the open-ended responses to study medical students’ understanding of the term, experiences, and impact of microaggressions. Results The response rate was 64% ( n = 351/545). Fifty-four percent reported experiencing microaggressions, of those the majority were female students (73% compared with 51% among male students, p = 0.0003); for female students from minority backgrounds this was 68% and for white female students 76% ( p = 0.2606). Microaggressions are more common in the second year of medical school (30%), followed by the third year (23%). Most students were able to recognize and identify microaggressions, but some denied the concept existed, attributing concerns about microaggressions to a culture promoting oversensitivity and political correctness. Students described microaggressions related to sexism; religion; skin colour; and ethnicity. Students described indifference, emotional reactions and denial of the event as coping mechanisms. Conclusion Microaggressions are prevalent on a day-to-day basis among medical students with female students from a minority background as well as white female students experiencing more microaggressions. Further research is needed to explore interventions to counter microaggressions in order to ensure a healthy learning environment.

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“…It has been widely acknowledged that medical school can be a stressful experience for many students, especially for those from socially diverse backgrounds [1]. Studying medicine requires a developmental change to adequately deal with a series of psychosocial challenges encountered in medical school [2].…”

Section: Introductionmentioning

confidence: 99%

Dealing with Academic Difficulty in Medical School: A Pilot Study

et al. 2020

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Some students struggle through medical school and do not have the confidence to seek help. This pilot study sought to explore the challenges and needs of medical students experiencing academic difficulty. Semi-structured interviews and online surveys were used to collect data from an academic advisor and thirteen medical students who had experienced academic difficulty. Unexpected academic failure and the loss of self-efficacy contributed to students hiding their academic difficulty and avoiding available support systems. Despite the sampling limitations, the findings of this pilot study have value in giving direction to future research. Programs that will change the current attitudes to academic difficulty, normalising access to support and encouraging early intervention, are needed to build the capacity for excellence among these students.

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Understanding the Leaky Pipeline: Perceived Barriers to Pursuing a Career in Medicine or Dentistry Among Underrepresented-in-Medicine Undergraduate Students

Abstract: Solving the issue of diversity in medicine and dentistry is multifaceted, but elucidated challenges from the undergraduate student perspective offer targeted areas where intervention may help remedy barriers and decrease pipeline leakiness.

Cited by 121 publications

References 28 publications

Motivation of Dutch high school students from various backgrounds for applying to study medicine: a qualitative study

Motivation of Dutch high school students from various backgrounds for applying to study medicine: a qualitative study

An exploratory study on microaggressions in medical school: What are they and why should we care?

Dealing with Academic Difficulty in Medical School: A Pilot Study

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