Perspectives on Medical School Admission for Black Students Among Premedical Advisers at Historically Black Colleges and Universities.

Importance: There remains a lack of representation of Black physicians in the physician workforce despite decades of national efforts to increase diversity. Historically Black Colleges and Universities (HBCUs) contribute to increasing representation in the workforce in the US. There is limited literature exploring the experiences of HBCU premedical students navigating the journey to medical school. Objective: To examine barriers to and facilitators of medical school matriculation among Black students by exploring the perspectives of premedical student advisers at HBCUs. Design, Setting, and Participants: In this qualitative study, HBCU advisers participated in a focus group in October 2019 or in semistructured interviews from January 2020 to March 2021. Using purposive sampling, premedical student advisers were recruited from different educational backgrounds and geographic locations and conducted 1-on-1 interviews. Data analysis was performed from March 2021 to March 2022. Main Outcomes and Measures: The main outcome was the experiences of HBCU premedical students navigating to medical school from the perspective of premedical advisers. An inductive approach to generate codes from the interviews and the focus groups was applied by reviewing transcripts and noting concepts and themes associated with advising strategies and student experiences. Results: Among the 26 participants, 18 (69.2%) were female, 13 (50.0%) had a doctorate degree, and 8 (30.8%) had more than 10 years of experience as advisers. Participants described 3 major themes: (1) the complex institutional relationship dynamics between undergraduate HBCUs and medical schools, (2) concerns about preferential treatment for students from predominantly white undergraduate schools when accessing clinical shadowing opportunities, and (3) the "it takes a village mindset" emphasizing family and peer involvement. Conclusions and Relevance: In this qualitative study, barriers to medical school matriculation included concerns for the preferential treatment of students from predominantly white institutions when engaging with medical schools and a lack of access to clinical opportunities for HBCU students. The findings suggest that medical schools should continue to build collaborative partnerships with HBCUs to ensure equitable access to opportunities that prepare students for medical school.

HIV-prevention measures on a university campus in South Africa - perceptions, practices and needs of undergraduate medical students.

Background: Young adults such as university students are considered to be a key population for HIV-prevention efforts. This study aimed to determine the perceptions, practices and needs of undergraduate medical students regarding HIV-prevention measures available on campus. Methods: The research design was descriptive cross-sectional. Data were collected using an anonymous, self-administered questionnaire distributed to all 745 undergraduate medical students in the School of Clinical Medicine, University of the Free State, South Africa, of whom 470 responded (63.1%). Results: Almost half (45.5%) of all respondents across the five academic years had received information about available HIV-prevention measures on campus. Most reported that information had been received during lectures (59.7%) and only 24.2% from the local health clinic on campus. The findings also revealed that 14.2% of students had used at least one prevention measure in the past, while the majority of students (70.2%) used abstinence as an HIV-prevention measure. A large percentage of all the students (47.6%) had been tested for HIV before the start of the study. Two-thirds (67%) of students indicated that the current HIV-prevention services on campus were not sufficient. Conclusion: Medical students received HIV-prevention information as part of their curriculum but this was deemed not to be sufficient. This study suggests that tertiary education institutions should evaluate the effectiveness of strategies currently in place for the distribution and awareness of HIV-prevention measures and sexual health issues affecting students, using a student-centred approach.

Parting ways: Sex-based differences in premedical attrition.

Despite women's greater propensity to enter college aspiring to careers in medicine, they are less likely than men to persist in these ambitions. Past research suggests that students' experiences in coursework strongly influence their decision to continue along or depart from the premedical track, yet it remains unclear whether women and men have differential experiences in coursework that contribute to sex-based disparities in premedical attrition. To gain insight into whether and how premeds' experiences in coursework contribute to gendered patterns of attrition, this study employs a mixed methods design that combines longitudinal survey data collected from premedical students at a large state university with in-depth interview data collected from a subset of respondents. Survey results (n = 268) demonstrate that while women report more stress from premedical coursework than men, these differences do not help to explain the female-male gap in attrition. Rather, it is women's lower levels of affinity for premedical coursework-specifically, their less positive evaluations of premed coursework, and greater enjoyment of non-premed courses-that contribute most notably to the gender gap in attrition. Qualitative results (n = 39) suggest that women's affinity for premed coursework is diminished by more frequent, negative interactions with faculty, and a tendency to interpret low grades in premedical coursework as a sign that this career track is a 'poor fit' for their strengths and aptitudes. These findings broadly align with scholarship on the role of self-expressive decision-making in curricular sex segregation. Interview data also point to a critical factor for sustaining women's medical career aspirations: clinical experiences. Ranging from shadowing, to volunteer experiences, to jobs in local hospitals, these experiences allow women to 'try on' the role of doctor and inspire resilience in the face of academic adversity. The implications of findings for future research on premedical education are discussed.

What's Your Style? Enhanced Interprofessional Communication and Practice Using the Communication Wheel.

Today's health care environment requires collaborative teams to provide safe, effective care. This study assessed the extent to which a face-to-face workshop increased nursing and premedical students' awareness of varying communication styles and their potential impact on interprofessional communication and practice. A self-assessment tool was administered before, immediately after, and 1 month after the workshop. Significant increases in familiarity working on interprofessional teams, identifying different communication styles, and ability to apply communication strategies were found immediately after and 1 month after the workshop.

Depressive symptoms, burnout, and declining medical career interest among undergraduate pre-medical students.

OBJECTIVES: To investigate the relationship between mental health issues and medical career interest among undergraduate premedical students, and to explore whether this association varies by gender. METHODS: A longitudinal survey of freshman and sophomore premedical students at Indiana University was conducted during the 2015-16 academic year. Survey data were collected from 390 respondents via an online questionnaire (response rate=14%) in September 2015, and 292 of these respondents participated in the follow-up survey in April 2016 (retention rate=75%). Multi-level regression models were used to estimate the associations among depressive symptoms, burnout, and medical career interest. RESULTS: Respondents who experienced more depressive symptoms (ß = -.07, z =-2.49, p =.013) and higher levels of burnout (ß = -.50, z =-3.98, p <.001) reported significant reductions in medical career interest over the study period. These associations remained consistent after controlling for socio-demographic characteristics and prior academic achievement. Depressive symptoms were associated with steeper declines in medical career interest among women compared to men (ß = -.09, z =-2.01, p =.045), though the relationship between burnout and medical career interest did not significantly vary by gender. CONCLUSIONS: Results provide evidence that premeds who experience more depressive symptoms and higher levels of burnout become less interested in entering the medical profession. The negative association between depressive symptoms and medical career interest was even more pronounced among premedical women compared to men. Findings suggest that colleges and universities in the United States should implement programs aimed at safeguarding the mental health of premedical students.

Friend or frenemy? Experiential homophily and educational track attrition among premedical students.

Support from experientially similar others-individuals who have been through the same life transition or faced a similar set of stressful circumstances-has been shown to be effective for coping with issues ranging from chronic illness to bereavement. Less research has examined how networks comprised of experientially similar others may shape academic outcomes. Using longitudinal egocentric network data collected from early career premedical students at a large research university (n = 268), results indicate that greater experiential homophily in premeds' networks are associated with a lower likelihood of departing from the premedical career track at the end of the academic year. Interview data (n = 39) highlight three support functions provided by premedical peers that help to explain this relationship: 1) concrete task assistance with assignments and studying, 2) empathic understanding and emotional support, and 3) advice and reassurance from more advanced peers. Results hint at the potential utility of peer support for the retention of students at-risk of straying from the premedical career track, and have implications for other fields of study.

Interaction Effects of Happiness and Physical Activity on Smoking Initiation.

OBJECTIVE: Our aim was to assess the potential relationships among happiness, physical activity, and smoking initiation among undergraduate medical students in Saudi Arabia. METHODS: We performed a cross-sectional study of randomly selected first- to fifth-year undergraduate medical students. Smoking initiation was defined as "ever trying smoking a cigarette, waterpipe, cigar/cigarillo, or other type of tobacco, even one or 2 puffs." The short scale Oxford Happiness Questionnaire was used to assess each student's happiness. Multivariate logistic regression analysis was performed. RESULTS: Of the 406 students surveyed (208 boys, 198 girls), 86 (21.1%) had initiated smoking. We found an interaction between physical activity (PA) and happiness on smoking initiation (p-interaction = .012). Among boys with low levels of PA, lower levels of happiness were associated with a greater likelihood of smoking initiation (OR = 5.8, 95%CI = 1.9 - 17.5). Also, high levels of PA increased the chance of smoking initiation among male students with high levels of happiness (OR = 5.6, 95%CI = 2.1 - 14.5). CONCLUSION: Our results suggest that young men with low levels of happiness and low levels of PA, as well as high levels of PA and high levels of happiness, may be targeted as a priority population in tobacco control intervention programs.

A Pharmacology-Based Enrichment Program for Undergraduates Promotes Interest in Science.

There is a strong need to increase the number of undergraduate students who pursue careers in science to provide the "fuel" that will power a science and technology-driven U.S. economy. Prior research suggests that both evidence-based teaching methods and early undergraduate research experiences may help to increase retention rates in the sciences. In this study, we examined the effect of a program that included 1) a Summer enrichment 2-wk minicourse and 2) an authentic Fall research course, both of which were designed specifically to support students' science motivation. Undergraduates who participated in the pharmacology-based enrichment program significantly improved their knowledge of basic biology and chemistry concepts; reported high levels of science motivation; and were likely to major in a biological, chemical, or biomedical field. Additionally, program participants who decided to major in biology or chemistry were significantly more likely to choose a pharmacology concentration than those majoring in biology or chemistry who did not participate in the enrichment program. Thus, by supporting students' science motivation, we can increase the number of students who are interested in science and science careers.

Association of academic performance of premedical students to satisfaction and engagement in a short training program: a cross sectional study presenting gender differences.

BACKGROUND: It is important that students have a high academic engagement and satisfaction in order to have good academic achievement. No study measures association of these elements in a short training program. This study aimed to measure the correlation between academic achievement, satisfaction and engagement dimensions in a short training program among premedical students. METHODS: We carried out a cross sectional study, in August 2013, at Cercle d'Etudiants, Ingénieurs, Médecins et Professeurs de Lycée pour le Triomphe de l'Excellence (CEMPLEX) training center, a center which prepares students for the national common entrance examination into medical schools in Cameroon. We included all students attending this training center during last examination period. They were asked to fill out a questionnaire on paper. Academic engagement was measured using three dimensions: vigor, dedication and absorption. Satisfaction to lessons, for each learning subject was collected. Academic achievement was calculated using mean of the score of all learning subjects affected with their coefficient. Pearson coefficient (r) and multiple regression models were used to measure association. A p value < 0.05 was statistically significant. RESULTS: In total, 180 students were analyzed. In univariate linear analysis, we found correlation with academic achievement for vigor (r = 0.338, p = 0.006) and dedication (r = 0.287, p = 0.021) only in male students. In multiple regression linear analysis, academic engagement and satisfaction were correlated to academic achievement only in male students (R2 = 0.159, p = 0.035). No correlation was found in female students and in all students. The independent variables (vigor, dedication, absorption and satisfaction) explained 6.8-24.3% of the variance of academic achievement. CONCLUSION: It is only in male students that academic engagement and satisfaction to lessons are correlated to academic achievement in this short training program for premedical students and this correlation is weak.

An analysis of preclinical students' perceptions of cardiothoracic surgical procedures.

BACKGROUND: Interest in cardiothoracic surgery training has decreased, and there is a predicted shortage of 1,500 cardiothoracic surgeons by 2020. This study aims to analyze the attitudes toward cardiothoracic surgery of premedical and medical students in the preclinical years. METHODS: An anonymous electronic survey assessing interest in the cardiothoracic surgery field was sent to preclinical medical students and interviewees at the University of Michigan Medical School in 2010. Respondents were analyzed as a single population (N=566) and then compared in premedical (n=460) and medical student (n=106) groups. Responses were compared using independent-sample t tests. RESULTS: Forty-six percent of respondents were women. Surgical specialty was ranked the top field of interest. Ninety-four percent reported intellectual interest, and 70% listed lifestyle as important factors when considering a specialty. Ninety-two percent of respondents were unaware of the new integrated training programs. Just 4% had had previous mentorship from a cardiothoracic surgeon. In group comparison, salary and lifestyle were of greater concern to the medical group than the premedical group (salary, 47% vs 33%; p<0.01; lifestyle, 78% vs 68%; p<0.05, respectively). Given the ability to achieve one's personal goals, the premedical group was more interested in cardiothoracic surgery than was the medical group (88% vs 76%; p<0.05). CONCLUSIONS: Cardiothoracic surgeons may be better served by aiming their recruiting and mentoring efforts toward premedical students, who are more open to longer training, less concerned about lifestyle and salary, and are generally more interested in pursuing thoracic surgery than are medical students.

Medical students' and prospective medical students' uncertainties about career intentions: cross-sectional and longitudinal studies.

BACKGROUND: Policy prompts medical students' earlier career awareness. AIM: To explore changes and uncertainty in medical (and prospective medical) students' career intentions in a 5-year problem-based curriculum. METHODS: Six postal questionnaire surveys of medical students and one survey of prospective medical students sought career intentions from three entry-cohorts (one also seeking why they chose medicine, and one, the reason for the career intention). RESULTS: From the 973 (91.4%) 2001/02 admission interviewees responding, 74/189 (39.2%) of those admitted and remaining 'in-year' re-reported career intentions 5 years later (2006/07). Of the 1999 entrants (start-Year 1; end-Year 1; and mid-Year 3) and 2001 entrants (start-Year 1 and end-Year 1), 61.2-77.9% responded. Up to mid-programme, only 9.5-18.8% reported general practice, significantly more of whom described altruistic reasons for choosing medicine (2001 entrants). Tracked longitudinally, career intentions stayed relatively stable, but a small significant retreat from general practice over Year 1 predated clinical placements. From pre-admission to mid-Year 5, uncertainty decreased significantly, but 14.9% replied 'do not know' both times. Significantly more prospective students from the least affluent English or Welsh postcodes specified a career intention. CONCLUSION: Many students might delay considering career intentions, particularly general practice. Socioeconomic determinants of early medical career decision making merit further study.

Multiple health risk behaviors in German first year university students.

Multiple health risk behaviors have been identified as a problem in young adults which includes university students. The goals of this study included assessing the prevalence of major health risk behaviors in a cohort of German first year university students, analyzing the clustering of these behaviors and assessing readiness to change across multiple behaviors. A total of 1262 students from the schools of law, teaching and medicine at a German university participated in a voluntary and anonymous survey in 2005. The study assessed indicators and readiness for change regarding fruit and vegetable consumption, exercise, smoking and binge drinking as well as sociodemographic variables. Confirming the hypotheses, prevalences for risk behaviors were high; over 95% ate less than five servings of fruits and vegetables, 60% did not exercise sufficiently, 31% were current smokers and 62% reported binge drinking. Only 2% had none, 10.5% had one, 34.5% had two, 34.8% had three, and 18.2% showed all four risk behaviors. Readiness for behavior change was very low across multiple risk behavior combinations, especially for reducing binge drinking and increasing fruit and vegetable consumption. Medical students showed slightly more positive patterns than other students. The results indicate the need for addressing health behaviors in the student population of this university. If these findings can be replicated in other universities, programs that promote individual behavior change as well as changes in environmental conditions in the university environment are necessary to address this urgent problem.

The post-baccalaureate premedical certification program at the University of North Texas Health Science Center strengthens admission qualifications for entrance into medical school.

The Post-Baccalaureate (postbac) Premedical Certification Program at the University of North Texas Health Science Center provides an opportunity for individuals to enhance their credentials for entry into medical school by offering a challenging biomedical science core curriculum in graduate biochemistry, cell biology, physiology, and pharmacology. In addition, students (called postbacs) receive instruction in human gross anatomy, histology, and embryology with first-year medical students. More than 90% of the students accepted into the postbac program have applied to medical school previously but have been rejected by admission committees at least once, primarily because of low cognitive scores. In spring 2001, seven postbacs completed the program, of which only one was admitted into the Texas College of Osteopathic Medicine (TCOM), the medical school affiliated with the University of North Texas Health Science Center. Three postbacs went to other medical schools. Thirty-one completed the program by spring 2006, of whom 13 were admitted to TCOM, and eight to other medical schools. After six years, 101 postbacs have completed the program, and 70 have been accepted into medical schools. Postbacs admitted into TCOM have performed well compared with their medical school classmates. Overall, average scores for postbacs are above those of their medical school classmates. In addition, postbacs have taken class leadership positions, served as tutors and mentors, and have served as school ambassadors for new applicants. The postbac premedical program has proven to be very successful in preparing students for the rigors of a medical school curriculum by allowing these students to develop the skills and confidence necessary to compete.

The ups and downs of medical school applicants.

The number of students applying to medical schools is shrinking after rising steadily during the 1990s. The decline is the latest turn in the behavior of the applicant pool, which historically has gone through many cycles. Although government policies have strongly influenced the past behavior of the applicant pool, the more recent cycles appear to be related to changes in the Medical College Admission Test (MCAT) and labor market conditions. This article first reviews the cyclical nature of the pool and outlines some of the important factors that have influenced its patterns. Then it focuses on more recent data covering 1990-2000, showing how changes made in 1991 to the MCAT have affected the applicant pool. Data are presented to document the close relationship between the number of students taking the MCAT and the number of medical school applicants in subsequent years. Using this relationship, a projection model has been developed for making projections of the number of applicants for the entering class in osteopathic medical schools in future years. Actual data are compared to the model's projections.