Improving Underrepresented Minority in Medicine Representation in Medical School.

OBJECTIVES: Despite the efforts of various leading organizations in medical education, representation of black students in US medical schools has declined since the mid-1990s. The Florida State University College of Medicine (FSUCOM) has undertaken efforts to increase black and other underrepresented minority in medicine (URMM) representation in medical school through the Bridge to Clinical Medicine Program. This program is described and analyzed by the authors. METHODS: Demographic information, Medical College Admission Test scores, undergraduate grade point average, US Medical Licensing Examination (USMLE) scores (Steps 1 and 2), residency match information, and current practice location from 2006 to 2015 were collected from the FSUCOM. Data were analyzed using SAS and linear regression analyses were performed, comparing Bridge students with the College of Medicine and national averages. RESULTS: Sixty percent of Bridge students were black, 21% were other URMM, and the remainder were non-URMM. Black Bridge students scored 7.4 points lower on their Medical College Admission Test, and other-URMM Bridge students scored 6.0 points lower (P < 0.0001) than their non-URMM non-Bridge classmates. Black Bridge students also started with a grade point average that was 0.28 points lower than their non-URMM non-Bridge counterparts, but there was no statistical difference for other-URMM Bridge students. Black students, regardless of Bridge participation, were less likely to pass USMLE Step 1 when compared with non-URMM classmates (P < 0.0001). For USMLE Step 2, however, there were no significant differences in passing rates for Bridge students compared with non-Bridge students. CONCLUSIONS: The FSUCOM Bridge program has not only increased its URMM enrollment but it also has effectively doubled the number of black students in its medical college. Other universities could produce similar results using the program outlined in this article.

Contributors of black men's success in admission to and graduation from medical school.

PURPOSE: To determine characteristics and individual experiences that contribute to black men's success in being admitted to and graduating from medical school. METHOD: In 2010, one of the authors, a black man, interviewed 10 black male medical students enrolled at Florida State University College of Medicine and 3 black male physicians associated with that school, using consensual qualitative research methodology to analyze the data. The investigators recorded and transcribed the interviews, coded them to determine themes, and identified an overarching theoretical construct. RESULTS: The authors identified six broad contributors to successful admission to and completion of medical school: social support, education, exposure to the field of medicine, group identity, faith, and social responsibility. The six categories were subsequently grouped into four major themes: educational experiences, exposure to medicine, psychosocial-cultural experiences, and personal attributes and individual perceptions. The metaphor of a table (success) with four legs (four major themes) illustrates the complex dynamics that contribute to success. CONCLUSIONS: The success of black men and the factors that contribute to that success guided this study. The results reinforced the conclusion that success for black men is achieved via a balance between educational experiences, exposure to medicine, psychosocial-cultural experiences, and personal attributes and individual perceptions. This information can be used by medical schools to strengthen their outreach programs, provide a theoretical construct for discussion and research, and generate questions for future quantitative studies.

Student's perspective of success in a postbaccalaureate program.

OBJECTIVE: To identify contributors to the success of students in medical school that graduate from a 1-year postbaccalaureate bridge program. METHOD: In 2010, using rigorous qualitative methodology, the principal investigator interviewed a random sample of 15 (23%) of current and past graduates of The Florida State University College of Medicine Bridge program. The investigators recorded and transcribed the interviews, utilized consensual qualitative research methodology to analyze the data, and identified an overarching theoretical construct. RESULTS: Content analysis of all 15 interviews yielded 73 themes, which were grouped into 6 broad categories/domains: The Florida State University College of Medicine Bridge Program attributes, personal attributes, proof of competence, support systems, exposure to medical programs, and faith/religion. CONCLUSION: Postbaccalaureate programs prepare students for success in medical school. The Florida State University College of Medicine Bridge Program has been particularly successful in identifying and educating students who demonstrated promise upon application, despite noncompetitive grades and Medical College Admission Test scores. The authors identify the characteristics and individual experiences of the students and program that relate to success.

Toward a common framework for rural background.

BACKGROUND AND OBJECTIVES: To develop a standardized framework to discuss rural background, a review of the literature to identify studies regarding the association of rural background with primary care and/or rural health practice was conducted. The various definitions of rural background were collated and from this data a framework for the conceptualization of rural background is proposed. METHODS: The Medline database from 1966-2009 was searched to find citations that included a rural background definition as a variable for rural intent to practice, rural career choice, or rural practice. Studies that included medical school admission outcomes of US medical schools were included if there was (1) a definition of rural background noted, (2) a research-based question, and (3) a defined outcome of rural practice intent or practice in rural area. RESULTS: A full text review was completed for all 45 articles identified. After applying the inclusion and exclusion criteria to the full length articles, there were 15 articles included in the review. The five most common definitions of rural background were (1) a positive answer to the question "Did you grow up in a rural area"? (2) a rural county of birth, (3) grew up in a town of less than 10,000 persons, (4) graduation from a high school located in a town of less than 10,000 persons, and (5) self-declared rural county of residence. CONCLUSIONS: There are multiple terms used in research to elucidate the conceptualization of rural background. Based on a definition of rural as the "anchor," we propose the use of the five most common definitions of rural background as "rural connectors" that can be used to buttress the definition of rural background. The framework of rural connectors can then be used to more closely define rural background.