Neurological interest and career exploration among black medical students: Perceptions and solutions for the pipeline.

PURPOSE: The goal of this study was to identify factors that influence the selection of Neurology as a career choice for Black medical students. METHODS: Survey data was collected from attendees at a national educational conference and at a large academic medical school. Two proportion z-tests were used to assess responses among students of different racial/ethnic backgrounds. RESULTS: 199 students participated in the survey. Compared to their Asian and White counterparts, Black students were significantly less likely to choose or consider a career in Neurology. In addition, we found that these students relied more heavily on their pre-clinical experiences to make this determination, citing preference for another specialty, lack of exposure, a preference for a different patient population, and a lack of racial/ethnic diversity as key reasons to not choose a career in Neurology. CONCLUSIONS: Neurological disorders are important contributors to morbidity and mortality. It is imperative that the field attract medical students toward careers in Neurology, particularly those students from traditionally and persistently underrepresented backgrounds. Our findings suggest that Black medical students consider Neurology as a specialty choice less frequently than their counterparts do, and this decision may be made prior to training. We conclude that a multifaceted approach is best to improve the racial/ethnic diversity within the neurological workforce, which should include targeted interventions prior to and after matriculation to medical school.

Reducing Reliance on Test Scores Reduces Racial Bias in Neurology Residency Recruitment.

PURPOSE: We sought to correct a low interview rate for racial groups underrepresented in medicine (URM) by analyzing our interview selection process, identifying sources of unintended bias, and developing a new process that would provide a more racially diverse interview pool. METHODS: We analyzed our review process to determine at which point we were eliminating URM candidates at a higher rate than those who are not from an underrepresented group. A point system was created incorporating clinical grades, extracurricular activities, research, letters of recommendation, board exam scores, and life experiences. We compared the rate at which interviews were offered to URM candidates and compared those rates to historical data. We then analyzed the new process by comparing groups who were offered interviews to those who were not. RESULTS: In 2016, 56% of URM applicants were screened out by a mandatory minimum United States Medical Licensing Examination (USMLE) test score, whereas only 39% of all other groups were disqualified by test scores. This led to 20% of the URM applicants receiving interview offers. By comparison, 30.6% of other groups were offered interviews. After removing the required minimum test score for application review and modifying the screening process to a more holistic one the following application cycle, 24.5% of URMs were offered interviews in 2017 compared to 28.1% of others. CONCLUSIONS: A comprehensive review of applications that minimizes emphasis on USMLE step 1 scores substantially reduced the difference between the percentages of URMs and those of other racial backgrounds who were offered interviews for a Neurology residency.