Academic journal article The Qualitative Report

Student Reflections on Position and Experiences in the Doctors of Tomorrow Program

Academic journal article The Qualitative Report

Student Reflections on Position and Experiences in the Doctors of Tomorrow Program

Article excerpt

Introduction

Despite the U.S. demographic trend towards increasing racial and ethnic diversity, African Americans, Native Americans, and Hispanic Americans are still substantially underrepresented in medicine (Castillo-Page, 2012; Cook & Cordova, 2006; Humes, 2011). The lack of diversity in the physician workforce limits the financial and innovative benefits of nonhomogeneous teams, negatively affects services provided to underserved populations, and affects patient comfort and compliance (Barr, Gonzalez, & Wanat, 2008; Page, 2008; Thomas, Manusov, Wang, & Livingston, 2011). Grade school, in particular, has become a focal point for educational interventions that support diversifying the U.S. physician workforce (Cohen & Steinecke, 2006; Nivet, 2011; Terrell & Beaudreau, 2003). However, there is an insufficient understanding from the perspective of students underrepresented in medicine (URiM) about what aspects of these initiatives were most meaningful at the time of matriculation to postsecondary education (Morrison & Cort, 2014).

Background

URiM populations made up 12.3% of U.S. medical school attendees in 1991 and only accounted for 15% of total medical school enrollment two decades later in 2011, compared to the 30% that would be expected if medical field involvement accurately represented the U.S. population (Castillo-Page, 2012). Significant barriers and attrition leaks associated with diverting URiM students away from medicine occur during high school (Morrison & Cort, 2014). In particular, URiM and under-resourced communities often have fewer opportunities for students to participate in research and clinical settings, while the competitive premedical environment continues to require more exposure with the field (Muller et al., 2014). Establishing relevant clinical opportunities and meaningful academic enrichment experiences for URiM high school students in partnership with college programs has the potential to reduce barriers to medical education (Lakhan, 2003; Ovink & Veazey, 2011; Perna & Swail, 2001).

URiM students from under-resourced communities may also have the additional challenge of being a first-generation college student (Kahn & Sneed, 2015; Muller et al., 2014). According to Kahn and Sneed (2015), exorbitant debt and deferred income often discourage first-generation students from their academic pursuits. Access to career specific mentors who are able to provide guidance to URiM students on their educational pathways can help address barriers that contribute to disproportionately smaller percentages of medical school attendees (Afghani, Santos, Angulo, & Muratori, 2013; Barr et al., 2008; Dennery, 2006; Figueroa, 2014; Freeman, Landry, Trevino, Grande, & Shea, 2016). Longitudinal, near-peer mentorship has the potential to broaden career awareness, educational preparation, and serve as a role model on the pathway to medicine (Afghani et al., 2013; Baker & Lyons, 1989; Dandavino, Snell, & Wiseman, 2007; Jackson et al., 1988; Kahn & Sneed, 2015; McQuillan, 2005; MedlinePlus, 2011; Nair et al., 2011; Ten Cate & Durning, 2007; Topping, 1996).

While hands-on experiences, mentorship, and practical insights into the medical school trajectory have been identified as best practices in outreach programming, a fuller exploration of meaningful experiences within pipeline programs from the perspective of URiM students is warranted (Afghani et al., 2013; Baker & Lyons, 1989; Jackson et al., 1988; Nair et al., 2011; Ten Cate & Durning, 2007). Doctors of Tomorrow (DoT) is a pipeline program that partners first-year medical students at the University of Michigan Medical School (UMMS) with high school freshmen from Cass Technical High School (CTHS) where more than 80% of the population are from racial and ethnic minority groups (Derck, Zahn, Finks, Mand, & Sandhu, 2016; Humes, 2011). The goal of DoT is to actively engage, inspire, and prepare URiM high school students to pursue careers in the field of medicine by combining three core components (Ross, Yates, Derck, Finks, & Sandhu, 2016). …

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