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Developing Racial and Ethnic Diversity in Iowa’s Physician Workforce – Recruiting Minority Students and Faculty
Des Moines University College of Osteopathic Medicine
Presenters:Carolyn L. Beverly, M.D., M.P.H.
Assistant Professor, Family Medicine, COMMedical Director, College of Health ScienceProject Director
Mary Pat Wohlford-Wessels, Ph.D.Former Associate Professor, Family MedicineAssistant Dean, Academic Quality and Medical Education Research, Des Moines University, COMProject AssociateCurrently Vice President, Institutional Effectiveness, Kansas City University of Medicine and Bioscience, COM
Acknowledgement
This project was made possible by grant number
1 D1DHP06382-01-00 from the Bureau of Health Professions, Health Resources and Services Administration, U. S. Department of Health and Human Services.
DMU’s proposal was funded through the Iowa Department of Public Health.
Diversity at Des Moines University
Like all post-secondary educational institutions in Iowa, Des Moines University (DMU) has experienced some challenges in recruiting and retaining a well qualified diverse student population. The same challenges exist with hiring an appropriately diverse faculty in the University’s College of Osteopathic Medicine (COM).
Diversity in Medical Education
Two data sources were used to develop the background for this project and presentation – the AACOM Annual Report & the AAMC Minority Report.
Diversity in Medical Education
The AACOM 2004 Annual Report: Underrepresented minorities (URMs),
(Black/African American, Hispanics and Native Americans), have kept pace with, but not gained on other groups in terms of enrollment. Students from the Asian/Pacific Islander minority group have steadily increased their share of first-year and total enrollment.
Diversity in Medical Education
Underrepresented minorities were 8.3% of total first-year enrollment in 2003-04, somewhat below the level of a decade ago. Asian/Pacific Islanders have increased their share of first-year enrollment from about 10% to more than 15% over the decade.
Diversity in Medical Education
A similar pattern exists in total enrollments, with URMs generally maintaining a level share, and the Asian/Pacific Islanders’ share rising to its current level of 15.4% of total enrollment.
Osteopathic Medical School Enrollment - Total Enrollment of Ethnic Minority Groups by School (03-04)
Osteopathic Medical Schools - Total Enrollment of Ethnic Groups 1994-2003
Diversity in Medical Schools AAMC Data
Source: Minorities in Medical Education; Facts and Figures 2005
In 2004, Blacks constituted 7.8% and Hispanics constituted 7.1% of all applicants. Of all minority applicants in 2004, Asians were the largest group (nearly 19%).
In 2004 nearly half (49.4%) of all applicants to medical school were accepted. Of the total number of Hispanic applicants 48.8% were accepted, and of Black applicants, 41.3% were accepted.
Medical School Applicants by Race and Ethnicity, 2004 - AAMC
Medical School Applicants by Race and Ethnicity, 1974 – 2004 AAMC
Total Enrollment by Ethnic Group (03-04)
Medical School Faculty by Race and Ethnicity – AAMC 2004
Medical School Faculty by Rank within Race and Ethnicity - 2004
In Summary - National Issues Medical Schools have made significant
investments in minority student recruitment, yet the yield is less than expected, this is especially true for underrepresented minorities.
The same old recruitment strategies have not worked – medical schools may need to invest in innovative programs.
Medical Schools do not have sufficient minority faculty mentors – in the basic sciences or among clinical faculty.
DMU’s Funded Recruitment Project
Two Objectives:Student Recruitment
African American & HispanicPhysician Recruitment
African American & Hispanic Lecturers Clinical Preceptors Mentors
Enrollment in Iowa’s Medical Schools
University of Iowa Des Moines University
Class Size 2002 142 202
Class Size 2005 142 217
Under represented minority (2005)
14% 4%
Other Minority (2005) 7% 16%
Student Objective – Two ComponentsFocus Group Research and Survey Research
Focus Group Research – to determine student perceptions related to: being a minority having minority faculty and preceptors the three most important determinants in selecting a
medical school solicit feedback to be used in the development of a
survey instrument
Focus Group Themes Regarding Student Perceptions
Hispanic vs. African American Students perceptions A parent or teacher had significant influence on the
students decision to attend medical school Wanted to be perceived as excellent students, rather than
minority students Little identification with their minority status Didn’t feel the need to be connected to a minority
community Generational Passion (facilitator vs. student expressed
passion)
Influence to become a physician
Influence – AAMC 2004
Top 5 Influences on Becoming PhysiciansDMU Students AAMC 20041. Science Course 1. Health-Related
Work Experience
2. Parent 2. Experience with Illness/Accident
3. Health-Related Work 3. Science Course Experience
4. Physician 4. Physician
5. Experience with 5. Parent Illness/Accident
Reason Student Chose DMU
AAMC 2004 data
Top 5 Reasons Why Students Selected Their SchoolsDMU Reasons A A M C 2004 R e a s o n s Hispanics/Blacks Hispanics Blacks1. Friendliness of school 1. Location 1. Friendliness
2. Reputation 2. Friendliness 2. Teaching Methods
3. Teaching Methods 3. Teaching Methods 3. Community Experience
4. Curriculum 4. Reputation 4. Curriculum
5. Ability to Place Residents 5. In-State School 5. Ability to Place Residents
Minority MentorsDescriptive Statistics
10 3.6000 .51640
10 3.5000 .52705
11 3.2727 1.19087
11 3.1818 1.16775
11 3.1818 1.25045
11 3.0909 1.22103
11 2.7273 1.19087
11 2.7273 1.27208
11 2.6364 1.02691
11 2.6364 1.28629
11 2.4545 1.21356
10
Importance of being ableto serve minoritypopulations in the future
Importance of being ableto work in anunderseerved area
Importance of serving asa minority physicianmentor in the future
Importance of beingmentored by a minorityphysician
Importance of minorityclinicians during years 3& 4
Importance of minorityclinicians duringthroughout the curriculum
Importance of beingconsidered a minority asa physician
Importance of minorityclinical faculty
Importance of beingconsidered a minority asa student
Importance of minoritybasic science faculty
Importance of minorityresearchers
Valid N (listwise)
N Mean Std. Deviation
DMU students were asked how important it is to have opportunities to work with minority mentors during medical school—
Top 5 Answers, most to least importance:1. Being able to serve minority populations in
the future2. Being able to work in an underserved area3. Serving as a minority physician mentor in
the future4. Being mentored by a minority physician5. Minority clinicians during year 3 and 4
The importance of minority basic science faculty was ranked second to last out of 11 items; and the importance of minority researchers ranked dead last!!
All URM COM students believed that there was not sufficient content regarding minority health and cultural competence in the curriculum.
So What is DMU-COM Doing To Address
This Situation?
1. Office of Enrollment Management
Eight person staff committed to increasing diversity enrollment among students in all of the 3 Colleges on DMU campus.
Strategies for Increasing Minority Enrollment:
Identify and participate in events targeted to under-represented minority undergraduate students with an interest in the health professions
Targeting Underrepresented Minority Undergraduate Students: McNair Scholars
Programs—a TRIO program
Student National Medical Association (SNMA)
National Black Graduate Student Association (NBGSA)
Society for Advancement of Chicanos and Native Americans in Science (SACNAS)
Targeting Underrepresented Minority Undergraduate Students: National Association of
Minority Medical Educators (NAMME)
AAMC identified schools with highest number of URM applicants to medical schools
Historically Black Colleges and Universities (HBCU); Hispanic Association of Colleges and Universities (HACU)
Strategies for Increasing Minority Enrollment, con’t:
Assist in identifying URM candidates for DMU-sponsored diversity scholarships, such as the Glanton Scholarship
2005-2006 Minority Recruiting Activities
Began tracking number of URM students with whom they came in contact with during recruiting eventsFeb-Jun 06: approx. 150 under graduates
self-identified as URMs23 undergraduate institutions with significant
URMs were visited
2005-2006 Minority Recruiting Activities
McNair Scholars Conference and Graduate School Fair
North Carolina Area Health professions recruiting Fair
Past attendees of the Medical Summer Institute will receive mailings encouraging applications to DMU-COM
2006-07 Planning Minority Recruiting Activities NAMME Natl. Conf. and
Recruitment fair Central Michigan University
SNMA Premed. Student Conf. and Med. School Fair
2 separate McNair Scholars conf. and recruiting fairs
SNMA and NBGSA Annual Conferences
SACNAS Natl. Conf. AAMC Minority Student
Med. Career Awareness Workshop/Recruitment Fair
HACU Annual conf. and college fair
Annual Biomedical Research Conf. for Minority Students
06-07 Visits to undergraduate institutions with high minority enrollments
Mississippi Tour Tennessee Tour George Wash. Univ. New York Univ. Univ. of TX El Paso New Mexico State Univ. of OK Florida Atlantic Univ.
Univ. of Michigan/Michigan State
UT Austin/San Antonio Univ. of IL
Chicago/Urbana-Champaign
Loyola and Xavier
Enrollment Office Abbreviations
TRIO Programs: Sponsored by the US Dept. of Education—educational opportunity outreach programs designed to motivate and support students from disadvantaged backgrounds. They include 2 outreach and support programs targeted to serve and assist low-income, first-generation college students and students with disabilities to progress through the academic pipeline from middle school to post baccalaureate programs.
Enrollment Office Abbreviations
NAMME: National Association of Minority medical Educators
SACNAS: Society for Advance of Chicanos and Native Americans in Science
HACU: Hispanic Association of Colleges and Universities
2. Department of Educational Support Services Efforts
1.Raise awareness of students to implicit biases they may have regarding persons different than themselvesThey take several Implicit Attitude Tests
regarding race, gender, sexual orientation and religion—interactive web-based ways to uncover hidden biases.
Department of Educational Support Services Efforts
2. “Campus climate” survey to assess current perception of how well the university is doing in the area of diversity promotion and acceptance—for students; staff; faculty; and administration
Department of Educational Support Services Efforts
3. Minority student focus groups to: assess the university’s strengths and
weaknesses in attracting and retaining students of diverse backgrounds
identify ways to enhance students’ future experiences and opportunities while at DMU
Summary We’re not sure we know what prospective
minority students want and expect. Our student responses to our survey are
different from the 2004 AAMC responses. More information is needed to determine
the best recruiting strategies; what we’ve invested in hasn’t produced a difference in yield.
Some schools are doing a great job, and we could learn from them.
Minority Population and Practicing Physicians in Iowa
Race % of Population in Iowa
% of Physicians in Iowa
AfricanAmerican
2.0 1.2
Hispanic 4.6 0.9
Physician Recruitment Objective
Physician Recruitment—add five additional physicians to our adjunct faculty
African American & Hispanic
LecturersClinical PreceptorsMentors
Physician Recruitment
Choice of underrepresented minorities targeted
IA Chapter of the National Medical Association
Prominent Hispanic physician in Des Moines
Physician Recruitment
Methods chosen to find these minority physicians:
Contacting medical societiesChecking current DMU adjunct faculty listWord of mouth INMA membership directory
Physician Recruitment
Initial plan
Develop more culturally appealing recruitment documents
Group presentation at the next INMA meeting
Face to face with Hispanic physician
Physician Recruitment
Second Plan
Face to face individual meetings with a meal or one to one in person or via telephone.
Time and labor intensive work for one person.
Physician Recruitment
Third Plan
Dr. Wohlford-Wessels located one source in IA that keeps an extensive database of physicians that includes race-ethnicity.
We sent out two mass mailings with recruitment information to everyone on the list.
Physician Recruitment Results
1st plan Group:
2 expressed interest
Face to Face:
Three signed up as preceptor
2nd plan 7 people expressed interest
Four signed up for preceptor or lecturer
3rd plan 6 contacted me with interest
One signed up as a lecturer
Physician Recruitment Results Final efforts were concentrated on follow-up
phone calls.
Successfully recruited eight physicians as adjunct professors—grant requirements were for five to be recruited
Three other physicians were very interested but we couldn’t get them approved in a timely manner.
Grant Timing Issues
Because the vast majority of the commitments and adjunct appointments were made towards the end of the grant period AND the school year, there were some timing problems in coordinating commitments with the curriculum schedule.
Grant Timing Issues
The timing of our courses did not allow enough time for coordination between DMU course coordinators and adjunct professors.
Grant Timing Issues
Adjunct lecturer interests were attempted to be matched with current lecture courses and schedules.
Course coordinators were asked verbally and in writing on several occasions to assist us in letting us know what opportunities existed.
The reality is currently that the vast majority of courses already have a pre-set selection of lectures and lecturers to give them.
DMU does have a great need for preceptors and we hope that more of these adjunct professors will be willing to precept our students.
Grant Timing Issues
As a result, our contract was modified to allow the adjunct professors to be reimbursed for signed Letters of Appointments.
The grantor gave us sufficient funding to cover the commitments made by the adjunct professors.
Grant Timing Issues
These funds are set aside in Accounting and will be available as each commitment is completed.
Adjunct Professor Committments
Preceptorships: 14
Lectures: 10
Lectures/Panel Discussions: 8
Thank you for your Attention!
