1 developing racial and ethnic diversity in iowa’s physician workforce – recruiting minority...
TRANSCRIPT
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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
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Presenters:
Carolyn Beverly, M.D., M.P.H.
Assistant Professor, Family Medicine
Medical Director, College of Health Science
Project Director
Mary Pat Wohlford-Wessels, Ph.D.
Associate Professor, Family Medicine
Assistant Dean, Academic Quality and Medical Education Research
Project Associate
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Objectives
This presentation has two primary objectives:To provide session participants with an
overview of minority student admissions and enrollment, along with minority faculty data and
To present an overview of DMU’s funded minority recruitment project
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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.
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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.)
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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
The AACOM 2004 Annual Report indicates that: Underrepresented minorities (Black/African American,
Hispanics and Native Americans) have kept pace with, but not gained on other groups in terms of enrollments. Students from the Asian/Pacific Islander minority group have steadily increased their share of first-year and total enrollment.
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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.
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Diversity in Medical Education
A similar pattern exists in total enrollments, with underrepresented minorities generally maintaining a level share, and the Asian/Pacific Islanders’ share rising to its current level of 15.4% of total enrollment.
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Osteopathic Medical School Enrollment - Total Enrollment of Ethnic Minority Groups by School (03-04)
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Osteopathic Medical Schools - Total Enrollment of Ethnic Groups 1994-2003
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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.
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Medical School Applicants by Race and Ethnicity, 2004 - AAMC
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Medical School Applicants by Race and Ethnicity, 1974 – 2004 AAMC
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Total Enrollment by Ethnic Group (03-04)
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Medical School faculty by Race and Ethnicity – AAMC 2004
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Medical School Faculty by Rank within Race and Ethnicity - 2004
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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.
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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
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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%
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DMU’s Funded Recruitment Project
Two Objectives:Student Recruitment
African American & HispanicPhysician Recruitment
African American & Hispanic Lecturers Clinical Preceptors Mentors
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Student Objective – Two ComponentsFocus Group Research and Survey Research
Focus Group Research – to determine student perceptions related to :being a minority. the importance of having minority faculty and
preceptors. the three most important determinants in
selecting a medical schoolsolicit feedback to be used in the
development of a survey instrument
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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)
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Survey Questions – We Asked… Who had the greatest influence on your
decision to enter medical school? Which factors were most important to you
in choosing to matriculate at DMU? How important is it to you to have
opportunities to work with minority mentors during medical school?
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Survey Questions, con’t Thinking of yourself, as a student and in
the future as a practicing physician, how important are the following:your status as a member of a minority
populationyour ability to serve minority and/or
underserved populationsopportunities to be mentored by a minority
physician
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Results – Respondents Year
DMU has 25 underrepresented minority students
11 chose to complete the survey1st year = 27%2nd year = 45%3rd year = 0%4th year = 18%
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Results – Respondents by Ethnicity
Hispanic = 36% Black = 45% Other = 18%
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Question: Many factors influence students decisions to become a physician, of the factors listed, please indicate how much influence each factor had on your decision to pursue a career in medicine?
1 = no influence 2 = some degree of influence 3 = moderate degree of influence 4 = great degree of influence
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Influence to become a physicianDescriptive Statistics
11 3.0909 .70065
11 3.0000 1.26491
11 2.8182 1.32802
11 2.6364 1.12006
11 2.3636 1.02691
11 1.6364 .80904
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Influence of sciencecourse
Influence of parent
Influence Health RelatedWork Experience
Influence of physician
Influence Experiencewith an illness
Influence Teacher
Valid N (listwise)
N Mean Std. Deviation
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Influence to become a physician
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Influence – AAMC 2004
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Question: When you think about the reason you chose to attend DMU, what factors were most important to you?
1 = unimportant 2= of little importance 3 = moderately important 4 = very important
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Reason Student Chose DMUDescriptive Statistics
9 3.7778 .44096
9 3.4444 .72648
10 3.1000 .99443
10 3.0000 .94281
11 3.0000 .77460
11 2.6364 1.20605
10 2.6000 1.07497
11 2.4545 .82020
9 2.4444 1.01379
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Chose DMU -Friendliness
Chose DMU - Reputation
Chose DMU - TeachingMethods
Chose DMU - Curriculum
Chose DMU - Ablitiy toplace Residents
Chose DMU - Location
Cose DMU - CommunityExperience Opportunities
Chose DMU - Cost toAttend
Chose DMU - MulticulturalAffairs Department
Valid N (listwise)
N Mean Std. Deviation
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AAMC 2004 data
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Question: How important is it to have opportunities to work with minority mentors during medical school?
1 = unimportant 2 = of little importance 3 = moderately important 4 = very important
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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
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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
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Question: When you think about the curriculum, do you believe there is sufficient content regarding minority health and cultural competence?
100% said “no”
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Summary
I’m not sure we know what prospective minority students want and expect.
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.
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Physician Recruitment Objective
Physician Recruitment—add five additional physicians to our adjunct faculty
African American & Hispanic
LecturersClinical PreceptorsMentors
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Physician Recruitment
Choice of underrepresented minorities targeted
IA Chapter of the National Medical Association
Prominent Hispanic physician in Des Moines
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Physician Recruitment
Methods chosen to find these minority physicians:
Contacting medical societiesChecking current DMU adjunct faculty listWord of mouth INMA membership directory
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Physician Recruitment
Initial plan:
Develop more culturally appealing recruitment documents
Group presentation at the next INMA meeting--result
Face to face with Hispanic physician--result
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Physician Recruitment
Second Plan
Face to face individual meetings with a meal—result
Time and labor intensive work for one person--result
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Physician Recruitment
Third PlanEUREKA!!! Dr. Wohlford-Wessels locates
one source in IA that keeps an extensive database of physicians that includes race-ethnicity
Provides us with 81 black names and addresses and 32 other that appear to be Hispanic
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Physician Recruitment
Some of the black names were duplicates but none of the other names were.
We then sent out a mass mailing with recruitment information to everyone on the list.
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Physician Recruitment Results to Date
1st plan Group
2 expressed interest
Face to Face
1 signed up as preceptor
2nd plan Face to Face
One signed up for preceptor or lecturer
3rd plan 3 contacted me with interest
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Solutions to Recruitment and Retention For years educators have spoken about
the need to increase the number of minority students applying to medical schools to decrease health disparities in health care.
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Solutions to Recruitment and Retention The question yet to be fully answered is:
How best is that done?Creating long-term solutions by creating
pipelines within our K-12 schools will make minority students more skilled in sciences and math
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Recruitment and Retention (R and R) Issues for Faculty
For faculty, the following are often cited as reasons for unsuccessful R and R efforts:Feelings of isolation of facultyPaucity of other faculty of color Insufficient mentoring and guidanceResistance from students and colleaguesDisproportionate demands for informal
advising and committee work
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Solutions to Recruitment and Retention We must take long-range ongoing
processes to success—not a single event. The advertising and interviewing process
must be sophisticated and posting must be able to reach minorities.
Strong leadership and accountability are important in recruiting faculty.
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Solutions to Recruitment and Retention Faculty search committees need to be
educated about best practices for proactive faculty search processes that identify a diverse yet outstanding applicant pool.
Dual career issues should be addressed carefully.
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Solutions to Recruitment and Retention ALWAYS be searching—networking at
conferences and meetings is important. Review your publicity materials—are they
inviting to people of color as well? Ensure you have a diverse search
committee—going outside of the campus if possible and necessary.
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Solutions to Recruitment and Retention Do not forget the Historically Black
Colleges and Universities or even local universities.
Regularly evaluate your success at recruitment efforts and success in hiring and retention—if possible try to learn why someone is moving on.
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Summary
Efforts in the past have been less than successful – for both the recruitment of students and faculty.
Underrepresented students may need assistance to be more competitive in math and science.
We need to engage students at a very young age.
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Summary
Minority physicians must be identified and sought to serve as mentors and role models.
Used “mixed methods” to recruit students and faculty
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Thank You!