the diversity experience: medical school pipeline … · the diversity experience: medical school...

The Diversity Experience: Medical School Pipeline

Programs, Retention & Cultural Competence

TrainingPresenter: Brandi Baker, Assistant Director of Multicultural Affairs

Ohio University Heritage College of Osteopathic Medicine

Morning Affirmation

DumelaA South African greeting that also means

“I affirm you, I believe in you, I see great

potential in you.”

Workshop Overview

Heritage College of Medicine

Why Diversity in Medicine?

National Data

OU-HCOM Diversity Experience

Pipeline Programs

Retention & Student Support Services

Cultural Competency Program

Cultural Competency Activity

Q & A

Change Activity

Pair with a partner next to you

No verbal communication

1 minute

Change 3 things

Share

Repeat

Ohio University

Heritage College of Osteopathic Medicine

The largest and only D.O. School in the state of Ohio

Ranked in 2013 by the US News & World Report as the 11th in the nation for

producing primary care physicians.

One College in 3 locations: Athens, Dublin, Cleveland

50% of Alumni practice in primary care

Close to 60% chose to practice in Ohio

Types of Medicine: Allopathic vs. Osteopathic

Two types of physicians are licensed to practice medicine in the United States:

osteopathic physicians (D.O.'s) and allopathic physicians (M.D.'s).

Both the Doctor of Osteopathic Medicine degree and the Doctor of Medicine

degree are typically earned in four years.

D.O. Distinctions:

200 hours of additional training in a hands-on diagnosis and treatment approach

called Osteopathic Manipulative Medicine (OMM).

D.O.'s use OMM to reduce pain, increase mobility and support the body’s

natural functions and structure.

D.O.’s are taught that each patient should be treated as a whole person, that

all body systems are interrelated and dependent on one another for a person’s

health and healing.

D.O. Philosophy

Osteopathic Medicine was developed in 1874 by Andrew Taylor Still, MD

Founder & Pioneer of Osteopathy and Osteopathic Medicine

Andrew Still believed that by diagnosing and treating the musculoskeletal system,

physicians could treat a variety of diseases.

Osteopathic physicians focus on unity of the body and takes a holistic approach to

medicine through patient-centered, preventive care.

Osteopathic Manipulative Medicine (OMM) has been used to treat a variety of

problems and has had a success rate high enough to convince many MDs to take

classes in OMM.

DOs have a strong history of serving rural and urban underserved areas, often

providing their unique brand of compassionate, patient-centered care to some of

the most economically disadvantaged members of society.

Ohio University

Heritage College of Osteopathic Medicine

Mission

Our medical school educates physicians committed to practice in Ohio, emphasizes

primary care, engages in focused research, and embraces both Appalachian and urban

communities. Integral to this mission, our college community commits itself to:

provide a clinically integrated, learning-centered, osteopathic medical education

continuum for students, interns, residents and primary care associates; embrace

diversity and public service; and improve the health and well-being of underserved

populations.

Why Diversity in Medicine?

URM doctors are more likely to provide more care to those

living below the poverty line.

A survey of recent medical school graduates (conducted by AAMC)

o 51% of African American, 33% of Hispanic and 41% of Native

American medical school graduates planned to practice medicine

in underserved minority communities versus 18% of surveyed

White medical school graduates (Kaplan, 2012).

Why Diversity Medicine?

By 2020, it is estimated that there will be a shortage of 100,000 physicians with 40,000 of them primary-care doctors (Jackson, 2013).

The U.S Department of Health & Human Services identified more than 63% of Ohio’s 88 counties as Health Professional Shortage Areas.

The lack of representation of URMs in the health care industry has had a negative effect on the U.S.’s health care system and has created a persistently widening health care gap within minority communities (Nivet et al., 2008).

National Data on URM Students in Medicine

Currently, minorities account for more than 30% of the U.S. populace.

By 2060 minorities will account for more than 57% of the U.S.

population, with specific ethnicities of African Americans and

Hispanics accounting for more than 40% of the United States

population (U.S. Census Bureau, 2012).

Minorities make-up 7% of dentists, 10% pharmacists, and 11% of

registered nurses, and 9% of doctors (Mittman & Sullivan, 2011).

Within these communities there is a widening health care disparity.

Diversity Initiatives

Aspiring D.O.C’s High School Pipeline Program

Early Assurance Program (EAP)

Summer Undergraduate Research Fellowship (SURF)

Summer Scholars

Post Baccalaureate Program

Pre-Matriculation Program

Rural & Urban Scholarship Program

Physician Diversity Scholarship Program (Ohio Health)

Physician Diversity Scholarship Program (Cleveland Clinic-Coming Soon 2017)

Student National Medical Association (SNMA-Medical Student for A Day)

HCOM’s Diversity Experience: Pipeline Programs

EAP-Summer Scholars---Post Bac---Pre-Matriculation—Medical School

Pathways to Medicine1. Traditional Pathway:

• Bachelors Degree ( Strong Background-Biology, Chemistry, Anatomy, etc.)

• Masters Degree

• 3.0 gpa or above

• MCAT- 500 or above

• Good Letters of Recommendation

• Level Up: Research, Community Service/Volunteer, Shadowing, Internships,

Fellowships, Summer Programs, Study Abroad, Student Organizations &

Leadership

• Apply Early, Visit the Campus, Meet Admissions Counselors

• Stand Out!

Pathways to Medicine: Planning

What Steps Can be Taken to Get to Medical School?

2. Non-Traditional Pathways:

Medical Pipeline Programs

A Pipeline Program is a curriculum designed to introduce and prepare URM students

to the rigors of medical school and the application process with the ultimate goal

of adding diversity to medical school.

OU-HCOM Pipeline Programs

o Early Assurance Program (EAP)

o Summer Scholars

o Post-Baccalaureate (Post Bac)

o Pre-Matriculation

Partner Institutions

Early Assurance Program (EAP)

Pathways to Medicine

Pipeline Program: Early Assurance Program(EAP)

• High Ability Ohio High School Students

• Interest in Primary Care Medicine

• Apply for undergraduate admission at Ohio University

• Want to attend medical school at OU-HCOM

• Be admitted by Dec 1st or applied to Honors Tutorial College (HTC)

• ACT Composite 28/ SAT combined score 1250-1280

• Completed: 4 yrs. Math, Science (chemistry, biology, physics) & English by high school

graduation

• Up to 12 Participants accepted each year

EAP Benefits

• No MCAT

• Assured acceptance into HCOM (if all program requirements have been met)

• Physician mentoring

• Invited to medical school events

• Medical student mentor

• Early shadowing experiences

• No secondary application fee

EAP Pipeline• 3+4 option (3 yrs. undergrad & complete bachelors first year of

medical school)

• 4+4 option (4 yrs. Undergrad + 4 yrs. Medical school)

• Have an overall GPA of 3.7 and a minimum science GPA of 3.6 at conclusion of program.

• Meet all course prerequisites & health and technical standards a minimum of 6 semester hours of English/or its equivalent

6 semester hours of behavioral science/or its equivalent

8 semester hours of biology

8 semester hours of general chemistry

8 semester hours of organic chemistry

8 semester hours of physics, all with the required lab where applicable

EAP Details

• Continuous enrollment at institution

• Complete the AACOMAS application by June 10th prior to the year of enrollment

• Criminal background check

• Maintain high academic & ethical standards

EAP Timeline

• Only interview once even if applying to multiple partner schools

• Interviews will continue through mid March

• Will be notified of decisions by March 31

• Final placement will be determined by your undergrad selection

• Can still accept students into cohort (space permitting) until beginning of sophomore year.


Pipeline Program: Summer Scholars

Five Week Residential Program

• Up to 25 Participants

• Eligibility – URM, or Economically or Educationally Disadvantaged

Academic Experiences

• Gross Anatomy (cadaver dissection)

• Biochemistry

• Immunology

• Histology

• Integrated Biomedical Sciences

• Introduction to Case Based Learning (CBL)

• Osteopathic Manipulative Medicine (OMM)

• Clinical Shadowing


Pipeline Program: Summer Scholars

Enrichment Programs

• Admissions Workshops

• Financial Aid Workshops

• Academic Success Workshops

• Medical Student Panels

• Alumni Guest Speakers

• Guaranteed Interview (For those who meet the requirements)

• Volunteer/Community Activities

Costs

• Housing, Living & Travel Allowance


Pipeline Program: Post Baccalaureate Benefits

Academic Programming:

• 1 Academic Year

• Graduate & Upper Level Biological Sciences

• 3.0 gpa or Higher—(Admitted into HCOM Medical School)

Academic Courses:

• Biochemistry

• Immunology

• Cell Biology

• Physiology

• Endocrinology

• Anatomy

• Bacteriology

• Medical Terminology, etc.


Pipeline Program: Post Baccalaureate Eligibility:

• URM or Appalachian Ohio Resident

• Interviewed & Waitlisted

• By Invitation Only (15 students accepted annually)

Program Benefits:

• Mentorship: Comrade Program

• Individual/Group Tutoring

• Weekly Enrichment Sessions

• Weekly One on One Advising

• Study Skills/Learning Skills/Learning Specialist

• Summer Pre-Enrollment Program (Pre-Matriculation)

• Build Relationships with Faculty/Staff

• Cohort Experience (In & Out of the Classroom)

• Tuition Waiver (based on eligibility)


Pipeline Program: Pre-Matriculation Eligibility:

• URM/Appalachian Admitted students & Post Bac Students

• Complete Application

Program Benefits:

• 4 week Early Arrival & Course Preparation

• Gross Anatomy (cadaver dissection)

• Immunology

• Histology

• Physiology

• Integrated Biomedical Sciences/Biochemistry

• Introduction to CBL/Osteopathic Manipulative Medicine (OMM)

• Academic Success Workshops/Medical School Preparation

• Build Relationships with Faculty/Staff

• Alumni Guest Speakers

• Living Stipend-$1200-$1600

Prosper: Outcomes of Post Bac Preparation,

Participation & Matriculation Findings:

• Over 95% matriculation rate

• Summers Scholars & Post Bac students are more prepared academically and personally for the transition to medical school

• Summer Scholars & Post Bac students excel during their first year of Medical School

Retention & Matriculation:

• 2009-2010- 13 invited- 11 matriculated

• 2010-2011- 14 invited-14 matriculated





• 2015-2016-14 invited-14 matriculated

Retention & Student Support Services

• Academic Monitoring & Tracking of Medical Students

• Retention Team across three campuses

• Learning Specialists across three campuses

• Free tutoring services

• Exam Review Sessions with Faculty

• Academic Coaching/Check-In’s

Professional Development in Cultural

Competency Program

DumelaA greeting used in Botswana and northern parts of South Africa. Dumela translates into “Good Day”, but also connotatively communicates a

powerful greeting of affirmation. Specifically, the implicit meaning of Dumela is:

“I affirm you, I believe in you,

I see great potential in you.”

Profess ional Development in Cul tural Competency Program

• Established in 2006 by Dr. Mark Orbe in collaboration with HCOM staff• PhD., Interpersonal/Intercultural Communication• Ohio University Alumni• Professor in the School of Communication at Western Michigan UniversityTeaching interests:• Intercultural communication• Interpersonal communication• Communicating about taboo topics• Human communication theoryResearch interests:• Co-cultural communication• Negotiation of cultural identities• Published over 100 articles and a dozen booksTrainings: Summer Institute of Diversity Training (SIDE), Executive Professional Development Program, Cultural Competency Program, Train the Trainer Program

Professional Development in Cultural Competency

Program Description

The “Professional Development in Cultural Competency” is a 4

part non-credit elective for first and second year medical

students.

Goal:

Based on the intercultural communication approach, the goal is to

move students through stages of cultural identity and awareness,

knowledge building and ultimately skill building.

Professional Development in Cultural Competency

Curriculum:

• The importance of cultural difference is weaved throughout the series

through exercise touching upon race, gender, ethnicity, class,

nationality/rationality, sexual orientation, etc.

• Students learn that cultural stereotyping denies the individuality of the

person and that the vest source of information about the patient is the

patient.

• Although cultural generalizations can assist in the physicians approach, they

cannot serve as the sole source for impacting the patient.

• As students move from identity and cultural awareness to knowledge, they

are challenged to exercise their insight through a skills-based exercise.

• Each student interacts with a simulated patient around a health care issue

impacted by culture.

Cultural Competency: A Theoretical Approach

Anxiety & Uncertainty Management

Communication Mindfulness

William Gudykunst

Premises:

• Interacting with strangers is characterized by anxiety and uncertainty

• Operating within maximum and minimum thresholds of uncertainty results in

effective communication

• Knowledge, skills and motivation influence levels of anxiety and uncertainty

• Consciously aware of communication = mindfulness

• Mindfulness=open to new communication; creation of new categories;

awareness of more than one perspective

• Mindfulness allows us to engage in anxiety and uncertainty management

Part 1: Introducing Key Concepts for a Multicultural Society

Theory: Communication Competency

Effectiveness

Appropriateness

Activities:

Global Awareness Activity: Cultural Scavenger Hunt

Global Awareness: Global Village

Self Reflective: Know you leadership style

Featured Activity:

Self Reflective: Salient Aspects of Cultural Identity

Most Salient Aspects

Situational Aspects

Least Salient Aspects

Part 2: Facilitating Effective Intercultural Communication

Theory:

Anxiety/Uncertainty Management

Mindful Communication

Activities:

Self-Reflective: Diversity & Communication Self Assessment

Global Awareness: Matching Cultural Patterns

Self Reflective: Challenge to….

Featured Activity:

Global Awareness Application: Worlds Apart, the Mohammed Kochi Story

What were some cultural issues that impacted the patients health care perceptions,

experiences & decisions?

What communication issues facilitated or hindered the doctor-patient relationship?

What were the issues regarding individual versus family decision making?

Part 3: Enhancing Cultural Competency in Health Care Settings

Theory:

Explanatory Models & Impact of Culture on Health Care and Consumption

Activities:

Self Reflective & Interactive: Visitor/Guide

Global Awareness: Worlds Apart & Small Group Discussion

Self Reflective: Professional Development Plan

Featured Activity:

Skill-Building: Simulated Patient Experience

Cultural Factors Simulated Patient Lab

Patient receive a case/scenario

Students receive a brief patient background

Students recorded conducting a brief medical interview influenced by cultural factors

Peer Facilitator led discussion of student/patient interaction

Part 4: Connecting Intercultural Communication Concepts and

Everyday Practice

Sim Lab Discussion & Follow Up:

What went well? What can be improved? What did you learn?

Group Connectedness & Affirmation

Dean and/or President welcome & statement of importance

Closing reception with presentations of certificates to

participants and peer facilitators


Aspects of Cultural Identity---(Individual/Small Group)

• Abilities 1.How do you see yourself? 2. How do you think others see

you?

• Age

• Class/SES

• Sexual Orientation

• Nationality

• Spirituality

• Rationality

• Ethnicity

• Sex/Gender

• Race

• Others……


• Cultural Identity Pyramid

Intercultural Relationships involve negotiation of similar sets of inherent tensions that

exist between two opposing pulls

Intercultural Dialects: Cultural vs. Individual

Personal vs. Social-Contextual

Differences vs. Similarities

Present-Future vs. History-Past

Privilege vs. Disadvantaged

Four Levels of Mindfulness

• Unconscious incompetence

• Conscious incompetence

• Conscious competence

• Unconscious competence

Cultural Competency Change Activity

• Change Activity Take Away

• Starting Change is easier than maintaining change

• Change typically generates feelings of awkwardness & isolation

• If you want people to change efficiently, you have to offer information, explanation

and more clarification

• Its important to use all available resources to change

• Change is contagious

Cultural Competency: Program Success

• In any year, 60-80% of the first year class participates

• Occurs 8:00-12:00pm on Saturdays

• (Peer Facilitators meet on Fridays from 5-8pm)

• 2nd years have the option serve as a Peer Facilitator

• Go through an additional 20 hours of training

• Both participants and facilitators receive certificates

• Professional Profile with Deans Letter

Where are we today?

Areas for Growth

• Program continues to grow and has reached its largest class yet in 2016

• Post research on alumni doctors who have gone through the program

• Moving toward required Cultural Competency Training

• Incorporate more aspects of culture and patient care in new curriculum

• Faculty Development

• Advocacy Program

• Students who choose to remain consciously biased

• Students who may feel we live in a post racial society

Contact Information

Brandi Baker, Assistant Director, Multicultural Affairs

Email: [email protected]

Phone: 740-593-2465

Website: www.oucom.ohiou.edu

mailto:[email protected]

http://www.oucom.ohiou.edu/

Admissions Contact Information

• John Schriner, Assistant Dean of Admissions (Athens) [email protected]

• Jill Harman, Director of Admissions (Athens)[email protected]

• Michael Rice, Assistant Director of Admissions (Athens)[email protected]

• Samantha Baker, Admissions Advisor (Cleveland)[email protected]

• Amy Martinez, Admissions Advisor (Dublin)[email protected]

1.800.345.1560 – Athens or 216.295.7941 - Cleveland






References

Kaplan, M. A. (2012, Oct 01). Patching the pipeline: Physician shortage in the U.S. The Hispanic Outlook in Higher Education, 23, 19-21. Retrieved from http://search.proquest.com/docview/1326333707?accountid=458

Kaiser family foundation. (2014). Distribution of the nonelderly with medicaid by race ethnicity. Retrieved from http://kff.org/medicaid/state-indicator/distribution-by-raceethnicity-4

Mittman, I. L., & Sullivan, L. W. (2011, August). Forming state collaborations to diversify the nation's health workforce: The experience of the Sullivan alliance to transform the health professions. Journal of Genetic Counseling, 20(6), 757-773.

Nivet, M., Taylor, V., Butts, G., Strelnick, A., Herbert-Carter, J., Fry-Johnson, Y., & .Kondwani, K. (2008). Diversity in academic medicine no. 1 case for minority faculty development today. The Mount Sinai Journal Of Medicine, New York, 75(6), 491-498. doi:10.1002/msj.20079

Nair, N., Marciscano, A. E., Vivar, K. L., Schaeffer, S., LaMont, E., & Francois, Fritz, M.D., M.S. (2011). Introduction to the medical professions through an innovative medical student-run pipeline program. Journal of the National Medical Association, 103(9), 832-8. Retrieved from http://search.proquest.com/docview/922055097?accountid=458

Yeo, G. (2009). How will the U.S. healthcare system meet the challenge of the ethnogeriatric imperative?. Journal Of The American Geriatrics Society, 57(7), 1278-1285. doi:10.1111/j.1532-5415.2009.02319.x

Gudykunst, William. Theorizing on Intercultural Communication. Thousand Oaks, CA: Sage Publications, 2004

Grainger-Monsen M. Haslett J. Worlds Apart. Brooklyn, NY Fanlight Productions, 2003

http://search.proquest.com/docview/1326333707?accountid=458

http://kff.org/medicaid/state-indicator/distribution-by-raceethnicity-4

http://search.proquest.com/docview/922055097?accountid=458

Thank you!

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