Faculty Bibliography

IMPORTANCE/UNASSIGNED:The 2023 Supreme Court of the United States (SCOTUS) Students for Fair Admissions, Inc. v President and Fellows of Harvard College ruling to restrict race-based affirmative action is a landmark decision with potentially far-reaching consequences. OBJECTIVE/UNASSIGNED:To examine application, acceptance, and matriculation rates into doctor of medicine (MD)-granting programs before and after the 2023 SCOTUS decision. DESIGN, SETTING, AND PARTICIPANTS/UNASSIGNED:This retrospective cross-sectional study used deidentified data from the Association of American Medical Colleges on applicants and matriculants to US MD-granting medical schools 5 years before (2019-2023) and 1 year after (2024) the SCOTUS ruling. MAIN OUTCOMES AND MEASURES/UNASSIGNED:Application, acceptance, and matriculation into MD-granting programs. RESULTS/UNASSIGNED:The study sample included 291 764 applicants to MD programs between 2019 and 2024 (162 211 identifying as female [55.59%]; 4576 American Indian, Alaska Native, Native Hawaiian, or Pacific Islander [1.57%], 84 122 Asian [28.83%], 34 256 Black [11.74%], 35 707 Hispanic [12.24%], and 154 621 White [53.00%]). Compared with mean acceptance rates in 2019 to 2023, acceptance rates in 2024 were higher for White (40.37% vs 47.47%; difference, 7.10 percentage points [95% CI, 6.21 to 7.98 percentage points]; P < .001) and Asian (38.26% vs 45.19%; difference, 6.93 percentage points [95% CI, 5.78 to 8.07 percentage points]; P < .001) applicants and lower for Black applicants (36.06% vs 33.08%; difference, -2.98 percentage points [95% CI, -4.74 to -1.21 percentage points]; P < .001) and underrepresented in medicine (URiM) applicants overall (39.68% vs 38.33%; difference, -1.35 percentage points [95% CI, -2.60 to -0.09 percentage points]; P = .02). No racial or ethnic difference in acceptance rates were observed in 2019 to 2023, but in 2024, URiM applicants had significantly lower acceptance rates than White (difference, -9.14 percentage points; P < .001) and Asian (difference, -6.86 percentage points; P < .001) applicants. Comparing the mean of 18 304 matriculants in 2019 to 2023 with 19 018 matriculants in 2024, White student representation decreased from 10 132 matriculants (55.35%) to 10 158 matriculants (53.41%) for a decrease of 1.94 percentage points (95% CI, -3.31 to -0.56 percentage points; P = .009), Asian student representation increased from 5102 matriculants (27.87%) to 6288 matriculants (33.06%) for an increase of by 5.19 percentages points (95% CI, 3.49 to 6.88 percentage points; P < .001), and URiM student representation decreased from 4466 matriculants (24.39%) to 3963 matriculants (20.83%) for a decrease of 3.56 percentage points (95% CI, -5.34 to -1.77 percentage points; P < .001), equating to 503 fewer URiM matriculants in 2024. Post-SCOTUS decision declines in URiM representation were concentrated in schools located in states without prior state-level affirmative action bans (mean [SD] change, -6.14 [8.93] percentage points vs 0.10 [8.11] percentage points; P < .001). CONCLUSIONS AND RELEVANCE/UNASSIGNED:In this study, URiM student matriculation into US medical schools declined after the 2023 SCOTUS ruling, with an emergent disparity in acceptance rates of URiM applicants relative to Asian and White students. The decline in URiM student matriculation was concentrated in states without a preexisting state-level affirmative action ban, suggesting that there may be an association between the SCOTUS ruling and demographic changes in matriculation.

BACKGROUND:Recruitment of a more diverse obstetrics and gynecology workforce may help improve patient outcomes in the US, particularly among women of color. Visiting rotations play a role in competing for a position in an obstetrics and gynecology residency, however, not all students may be able to complete these expensive experiences. Our objective was to evaluate socioeconomic and other demographic differences among US obstetrics and gynecology-bound students who participate in visiting rotations versus those who do not. METHODS:We obtained de-identified data from the Association of American Medical Colleges for students graduating in US allopathic medical schools 2019 or 2020. We analyzed self-reported receipt of state and/or federal assistance to obtain postsecondary education, medical education debt, sex, and race and ethnicity data using chi-square and ANOVA analyses and logistic regression. RESULTS:Of 33,287 US graduating medical students, 1978 (5.9%) indicated "Obstetrics and Gynecology" as their intended practice and included socio-demographic data; 1110 (56.1%) of these completed at least one visiting rotation. In multivariable analysis controlling for medical education debt, race and ethnicity, and sex, students with moderate debt were less likely to complete any visiting rotation (aOR 0.68, 95% CI: 0.52, 0.89) and students with any debt were less likely to complete two or more visiting rotations than those without debt. However, Black students were significantly more likely to complete two or more rotations than white students when adjusted for debt and sex (aOR 1.48, 95% CI: 1.02, 2.11). CONCLUSIONS:Among US obstetrics and gynecology-bound medical students, moderate medical education debt was associated with lower odds of completing visiting rotations when adjusted for race and ethnicity and sex. Black students were more likely to complete two or more visiting rotations compared to their white counterparts when adjusted for levels of debt, perhaps to improve the likelihood of a successful match that is lower than that of their white colleagues despite the risk of worsening their debt. Providing more financial support or deemphasizing the visiting rotation as part of the application could help recruit a workforce that better reflects the diversity of the general population.

OBJECTIVES/OBJECTIVE:The 2024 Society for Academic Emergency Medicine Consensus Conference focused on developing a pathway to build and support a diverse and sustainable emergency medicine (EM) clinician-scientist workforce. The underlying premise is that the specialty of EM needs a robust clinician-scientist workforce to fulfill its research mission of creating new knowledge to improve patient care and outcomes. METHODS:Preconference workgroups assessed existing pathways to develop and support EM clinician-scientists and generated unranked lists of strategies to holistically and comprehensively grow the clinician-scientist workforce. These strategies were refined and prioritized during a one-day, in-person conference, which was followed by a virtual conference to reach consensus on metrics, goals, and timelines for implementation. RESULTS:Overarching strategies included fostering a departmental culture that values research, addressing barriers to recruiting and retaining a diverse research work force, and enhancing the national reputation of EM research. At the undergraduate and medical school stage, creating a portfolio of medium- and long-term research training opportunities with EM faculty mentors was the highest priority. At the resident and fellow stage, top priorities were dedicated research training built into EM residencies and clinical fellowships. Early-career faculty strategies prioritized departmental support for federally funded K awards. Mid-career faculty strategies prioritized securing federal support for research mentoring, leading institutional training grants, and building research teams that include PhD scientists. At all stages, we addressed recruitment and retention of trainees and faculty from disadvantaged and underserved groups. CONCLUSIONS:These prioritized strategies with respective metrics, goals, timelines, and responsible parties provide a roadmap for EM to build a broadly inclusive and sustainable clinician-scientist workforce, capable of creating the new knowledge needed to advance emergency medical care. Successful implementation will require substantial commitment and investment from national EM organizations and academic department chairs. The result will be improved care and outcomes for the patients and communities we serve.

IMPORTANCE/UNASSIGNED:Personal and professional development are integral to students' professional identity formation. OBJECTIVES/UNASSIGNED:To examine the association between race, ethnicity, family income, and growing up in an underresourced neighborhood with perception of medical school support of professional and personal development. DESIGN, SETTING, AND PARTICIPANTS/UNASSIGNED:Retrospective cross-sectional study using deidentified data of medical graduates who completed the Association of American Medical Colleges Graduation Questionnaire in 2018 to 2022. Statistical analysis was performed from October 1 to November 1, 2024. MAIN OUTCOMES AND MEASURES/UNASSIGNED:Perception of medical school support of professional and personal development. Multivariate logistic regression models to assess the association of family income, race, ethnicity, and underresourced neighborhood status with perception of medical school support of professional and personal development during medical school, adjusting for students' sex, age at graduation in quartiles, and clustered by school to account for school-to-school variability. RESULTS/UNASSIGNED:Among 66 898 respondents in the study cohort, 34 731 identified as female (51.9%), 14 100 as Asian (21.1%), 3594 as Black or African American (5.4%), 3419 as Hispanic (5.1%), and 38 483 as White (57.5%). The mean (SD) age of respondents was 27.5 (2.6) years and 10 088 were from households with incomes less than $50 000 a year (15.1%). Students from families with incomes in the lowest 2 quintiles were significantly less likely to report medical school support of professional and personal development than students from household incomes of more than $200 000 (less than $50 000: 69.5% vs 75.1%; relative risk [RR], 0.96; 95% CI, 0.94-0.98; $50 000-$74 999: 71.0% vs 75.1%; RR, 0.96; 95% CI, 0.94-0.98). Compared with White students, Asian students (aRR, 0.97; 95% CI, 0.96-0.98) and Black students (adjusted relative risk [aRR], 0.97; 95% CI, 0.95-0.99) were less likely to report medical school support of professional development, and Black students were less likely to report medical school support of personal development (aRR, 0.93; 95% CI, 0.89-0.97). Compared with their peers, students who reported growing up in an underresourced neighborhood were significantly less likely to report medical school support of professional and personal development. Intersectionality analysis of family income, race, ethnicity, and underresourced neighborhood status suggested that perception of medical school support of professional and personal development decreased with increasing number of minoritized identities, with students who were URIM, from a low-income family, and reported growing up in underresourced neighborhoods the least likely to report medical school support of professional and personal development. CONCLUSION AND RELEVANCE/UNASSIGNED:In this cross-sectional study of medical graduates, students who were URIM, low-income, and students who reported growing up in underresourced neighborhood were significantly less likely to report medical school support of professional and personal development. It is therefore critical for medical schools and accreditation bodies to evaluate current curriculum and practices to foster professional and personal development that are equitable for all students.