Des Moines University College of Osteopathic Medicine

1. Developing Racial and Ethnic Diversity in Iowa’s Physician Workforce – Recruiting Minority Students and Faculty Des Moines University College of Osteopathic Medicine

2. Presenters: Carolyn L. Beverly, M.D., M.P.H. Assistant Professor, Family Medicine, COM Medical Director, College of Health Science Project Director Mary Pat Wohlford-Wessels, Ph.D. Former Associate Professor, Family Medicine Assistant Dean, Academic Quality and Medical Education Research, Des Moines University, COM Project Associate Currently Vice President, Institutional Effectiveness, Kansas City University of Medicine and Bioscience, COM

3. 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.

4. 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).

5. 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.

6. 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.

7. 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.

8. 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.

9. Osteopathic Medical School Enrollment - Total Enrollment of Ethnic Minority Groups by School (03-04)

10. Osteopathic Medical Schools - Total Enrollment of Ethnic Groups 1994-2003

11. 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.

12. Medical School Applicants by Race and Ethnicity, 2004 - AAMC

13. Medical School Applicants by Race and Ethnicity, 1974 – 2004 AAMC

14. Total Enrollment by Ethnic Group (03-04)

15. Medical School Faculty by Race and Ethnicity – AAMC 2004

16. Medical School Faculty by Rank within Race and Ethnicity - 2004

17. 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.

18. DMU’s Funded Recruitment Project • Two Objectives: • Student Recruitment • African American & Hispanic • Physician Recruitment • African American & Hispanic • Lecturers • Clinical Preceptors • Mentors

19. Enrollment in Iowa’s Medical Schools

20. 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

21. 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)

22. Influence to become a physician

23. Influence – AAMC 2004

24. Top 5 Influences on Becoming Physicians DMU StudentsAAMC 2004 1. 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

25. Reason Student Chose DMU

26. AAMC 2004 data

27. Top 5 Reasons Why Students Selected Their Schools DMU ReasonsA A M C 2004 R e a s o n s Hispanics/BlacksHispanics Blacks 1. 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

28. Minority Mentors

29. 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: Being able to serve minority populations in the future Being able to work in an underserved area Serving as a minority physician mentor in the future Being mentored by a minority physician Minority clinicians during year 3 and 4

30. 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.

31. So What is DMU-COM Doing To Address This Situation?

32. 1. Office of Enrollment Management • Eight person staff committed to increasing diversity enrollment among students in all of the 3 Colleges on DMU campus.

33. Strategies for Increasing Minority Enrollment: • Identify and participate in events targeted to under-represented minority undergraduate students with an interest in the health professions

34. 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:

35. 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) Targeting Underrepresented Minority Undergraduate Students:

36. Strategies for Increasing Minority Enrollment, con’t: • Assist in identifying URM candidates for DMU-sponsored diversity scholarships, such as the Glanton Scholarship

37. 2005-2006 Minority Recruiting Activities • Began tracking number of URM students with whom they came in contact with during recruiting events • Feb-Jun 06: approx. 150 under graduates self-identified as URMs • 23 undergraduate institutions with significant URMs were visited

38. 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

39. 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 2006-07 Planning Minority Recruiting Activities

40. 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 06-07 Visits to undergraduate institutions with high minority enrollments

41. 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.

42. 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

43. 2. Department of Educational Support Services Efforts 1.Raise awareness of students to implicit biases they may have regarding persons different than themselves • They take several Implicit Attitude Tests regarding race, gender, sexual orientation and religion—interactive web-based ways to uncover hidden biases.

44. 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

45. Department of Educational Support Services Efforts • 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

46. 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.

47. Minority Population and Practicing Physicians in Iowa

48. Physician Recruitment Objective • Physician Recruitment—add five additional physicians to our adjunct faculty • African American & Hispanic • Lecturers • Clinical Preceptors • Mentors

49. Physician Recruitment • Choice of underrepresented minorities targeted • IA Chapter of the National Medical Association • Prominent Hispanic physician in Des Moines

50. Physician Recruitment • Methods chosen to find these minority physicians: • Contacting medical societies • Checking current DMU adjunct faculty list • Word of mouth • INMA membership directory