Inclusion of Socioeconomic Status as an Additional Criterion in Holistic Pharmacy School Admission Processes.

Objective. To investigate the impact of socioeconomic status as an admissions criterion for pharmacy school admissions. Methods. Using de-identified data from two PharmCAS application cycles (2012-2013 and 2015-2016), a new socio-economic status indicator was crafted based on complex parental education and occupation information provided by applicants. The indicator was calibrated on federal standards to ensure uniform composition regardless of the applicant's location. The indicator was then used to describe acceptance patterns within each pharmacy application cycle, explore correlations with other demographic and academic indicators, and develop a regression model to understand the impact of this indicator on applicants' acceptance into pharmacy school. Results. The new education and occupation (EO) indicator for an applicant's parent(s) provided new insight into complex applicant demographic information. The number of academically qualified applicants that could have received further admission consideration based on identification of a low socioeconomic status for parent one were 2016; n=435, 13%, 2103; n=767, 14%. The EO indicator by itself had limited value for predicting acceptance rates and became less predictive when academic performance variables were incorporated, demonstrating socioeconomic status was not accounted for in admissions. Conclusion. Based on the Accreditation Council of Pharmacy Education Standards 2016, schools are required to admit a diverse group of students. The addition of the EO indicator will be valuable in identifying diverse and promising future pharmacists during each pharmacy school's holistic review process.

U.S. Dental School Deans' Perceptions of the Rising Cost of Dental Education and Borrowing Pressures on Dental Students: Report of Survey Results.

This report presents findings from a survey of U.S. dental school deans designed to capture their perceptions regarding the rising cost of dental education and its impact on borrowing by dental students to finance their education. The survey included questions about factors influencing the cost of dental education, concerns about dental student borrowing, and financial awareness resources for students. The survey was distributed to the deans of all 63 U.S. dental schools in January 2013; 42 deans responded, for a 67% response rate. The results indicate that, according to the responding deans, new clinical technologies, technology costs, and central university taxes are the main factors that contribute to the increasing cost of dental education. Coupled with reduced state appropriations at public dental schools and declines in private giving at all dental schools, dental school deans face a perplexing set of financial management challenges. Tuition and fees are a primary source of revenue for all dental schools; however, many deans do not have total control over the cost of attending their schools since tuition and fees are often tied to mandates and policies from the parent university and the state legislature. The findings of this study indicate that U.S. dental school deans are aware of and concerned about the impact of increases in tuition and fees on dental student debt and that they are using a variety of strategies to address the growth in dental student borrowing.

Dental school vacant budgeted faculty positions, academic years 2008-09 to 2010-11.

The annual turnover of dental school faculty creates a varying number of vacant budgeted positions from year to year. The American Dental Education Association (ADEA) conducts an annual survey to determine the status and characteristics of these vacant faculty positions. The number of vacant budgeted faculty positions in U.S. dental schools increased throughout the 1990s, with a peak of 417 positions in 2005-06. Since that time, there has been a decrease in the number of estimated vacancies, falling to 227 in 2010-11. The 2008-09 to 2010-11 faculty vacancy surveys explored these decreases, along with information relevant to the number and characteristics of dental faculty vacancies, including data on the distribution of full-time, part-time, and volunteer faculty, reasons for faculty separations, and sources of new faculty.

Racial and ethnic minority medical students' perceptions of and interest in careers in academic medicine.

PURPOSE: To describe diverse medical students' perceptions of and interest in careers in academic medicine. METHOD: In 2010, the authors invited students attending three national medical student conferences to respond to a survey and participate in six focus groups. The authors identified trends in data through bivariate analyses of the quantitative dataset and using a grounded theory approach in their analysis of focus group transcripts. RESULTS: The 601 survey respondents represented 103 U.S. medical schools. The majority (72%) were in their first or second year; 34% were black and 17% were Hispanic. Many respondents (64%) expressed interest in careers in academic medicine; teaching and research were viewed as positive influences on that interest. However, black and Hispanic respondents felt they would have a harder time succeeding in academia. The 73 focus group participants (25% black, 29% Hispanic) described individual- and institutional-level challenges to academic medicine careers and offered recommendations. They desired deliberate and coordinated exposure to academic career paths, research training, clarification of the promotion process, mentorship, protected time for faculty to provide teaching and research training, and an enhanced infrastructure to support diversity and inclusion. CONCLUSIONS: Medical students expressed an early interest in academic medicine but lacked clarity about the career path. Black and Hispanic students' perceptions of having greater difficulty succeeding in academia may be an obstacle to engaging them in the prospective pool of academicians. Strategic and dedicated institutional resources are needed to encourage racial and ethnic minority medical students to explore careers in academic medicine.

U.S. graduate medical education and physician specialty choice.

PURPOSE: The United States is facing a critical physician shortage. It will only get worse as many more Americans gain insurance coverage under the Affordable Care Act and as additional millions enter the Medicare system. There is a serious concern that the pipeline for the production of the physician workforce is inadequate to meet future needs. It is imperative to continue to monitor the structure and size of this pipeline-the purpose of the research reported here. METHOD: This descriptive analysis uses data derived from the National Graduate Medical Education Census, which includes reports on the entire population of residents in programs accredited by the Accreditation Council for Graduate Medical Education. Data for the years 2001 to 2010 are reported both on specialties which can be entered directly from medical school or with one preliminary year and on subspecialty residencies and fellowships, which require completion of an earlier residency program. Estimates of the number of new trainees who will practice primary care are provided. RESULTS: In 2010, there were 4,754 residents reported in preliminary programs, 89,142 residents in core specialty and combined specialty programs, and 20,007 in subspecialty and sub-subspecialty programs. Between 2001 and 2010, there was a 13.6% (13,655) increase in all residents. Since 2001, there has been a 6.3% (540) decrease in the number expected to enter primary care. CONCLUSIONS: Without a substantially accelerated growth in graduate medical education, the physician workforce will fall short of the nation's needs, and competition for available residency positions will radically increase.

Assessing the evolving definition of underrepresented minority and its application in academic medicine.

PURPOSE: To assess how U.S. academic health centers (AHCs) define the term underrepresented minority (URM) and apply it to their diversity programs, following the 2003 revision of the Association of American Medical Colleges' (AAMC's) definition of URM. METHOD: In 2010, the authors developed and deployed a cross-sectional survey of diversity leaders at 106 AHCs. The survey included questions about the diversity leader and institution's diversity program; institution's URM definition; application of that definition; and the diversity leader's perceptions of the representation and institutional contribution of various ethnic/racial groups. The authors used descriptive statistics to analyze the results. RESULTS: Of the 106 diversity leaders invited, 89 (84.0%) responded and 78 (73.6%) provided a working definition of URM. Most programs (40/78; 51%) used the 2003 AAMC definition of URM, which includes racial/ethnic groups that are underrepresented in medicine relative to local and national demographics. Only 14.1% (11/78) used the pre-2003 AAMC definition, which included only African Americans, Mexican Americans, Native Americans, and mainland Puerto Ricans. Approximately one-third (23/78; 29.5%) also considered other diversity factors, such as socioeconomic status, sexual orientation, and disability, in defining URM. Fifty-eight respondents (74.4%) confirmed that their diversity programs targeted specific groups. CONCLUSIONS: The definition of URM used by diversity programs at U.S. AHCs varied widely. Although some classified URMs by racial/ethnic categories, the majority defined URM more broadly to encompass other demographic and personal characteristics. This shift should prepare academic medicine to eliminate health disparities and meet the health needs of an increasingly diverse population.

U.S. dental school applicants and enrollees, 2011 and 2012 entering classes.

This report examines the characteristics of dental school applicants and enrollees using data from the 2010-11 and 2011-12 application cycles of the American Dental Education Association's Associated American Dental Schools Application Service (ADEA AADSAS). The report presents data on the demographic composition and academic preparation of applicants, first-time enrollees, and total first-year enrollees during these two application cycles. The data indicate that the number of applicants has decreased modestly during this time, yet the number of first-time, first-year enrollees continues to rise mainly reflecting the opening of new dental schools and expansion of existing class sizes at some schools. Findings also indicate reduced gaps by gender in dental school applicants and enrollees. By contrast, the percentage of underrepresented minority applicants and enrollees increased only slightly. The results highlighted in this study have important implications for health professions education advisors, dental educators, and members of the broader dental education community.

Participation in U.S. graduate medical education by graduates of international medical schools.

PURPOSE: International medical graduates (IMGs) are an important part of U.S. graduate medical education (GME) and medical practice. They make up a significant number of the participants in both the Electronic Residency Application Service (ERAS) and the National Resident Matching Program (NRMP). The authors analyze and report statistics describing the multiple pathways used by IMGs in pursuit of a U.S. residency position. METHOD: This is a descriptive study of 10,328 IMGs certified by the Educational Commission for Foreign Medical Graduates (ECFMG) between July 1, 2005 and June 30, 2006. Linked data on this cohort were obtained from the ECFMG, ERAS, and the NRMP, combined with residency data from the National GME Census. The study determined the numbers of members of the study cohort who participated in ERAS and/or the NRMP in 2003 through 2009, and who found a residency appointment in the United States between 2003 and the first half of 2010. RESULTS: The IMGs in the study cohort began applying for residencies in significant numbers in the year immediately following ECFMG certification, but almost half were unsuccessful in their first attempts. Three-quarters of the members of the cohort had begun a residency by 2010. CONCLUSIONS: IMGs make up a very substantial fraction of ERAS and NRMP participants. Although they face significant hurdles in achieving their goal, the majority of those who persist are ultimately successful. If enrollments and graduations of U.S. MD- and DO-granting medical schools continue to rise, IMGs' difficulty in finding residencies is sure to increase.

Perspective: PhD scientists completing medical school in two years: looking at the Miami PhD-to-MD program alumni twenty years later.

Producing and retaining physician-scientists remains a major challenge in advancing innovation, knowledge, and patient care across all medical disciplines. Various programs during medical school, including MD-PhD programs, have been instituted to address the need for continued production of physician-scientists. From 1971 through 1989, 508 students with a prior PhD in the sciences, mathematics, or engineering graduated in two years from an accelerated MD program at the University of Miami School of Medicine. The program, designed to address potential clinical physician shortages rather than physician-scientist shortages, quickly attracted many top-notch scientists to medicine. Many program graduates went to top-tier residencies, pursued research careers in academic medicine, and became academic leaders in their respective fields. A retrospective examination of graduates conducted in 2008-2009 demonstrated that approximately 59% took positions in academic university medical departments, 3% worked for governmental agencies, 5% entered industry as researchers or executives, and 33% opted for private practice. Graduates' positions included 85 full professors, 11 university directors or division heads, 14 academic chairs, 2 medical school deans, and 1 astronaut. Overall, 30% of graduates had obtained National Institutes of Health funding after completing the program. These results suggest that accelerated medical training for accomplished scientists can produce a large number of successful physician-scientists and other leaders in medicine. Furthermore, these results suggest that shortening the medical portion of combined MD-PhD programs might also be considered.

Three pathways to a physician career: applicants to U.S. MD and DO schools and U.S. Citizen applicants to international medical schools.

PURPOSE: To determine the size of the overall applicant pool for medical education (applicants to U.S. MD schools and DO schools, and to international medical schools) and to determine the degree of overlap of the three types of applicants. METHOD: A cooperative agreement among the Association of American Medical Colleges, the American Association of Colleges of Osteopathic Medicine, and the Educational Commission for Foreign Medical Graduates permitted the authors to uniquely identify applicants and students of all three types and to combine their data into a study file containing data on applicants for each year. Overlaps in the three applicant pools were then determined, and repeat applicants were separated from first-time applicants. RESULTS: A key finding is that two thirds of osteopathic applicants in any recent year also applied to U.S. MD schools, whereas only one in seven U.S. MD applicants also applied to DO schools. Seventy-two percent of students in international medical schools did not apply to any U.S. school in the same year. After separating out repeat applicants, the authors found that 90% of all first-time applicants applied to a U.S. MD school. CONCLUSIONS: If all first-time applicants applied to U.S. MD schools, the pool of first-time applicants would be increased by only 11%. It may be necessary to recruit additional applicants to meet projected growth in the aggregate capacity of both U.S. MD and DO schools. Although the number and quality of applicants seem to be adequate for the near term, it will be important to continue to monitor these trends.