Global Health Leadership Initiative, Yale School of Public Health, New Haven, Connecticut.
Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
JAMA Netw Open. 2023 May 1;6(5):e2310795. doi: 10.1001/jamanetworkopen.2023.10795.
Since 1964, the National Institutes of Health (NIH) has funded the Medical Scientist Training Program (MSTP) MD-PhD program at medical schools across the US to support training physician-scientists. Recent studies have suggested that MSTPs have consistently matriculated more students from racial and ethnic backgrounds historically underrepresented in science than MD-PhD programs without NIH funding; however, the underlying basis for the increased diversity seen in NIH-funded MSTPs is poorly understood.
To investigate how administrators and faculty perceive the impact of MSTP status on MD-PhD program matriculant racial and ethnic diversity.
DESIGN, SETTING, AND PARTICIPANTS: This qualitative study used a positive deviance approach to identify 9 high-performing and 3 low-performing MSTPs based on the percentage of students underrepresented in science who matriculated into the program between 2014 and 2018. This study, a subanalysis of a larger study to understand recruitment of students underrepresented in science at MSTPs, focused on in-depth qualitative interviews, conducted from October 26, 2020, to August 31, 2022, of 69 members of MSTP leadership, including program directors, associate and assistant program directors, and program administrators.
The association of NIH funding with institutional priorities, programs, and practices related to MD-PhD program matriculant racial and ethnic diversity.
The study included 69 participants (mean [SD] age, 53 [10] years; 38 women [55%]; 13 African American or Black participants [19%], 6 Asian participants [9%], 12 Hispanic participants [17%], and 36 non-Hispanic White participants [52%]). A total of 51 participants (74%) were in administrative roles, and 18 (26%) were faculty involved in recruitment. Five themes emerged from the data: (1) by tying MSTP funding to diversity efforts, the NIH created a sense of urgency among MSTP leadership to bolster matriculant diversity; (2) MD-PhD program leadership leveraged the changes to MSTP grant review to secure new institutional investments to promote recruitment of students underrepresented in science; (3) MSTPs increasingly adopted holistic review to evaluate applicants to meet NIH funding requirements; (4) MSTP leadership began to systematically assess the effectiveness of their diversity initiatives and proactively identify opportunities to enhance matriculant diversity; and (5) although all MSTPs were required to respond to NIH criteria, changes made by low-performing programs generally lacked the robustness demonstrated by high-performing programs.
This study suggests that NIH funding requirements may be a powerful incentive to promote diversity and positively affect representation of students underrepresented in science in the biomedical scientific workforce.
自 1964 年以来，美国国立卫生研究院（NIH）一直在资助美国各地医学院的医学科学家培训计划（MSTP）MD-PhD 项目，以支持培训医师科学家。最近的研究表明，MSTP 项目从历史上科学领域代表性不足的种族和族裔背景中招收的学生人数一直多于没有 NIH 资助的 MD-PhD 项目；然而，NIH 资助的 MSTP 项目中观察到的多样性增加的根本原因还不太清楚。
调查管理人员和教师如何看待 MSTP 身份对 MD-PhD 项目入学学生的种族和族裔多样性的影响。
设计、设置和参与者：这项定性研究使用了积极偏差方法，根据 2014 年至 2018 年间进入该项目的科学领域代表性不足的学生比例，确定了 9 个表现出色的和 3 个表现不佳的 MSTP。这项研究是一项旨在了解 MSTP 中科学领域代表性不足的学生招募情况的更大研究的子分析，重点是对 69 名 MSTP 领导层成员（包括项目主任、副主任和助理项目主任以及项目管理人员）进行深入的定性访谈，访谈时间为 2020 年 10 月 26 日至 2022 年 8 月 31 日。
NIH 资助与机构优先事项、与 MD-PhD 项目入学学生的种族和族裔多样性相关的计划和实践之间的关联。
该研究包括 69 名参与者（平均[SD]年龄，53[10]岁；38 名女性[55%]；13 名非裔美国人或黑人参与者[19%]，6 名亚洲参与者[9%]，12 名西班牙裔参与者[17%]，36 名非西班牙裔白人参与者[52%]）。共有 51 名参与者（74%）担任行政职务，18 名（26%）为参与招聘的教师。数据中出现了五个主题：（1）通过将 MSTP 资金与多样性工作联系起来，NIH 促使 MSTP 领导层产生了提高多样性的紧迫感；（2）MD-PhD 项目领导层利用 MSTP 资助审查的变化，确保了新的机构投资，以促进科学领域代表性不足的学生的招募；（3）MSTP 越来越多地采用整体审查来评估申请人，以满足 NIH 资助的要求；（4）MSTP 领导层开始系统评估其多样性计划的有效性，并积极寻找机会提高入学学生的多样性；（5）尽管所有 MSTP 都必须回应 NIH 的标准，但表现不佳的项目所做的改变通常缺乏表现出色的项目所展示的稳健性。
这项研究表明，NIH 资助的要求可能是促进多样性的强大动力，并对生物医学劳动力中科学领域代表性不足的学生的代表性产生积极影响。
