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The Case of the Leaky Pipeline: Exploring the Experiences of Underrepresented Minority Premed Students in the UC System

Abstract

The lack of diversity in the physician workforce poses a complex problem for the US healthcare system. Despite numerous efforts over the last 45 years, the lack of representation in the physician workforce persists, with no significant signs of reversing course. There is therefore an urgent need to engage in research to aid in the development of innovative, systemic and sustainable methods of addressing barriers in the educational pipeline leading into medicine for URM students.

Much of the previous research in this area has focused largely on examining undergraduate program outcomes and impact on physician specialty/service area choice with very few examining the undergraduate premed experience in detail. These experiences can have deleterious effects which serve as barriers to academic achievement and outcomes, thereby preventing matriculation into medical school and the physician workforce. This research seeks to fill this gap in knowledge and employs qualitative methodology to accomplish three overarching goals:

1. Better understand the experiences of URM premed students as they navigate their undergraduate premed pathway. Focusing on the multi-level factors associated with academic achievement and enrollment in post-bac programs.

2. Explore the role and sustainability of post-baccalaureate premed programs in facilitating entry into medical school for URM graduates of the UC system.

3. Develop empirically based recommendations to ameliorate barriers and challenges reported by URM students in the UC system.

This dissertation resulted in three papers. The first paper illuminates the barriers and challenges faced by URM premed students and outlines their relation to student achievement and outcomes. The second paper sheds light on URM student perceptions and the specific reasons they apply to post-bac programs in addition to providing data that suggests that post-bacs are not a sustainable strategy to address diversity in the physician workforce. The third paper presents a list of empirically based recommendations aimed at addressing institutional-wide barriers to student achievement such as campus climate, academic/students services and course size and curriculum.

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