Healthcare disparities are the unequal health outcomes of specific groups of the population based on race, ethnicity, culture, or country of origin. Of the many strategies researched that disable and reduce these disparities are to increase the diversity of the healthcare workforce. Medical pipeline programs targeting underrepresented minorities play a key role in increasing medical workforce diversity. Some colleges, universities, medical education institutions and secondary schools have these medical pipeline programs aimed at equipping underrepresented minorities with the tools necessary to gain medical school acceptance. The objective of this study was to identify medical pipeline programs in existence that optimized underrepresented minorities matriculation to medical school. In such, this study was designed to compare and identify the relative effectiveness between three types of medical pipeline programs, K-12 level, college/university level, and post-baccalaureate level. This study also identified characteristics of effective medical pipeline programs and hopes to further the knowledge base used for evaluating medical pipeline programs targeting underrepresented minorities in medicine. This study employed two methodologies to collect data: survey instrumentation and personal interviews (transcript review). An optional online survey was distributed through the College of California's Medical School office of diversity and volunteer participants were selected from this sample for personal interviews. Almost two-thirds of underrepresented minority medical students participated in some form of medical pipeline program, which they reported as having helped them gain admission into medical school. Less than 30% of students participated in college/university level pipeline program; however, greater than 70% indicated they believed college/university level type of programs to be the most effective type of pipeline program for preparing underrepresented minorities for acceptance into medical school. The large majority of students reported a strong motivational influence from a college level professor or advisor. Lastly, interview transcripts indicated the most powerful components for pipeline programs are the advising ones (academic, financial, medical school admissions, and life issues).

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.

The underrepresentation of minorities in health and other professions has long cast a shadow over our nation's efforts to develop a more representative and productive society. Many programs have been developed to enlarge the presence of minorities in health careers, but these efforts have been unable to develop the infrastructure and momentum needed to produce and sustain an adequate number of minority professionals among the ranks of clinicians, researchers, and teachers. This book looks at the historical significance of this underrepresentation, presents data that define the problem, and identifies underlying factors that contribute to the failure to achieve fairness in opportunity. The volume examines programs that have made successful efforts to decrease underrepresentation and sets forth an action and research agenda for further enhancing the numbers of minorities in the health professions.

In order for the United States to maintain the global leadership and competitiveness in science and technology that are critical to achieving national goals, we must invest in research, encourage innovation, and grow a strong and talented science and technology workforce. Expanding Underrepresented Minority Participation explores the role of diversity in the science, technology, engineering and mathematics (STEM) workforce and its value in keeping America innovative and competitive. According to the book, the U.S. labor market is projected to grow faster in science and engineering than in any other sector in the coming years, making minority participation in STEM education at all levels a national priority. Expanding Underrepresented Minority Participation analyzes the rate of change and the challenges the nation currently faces in developing a strong and diverse workforce. Although minorities are the fastest growing segment of the population, they are underrepresented in the fields of science and engineering. Historically, there has been a strong connection between increasing educational attainment in the United States and the growth in and global leadership of the economy. Expanding Underrepresented Minority Participation suggests that the federal government, industry, and post-secondary institutions work collaboratively with K-12 schools and school systems to increase minority access to and demand for post-secondary STEM education and technical training. The book also identifies best practices and offers a comprehensive road map for increasing involvement of underrepresented minorities and improving the quality of their education. It offers recommendations that focus on academic and social support, institutional roles, teacher preparation, affordability and program development.

The lack of diversity in medicine is a long-standing issue for US medical schools who have yet to make serious progress. Students who identify as Black, Hispanic, Native American, and Pacific Islander are considered Underrepresented in Medicine (URM) are those historically obstructed from entering medical school. There remain high costs to apply, enter, and stay in medical school. Additionally, the faculty who teach these students are more likely to be white and URM faculty are more likely to leave due to racism, discrimination, and the "minority tax" they experience too often. The effects of racism and discrimination combined with the lack of support negatively affect both URM students' and faculties' mental health, which makes staying in medicine even more challenging. Many solutions have been proposed. Specifically, Pathways programs allow medical students to become involved and work hand-in-hand with their local colleges and medical schools by becoming mentors, establishing safe spaces, and disseminating advice and free resources. Although the evidence is anecdotal, Pathways programs show promise in creating solutions for URM students, this is exemplified by student testimonials. If medical institutions continue to fail to address the lack of diversity, their students can step up and create Pathways programs to fill the gaps they cannot seem to find.