Developing an Evidence-Based Toolkit to Improve Diversity in the Physician-Scientist Workforce

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The National Institutes of Health and the US Congress have cited the lack of gender and racial/ethnic diversity in the biomedical workforce as a source of very serious concern. A diverse biomedical workforce provides many benefits including research teams with greater ability to solve complex problems, higher quality research, and more participation in clinical trials by underrepresented minorities. Despite these benefits, Black, Hispanic, and Native American MD-PhDs combined represented just 4.5% of all NIH Research Project Grant awardees in 2012 with women comprising just 22%. To address this disparity in representation, the NIH's Physician-Scientist Workforce Working Group (PSW-WG) has recommended that the NIH intensify efforts to increase diversity in the biomedical research workforce. In an effort to bolster diversity in undergraduate medical education, the Liaison Committee on Medical Education (LCME) introduced two diversity accreditation standards in 2009 mandating that all MD-degree programs must have policies and practices to achieve appropriate diversity amongst students. In preliminary work for this proposal, our group has demonstrated national increases in the proportion of women and URM matriculants to MD-PhD programs after the introduction of the LCME diversity accreditation standards. Nevertheless, little is known about the actions taken by MD-PhD programs to increase the percentage of women and URM matriculants. To address this important knowledge gap, we propose conducting a mixed methods study to identify the organizational characteristics and diversity recruitment practices of MD-PhD programs demonstrating the greatest proportion of women and URM matriculants following the introduction of the LCME diversity accreditation standards. The specific aims of the study are to: 1) assess variation between MD-PhD programs regarding matriculant gender and racial/ethnic diversity after the LCME diversity accreditation standards implementation, 2) identify diversity recruitment best practices by conducting in-depth qualitative interviews at MD-PhD programs demonstrating the greatest and least gender and racial/ethnic matriculant diversity after the LCME diversity standards implementation using a positive deviance methodology, 3) evaluate the association between best practices identified in Aim 2 and MD-PhD gender and racial/ethnic matriculant diversity by means of a national survey of all MD-PhD programs. The study's final product would be a toolkit of evidenced based strategies to increase diversity in the biomedical workforce ready for dissemination and implementation.