Longitudinal Evaluation of Research Career Intentions among Students Underrepresented in Medicine

医生-科学家劳动力努力吸引历史上代表性不足的种族和民族群体， 医学（URiM），包括黑人，西班牙裔，美洲印第安人或阿拉斯加原住民，原住民 夏威夷人和其他太平洋岛民。因为国家研究议程往往是由那些进行 科学研究，增加医生科学家劳动力的多样性有可能带来更大的 重点关注不成比例地影响种族和族裔少数群体的问题。值得注意的是，种族和族裔少数群体 医生科学家更有可能追求与种族/民族健康不平等有关的奖学金。 先前的工作表明，研究职业生涯的意图在医学院显着演变， 毕业时的研究职业意向与研究的有形下游措施有关 成功，包括随后获得NIH资助。我们的初步数据显示， URiM和非URiM学生在医学院期间的研究职业意向。 我们提出了一项为期5年的纵向混合方法研究，以确定轨迹（即，随着时间的推移） 400名URiM（基于种族和民族）学生的研究职业意向及其决定因素 录取到MD计划，并比较这些轨迹和决定因素在200个非URiM 学生我们将研究个人层面的经验，如指导的质量和经验， 歧视，以及在机构一级的经验，如URiM代表在学校的 领导本研究的目的是：1）确定研究生的研究生涯意图的轨迹 在整个医学院的培训，并与非URiM学生的轨迹进行比较; 2）确定 URiM学生研究职业意图轨迹的学生和机构水平预测因子 与非URiM学生中的预测因子进行比较; 3）使用定性方法来表征细微差别，生活 与研究职业意图的演变有关的经验。将整合定量和定性数据 在研究设计、分析、解释和结果报告等层面采用趋同方法。 这项研究是重要的，因为它将确定潜在的影响时间点和变化的预测因素， 研究的职业生涯中URiM MD学生的意图，可用于增加种族和民族的多样性 of the physician-scientists科学家workforce劳动力.这种多样性可以通过扩大国民保健服务， 研究议程和增加代表性不足人口的研究参与。的评估而 种族主义和歧视在形成研究职业意向方面的作用是创新的。我们的发现的影响 将通过我们与国家组织的强有力的伙伴关系，包括医学教育领导者， 美国国家科学院、工程院和医学院（NASEM）以及美国医学会 学院（AAMC）传播我们的研究结果。这项研究将成为今后建议开展下列活动的基础： 通过住院医师和职业早期和中期职位对本研究中聚集的队列进行随访。

The physician-scientist workforce struggles to attract racial and ethnic groups historically underrepresented in medicine (URiM), including individuals who are Black, Hispanic, American Indian or Alaskan Native, Native Hawaiian, and other Pacific Islander. Because the national research agenda is often set by those conducting scientific studies, increasing the diversity of the physician-scientist workforce has the potential to bring greater focus on issues that disproportionately affect racial and ethnic minorities. Notably, racial and ethnic minority physician-scientists are more likely to pursue scholarship related to racial/ethnic health inequities. Prior work has demonstrated that research career intentions evolve significantly during medical school and that research career intentions at graduation are associated with tangible downstream measures of research success, including subsequent receipt of NIH funding. Our preliminary data show marked disparities between URiM and non-URiM students in research career intentions during medical school. We propose a 5-year, longitudinal, mixed-methods study to identify trajectories (i.e., evolution over time) of research career intentions, and determinants thereof, in 400 URiM (based on race and ethnicity) students matriculating into MD programs and to compare these with trajectories and determinants in 200 non-URiM students. We will examine experiences at the individual level, such as quality of mentorship and experiences of discrimination, as well as experiences at the institutional level, such as URiM representation in the school's leadership. The aims are to: 1) identify trajectories of research career intentions among URiM students throughout medical school training and make comparisons with trajectories in non-URiM students; 2) identify student- and institutional-level predictors of research career intention trajectories in URiM students and make comparisons with predictors in non-URiM students; 3) use qualitative methods to characterize nuanced, lived experiences related to evolution of research career intentions. Quantitative and qualitative data will be integrated using a convergent approach at the levels of study design, analysis, interpretation, and reporting of results. This study is significant because it will identify potentially influential timepoints and predictors of change in research career intention among URiM MD students that can be used to increase the racial and ethnic diversity of the physician-scientist workforce. This diversity can help mitigate health disparities by broadening the national research agenda and increasing research participation by underrepresented populations. Our assessment of the roles of racism and discrimination in shaping research career intentions is innovative. The impact of our findings will be enhanced by our strong partnerships with national organizations, including medical education leaders at the National Academies of Sciences, Engineering, and Medicine (NASEM) and Association of American Medical Colleges (AAMC) to disseminate our findings. This study will form the basis of a future proposal to conduct follow-up of the cohort assembled in this study through residency and into early- and mid-career positions.