Longitudinal Evaluation of Research Career Intentions among Students Underrepresented in Medicine

医生-科学家队伍努力吸引种族和民族群体，历史上在 医学(URIM)，包括黑人、西班牙裔、美国印第安人或阿拉斯加原住民 夏威夷人和其他太平洋岛民。因为国家研究议程通常是由那些进行 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 把重点放在对种族和少数族裔影响不成比例的问题上。值得注意的是，种族和少数民族 内科科学家更有可能追求与种族/民族健康不平等相关的学术研究。 先前的工作已经证明，在医学院期间，研究职业的意向会发生显著的变化，而且 毕业时的研究职业意向与研究的具体下游指标有关 成功，包括随后收到了国家卫生研究院的资助。我们的初步数据显示， 乌里姆和非乌里姆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，以确定以下轨迹(即随时间的演变) 对400名乌里姆(基于种族和民族)学生的职业意向及其决定因素进行研究 进入MD项目，并与200名非URIM患者的轨迹和决定因素进行比较 学生们。我们将审查个人层面的经验，例如导师的质量和 歧视，以及机构一级的经验，例如乌里姆在学校的代表 领导力。本研究的目的是：1)确定URIM学生的研究职业意向的轨迹 通过医学院培训，并与非乌里姆学生的轨迹进行比较；2)确定 URIM学生研究职业倾向轨迹的学生和机构层面的预测因素 与非乌里姆学生预测因子的比较；3)用定性的方法来描述细微差别的、生活的 与研究职业意向演变相关的经验。将整合定量和定性数据 在研究设计、分析、解释和报告结果的层面上采用趋同的方法。 这项研究具有重要意义，因为它将确定潜在的影响时间点和变化的预测因素 乌里木医学专业学生职业倾向研究可用于增加种族和民族多样性 医生-科学家队伍的一部分。这种多样性可以通过扩大全国范围内的 研究议程和代表不足的人群更多地参与研究。我们对这一事件的评估 种族主义和歧视在塑造研究职业意向方面的作用是创新的。我们的发现所产生的影响 将通过我们与国家组织的强有力的伙伴关系来加强，包括在 美国国家科学、工程和医学研究院(NASEM)和美国医学协会 大学(AAMC)传播我们的研究结果。这项研究将成为未来进行 对这项研究中收集的队列的跟踪调查，从住院期间到职业生涯早期和中期的职位。

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.