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Perspectives of Historically Black College and University Advisors to Premedical Students During the COVID-19 PandemicA Qualitative Study

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME
Key Points

Question  How do premedical student advisors describe the impact of COVID-19 on premedical students at historically Black colleges and universities (HBCUs) pursuing admission to medical school?

Findings  This qualitative study of interviews with 21 premedical advisors from HBCUs described 3 major ways that the pandemic affected premedical students: balancing academic responsibilities with family demands, difficulty with the virtual learning environment, and new stressors for medical school applicants.

Meaning  These findings suggest that the pandemic adversely affected HBCU premedical students, which has implications for the well-being of individual students, their medical school preparation, and physician workforce diversity.


Importance  Black students remain underrepresented in medicine despite national efforts to increase diversity in the physician workforce. Historically Black College and University (HBCU) students play a vital role in increasing representation in the workforce. Currently, there is a paucity of literature understanding the impact of COVID-19 on premedical students from HBCUs. Understanding the adverse impact of the pandemic on HBCU students is essential to inform strategies that promote holistic medical school admissions and increased diversity, equity, and inclusion in the medical workforce.

Objective  To explore premedical advisors' perspectives on the impact of the COVID-19 pandemic on HBCU premedical students pursuing admission to medical school.

Design, Setting, and Participants  In this qualitative study, semistructured interviews of HBCU premedical advisors were performed from March 2020 to March 2021. One-on-one interviews were conducted with 21 advisors with a depth of experience as advisors, varied educational backgrounds, and diverse geographic representation. Data analysis was performed from March 2021 to December 2021.

Main Outcomes and Measures  The experiences of HBCU premedical students during the COVID-19 pandemic from the perspective of the premedical advisor.

Results  Among the 21 participants, 13 (62%) were female, 15 (71%) were Black or African American, 11 (52%) had a doctorate degree, and 7 (33%) had more than 10 years of experience as advisors. Participants described 3 major themes: (1) balancing academic responsibilities with family demands; (2) distraction, disruption, and isolation in the virtual learning environment; and (3) harmful impact of new stressors for HBCU applicants in the medical school admissions process.

Conclusions and Relevance  In this qualitative study of HBCU advisors to premedical students, advisors described how the COVID-19 pandemic adversely affected undergraduate HBCU premedical students; students faced family hardships, challenges with virtual learning, and uncertainty in the medical school admissions process. These findings suggest that medical schools should continue to create direct interventions to address the challenges that HBCU students faced during the height of the pandemic and as longitudinal consequences of the pandemic. Addressing these issues may improve physician workforce representation and promote more equitable patient care for underserved communities disproportionately affected by COVID-19 and other health disparities.

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Article Information

Accepted for Publication: September 8, 2022.

Published: October 21, 2022. doi:10.1001/jamanetworkopen.2022.38563

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Weiss J et al. JAMA Network Open.

Corresponding Author: Jasmine Weiss, MD, MHS, Division of General Pediatrics and Adolescent Medicine, University of North Carolina School of Medicine, 231 MacNider Hall, Campus Box #7225, Chapel Hill, NC 27599 (jasmine_weiss@med.unc.edu).

Author Contributions: Dr Weiss had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Weiss, Keene, Balasuriya, Latimore, Genao.

Acquisition, analysis, or interpretation of data: Weiss, Holaday, Keene, Akingbesote, Sharifi, Latimore.

Drafting of the manuscript: Weiss, Akingbesote, Balasuriya, Latimore.

Critical revision of the manuscript for important intellectual content: Weiss, Holaday, Keene, Balasuriya, Sharifi, Latimore, Genao.

Statistical analysis: Weiss, Balasuriya.

Obtained funding: Weiss.

Administrative, technical, or material support: Weiss, Akingbesote.

Supervision: Keene, Sharifi, Genao.

Conflict of Interest Disclosures: Dr Weiss reported being the founder of iDream Enterprise LLC, a social enterprise to promote health care workforce diversity; and founder of Let’s Diversifi PBLLC, a social enterprise outside the submitted work. No other disclosures were reported.

Funding/Support: This manuscript was supported by the Yale National Clinician Scholars Program and by Clinical and Translational Science Awards (CTSA) Grant Number TL1 TR001864 from the National Center for Advancing Translational Science (NCATS), a component of the National Institutes of Health (NIH). This funding supported Dr Weiss, Dr Holaday and Dr Balasuriya during this study. Dr Holaday currently receives research support through the National Institutes of Aging of the National Institutes of Health (NIH T32AG066598). Dr Balasuriya received support from the US Department of Veterans Affairs (VA) Office of Academic Affiliations through the VA/National Clinician Scholars Program and Yale University at the time of the study.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The contents are solely the responsibility of the authors and do not necessarily represent the official view of the NIH. The contents do not represent the views of the US Department of Veterans Affairs or the United States Government.

Additional Contributions: Special thanks to Michelle Salazar, MD, MHS, Yale School of Medicine, for helping to pilot our interview guide. Dr Salazar was not compensated for her contributions.

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