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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

JAMA Network Open

Published Online: October 21, 2022

Original Investigation

Article Information and Disclosures

Jasmine Weiss, MD, MHS¹;

Louisa Holaday, MD, MHS^2,3;

Danya Keene, PhD⁴;

et al

Ngozi D. Akingbesote, BS^5,6;

Lilanthi Balasuriya, MD⁷;

Mona Sharifi, MD, MPH^7,8;

Darin Latimore, MD⁹;

Inginia Genao, MD¹⁰

Author Affiliations

¹Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill
²Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
³Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New York, New York
⁴Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut
⁵Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, Connecticut
⁶Department of Internal Medicine (Endocrinology), Yale University School of Medicine, New Haven, Connecticut
⁷Yale National Clinician Scholars Program, Yale University School of Medicine, New Haven, Connecticut
⁸Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
⁹Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
¹⁰Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania

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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.

Abstract

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

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.

References

Legier K . Infant mortality and race in the United States. Perspectives (Montclair). 2021;13(1). https://scholars.unh.edu/perspectives/vol13/iss1/3 Google Scholar

Cunningham TJ , Croft JB , Liu Y , Lu H , Eke PI , Giles WH . Vital Signs: racial disparities in age-specific mortality among Blacks or African Americans - United States, 1999-2015. MMWR Morb Mortal Wkly Rep. 2017;66(17):444-456. doi:10.15585/mmwr.mm6617e1 PubMed Google Scholar Crossref

Moaddab A , Dildy GA , Brown HL , et al. Health care disparity and pregnancy-related mortality in the United States, 2005-2014. Obstet Gynecol. 2018;131(4):707-712. doi:10.1097/AOG.0000000000002534 PubMed Google Scholar Crossref

Sood L , Sood V . Being African American and rural: a double jeopardy from COVID-19. J Rural Health. 2021;37(1):217-221. doi:10.1111/jrh.12459 PubMed Google Scholar Crossref

Turk S . Racial disparities in Louisiana’s COVID-19 death rate reflect systemic problems. 4WWL. Published April 11, 2020. Accessed October 12, 2021. https://www.wwltv.com/article/news/health/coronavirus/racial-disparities-in-louisianas-covid-19-death-rate-reflect-systemic-problems/289-bd36c4b1-1bdf-4d07-baad-6c3d207172f2

Ramos E , Zamudio MI . In Chicago, 70% of COVID-19 deaths are Black. WBEZ Chicago. Published April 5, 2020. Accessed October 12, 2021. https://www.wbez.org/stories/in-chicago-70-of-covid-19-deaths-are-black/dd3f295f-445e-4e38-b37f-a1503782b507

Millett GA , Jones AT , Benkeser D , et al. Assessing differential impacts of COVID-19 on black communities. Ann Epidemiol. 2020;47:37-44. doi:10.1016/j.annepidem.2020.05.003 PubMed Google Scholar Crossref

Thebault R , Tran AB , Williams V . The coronavirus is infecting and killing black Americans at an alarmingly high rate. Washington Post. Published April 7, 2020. Accessed October 12, 2021. https://www.washingtonpost.com/nation/2020/04/07/coronavirus-is-infecting-killing-black-americans-an-alarmingly-high-rate-post-analysis-shows/

The Commonwealth Fund. COVID-19 more prevalent, deadlier in U.S. counties with higher Black populations. doi:10.26099/y3xs-qr19

10.

Yancy CW . COVID-19 and African Americans. JAMA. 2020;323(19):1891-1892. doi:10.1001/jama.2020.6548 PubMed Google Scholar Crossref

11.

Murphy L , Eduljee NB , Croteau K . College student transition to synchronous virtual classes during the COVID-19 pandemic in northeastern United States. Pedagogical Research. Published 2020. Accessed September 3, 2021. https://eric.ed.gov/?id=EJ1275517

12.

Cao W , Fang Z , Hou G , et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934. doi:10.1016/j.psychres.2020.112934 PubMed Google Scholar Crossref

13.

Wang X , Hegde S , Son C , Keller B , Smith A , Sasangohar F . Investigating mental health of US college students during the COVID-19 pandemic: cross-sectional survey study. J Med internet Res. 2020;22(9):e22817. doi:10.2196/22817 PubMed Google Scholar Crossref

14.

Saraswathi I , Saikarthik J , Senthil Kumar K , Madhan Srinivasan K , Ardhanaari M , Gunapriya R . Impact of COVID-19 outbreak on the mental health status of undergraduate medical students in a COVID-19 treating medical college: a prospective longitudinal study. PeerJ. 2020;8:e10164. doi:10.7717/peerj.10164 PubMed Google Scholar Crossref

15.

Birmingham WC , Wadsworth LL , Lassetter JH , Graff TC , Lauren E , Hung M . COVID-19 lockdown: impact on college students’ lives. J Am Coll Health. 2021;0(0):1-15. doi:10.1080/07448481.2021.1909041 PubMed Google Scholar Crossref

16.

The Numbers Don’t Lie. HBCUs Are Changing the College Landscape. UNCF. Published July 2, 2019. Accessed October 12, 2021. https://uncf.org/the-latest/the-numbers-dont-lie-hbcus-are-changing-the-college-landscape

17.

Minority Serving Institutions Program. Published July 1, 2015. Accessed October 12, 2021. https://www.doi.gov/pmb/eeo/doi-minority-serving-institutions-program

18.

Palinkas LA , Horwitz SM , Green CA , Wisdom JP , Duan N , Hoagwood K . Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm Policy Ment Health. 2015;42(5):533-544. doi:10.1007/s10488-013-0528-y PubMed Google Scholar Crossref

19.

Tong A , Sainsbury P , Craig J . Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-357. doi:10.1093/intqhc/mzm042 PubMed Google Scholar Crossref

20.

Hennink MM , Kaiser BN , Marconi VC . Code saturation versus meaning saturation: how many interviews are enough? Qual Health Res. 2017;27(4):591-608. doi:10.1177/1049732316665344 PubMed Google Scholar Crossref

21.

Al Omari O , Al Sabei S , Al Rawajfah O , et al. Prevalence and predictors of depression, anxiety, and stress among youth at the time of COVID-19: an online cross-sectional multicountry study. Depress Res Treat. 2020;2020:8887727. doi:10.1155/2020/8887727 PubMed Google Scholar Crossref

22.

Vasquez Reyes M . The disproportional impact of COVID-19 on African Americans. Health Hum Rights. 2020;22(2):299-307.PubMed Google Scholar

23.

Garg S , Kim L , Whitaker M , et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 - COVID-NET, 14 states, March 1-30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):458-464. doi:10.15585/mmwr.mm6915e3 PubMed Google Scholar Crossref

24.

Cyrus E , Clarke R , Hadley D , et al. The impact of COVID-19 on African American communities in the United States. Health Equity. 2020;4(1):476-483. doi:10.1089/heq.2020.0030 PubMed Google Scholar Crossref

25.

Palmer RT , Maramba DC , Dancy TE . A qualitative investigation of factors promoting the retention and persistence of students of color in STEM. J Negro Educ. 2011;80(4):491-504. https://www.jstor.org/stable/41341155 Google Scholar

26.

Bonous-Hammarth M . Pathways to success: affirming opportunities for science, mathematics, and engineering majors. J Negro Educ. 2000;69(1/2):92-111.Google Scholar

27.

Hurtado S , Cabrera NL , Lin MH , Arellano L , Espinosa LL . Diversifying science: underrepresented student experiences in structured research programs. Res High Educ. 2009;50(2):189-214. doi:10.1007/s11162-008-9114-7 PubMed Google Scholar Crossref

28.

Hurtado S , Eagan MK , Cabrera NL , Lin MH , Park J , Lopez M . Training future scientists: predicting first-year minority student participation in health science research. Res High Educ. 2008;49(2):126-152. doi:10.1007/s11162-007-9068-1 PubMed Google Scholar Crossref

29.

Freeman BK , Landry A , Trevino R , Grande D , Shea JA . Understanding the leaky pipeline: perceived barriers to pursuing a career in medicine or dentistry among underrepresented-in-medicine undergraduate students. Acad Med. 2016;91(7):987-993. doi:10.1097/ACM.0000000000001020 PubMed Google Scholar Crossref

30.

Genao I , Gelman J . The MCAT’s restrictive effect on the minority physician pipeline: a legal perspective. Ann Intern Med. 2018;169(6):403-404. doi:10.7326/M18-0545 PubMed Google Scholar Crossref

31.

Corridon PR . Admissions to medical school during the COVID-19 era without the MCAT. J Med Educ Curric Dev. Published online April 29, 2021. doi:10.1177/23821205211014898 Crossref

32.

Michalec B . MCAT Testing during the COVID-19 pandemic. Acad Med. 2020;95(9):1292-1293. Published online 2020. doi:10.1097/ACM.0000000000003526 PubMed Google Scholar Crossref

33.

Garden E , Loebel E , Sanky C , Chudow J , Fallar R , Parkas V . Key insights from the development and implementation of a novel virtual interview process for medical school admissions during the COVID-19 Pandemic. Acad Med. 2021;96(8):1156-1159. doi:10.1097/ACM.0000000000004149 PubMed Google Scholar Crossref

34.

Seifi A , Mirahmadizadeh A , Eslami V . Perception of medical students and residents about virtual interviews for residency applications in the United States. PLoS One. 2020;15(8):e0238239. doi:10.1371/journal.pone.0238239 PubMed Google Scholar Crossref

35.

Nakae S , Porfeli EJ , Davis D , et al. Enrollment management in undergraduate medical school admissions: a complementary framework to holistic review for increasing diversity in medicine. Acad Med. 2021;96(4):501-506. doi:10.1097/ACM.0000000000003866 PubMed Google Scholar Crossref

36.

Ballejos MP , Sapien R . Medical school admissions and enhancing holistic review practices during COVID-19. Acad Med. 2020;95(11):e5-e6. Published online 2020. doi:10.1097/ACM.0000000000003578 PubMed Google Scholar Crossref

37.

Diaz T , Huerto R , Weiss J . Making merit just in medical school admissions. AMA J Ethics. 2021;23(3):E223-E228. doi:10.1001/amajethics.2021.223 PubMed Google Scholar Crossref

38.

Association of American Medical Colleges. The complexities of physician supply and demand: projections from 2017-2032. Accessed September 28, 2022. https://aamc-black.global.ssl.fastly.net/production/media/filer_public/31/13/3113ee5c-a038-4c16-89af-294a69826650/2019_update_-_the_complexities_of_physician_supply_and_demand_-_projections_from_2017-2032.pdf

39.

Petterson SM , Liaw WR , Tran C , Bazemore AW . Estimating the residency expansion required to avoid projected primary care physician shortages by 2035. Ann Fam Med. 2015;13(2):107-114. doi:10.1370/afm.1760 PubMed Google Scholar Crossref

40.

Zhang X , Lin D , Pforsich H , Lin VW . Physician workforce in the United States of America: forecasting nationwide shortages. Hum Resour Health. 2020;18(1):8. doi:10.1186/s12960-020-0448-3 PubMed Google Scholar Crossref

41.

Bhatla A , Ryskina KL . Hospital and ICU patient volume per physician at peak of COVID pandemic: state-level estimates. Healthc (Amst). 2020;8(4):100489. doi:10.1016/j.hjdsi.2020.100489 PubMed Google Scholar Crossref

42.

Ripp J , Peccoralo L , Charney D . Attending to the emotional well-being of the health care workforce in a New York City health system during the COVID-19 pandemic. Acad Med. Published online April 21, 2020. doi:10.1097/ACM.0000000000003414 Google Scholar Crossref

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

COVID-19 Has Exacerbated Inequities That Hamper Physician Workforce Diversification

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