Supporting Black Students Through Their Science, Engineering, and Medicine Career Journeys: Proceedings of a Workshop (2024)
Chapter: 4 Postsecondary Success
Two sessions of the workshop focused on postsecondary education. Presenters in the session on undergraduate education considered how to develop science, engineering, and medicine (SEM) identities among Black students and how to ensure that more students who are interested in SEM when entering college persist and graduate in these fields. The second session, on professional and graduate school, introduced some best practices to hone the skills of medical and doctoral students, as well as programs available to them.
COLLEGE—DEVELOPING SEM IDENTITIES
Marc A. Nivet, Ed.D., M.B.A. (University of Texas Southwestern Medical Center) served as moderator of the panel to consider how to broaden and strengthen the pipeline of Black college students in SEM. Discussants were Coyness L. Ennix, M.D. (California Medicine Coalition), Reginald Blake, Ph.D. (New York City College of Technology), and Christopher Botanga, Ph.D. (Chicago State University).
California Medicine Scholars Program and National Medical Corps Act
In discussing the need to bring more Black students into the health professions, Dr. Ennix drew on the report chaired by Louis Sullivan, M.D., in 2004, which concluded that African Americans, Hispanic Americans, and American Indians are “missing persons” in the health professions and in the faculties of health professional schools (Sullivan Commission, 2004). More than 15 years later, when looking at the heavy tool of COVID-19 on communities of color, “evidence is clear that access to care from a diverse provider health workforce would reduce this burden,” as James E. K. Hildreth, M.D., Ph.D., president of Meharry Medical College, publicly stated.1
Dr. Ennix explained that the California Medicine Scholars Program (CMSP) and the proposed National Medical Corps Act (H.R. 9105, 117th Congress) are set up so that the state and nation will gain tangible benefits from increasing the number of physicians and dentists of color. He noted the subtle but profound relationship between improved health care, cultural competence, and concordant mentorship, and that health disparities and economic and social inequities are inextricably entwined. Beginning at a young age, multiple barriers exist for students of color entering medicine and dentistry. Institutional change is the most difficult part of the framework to maximize student development, but it is the most important.
The Need for Change
The nation is projected to have a physician shortage by 2025, particularly for historically underrepresented physicians needed to practice in diverse communities. According to a study by the Kaiser Family Foundation (2022), people of color fare worse than their white counterparts across many health status measures. Placed in sharper focus, these health disparities are driven by social and economic disparities. A person’s zip code is a better predictor of their health than their genetic code, Dr. Ennix said. U.S. health spending is higher per capita than other Organisation for Economic Co-operation and Development nations, at $11,071.72, yet life expectancy is lower. According to the Primary Care Collaborative, most of that spending, 38 percent, goes to hospital care, with only 5 to 7 percent
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1 “Senator Melissa Hurtado to Address Doctor Shortage in California.” Senator Melissa Hurtado, August 28, 2020, https://sd16.senate.ca.gov/index.php/news/press-release/senator-melissa-hurtado-address-doctor-shortage-california.
spent on primary care. What would happen to the nation’s health status, he posed, if those percentages were reversed?
Dr. Ennix shared data on the gender, racial, and ethnic distribution of the national medical student body. The numbers of women have greatly risen since 1978, with Asian women accounting for a large part of the increase (Morris et al., 2021). Black males accounted for 3.1 percent of the national medical school body in 1978, and were 2.9 percent in 2019. Dr. Ennix reported on the findings of a 10-year study to identify barriers to entering the health professions by Black aspirants (Toretsky et al., 2018). They identified six barriers: (1) cost of education; (2) lack of academic preparation, as well as admissions requirements for those considering doctoral degree programs; (3) lack of concordant mentors; (4) threats from stereotyping; (5) limited exposure to health careers; and (6) poor advising.
California Medicine Scholars Program Framework
Dr. Ennix offered a framework to maximize student development paired with legislative action to result in both individual support and institutional change. The framework consists of forming institutional partnerships, providing tailored student support/academic success, and engaging faculty/institutional change and will be embodied in the CMSP.2 Six years in the making, CMSP is a systemwide coordinated pathway to support and increase the number of underrepresented physicians of color from community college through residency and practice. The idea is not new, he commented, noting that the Sullivan Commission referred to community colleges as a valuable resource back in 2004. Two obstacles have been the lack of articulation agreements between schools (e.g., a community college student has to repeat the same math or science class when going on to a 4-year school) and lack of bridging programs for transfer students.
The CMSP model creates a hub with a partnership of three community colleges, two undergraduate institutions, three community health partners, and a medical school. Elements of the model include priority course enrollment, tailored advising, enhanced curriculum, medical school and clinical partnerships, portfolio development, and networking and mentoring.
Successful institutional applicants must demonstrate how they will establish or strengthen existing regional collaborative relationships; develop
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2 For more information on CMSP, see https://californiamedicinescholarsprogram.org/scholars-program/.
a systematic approach to preparing community college students to advance; engage in partnerships in which one or more partners can track student admissions, enrollment, and academic progress; and build a culture within the hub that promotes equity of opportunity. Legislatively, the bill to create and fund the program (CA SB-40) was passed by the California legislature and appropriated $10.5 million in the 2021 state budget. By year 10, the goal is to serve 2,500 to 2,900 students with at least 300 new scholars per year, 300 new medical doctors produced from the first two cohorts, and at least 100 primary care residents. On the federal level, Rep. Barbara Lee (D-CA) has introduced legislation for the development of a National Medical Corps Act to be administered by the Health Resources and Service Administration. If passed, the plan is to start with 20 consortia with 50 students in each hub.
Geoscience and Other STEM Programs at City Tech
Dr. Blake reported on geoscience programs for African American and Hispanic students in New York City, with a focus on New York City College of Technology (City Tech). The programs discussed were the Black Male Initiative (BMI), National Science Foundation (NSF) Research Experiences of Undergraduates (REU) program, and NSF Improving Undergraduate STEM Education/GEOPAths Undergraduate Preparation. He also offered guiding strategies about what has worked in these programs.
Black Male Initiative
As context, BMI is implemented on 23 of the 25 campuses that make up the City University of New York system, but City Tech is the only one designated for STEM, Dr. Blake explained. It started in 2005 with 15 students and has now served more than 8,100, both male and female. City Tech’s goal is to increase the enrollment and success in STEM of African American and Hispanic males by developing strong, sustainable interventions. Ninety percent of all programmatic activities are “acad-centric,” that is, centered on academics through a structured mentoring program (see Figure 4-1).
Faculty, peer, and community mentoring are offered to BMI students to equip them with what they need for academic success. Faculty provide STEM exposure trips, graduate school preparation, research experiences conferences, and other support. In addition to peer-to-peer workshops and
SOURCE: Reginald Blake, Workshop Presentation, May 2, 2022.
tutoring, BMI provides a safe place for students to share experiences and concerns. Students also undertake community service and service learning. Noted accomplishments include strong academic performance, research at leading labs, and designation as a Model Replication Institution. About 50 students per year receive STEM research internships, and annually, many BMI students present at major local and national conferences.3
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3 For more information on BMI, see https://www1.cuny.edu/sites/bmi/about/.
National Science Foundation Programs
Through the NSF REU program, students work with faculty mentors to conduct research in satellite and ground-based remote sensing. The goals are to offer a transformative research experience for undergraduates, promote geoscience research among historically underrepresented students, embolden and support undergraduates to pursue advanced careers in STEM, and stimulate interdisciplinary learning. The REU scholars participate in three components: structured learning environments, student support, and vision and impetus for advancement. They are set up to succeed in research through a 1-week orientation, minicourses, research seminars, and a skills workshop. Faculty, postdocs, graduate students, and the undergraduate REU scholars themselves also engage with high school students, for example, at a Brooklyn summer program that used drones to teach geosciences.
City Tech does not have a specific geoscience department, but many majors, such as computer science and various engineering technologies, integrate geoscience into the curriculum and offer hands-on training and research. Internships are offered through public agencies and private companies. Students are also involved in geoscience exposure trips, networking, and engagement with scientists from a diversity of ethnic cultures.4
Cornerstones and Guiding Strategies
Each of these programs have featured culturally competent peer-to-peer mentoring, socio-emotional programming, diversity recruitment, and academic enhancements, Dr. Blake pointed out. He also suggested the following:
- At the department and university levels, more diversity fellowships, scholarships, and internships to attract and retain Black SEM students
- More partnerships (and equitable relationships) between minority-serving institutions (MSIs) and R1 universities
- More MSI-industry partnerships
- More MSI-professional organization partnerships
- A paradigm shift to create and reward altruistic scholarly activities
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4 For more information on NSF’s REU, see https://new.nsf.gov/funding/opportunities/research-experiences-undergraduates-reu.
National Science Foundation–Supported Alliances
The Illinois Louis Stokes Alliance for Minority Participation (ILSAMP) is one of 56 Louis Stokes alliances across the country funded by NSF. Dr. Botanga focused on several programs within the broader alliance.
Illinois LSAMP STEM Pathway and Research Alliance
The Illinois LSAMP STEM Pathway and Research Alliance, or ILSPRA, consists of an alliance of four 2-year institutions, nine 4-year institutions, the Argonne National Laboratory, and the Field Museum of Natural History. As with other programs presented throughout the workshop, Dr. Botanga said the goal is to increase the number of underrepresented minority (URM) students in the STEM pipeline who graduate with degrees and join the workforce or graduate programs. Major activities include mentor-led, national laboratory, and international research experiences; a learning assistant model and peer mentoring; an annual STEM research symposium; a Technology and Engineering Research Toolkit (TERT); and a summer scholars program. STEM educational research is being conducted to understand which elements are most critical to success. Points of pride include more than 870 URM graduates per year. Eight Bridge-to-the-Doctorate (BD) cohorts have been created to date, through which 53 BD students have earned Ph.D.’s in 17 STEM disciplines, and 19 students are in the pipeline to do so.
“We cannot emphasize the value of mentors enough,” he said. Involving the national laboratory and trying to get students overseas to see that research is not limited to the United States are also important. The TERT has helped students who cannot easily do offsite research because of family or other issues; they can conduct research online wherever they are. Dr. Botanga noted that although LSAMP is a national alliance, there is little systematic documentation. The STEM education research component will conduct studies to publish in peer-reviewed journals.5
Louis Stokes Midwest Regional Center of Excellence
The Louis Stokes Midwest Regional Center of Excellence (LSMRCE) is a collaborative program that, like LSAMP, is designed to broaden participation through institutional change and capacity building. LSMRCE’s
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5 For more information on LSAMP, see https://new.nsf.gov/funding/opportunities/louis-stokes-alliances-minority-participation.
four objectives are to cultivate community, conduct research, provide professional development, and serve as a dissemination hub. One of the co-principal investigators is a scholar of STEM education research to better understand what works and what does not.
All these programs, Dr. Botanga explained, are based on the Tinto Model of Student Retention (Tinto, 1975), which encompasses both academic and social integration to lead to STEM professionalization and entry into graduate school or the STEM workforce. Through professionalization, students gain the skills, culture, and attitudes of a STEM discipline. “What is becoming clear is we need opportunity, but when an opportunity comes, there might not be support. Access alone does not imply opportunity,” Dr. Botanga said. “My hope and wish is that once we get the desire to include underrepresented minorities, we must be committed to provide the support needed for them to be successful.”6
DISCUSSION OF UNDERGRADUATE BEST PRACTICES
Dr. Nivet recognized the sharing of best practices, as well as the personal passion and commitment of the three presenters. The critical challenge, he observed, is to ensure sustainability. He asked how funding of the programs discussed reaches students, who are involved in many years of study without earning much income and whose families often do not have the means to help them. Dr. Blake said that NSF requires City Tech and other institutions to be explicit about how students will receive stipends. NSF program officers are serious about how money is reaching students. For program sustainability, Dr. Ennix noted the program in California has state and foundation funding, and he is hopeful for federal funding. Dr. Botanga commented that while NSF does support students, many are faced with everyday challenges. He recalled a student was apologetic about his performance on an exam but said he did not have the money to pay for gas to get to campus. He and others often help students with incidental expenses from their own pockets. Dr. Nivet suggested a fund for these kinds of emergencies.
Each of the highlighted partnerships started early, in K–12 or in the community, Dr. Nivet observed. “We never have a lack of curious Black children,” he said. “What should we do differently to keep kids curious and have more enter the pipeline?” Dr. Botanga emphasized the importance
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6 For more information on LSMRCE, see https://lsmrce.org/.
of a cohort. His alliance helps students attend conferences together, even students who not yet ready to present research, so they see what conferences are like and how work is done collaboratively in a social setting.
Partnering with community colleges is not new but offers a great opportunity to reach diverse students, Dr. Ennix pointed out. Nationwide, among 1,167 community colleges, 21 percent of students report two or more races, 19 percent are Hispanic, 19 percent are African American, 18 percent are American Indian, 16 percent are Caucasian, and 15 percent are Asian American (Ma and Baum, 2016). California law, for example, precludes using race in admission decisions, but there is no bias against community colleges, which are mostly students of color.
Dr. Blake said that for the last 40 years, a great deal of money has gone into engaging students in SEM with meager returns. He continued:
What’s wrong? There is no silver bullet, there’s no one solution for everything. I posit we need to look at everything we’ve been doing and not just think “outside the box” but to destroy the box. We need to reenvision the way we deliver education. Our students culturally are altruistic. They are spurred on by relevance to society. Our students gravitate to projects, programs, and internships that deal with the community.
In the geosciences program at City Tech, for example, many students get involved with remote sensing to understand the impacts of climate change on their neighborhood or the link between climate change and redlining. “Bringing relevance to the enterprise changes the paradigm,” he urged. “This increases interest, they want to become part of it. That may be one of the hooks.”
PROFESSIONAL AND GRADUATE SCHOOL—HONING SKILLS
Moving on to graduate and professional school, workshop co-chair Louis Sullivan, M.D., served as moderator to explore strategies and programs aimed at supporting Black SEM professionals in research careers. Undergirding the strength of institutions means having diversity of faculty and students and adequate financial resources to support them, he commented, and added that research enriches the entire learning environment because research is a strategy for problem solving. It improves the health
system and other scientific areas. Describing programs at their organizations were Peter MacLeish, Ph.D. (Morehouse School of Medicine [MSM]), Michellene Davis, J.D. (National Medical Fellowships, Inc. [NMF]), David Asai, Ph.D. (Howard Hughes Medical Institute [HHMI]), and Marie Bernard, M.D. (National Institutes of Health [NIH]).
Neuroscience Institute at Morehouse School of Medicine
Dr. MacLeish described the establishment of the Neuroscience Institute at MSM, which he helped create in 1994–1995, as the first of its kind at a Historically Black College and University (HBCU).7 It came about through young, enterprising MSM faculty working with program officers at the National Institute of Neurological Disorders and Stroke. Pilot projects were set up to recruit senior scientists. He noted the commitment of senior leadership from both the institution and the funding agency as critical to success.
The Neuroscience Institute supports the research of independent investigators, trains students, and fosters a culture of excellence. From the start, weekly discussions on neuroscience have been held to talk about ongoing work and provide feedback in a rigorous, nonthreatening environment. A seminar series brings in outside experts who meet with MSM investigators. An external advisory committee of senior scientists offers advice on where the field was headed. The committee interfaces with the MSM administration and recommends strategies for young investigators to obtain independent funding. These strategies have included collaborating where appropriate, careful and helpful annual reviews, and mock reviews. In recruiting, “we sought those who had completed a postdoc and had a science story to tell that was exciting, authentic, and ready to be turned to R01 or equivalent level,” he said. Among the initial nine applicants for R01 grants from NIH, six were funded, four of whom were investigators from historically underrepresented backgrounds. “The results show you can recruit junior faculty and develop them to national competitiveness at the highest level,” Dr. MacLeish stated.
Several developments came from this success. A request came from the RCMI (Research Centers in Minority Institutions) community to develop similar programs at other institutions. The first such program was established in 2001 and had 11 programs at its height, but it is not active.
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7 See https://www.msm.edu/Research/research_centersandinstitutes/NI/index.php.
In addition, the success of the MSM investigators made them a target of recruitment by other institutions. While pleased for their opportunities, Dr. MacLeish did express the wish they could have spent more time at MSM. Training of undergraduate and graduate scientists now includes a collaborative program with Harvard Medical School.
Dr. MacLeish closed by pointing out the value of establishing institutes at HBCUs not only in neuroscience but also in cardiovascular health, reproductive health, and other fields. They can play a major role in producing Black Ph.D.’s, and he urged their expansion as a high priority.
National Medical Fellowships, Inc.
Ms. Davis explained that NMF has been addressing health equity at the intersection of health and wealth since the 1940s. The need for a strong pathway is urgent, she said:
Not only have we not kept pace in relation to our demographic in the population, but indeed as a result of the pandemic, we are an entire generation behind where we had been making some ground. As a result, NMF has adopted a new strategic framework. The framework ensures that we do not merely wait for [students] to get to medical school, but we go and get them.
Ms. Davis noted this means acknowledging the role of the K–12 academic system. Black and Latinx students are often shut out of gifted and talented programs as early as elementary school. For example, Blacks make up 16 percent of enrollment in elementary schools, but only 9 percent in talented and gifted programs. The pathway has to examine this reality.
Representation matters, she continued. Diversity is needed within clinical trials. The curriculum needs to center community voice. Ms. Davis added, “You cannot talk about health equity without talking about the health-wealth gap.” Many private foundations state they do not fund individual scholarships, but she challenged those that state they are concerned with equity if they do not offer financial aid to diverse students in need of these resources. She also commented on the need to understand the effect of weathering: that is, the consequences of living under constant stress due to unremitting exposure to systemic and structural racism. “Academic medical centers have to be aware of the impact on students,” she said. “There is no such thing as a ‘microaggression.’ All are macroaggressions.” She urged that cultural com-
petency training and racial equity assessment tools be used with all staff and faculty. Generational trauma, historic disinvestment, and implicit bias have resulted in an uneven distribution of power and privilege, she said.
Ms. Davis called for “active inclusion,” which involves more than diversity by numbers but to actively recruit, retain, and support diverse students; provide a tangible demonstration of the worth and value of all students; and foster a sense of belonging. Diversity in health care is important. According to the KFF/Undefeated Survey on Race and Health (Kaiser Family Foundation/The Undefeated, 2020), one in five respondents had experienced race-based discrimination in health care in the past year, and 37 percent of Black women who have children under age 18 reported they have been treated unfairly based on race when getting health care for themselves or a family member. Diversity in medicine leads to better health outcomes, Ms. Davis reminded the group, which both research and anecdotal observations confirm. A 2018 National Bureau of Economic Research study showed that when Black patients and physicians were paired together, Black patients had better health outcomes (see Figure 4-2).
Equity-minded health professionals from the communities that have endured the highest levels of health inequity are urgently needed to address the historical and present-day causes of mistrust in the health-care system, she concluded. National Medical Fellowships offers a solution as the only national organization solely dedicated to providing scholarships to medical and health professions for students in all groups underrepresented in health care. NMF seeks to reduce health-care disparities by creating new generations of clinicians and health-care leaders who are dedicated to realizing health equity.8
Howard Hughes Medical Institute Gilliam Fellows Program
Dr. Asai echoed Ms. Davis’s comments about why inclusion is important and observed that the current culture of STEM is focused on exclusion and pedigree. It is time to change culture and behaviors, he stated.
The Thinking Behind “PEER”
As he shared what HHMI is doing, Dr. Asai explained he no longer uses the acronym “URM.” “I believe it is inaccurate, it is pejorative, and
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8 For more information on the NMF principles, see https://nmfonline.org/.
SOURCE: Michellene Davis, Workshop Presentation, May 2, 2022.
it fails to call out the system’s responsibility,” he stated. “Instead, I use PEER—Persons Excluded because of Ethnicity or Race.” Currently, PEER persistence in STEM is one-half the rate of non-PEERs at the bachelor’s level and larger at the graduate level, he continued:
It is not for lack of interest, in that PEERs are overrepresented in the percentage of students entering college intending to study STEM. It is not because of a lack of preparation. In studies that have compared students with similar math preparation and family interest in higher education, the persistence of PEERs is much less than non-PEERs. Most distressing, the gap has not narrowed in three decades, even while resources have been spent to try to change.
The general approach in previous efforts, Dr. Asai pointed out, has been a deficit mindset to “fix the student” so that they can assimilate into a culture not of their making. These efforts are not sufficient and usually not sustained when the funding goes away. What is largely missing is a commitment to change the learning and training environment and to change the culture of STEM (Asai, 2020; Riegle-Crumb et al., 2019).
Dr. Asai said HHMI is pivoting from a deficit mindset to an equity-framed approach in the HHMI Gilliam Fellows Program. It leverages structural and behavioral change in the STEM ecosystem by focusing on the role of dissertation advisors. Doing so prepares graduate students from groups historically excluded from and underrepresented in science to assume leadership roles in science and science education. It aims to develop a healthy, more inclusive academic ecosystem and advance mentorship skills development as a drive toward equity and inclusion. The hope is that many participants will become faculty members, he said.
Changes to the Gilliam Fellows Program
According to Dr. Asai, in the first 9 years of the program, many participants were “just hanging on” and had lost their joy in science. Many left science completely. In 2014, HHMI suspended the program to dissect and rebuild it. He focused on some of what he considers the most important adjustments to leverage cultural change.
First, the Gilliam advisor must agree to participate in a mentorship training course, no matter their experience. The course lasts a year and is a
culturally aware mentorship skills development course designed and delivered by the Center for the Improvement of Mentored Experiences in Research, or CIMER, at the University of Wisconsin–Madison.9 It recognizes the reality that nearly all students in the program are non-white, while nearly all the advisors are white or Asian American. The course provides an opportunity for the mentors to consider their own cultural identity and practice communicating across cultures. Thirty hours of online and in-person sessions cover the science of mentoring, exploring oneself as a cultural being, seizing opportunities to raise issues of culture, communication styles, exploring disparities using institutional data, putting culturally aware mentoring principles into practice, and encouraging institutional culture change. About 240 advisors will have completed the course by the end of September 2022. Data indicate that they have gained culturally aware mentoring skills and have become more effective mentors to benefit themselves and their mentees (Pfund et al., 2022).
As an example, Dr. Asai highlighted an exercise that encourages advisors to shift from a deficit mindset to questioning the role of their institution. It builds from research (Nettles and Millet, 2006) that even small differences in publication output have amplified effects through scientists’ careers. Before the exercise, the advisors collect data from their institutions about the publication history of students in their department. They also collect data on the demographics of students currently enrolled in their program, as well as those who completed Ph.D.’s in the last 5 years and how many papers (as first author or co-author) they published from their dissertation work. The data from all the participants are compiled and shared as an informal survey. The data consistently show that women complete Ph.D.’s at a greater rate than males, but they publish less than males. The data also show that PEERs complete Ph.D.’s at a lower rate than non-PEERs and also publish less than non-PEERs. In the data from the 2021 cohort of advisors, for example, PEERs published an average of 2.65 papers per person compared with 3.77 papers for non-PEERs.
After being presented with the data, participants are asked to pose hypotheses about the differences. Dr. Asai shared that this exercise has taken place since 2015, and there have always been three responses, always in the same order. First, the participants “blame the messenger,” saying that Dr. Asai exaggerated the differences or cherry-picked the data; they are denying the evidence accumulated from 69 programs in 44 universities covering
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9 For more information, see https://cimerproject.org/.
4,532 Ph.D.’s. Second, they blame the PEER students’ lack of preparation, impoverished backgrounds, lack of computer skills, or other preparation with a deficit-minded hypothesis. Finally, some reflect on their own roles. They may consider if they assign non-PEER students to the projects that are most likely to yield high-impact papers or may not feel comfortable pushing a PEER student who has a different cultural identity than they do.
The Gilliam Fellows Program is an example of working to change the culture instead of fixing the student. Engaging in this work does not come naturally, but it can be learned, he stressed. HHMI recently announced it will expand the required mentoring program to all HHMI scientists, about 500 per year.10
Pathways for Success at the National Institutes of Health
Dr. Bernard spoke about smoothing the pathway to success for scientists from diverse backgrounds in NIH intramural and extramural programs. She agreed that interventions at the individual level are necessary but not sufficient. She highlighted many NIH funding opportunities with the goal to establishing independent investigators (see Figure 4-3). “It may seem like a smooth pathway from K–12 through undergraduate, graduate, postdoc, and early research stages, but there are a lot of on-ramps and off-ramps,” she pointed out.
Dr. Bernard highlighted four NIH programs: Diversity Program Consortium (DPC), Maximizing Opportunities for Scientific and Academic Independent Careers (MOSAIC) Program to Promote Faculty Diversity, activities of the Chief Officer for Scientific Workforce Diversity (COWSD), and NIH UNITE.
Diversity Program Consortium
The DPC is a highly integrated national consortium funded through the NIH Common Fund. It has 10 Building Infrastructure Leading to Diversity (BUILD) sites. Nearly half of the BUILD sites and partnership institutions are MSIs. It also has the National Research Mentoring Network and the Coordination and Evaluation Center. Currently in year 8 of a 10-year program, interventions are tested and evaluated for possible incor-
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10 For more information on the Gilliam Fellows Program, see https://www.hhmi.org/programs/gilliam-fellows.
SOURCE: Marie Bernard, M.D., Workshop Presentation, May 2, 2022.
poration into future funding announcements. DPC will broaden its community, continue to gather data to test site-specific and consortium-wide interventions, transition into sustainable models for enhancing diversity in biomedical fields, and disseminate effective strategies to have a lasting effect nationally. For example, based on what was learned in DPC’s first phase, the importance of sponsored program administration was recognized. It now supports creating or enhancing offices of sponsored programs. A major goal is to enhance faculty and student participation in biomedical research and research-training programs.11
MOSAIC Program to Promote Faculty Diversity
Dr. Bernard turned to the NIH MOSAIC Program to Promote Faculty Diversity. The first cohort was recruited last year and comprises postdoctoral researchers from underrepresented groups in biomedical sciences preparing to launch independent research careers. MOSAIC facilitates the transition into independent tenure-track or equivalent research-intensive faculty positions. Participants receive a K99/R00 award for 3 years, as well as cohort-based mentoring and career development. Current awardee organizations are the American Society for Biochemistry and Molecular Biology, American Society for Cell Biology, and Association of American Medical Colleges.12
COWSD Activities
Dr. Bernard said her office recently led development of a Notice of Special Interest (NOSI): Administrative Supplements to Recognize Excellence in Diversity, Equity, Inclusion, and Accessibility (DEIA) Mentorship.13 Recognizing that mentoring can make the difference in a person’s research career but is frequently not compensated, it adds funding for this purpose to already-funded research. The large response, she posited, demonstrates an unmet need. She noted support for mentors who will enhance outreach in keeping with the NOSI objective to prioritize diversity.
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11 For more information on the DPC, see https://diversityprogramconsortium.org/.
12 For more information on the MOSAIC Program, see https://www.nimhd.nih.gov/programs/extramural/training-career-dev/mosaic-program.html.
13 Notice Number NOT-OD-22-057; available at https://grants.nih.gov/grants/guide/notice-files/NOT-OD-22-057.html.
COWSD also conducts a Scientific Workforce Diversity Seminar Series, with perspectives and data.14
NIH UNITE
NIH UNITE is a major initiative unveiled in February 2021 with three overlapping components: health disparities, minority health, and health equity research; internal workforce; and external workforce (Bernard et al., 2021). Up to $58 million was committed from the NIH Common Fund to support transformative research to address health disparities and advance health equity. Responding to two funding opportunity announcements, RFA-RM-21-021 and RFA-RM-21-022, 11 awards were announced in October 2021. An open solicitation is out for more research, she added.15
Multiple institutes and centers are involved in an initiative called ComPASS (Community Partnerships to Advance Science for Society). ComPASS supports community-driven, health equity structure interventions through local Health Equity Research Assemblies that drive the agenda, a coordination center with a National Health Equity Research Assembly. It also funds health equity research hubs for scientific support and partnership. It commits $23 to $52 million per year over the next 10 years.16
Related to workforce issues, NIH has a solicitation for FIRST (Faculty Institution Recruitment for Sustainable Transformation) to create cultures of inclusive excellence through a faculty cohort model for hiring, multilevel mentoring, and professional development. The first six cohorts are at Cornell University, Drexel University, Florida State University, Icahn School of Medicine at Mount Sinai, San Diego State University, Tuskegee University, and University of Alabama at Birmingham. Morehouse School of Medicine is serving as the FIRST coordination and evaluation center.
Through UNITE, NIH is launching a prize competition to recognize the practices and processes that institutions are developing to achieve excellence in diversity, equity, inclusion, and accessibility. Dr. Bernard welcomed comments about how to best design the competition.17 Great minds think
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14 For more information on COWSD, see https://diversity.nih.gov/.
15 For information on RFA-RM-021, see, for example, https://grants.nih.gov/grants/guide/rfa-files/RFA-RM-21-021.html; for information on RFA-RM-21-022, see, for example, https://grants.nih.gov/grants/guide/rfa-files/RFA-RM-21-022.html.
16 For more information about ComPASS, see https://commonfund.nih.gov/compass.
17 For more information about this award and other UNITE milestones and progress, see https://www.nih.gov/ending-structural-racism/unite-milestones-progress.
differently, Dr. Bernard concluded, and said she looked forward to comments and follow up.
DISCUSSION OF PROFESSIONAL AND GRADUATE SCHOOL BEST PRACTICES
Commenting on MSM Neuroscience Institute researchers being recruited to other neuroscience centers, Dr. Sullivan recalled advice he received when he switched from research to administration: Get used to people stealing your faculty, because it is worse to have a faculty that no one is trying to steal. He also commented on how research not only develops new knowledge but also enriches the educational environment for clinicians, teachers, and others. Dr. McLeish agreed; in neuroscience, the field changes rapidly, and students need to be exposed to the newest advances and ways of thinking.
Discussing how to increase the percentage of Black students in elementary school gifted and talented programs, Ms. Davis said the responses are interwoven throughout the workshop presentations. Schools must be accountable. Parents and others must be equipped to question this discordance. She said it is also imperative to push school boards and other decision-makers to understand the evolving need for equity in education. She urged challenging assumptions, such as how students may process information differently. Racial equity assessment tools can be useful, she suggested.
Dr. Sullivan noted that in the Great Society programs in the 1960s, many student support programs were developed but were later curtailed or eliminated. For low-income students, this was a disaster. Many were discouraged from continuing their studies or graduated with huge debt. Reducing indebtedness for students who may be first-generation medical school, college, or even high school is necessary. Partners are needed to ensure the interconnectedness between health and wealth equity. Students want to return to their communities to serve, but economically many cannot.
Referring to Dr. Asai’s publication data by PEER and non-PEER researchers, Dr. Sullivan asked whether a contributing factor may be that minority faculty of historically underrepresented backgrounds are asked to serve on so many committees that divert them from their research. Dr. Asai agreed this may be a contributing factor but clarified that the data were for graduate students, not faculty. In those cases, the PEER students’ advisors are mainly white or Asian American. There may be a disparity between how
advisors are treating students from their own compared with other cultural backgrounds. The purpose of the workshop exercise he described is to get advisors to reflect on their own practices when working with students.
Dr. Bernard was asked about the role for the National Institute on Minority Health and Health Disparities (NIMHD). She said NIMHD takes a leadership role in health disparities research. She noted that about 50 percent of researchers from underrepresented groups are interested in this area, but only a few institutes and centers had funded it. NIMHD can enhance health disparities research across the board, she said. Dr. Bernard also said she would like to see greater utilization of Diversity Supplements. In her tenure as deputy director at the National Institute on Aging, they were associated with great success for researchers but are used in less than 5 percent of R01 grants.18
REFERENCES
Asai, D. J. Race matters. 2020. Cell 181(4):754–757. doi: 10.1016/j.cell.2020.03.044. PMID: 32413295.
Bernard, M., A. C. Johnson, T. Hopkins-Laboy, and L. A. Tabak. 2021. The NIH UNITE Initiative. Nature Medicine. https://doi.org/10.1038/s41591-021-01532-1.
Kaiser Family Foundation. 2022. Key Data on Health and Health Care by Race and Ethnicity. https://www.kff.org/racial-equity-and-health-policy/report/key-facts-on-health-and-health-care-by-race-and-ethnicity/.
Kaiser Family Foundation/The Undefeated. 2020. Race, Health, and COVID-19: The Views and Experiences of Black Americans: Key Findings from the KFF/Undefeated Survey on Race and Health, prepared by L. Hamel, L. Lopes, C. Muñana, S. Artiga, and M. Brodie. https://files.kff.org/attachment/Report-Race-Health-and-COVID-19-The-Views-and-Experiences-of-Black-Americans.pdf.
Ma, J., and S. Baum. 2016. Trends in community colleges: Enrollment, prices, student debt, and completion. College Board Research: Research Brief April 2016. https://research.collegeboard.org/media/pdf/trends-community-colleges-research-brief.pdf.
Morris, D., P. A. Gruppuso, H. A. McGee, A. L. Murillo, A. Grover, and E. Y. Adashi. 2021. Diversity of the national medical student body—Four decades of inequities. New England Journal of Medicine 385:1661–1668. https://www.doi.org/10.1056/NEJMsr2028487.
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18 The goal of these supplements is “to increase diversity in the research workforce by providing training, mentoring, and career development opportunities to individuals who are underrepresented in biomedical, behavioral, clinical, social and basic sciences research.” For more information, see https://www.nimhd.nih.gov/programs/extramural/training-career-dev/research-supplements/diversity-supplements.html.
National Bureau of Economic Research. 2018. Does doctor race affect the health of Black men? Bulletin on Aging & Health 4. https://www.nber.org/bah/2018no4/does-doctor-race-affect-health-black-men.
Nettles, M. T., and C. M. Millet. 2006. Three Magic Letters: Getting to Ph.D. Baltimore, MD: Johns Hopkins University Press.
Pfund, C., F. Sancheznieto, A. Byars-Winston, S. Zárate, S. Black, B. Birren, J. Rogers, and D. J. Asai. 2022. Evaluation of a culturally responsive mentorship education program for the advisers of Howard Hughes Medical Institute Gilliam Program Graduate Students. CBE—Life Sciences Education 21(3). https://www.lifescied.org/action/doSearch?AllField=Gilliam+mentors+self-reported+gains+in+selected+culturally+aware+mentoring+skills.
Riegle-Crumb, C., B. King, and I. Irizarry. 2019. Does STEM stand out? Examining racial/ethnic gaps in persistence across postsecondary fields. Educational Researcher 48(3):133–144. https://doi.org/10.3102/0013189X19831006.
Sullivan Commission. 2004. Missing Persons: Minorities in the Health Care Professions. A Report of the Sullivan Commission on Diversity in the Healthcare Workforce. https://campaignforaction.org/resource/sullivan-report-diversity/.
Tinto, V. 1975. Dropouts from higher education: A theoretical synthesis of recent research. Review of Educational Research 5(1):89–125.
Toretsky, C., S. Mutha, and J. Coffman. 2018. Breaking Barriers for Underrepresented Minorites in the Health Professions. San Francisco: Healthforce Center at UCSF. https://healthforce.ucsf.edu/sites/healthforce.ucsf.edu/files/publication-pdf/Breaking%20Barriers%20for%20Underrepresented%20Minorities%20in%20the%20Health%20Professions%20.pdf.
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