The Leaky Pipeline: Factors Associated With Early Decline in Interest in Premedical Studies Among Underrepresented Minority Undergraduate Students

Department of Sociology, Stanford University, Stanford, California 94305-2047, USA.
Academic medicine: journal of the Association of American Medical Colleges (Impact Factor: 2.93). 06/2008; 83(5):503-11. DOI: 10.1097/ACM.0b013e31816bda16
Source: PubMed


To determine the causes among underrepresented racial and ethnic minority groups (URM) of a decline in interest during the undergraduate years in pursuing a career in medicine.
From fall 2002 through 2007, the authors conducted a longitudinal study of 362 incoming Stanford freshmen (23% URM) who indicated on a freshman survey that they hoped to become physicians. Using a 10-point scale of interest, the authors measured the change in students' levels of interest in continuing premedical studies between the beginning of freshman year and the end of sophomore year. Follow-up interviews were conducted with 68 participants, approximately half of whom had experienced decreases in interest in continuing as premeds, and half of whom who had experienced increases in interest.
URM students showed a larger decline in interest than did non-URM students; women showed a larger decline than did men, independent of race or ethnicity. The authors found no association between scholastic ability as measured by SAT scores and changes in level of interest. The principal reason given by students for their loss of interest in continuing as premeds was a negative experience in one or more chemistry courses. Students also identified problems in the university's undergraduate advising system as a contributor.
Largely because of negative experiences with chemistry classes, URM students and women show a disproportionate decline in interest in continuing in premedical studies, with the result that fewer apply to medical school.

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    • "The current demographics of who attends medical school and subsequently becomes medical doctors are one such case. Having at least one parent who is a medical doctor or coming from a family with a high income have been shown in numerous studies to be significant predictors of having a high interest in and/or actually becoming a MD; Antony, 1998; Barr, Gonzalez, & Wanat, 2008; Pascarella, Brier, Smart, & Herzog, 1987). In 2005, 75% of entering medical students in U.S. medical schools came from families in the top two highest income quintiles (Jolly, 2008). "
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    ABSTRACT: Interview, survey, and academic transcript data with a diverse sample of first-generation college (FGC) and continuing generation college (CGC) premedical intended emerging adults are analyzed to study academic outcomes and any differences in the availability and use of social capital the first year of college. CGC students know many people with college degrees including those in careers they aspire to obtain, while FGC students do not. All students identify parents as very important forms of social capital who contribute to their success in college, but the types of support differs by educational background. Students whose parents have at least a bachelor’s degree (CGC) are “pulled” through their first year with specific advice from their parents about how to succeed in college, while FGC students are “pushed” by their parents with support. In addition, CGC students display evidence of enacting Lareau’s concept of concerted cultivation, being much more likely than FGC students to approach and gain assistance from professors, openly critiquing those professors and classes in which they are not doing well and showing a sense of entitlement to and confidence in their ability to stay on the premedical track, even when receiving low test scores.
    No preview · Article · May 2015 · Journal of Adolescent Research
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    • "Anecdotal evidence and small-scale studies have identfed several course-related factors that may explain why students lose their interest in STEM programs, including negatve experiences encountered in gatekeeper or introductory math and science courses; limited exposure to STEM coursework in the frst 2 years in college; and poor performance in STEM courses, especially relatve to performance in non-STEM courses (Betnger, 2010; Barr, Gonzalez & Wanat, 2008; Mervis, 2010; Ost, 2010; Rask, 2010; Seymour, 2001; Seymour & Hewit, 1997; Stnebrickner & Stnebrickner, 2011). These fndings, however, have not been validated using natonally representatve data. "

    Preview · Article · Mar 2015
    • "The few existing empirical premedical studies focus on the premedical academic experience. These studies examine issues such as: whether premedical academic performance is a good predictor of medical school performance (Caplan et al., 1996; Mitchell, 1990); how premedical students select courses; whether these decisions affect their chances of admission to medical school (Creditor and Creditor, 1982; Dornbush et al., 1987; Maguire, 1999); and how negative academic experiences, particularly performance in difficult " weeder " courses, can lead underrepresented minority and women students to leave the premedical track (Barr et al., 2008, 2010; Lin et al., 2013). A few foundational studies look beyond the academic experience of the premedical years to document and explain the utility of a " cutthroat " premedical stereotype (Conrad, 1986; Hackman et al., 1979; Sade et al., 1984). "
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    ABSTRACT: How does a lay person become a doctor? How is a physician made? These questions have been central to work of medical sociologists for well over a half-century. Despite this abiding focus on socialization, nearly all of the literature on this process in the US is informed by studies of the medical school and residency years, with almost no empirical attention paid to the premedical years. Our study addresses this gap in knowledge. To better understand the premedical years we conducted 49 in-depth interviews with premedical students at a selective, public Midwestern university. We found that students understand and explain decisions made during the premedical years with narratives that emphasize the qualities of achievement-orientation, perseverance, and individualism. We also find that these qualities are also emphasized in narratives employed to account for the choice to collaborate with, or compete against, premedical peers. Examination of premedical narratives, and the qualities they emphasize, enriches our understanding of how premedical education shapes a physician's moral development, and underscores the need to include the premedical years in our accounts of “becoming a doctor.”
    No preview · Article · Oct 2014 · Social Science & Medicine
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