BIOMEDICAL RESEARCH POLICY COMMITTEE REPORT WAS PUBLISHED AS A SUPPLEMENT TO THE AUGUSTJOURNAL OF MEDICAL EDUCATION. A REPRINT IS ENCLOSED. REQUESTS FOR ADDITIONAL COPIES SHOULD BE ADDRESSED TO THISOFFICE. -COPIES ARE BEING SENT TO MEMBERS OF CONGRESS AND THE KEY MEMBERS OF THE ADMINISTRATION. CALLING UPON-YOUR SENATORSAND CONGRESSMEN TO TELL THE STORY OF THE ROLE. OF MEDICAL SCHOOLS IN BIOMEDICAL RESEARCH AND HEALTH CARE IS IMPORTANT.I STRONGLY URGE THAT YOU MAKE AN 411 APPOINTMENT TO SEE YOUR CONGRESSIONAL REPRESENTATIVES WHILE YOU ARE IN WASHINGTON FOR THE COUNCIL MEETINGON OCTOBER 29. UPON REQUEST WE CAN SUPPLY THE NAMES OF APPOINTMENT SECRETARIES AND PHONE NUMBERS OF YOUR SENATORS AND CONGRESSMEN. APPROPRIATIONS COMMITTEE ACTED WITH EXTRAORDINARY ALACRITY THIS YEAR. THE-NIH APPROPRIATION WAS INCREASED BY 242 MILLION DOLLARSOVER 1971, REPRESENTING A 142 MILLION DOLLAR INCREASE OVER. THE ADMINISTRATION BUDGET, THE BLUE SHEET ASCRIBES APPROPRIATIONS OUTCOME TO THE EFFECTIVENESS OF THE COALITION FOR HEALTH FUNDING UNDER THE LEADERSHIP OF JOHN A. D. COOPER.

The Association of American Medical Colleges

Context Many medical schools assert that a racially and ethnically diverse student body is an important element in educating physicians to meet the needs of a diverse society. However, there is limited evidence addressing the educational effects of student body racial diversity. Objective To determine whether student body racial and ethnic diversity is associated with diversity-related outcomes among US medical students. Design, Setting, and Participants A Web-based survey (Graduation Questionnaire) administered by the Association of American Medical Colleges of 20112 graduating medical students (64% of all graduating students in 2003 and 2004) from 118 allopathic medical schools in the United States. Historically black and Puerto Rican medical schools were excluded. Main Outcome Measures Students' self-rated preparedness to care for patients from other racial and ethnic backgrounds, attitudes about equity and access to care, and intent to practice in an underserved area. Results White students within the highest quintile for student body racial and ethnic diversity, measured by the proportion of underrepresented minority (URM) students, were more likely to rate themselves as highly prepared to care for minority populations than those in the lowest diversity quintile (61.1 % vs 53.9 %, respectively; P<.001; adjusted odds ratio [OR], 1.33; 95% confidence interval [Cl], 1.13-1.57). This association was strongest in schools in which students perceived a positive climate for interracial interaction. White students in the highest URM quintile were also more likely to have strong attitudes endorsing equitable access to care (54.8% vs 44.2%, respectively; P<.001; adjusted OR, 1.42; 95% Cl, 1.15-1.74). For nonwhite students, after adjustment there were no significant associations between student body URM proportions and diversity-related outcomes. Student body URM proportions were not associated with white or nonwhite students' plans to practice in underserved communities, although URM students were substantially more likely than white or nonwhite/ non-URM students to plan to serve the underserved (48.7% vs 18.8% vs 16.2%, respectively; P<.001). Conclusion Student body racial and ethnic diversity within US medical schools is associated with outcomes consistent with the goal of preparing students to meet the needs of a diverse population.

Student Body Racial and Ethnic Composition and Diversity-Related Outcomes in US Medical Schools. Commentary

The achievement gap is a disparity in academic and standardized test performance that exists between White and underrepresented minority (URM) students that begins as early as preschool and worsens as students progress through the educational system. Medical education is not immune to this inequality. URM medical students are more likely to experience delayed graduation and course failure, even after accounting for science grade point average and Medical College Admission Test performance. Moreover, URM students are more likely to earn lower scores on licensing examinations, which can have a significant impact on their career trajectory, including specialty choice and residency competitiveness. After the release of preliminary recommendations from the Invitational Conference on USMLE Scoring (InCUS) and public commentary on these recommendations, the National Board of Medical Examiners and Federation of State Medical Boards announced that the United States Medical Licensing Examination (USMLE) Step 1 would transition from a 3-digit numeric score to pass/fail scoring. Given that another of InCUS's recommendations was to "minimize racial demographic differences that exist in USMLE performance," it is paramount to consider the impact of this scoring change on URM medical students specifically. Holistic admissions are a step in the right direction of acknowledging that URM students often travel a further distance to reach medical school. However, when residency programs emphasize USMLE performance (or any standardized test score) despite persistent test score gaps, medical education contributes to the disproportionate harm URM students face and bolsters segregation across medical specialties. This Perspective provides a brief explanation of the achievement gap, its psychological consequences, and its consequences in medical education; discusses the potential effect of the Step 1 scoring change on URM medical students; and provides a review of strategies to redress this disparity.

Admissions Is Not Enough: The Racial Achievement Gap in Medical Education

Current Views on the New United States Medical Licensing Examination Step 1 Pass/Fail Format: A Review of the Literature.

BackgroundUnited States Medical Licensing Examination (USMLE) Step 1 will transition to pass/fail score by 2022. We aim to investigate US medical students’ perspectives on the potential implication...

Implications of the United States Medical Licensing Examination Step 1 Examination Transition to Pass/Fail on Medical Students Education and Future Career Opportunities.

Three-digit United States Medical Licensing Examination (USMLE) Step 1 scores have assumed an outsized role in residency selection decisions, creating intense pressure for medical students to obtain a high score on this exam. In February 2020, the Federation of State Medical Boards and the National Board of Medical Examiners announced that Step 1 would transition to pass/fail scoring beginning in 2022.The authors discuss the potential advantages and disadvantages of the pass/fail scoring change for underrepresented-in-medicine (UiM) trainees. UiM students may benefit from this change because it reduces the effect of an inequitable exam; helps correct for students who attend medical schools with a curriculum heavier on nontested formative elements; and decreases stress, improves quality of life, and undermines imposter syndrome. However, this change may also precipitate unforeseen challenges, such as increased discrimination toward UiM trainees, an increase in high-stakes test failures due to a reduced focus on preparing for standardized exams, or the development of new (e.g., subject exams) or overreliance on existing (e.g., school ranking) metrics that would make UiM residency candidates less competitive.To enhance UiM representation in the future health care workforce, it is imperative that national organizations (e.g., accrediting, licensing, regulatory, professional, honor, student, and faculty), hospitals, residency programs, and patient advocacy groups undertake a shared, rigorous approach in assessing the impact of the pass/fail scoring change on UiM applicants' selection to specialty and subspecialty residencies.

Anticipating the Impact of the USMLE Step 1 Pass/Fail Scoring Decision on Underrepresented-in-Medicine Students.

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Anticipating the Impact of the USMLE Step 1 Pass/Fail Scoring Decision on Underrepresented-in-Medicine Students.