Minority and low-income students benefit from postbaccalaureate premedical programs

Kevin Grumbach, MD -----

Postbaccalaureate premedical programs are a valuable tool for increasing the number of disadvantaged and underrepresented students who matriculate into medical scho
ol, according to a study by researchers at the University of California, San Francisco. 

The study is the first of its kind to use rigorous scientific methods to evaluate whether postbaccalaureate programs are an effective strategy to help address the lack of racial and ethnic diversity in the physician workforce. Study findings strongly support the premise that this type of educational program is a positive and important intervention that furthers the academic achievement and health career aspirations of minority and low-income youth. 

The study appears in the September 6, 2006 issue of the “Journal of the American Medical Association.”

Postbaccalaureate premedical programs, which mostly enroll college graduates who have previously applied unsuccessfully for admission to medical school, provide preparation in studying, test-taking and medical school applications, as well as opportunities for clinical and research experiences. More than 75 academic institutions in the United States offer non-degree postbaccalaureate premedical programs. 

“A racially and ethnically diverse physician workforce is important for increasing access to care for underserved populations and improving the cultural competence of the workforce,” said lead author Kevin Grumbach, MD, professor and chair of the UCSF Department of Family and Community Medicine and chief of the Family and Community Medicine Service at San Francisco General Hospital Medical Center.

“Unfortunately, the face of medicine bears little resemblance to the racially diverse profile of the nation’s population. African Americans, Latinos and Native Americans comprise more than 25 percent of the US population, but only 7 percent of the nation’s physicians,” he added.

Postbaccalaureate programs rely on funding from a variety of sources, including federal and state governments, private foundations and sponsoring institutions.  According to the US Health Resources and Services Administration, federal funding of the Title VII Health Careers Opportunity Programs (an important funding source for many postbaccalaureate premedical programs) decreased from $35.6 million in 2005 to only $4.0 million in 2006, an 89 percent reduction.

“We found that minority and disadvantaged students who participated in UC postbaccalaureate programs were 3 times more likely to gain admission to medical school than comparable students who did not participate in these programs,” said Grumbach. “It is alarming that in the past year the federal government has virtually eliminated funding for these types of pipeline programs for disadvantaged students, when we now have solid evidence of the effectiveness of these programs and the need is so great.”

In the retrospective study, Grumbach and Eric Chen, MPH, project analyst in the UCSF Department of Family and Community Medicine, assessed postbaccalaureate premedical programs from 1999 through 2003 at the five UC medical schools: Davis, Irvine, Los Angeles, San Diego and San Francisco. The schools have similar admissions standards and curriculum, and they target disadvantaged students from California who meet minimum academic requirements. Each school gives additional preference to students who express a strong interest in practicing medicine in underserved communities. 

The authors compared a sample of 265 students who were accepted into a UC postbaccalaureate premedical program to a control group of 396 college graduates who had applied to the same programs but were denied admission. The characteristics compared included gender, age, undergraduate degrees, parental education levels, race/ethnicity, cumulative college grade point average (GPA), and medical college admission test (MCAT) score at the time of applying to the postbaccalaureate program.

Nearly 50 percent of students participating in UC postbaccalaureate programs came from homes in which the highest level of parental education was no greater than high school, and 66 percent identified themselves as African American or Latino. The researchers followed the students for several years to determine how many in each group eventually were admitted to and enrolled in medical school.

While the average baseline MCAT scores and other characteristics of the postbaccalaureate participants and controls were relatively similar, 67.6 percent of program participants had matriculated into medical school by the year 2005 compared to only 22.5 percent of the non- participant control group. This large difference in matriculation rates persisted when the researchers used statistical methods to account for the small differences in underlying characteristics between the participants and controls, such as the slightly higher average college GPA among participants.
The study also revealed that by 2005, 91 percent of the postbaccalaureate program participants who had matriculated into medical school during 2000 and 2001 had successfully graduated. “This high graduation rate indicates that once in medical school, these students do very well and almost all successfully enter the medical workforce.” added Grumbach. “These programs make a real difference, and society benefits.”

The study was supported by a grant from the Bureau of Health Professions, Health Resources and Services Administration.

UCSF is a leading university that consistently defines health care worldwide by conducting advanced biomedical research, educating graduate students in the life sciences, and providing complex patient care.