Rationales for expanding minority physician representation in the workforce: a scoping review.

Objectives: The purpose of this study was to conduct a scoping review of the literature and to categorically map a 15‐year trajectory of US undergraduate medical education rationales for and approaches to expanding under‐represented minority (URM) physician representation in the medical workforce. F...

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Publicado en:Medical Education Vol. 52; no. 9; pp. 925 - 936
Autores principales: Kelly‐Blake, Karen, Garrison, Nanibaa’ A., Fletcher, Faith E., Ajegba, Brittany, Smith, Nichole, Brafford, Morgann, Bogdan‐Lovis, Elizabeth
Formato: research systematic review tables/charts Journal Article
Publicado: Wiley-Blackwell Sep2018
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Rationales for expanding minority physician representation in the workforce: a scoping review.
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        au:
          Kelly‐Blake, Karen
          Garrison, Nanibaa’ A.
          Fletcher, Faith E.
          Ajegba, Brittany
          Smith, Nichole
          Brafford, Morgann
          Bogdan‐Lovis, Elizabeth
        affil: Center for Ethics and Humanities in the Life Sciences, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
      sug:
        subj:
          Workforce
          Education, Medical United States
          Physician's Role
          Minority Groups
          Human
          Systematic Review
          Scoping Review
          United States
          Comparative Studies
          Cochrane Library
          ERIC Database
          Psycinfo
          PubMed
          Schools, Medical
          Physician-Patient Relations
          Affirmative Action
      ab: Objectives: The purpose of this study was to conduct a scoping review of the literature and to categorically map a 15‐year trajectory of US undergraduate medical education rationales for and approaches to expanding under‐represented minority (URM) physician representation in the medical workforce. Further aims were to comparatively examine related justifications and to consider international implications. Methods: From 1 June to 31 July 2015, the authors searched the Cochrane Library, ERIC, PsycINFO, PubMed, Scopus, Web of Science and Google Scholar for articles published between 2000 and 2015 reporting rationales for and approaches to increasing the numbers of members of URMs in undergraduate medical school. Results: A total of 137 articles were included in the scoping review. Of these, 114 (83%) mentioned workforce diversity and 73 (53%) mentioned concordance. The patient–physician relationship (n = 52, 38%) and service commitment (n = 52, 38%) were the most commonly cited rationales. The most frequently mentioned approaches to increasing minority representation were pipeline programmes (n = 59, 43%), changes in affirmative action laws (n = 32, 23%) and changes in admission policies (n = 29, 21%). Conclusions: This scoping review of the 2000–2015 literature on strategies for and approaches to expanding URM representation in medicine reveals a repetitive, amplifying message of URM physician service commitment to vulnerable populations in medically underserved communities. Such message repetition reinforces policies and practices that might limit the full scope of URM practice, research and leadership opportunities in medicine. Cross‐nationally, service commitment and patient–physician concordance benefits admittedly respond to recognised societal need, yet there is an associated risk for instrumentally singling out members of URMs to fulfil that need. The proceedings of a 2001 US Institute of Medicine symposium warned against creating a deterministic expectation that URM physicians provide care to minority populations. Our findings suggest that the expanding emphasis on URM service commitment and patient–physician concordance benefits warrants ongoing scrutiny and, more broadly, represent a cautionary tale of unintended consequences for medical educators globally.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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