In this episode of Cobb & Company, recorded live at the National Medical Association Annual Convention and Scientific Assembly in New York, Dr. Randall Morgan, President and CEO of the W. Montague Cobb Health Institute, sits down with Dr. Geoffrey Young from the Association of American Medical Colleges (AAMC). They discuss the AAMC's new strategic action plan aimed at diversifying the healthcare workforce.
Dr. Young, who leads the AAMC’s Transforming the Healthcare Workforce portfolio, shares insights into the organization's efforts to engage younger learners, particularly those from historically marginalized communities, in pursuing careers in healthcare. He highlights the importance of establishing pathway programs, developing educational resources, and fostering community partnerships to create a more inclusive healthcare workforce.
Additionally, Dr. Young and Dr. Morgan delve into the challenges and opportunities within K-12 education, the role of community colleges, and the critical need for academic health centers to engage with their local communities. They also discuss the impact of the recent Supreme Court decision on diversity, equity, and inclusion initiatives in medical education.
Tune in to learn about innovative strategies, successful programs, and the ongoing efforts to ensure that the future healthcare workforce is diverse, well-prepared, and capable of meeting the needs of all communities.
Dr. Young leads the Transforming the Health Care Workforce portfolio, an extension of his responsibility leading the AAMC’s Strategic Action Plan 4, which seeks to diversify the health care workforce.
His portfolio’s work is focused on the education, professional development, and wellness of future health care workers and on creating viable pathways for historically marginalized communities to enter the health care profession.
Focus areas include disseminating research and data that provide insights on trends, structural inequities, and institutional culture that impact the diversity of the health care workforce and scanning the full medical education continuum to highlight promising practices, leverage points of intersection, and inform resource development that support innovations to UME and GME.
His team is also recognized as a leader in holistic review in selection and pre-medical and applicant resources, providing inspiration, resources, data, and tools so that anyone can aspire to a career in medicine.
Before joining the AAMC in 2011, Geoffrey served in leadership positions in medical school admissions and student affairs at Rutgers University-Robert Wood Johnson Medical School, Virginia Commonwealth University School of Medicine, and the Medical College of Georgia at Augusta University. Dr. Young earned his B.A. from Hampton University and his M.A. and Ph.D. in clinical psychology from the Ohio State University.
Randall C. Morgan, Jr., MD, MBA, is the President and CEO of the W. Montague Cobb/NMA Health Institute based in Washington, D.C. In that role he leads a staff of scholars and research specialists who focus upon the elimination of Health Disparities. He is also an active orthopedic surgeon who has practiced in Sarasota and Bradenton, Florida since 2005. He serves as founder and President of University Park Orthopedics in that community. He is also Clinical Associate Professor of Orthopedic Surgery at Florida State School of Medicine and is also a Clinical Associate Professor in the Department of Community Medicine at the University of Connecticut. He is a graduate of Grinnell College with a B.A. in Chemistry. He received the M.D. degree from Howard University. He served as a resident in Orthopedic Surgery at Northwestern University and served a Pediatric Orthopedic Fellowship at Children’s Hospital in Cincinnati. He later received an MBA degree from the University of South Florida.
Dr. Morgan served as the 95th President of the Nat
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Transcript
Episode Transcript
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(00:01):
For the first time, the AAMC has embraced the need to think about how we can
better have impact in that K-12 space.
And again, encouraging our member schools to be thinking differently about how
they show up in their communities.
The AAMC established a new strategic plan, and that plan includes 10 action
(00:26):
plans. And I was asked to lead one of them, looking at ways in which we can
diversify the health care workforce.
The Pathway community, the administrators, needed a place where they could come
together and basically talk.
So we've created a virtual community that's dedicated to those working to enhance
(00:49):
opportunities for our young learners.
And so what we want to do is that we want to develop and enhance external relationships
and leverage those relationships to co-create and contribute to initiatives
that include professional development toolkits and other resources and interventions.
(01:10):
Having a student that has attended a community college may be viewed less valuable
than someone that has not. So we have to address some of the biases that we
have within our own admissions processes.
We're not going to really be able to diversify the healthcare workforce until
(01:31):
we start doing things differently.
Music.
Welcome to this episode of Cobb & Company, the podcast of the W.
Montague Cobb Health Institute that is being recorded live at the National Medical
Association Annual Convention and Scientific Assembly in New York. I am Dr. Randall Morgan.
(01:57):
I'm the president and the CEO of the Cobb Institute, and I was one of the students
fortunate enough to attend Dr.
Cobb's lectures at Howard University, where he was our distinguished professor
of anatomy. We are delighted if this podcast series serves as your introduction to Dr.
Cobb. He was both a historian of medicine and a history maker.
(02:22):
Over the coming months, we will be featuring thought leaders in areas such as
health equity and initiatives, increasing diversity in the health care workforce. force.
Today, it's my great pleasure to welcome Dr.
Jeffrey Young from the Association of American Medical Colleges to the podcast.
(02:44):
Thank you for having me. I'm very excited to be here. Dr.
Young leads the Transforming the Healthcare Workforce portfolio,
an extension of his responsibility leading the AAMC's Strategic Action Plan
4, which seeks to diversify the healthcare workforce. force.
His portfolio's work is focused on the education,
(03:08):
professional development, and wellness of future health care workers and on
creating viable pathways for historically marginalized communities to enter
the health care profession.
Focus areas include disseminating research and and data that provide insights on trends,
(03:29):
structural inequities, and institutional culture that impact the diversity of
healthcare workforce and scanning
the full medical education continuum to highlight promising practices,
leverage points of intersection,
and inform resource development that support innovations to UME and graduate medical education.
(03:54):
His team is also recognized as a leader in holistic review and selection and
pre-medical and applicant resources, providing inspiration.
Resources, data, and tools so that anyone can aspire to a career in medicine.
Before joining the AAMC in 2011, Dr.
(04:18):
Young served in leadership positions in medical school admissions and student
affairs at Rutgers University,
Robert Wood Johnson Medical School, Virginia Commonwealth University School
of Medicine, and the Medical College of Georgia, Augusta University.
Dr. Young earned his B.A. from Hampton University and his M.A.
(04:41):
And Ph.D. in clinical psychology from the Ohio State University. Yes, the.
Does that get it, Dr. Young? That was perfect, Dr. Morgan. Thank you so much.
So I have a grandson that's entering the Ohio State University in about a week.
Okay, congratulations.
Yes, thank you very much. But I've been totally schooled on that university.
(05:05):
Yeah, I always say the myself because I'm fearful that they'll come and try
to take my degree back. Yeah. You have to say the, so.
Well, I grew up in Indiana, so we were on the poor side of the football team most of the time.
When Ohio State came to Indiana to play, it was usually kind of rough for Indiana.
(05:26):
The AAMC has been an organization that has meant a lot to me during my tenure
of leadership with the National Medical Association.
And I did serve as the president of the NMA in 1996 and 1997.
And I was very much influenced by Jordan Cohen. And he, in fact,
(05:50):
was one of my presidential awardees at the convention in Hawaii in 1997, this very convention.
And the Project 3000 by 2000 effort that was going on at the time was a significant
part of my presidency. So...
(06:12):
I've always been, of course, very impressed with the work of AAMC,
and now more than ever, as we need to understand data, it's so important.
So I'm sure you will share some of that with us.
But to get to our discussion today, can you describe for us your role at AAMC?
(06:34):
Sure. I'm happy to do that.
I've been at the AAMC, again, since 2011. When I started my career there,
I was hired really as a subject matter expert in student affairs services.
So that would be student affairs, admissions, student diversity affairs,
records, and financial aid.
(06:54):
And I also worked very closely then with the Group on Student Affairs,
as well as with the Organization of Student Representatives.
So, again, very focused on working with administrators that work closely with learners,
medical students, from recruitment through graduation and preparing them for
(07:17):
that transition to residency.
In 2020, the AAMC established a new strategic plan, and that plan includes 10 action plans.
And I was asked to lead one of them, and that is looking at ways in which we
can diversify the healthcare workforce. force.
(07:40):
And so in doing that, we have been working, you know, for the past really four
years doing a lot of listening,
meeting with learners from historically marginalized communities.
Working and listening to their needs.
(08:01):
And so what we've learned over the course of the past four years is the importance
of establishing new relationships in order to to really address the lack of
diversity within medical education specifically.
Let me just also say that that part of our work has been focused on addressing
(08:27):
the needs of our younger learners and and that is the k-12 space.
And in doing that, we've had the opportunity to talk with K-12 educators.
We had a summit, Pathway Education Summit, in 2023, where we brought together
(08:48):
administrators of NK-12 education, medical schools. We had federal agencies represented.
We had various pathway program schools talk about their work. And what we learned, Dr.
Morgan, is that everyone really wants to address this issue,
but we're doing it in silos.
And so part of our work is trying to think about ways in which we can bring
(09:13):
these voices together in order to try to really impact or increase the diversity
of those that are historically marginalized.
What would be the definition of the healthcare workforce in this scenario?
Yeah, that's a great question.
So, specifically for the AAMC, we're looking at medicine, right?
(09:36):
Really, how do we provide information, access, education about the pathways to medicine?
So, that's, from my standpoint, that is key.
I think the secondary gain, though, is if we are able to help a learner,
(09:57):
and again, when I say learner, I'm really talking further up, you know, younger.
If they decide that they want to be a dentist, if they decide they want to be
a nurse, if they decide they want to be more more technical within the health care workforce.
(10:17):
I have no problem with that because, again, I think we need diversity within all of those sectors.
And as you have interacted with K-12 programs,
which is something that I've been interested in even since my early days in
private practice where I was in Gary for 20, 30 years in orthopedics,
(10:41):
and, of course, that's where I grew up.
And my fourth grade teacher, when I went back, was in charge of gifted education for the city of Gary.
And so she was very interested in developing a pathway, pipeline program,
if you will, primarily looking at high school students in four different areas,
(11:02):
medicine, dentistry, law, and engineering. Erie.
And so I was actually helped to put that program together. And for over 20 years, we had that program.
Sadly, we didn't get the data that we should.
So I have a lot of, you know, information that is not as complete as it should be.
(11:23):
But the influence on the K through 12.
Primarily in this case, would be the secondary school student,
was immense having the Saturday opportunities for six to eight weeks and having
a chance to visit and to meet doctors, engineers, and, you know, in their space.
What have you found in terms of existing K-12 programs,
(11:50):
that seems to maybe be the most effective and the one that we could have the most confidence in.
So what we've learned, what I've learned, is that, first, many of our member
medical schools have pathway programs.
And so when I was at Robert Wood Johnson, when I was at the Medical College
(12:15):
of Georgia, working in the dean's office, those schools, those medical schools, had pathway programs.
So, we know that many of our member institutions have pathway programs that
may focus on high school, college.
Some may actually go further upstream and maybe have work with middle school age kids.
(12:40):
So, they exist. And so I think part of the issue is that while those programs,
in my humble opinion, are effective and can be more effective,
we have to really start thinking a little differently about how we integrate
some of the resources and the educational benefits within the actual curriculum in K-12 education.
(13:08):
So, just as an example, the AAMC, for as long as I've been there,
we recognize the importance of supporting pathway programs.
We have a very successful program ourselves that attracts students interested
in medicine, dentistry, public health, and that's a very successful program.
(13:28):
What we need to do, though, is to
basically provide information and resources to school systems and or those organizations
that live in the space of interacting with educators to basically share the resources,
(13:51):
talk about the critical competencies for medicine. Right.
And embed that so it doesn't become sort of just an eight-week or six-week, which is important.
But a student will potentially,
if a teacher knows, oh, I didn't realize that this particular lesson plan could
(14:14):
also be shaped to talk about health literacy or potentially becoming a physician
or a healthcare provider, wider,
then we have to embed that. So I think that's important.
It's a key point. Yeah. It's not one that is often appreciated.
Right. Thank you for that. And that's what we're learning. That's one of the things.
(14:38):
And the other piece that I think is important is that we have to engage the community.
So, it's good to expose a child to information.
It's wonderful when a physician of color can come and talk about his or her
(15:00):
path to medicine, because that, you know, I believe if you see one,
you can believe that you can be one.
That's really important. I think it's equally important, though,
that an educator be thinking about, wow, how might this lesson plan,
recognizing that there are national standards or whatever,
(15:22):
how might I build upon this in a way that may advance the workforce? force.
Have there been materials developed for broad dissemination in K through 12 so that.
The majority of these teachers are science teachers or advisors who really don't
(15:45):
have a good sense of what students need to do to get into competitive schools
like medicine, dentistry.
Is there more information that's being provided for them so they're just not
riding by the seat of their pants, so to speak? Right.
I would say we, the AAMC, what we're doing currently is developing relationships with organizations,
(16:11):
national organizations that actually are in, say, most of them are high school,
and they have access to educators.
And so we're working with them with the idea of sharing specific information
and the key competencies needed for medicine that can then potentially be shared
(16:33):
within that educational environment.
One of the things that we're also doing is, for the first time,
the AAMC has embraced the need to think about how we can better have impact in that K-12 space.
And again, encouraging our member schools to be thinking differently about how
they show up in their communities.
(16:55):
Many of our academic health centers are located in underserved communities,
and I think that they can be doing more.
So we're in the process. We've just actually hired, about two months ago,
a director of K-12 education initiatives.
And he is an experienced educator as well as administrator.
(17:18):
And we are working very closely with him to better understand the landscape of K-12 education.
And we are currently working or finalizing.
Key competencies that would be necessary for a pre-med.
(17:38):
We've translated that into language that a middle schooler could understand.
And so we're going to be developing or finalizing those resources so that we
can then push that out to those that would benefit from that.
So those are just some of the things that we're doing.
The work that AAMC does is authentic. It tells exactly the story.
(18:06):
It's totally up to date in terms of the requirements for achievement of students
in order to matriculate successfully in medical school.
And I would say that the more of this material that you just spoke of that is made available,
(18:26):
the deeper that it could be made available and the earlier that it could be made available.
Seventh graders, you know, seventh and eighth grade science. Right.
Where the teachers don't have to really try to make up the script.
Exactly. It's already there. And
so I'm just thinking about ways that that could happen in the communities and
(18:52):
maybe through our National Medical Association local societies where you have
a number of people that have family members or spouses that are teaching.
They're in the education system. And they'll make sure that that gets there
because so much of this material, this good material, sits on the shelf and people don't read it.
(19:18):
Or those of us who, for instance, are like our group of Bule members in Sarasota.
We have a very, very extensive mentoring program in three high schools in Sarasota.
And we also have a couple of middle schools that we've begun to do more work in.
(19:41):
And I've spoken to students about careers in health care and not just,
you know, medicine, because you lose a lot of them if that's the only point
that you're really making.
And so, because of that,
I think that if we could come up with some system of mass distribution where
(20:08):
every seventh grader would get certain information about the career described by AAMC,
that it would really help a number of schools that have no idea about how to advise.
That's exactly right. And that's ultimately what we hope to do.
(20:29):
What we hope to do is to create the resources and then provide them to a range
of users, potential users,
in education, in the community.
We've talked about the importance of, you know, Divine 9.
(20:49):
I mean, the whole spectrum that we just need to try to maximize the impact of
getting resources in the hands of those that have influence and can share that information.
And we're also thinking about we don't want anyone to have to create something from scratch.
So we want to provide various templates and ways in which they can do this work.
(21:13):
So it's not an add-on. It's just an included.
Okay. And so that's some of the things that we're doing.
You said a couple of other things that I think I just really wanted to share with you.
And what we've learned from our
time in listening and meeting with educators and
learners is that ideally what we need to be thinking about is how might we create
(21:41):
structured curricula between K-12 and college universities integrating health
career preparation and academic coursework?
Because you have to be academically prepared to do that.
We've also thought about how might we be able to create experiential partnerships
where students can gain clinical research, clinical and research experiences.
(22:07):
Again, that's critical to that pathway.
As we've talked about previously, is we also recognize that there's a need to
develop toolkits for academic health centers to facilitate engagement with school districts.
And then also really thinking about how might our academic health centers and
(22:30):
our medical schools really provide protected time for faculty and clinicians
to engage in K-12 education.
We think those are all really important. And then I'll say the final thing that
we heard consistently is that medical schools really need to be active in the
communities, listening to learners, parents,
(22:52):
educators, and education administrators.
So that's part of what our message is. And we, again, recognize that we can't do this by ourselves.
Our expertise is sort of in In that pre-med space, you and me,
undergraduate medical education, helping then the learner with that transition
to residency and then beyond.
(23:13):
So to be able to really work in the area of K-12 education, for me,
could be a real game changer. Well, I agree with you wholeheartedly.
And also, I think that you have information about how people progress through
(23:34):
medical education and why people don't progress successfully through medical education.
Is that being packaged in such a way that it can be shared earlier and by those
of us who are mentoring to just even emphasize certain points or maybe emphasize
(23:54):
certain points to the chemistry teacher who's in the community that seems to be interested? Yes.
Yeah. So that's an issue, right? And so the AAMC has a tremendous amount of data.
And so data, research and data analysis is a core area of the work that we're doing at the AAMC.
(24:16):
So just as an example.
You know, we've looked at the value, if you will, air quotes, of community college.
We know that many of our learners or diverse learners may start at community
college for multiple reasons before they go to a four-year college and get their degree.
What we've learned, though, is that in the admissions process of medical school,
(24:43):
having a student that has attended a community college may be viewed less valuable
than someone that has not.
So we have to address some of the biases that we have within our own admissions processes.
Another fact that we've just really done just really recently,
we have a data snapshot, that's what we call it, where we basically looked at
(25:07):
the number of colleges and universities in this country and then looked at how many of students,
how many students may come from a particular And what we found was that 3%,
3% of all four-year colleges produce 61% of all matriculates in medical education.
(25:33):
So that means roughly about 70 out of 2,300 schools.
And then when we break that down further, what we found is that the most selective
schools basically produce 50% of all matriculants.
So we're talking about a very narrow population.
(25:53):
Now, are we talking underrepresented or the entire? The entire.
The entire applicant pool.
We are actually having conversations about looking at that by race.
So those are the facts that people don't necessarily know about.
Or when I share this with others, they go, really? They're shocked.
(26:14):
But this is the kind of transparency I think that we need.
Well, I think that looking at the data of those who are successful,
underrepresented minority students who are successful in medical school,
and if even a small percentage of them went through community college pathways
(26:36):
and ended up being successful,
That evidence would probably begin to sway people who have sort of implicit
bias toward them because there are a lot of reasons why community colleges are
important, a lot of them now financial,
that the students just clearly can't afford to take the traditional track.
(27:02):
And then maybe sometimes they're able to get scholarships after they've performed.
So it's sort of the yin and the yang because there are a lot of programs now
where they're trying to edify community college education.
And then it would be sad if there was a pushback.
(27:24):
For those who actually were successful in traveling that way.
So what I'd like to kind of do now is just pivot to the reason you're here,
besides coming to see New York and go to a play or two or whatever.
But we at the Cobb Institute have a symposium tomorrow, which is a very important
(27:45):
symposium entitled Then and Now, Navigating Best-in-Class Mentoring Innovation.
The idea was planted by Dr.
Bright when he was chair of the Pathway and Pipeline Committee,
that we should talk about what's working and what isn't working.
And, of course, now we're looking at it through the lens of the Supreme Court
(28:07):
decision of June 2023 as well.
We're so pleased to have AAMC be a part of this discussion.
And, I mean, you've described several pipeline and pathway programs and innovations,
and the two or three that we'll be looking at are those that founded by members
of our board with the Cobb Institute and have been successful,
(28:31):
and they all have been 15-, 20-year programs.
And so that's kind of unique to have programs that were started by these people,
and they're here, and then to also compare them to what's going on in your case with AAMC, Dr.
Bright's case, what's going on in a typical undergraduate or medical school environment.
(28:54):
So we wanted to have a chance to maybe talk to you a little bit more about what
your thoughts are and the comments that you're going to be sharing with us tomorrow,
what you'd like to emphasize,
because we realize we only have a small period of time tomorrow.
And so we want to be able to use our podcast as well to amplify the points that
(29:17):
are being made and give some background.
Yeah, no, that's good. It's a nice pivot, as you indicated.
So, in essence, what I'm going to share tomorrow will really talk about some
of what I've stated already, that we're not going to really be able to diversify
the healthcare workforce until we start doing things differently.
(29:39):
And again, for me and for my team, and that's focused on working with younger learners.
And we also recognize that there are additional things that must be done.
So I'll just, if you don't mind, just sort of tick them off and please feel free to interrupt me.
One of the things that we've learned after, as I stated earlier,
(30:02):
we've been listening a lot to programs and what the needs are within the various communities.
So one thing that we've heard consistently is that there needs to be increased
capacity building for pathway programs. You know, as you indicated,
there are programs that are out there, they're doing the work,
but there may be some challenges.
And so some of the things that we've done at the beginning of this work was
(30:27):
we actually worked with the Morehouse School of Medicine and did a survey of pathway programs,
STEM pathway programs within our member medical school. Again,
just trying to understand the landscape.
We also heard continuously that the pathway community, the administrators,
(30:48):
needed a place where they could come together and basically talk, right?
Think about effective practices and talk about resources and financial support.
So we've created a virtual community that's dedicated to those working to enhance
opportunities for our young learners.
(31:10):
We've also heard very continuously, and this is something that you mentioned, Dr.
Morgan, was that one of the challenges that we've heard continuously is that
our pathway programs have a difficult time monitoring or tracking student outcome data.
And so one of the things that we've done is that we've just launched a pilot.
(31:33):
We call it the AAMC Educational Pathways Network.
That basically is, at this point, it's a longitudinal study that will help the
AAMC understand the current landscape of pathway programs.
Our hope is that it will allow medical schools and pathway program leaders to
(31:54):
access data on students' educational and professional paths.
We think that's really important. I've heard that since, for as long as I've
been in undergraduate medical education, going back to the 90s.
So this is something that we're very, very excited about.
We have also just initiated what we're calling the Minority Serving Institution Pathway Initiative,
(32:16):
which is modeled after the Robert Wood Johnson Foundation Summer Health Professions
Education Program, which is a AAMC in partnership with the AAMC.
We have a pilot grant program that's designed specifically to work with American
Indian and Alaskan Native learners.
Learners and then we've also just received application for a HBCU.
(32:40):
So again, those are things that we're doing at that level. I've talked a little
bit about, so that's one work stream.
The second work stream, and please interrupt me if you need to,
is the K-12 initiatives.
And I've talked a lot about that. And this work really is designed to advance
our goal of improving the K-12 pathway to healthcare professions for learners from,
(33:07):
again, historically marginalized communities.
And so what we want to do is that we want to develop and enhance
external relationships and leverage those relationships to co-create and contribute
to initiatives that include professional development toolkits and other resources
and interventions that can be used to support learners and their support systems and educators,
(33:33):
because I think the support system is so critical, and that could be mentorship, it could be family.
And I also mentioned that we're also working with,
various organizations that have access to younger learners and educators so
we're working with the national academy foundation academy's career and medical
(33:53):
i'm sorry medicine resources,
and we're also working with hosa future health professions health education
in that space the third area that we're focused on is resources and tools for
for learners and again those that that support them.
And so this is the reference that I made earlier, Dr.
Morgan, when I talked about, we have in essence translated the 17 pre-med competencies for medicine.
(34:24):
Into language that would be applicable to middle schoolers.
And so our goal is to really increase that awareness in careers of medicine
and then provide information about steps needed to pursue a career directly and indirectly.
So when we talk about the NMA-AMC collaborative, where do these action steps fit?
(34:53):
Yeah, so the collaboration, the action collaborative between the AAMC and the
NMA is one element of the,
one part of the six-pronged wheel. if you will.
This is work that was initiated by colleagues in the relationship between NMA
(35:15):
leadership and our equity, diversity, and inclusion unit.
And so the work of the AC is really focused on Black men.
And so I know that Dr. Bright will talk about this a little bit more tomorrow,
but we've identified key areas in addressing the lack of Black men in medicine over many years.
(35:40):
So one is thinking about pre-health advising.
Another is leadership accountability, again, within our medical schools in leadership.
Also about financing and funding, and then support systems, which would be part
of the mentoring work that I think we've been talking about.
(36:05):
So that's where that fits. So it is part of the larger scheme of work.
And I would, just from having attended one session or one series of meetings,
meetings feel that a lot of this information is pretty well verified,
(36:27):
shall we say, and,
getting it out in such form that everybody knows about it, or at least knows the basics.
Even in meetings like this, where.
All of us that attend this meeting are primarily working in our communities.
And so we're ambassadors for medicine, careers in medicine.
(36:51):
And so I think if we're distributing information, you know, that's been vetted
and approved by AAMC and NMA and whichever other, you know, organizations are there.
I would encourage, you know, earlier dissemination of the information,
I guess, is what I'm saying,
because it's really hard to influence what goes on in the community unless you
(37:16):
have some fairly convincing data.
Data and many times there's administrators that
are just not positive about the
ability of their students in their school unfortunately to be able to to do
this and it seems like it is possible i believe it is and if i didn't i i wouldn't
(37:43):
be having this conversation you know with you and,
But again, I think part of what I'm hearing you say, Dr.
Morgan, is that we collectively have to change our approach.
The way I look at this work, and I've described this to some colleagues,
is that, you know, we are trying to connect dots.
There are people that are committed, there are resources, there are folks that
(38:07):
want to do this but don't know where to start.
And so what I like to think about is that we're almost creating a web.
And as we strengthen that web, then my hope is that we're going to be better
able to capture, if you will,
those learners that hadn't
(38:30):
thought about a career in medicine or the health professions or had an interest
but didn't know where to start or provide resources to those mentors that could
be impactful on a young learner's life.
So my hope is that that web is going to be strengthened by the partnerships
(38:52):
that we're establishing now.
Yeah, certainly I feel that as well, and I think that's one of the reasons maybe
for having feedback back and constantly having updates about what actually is going on.
Of course, the different school systems are different as well,
but so many counselors and teachers, I think, feel a bit overwhelmed.
(39:20):
And they don't want to make a recommendation that a family may misconstrue or
take in such a way that it ends up, you know, harming the student.
So there's a bit of reality, a bit of honesty, but also a bit of hope,
you know, that they certainly can and deserve to succeed. Yes.
(39:42):
If I may just sort of piggyback on something that you said, you're right.
We need to be careful about the community's sensitivities to various things.
And so that's why our work, we are consistently talking about the importance
of engaging the local community.
(40:02):
So, just as an example, we are going to have focus groups with communities,
diverse communities within the D.C.
Area that, again, understand what those issues are and ways in which we can
do that. Because, again, it's part of that web, right?
And then the last thing that I'll share about that is I mentioned our new director
(40:25):
for K-12 initiatives, Dr.
Brian Ingram. we have just started working with a group.
Firm that's helping us to think about a change
theory to develop a K-12 education
roadmap so that we can then begin to roll
out to try to think how do we get influencers within the various systems to
(40:51):
potentially think differently about how we can share information and really
think about academic preparedness for those learners interested in pursuing
medicine or fill in the Right.
Well, I'm happy that this is taking place.
I'm happy that the momentum is picking up.
And particularly during this bit of time uncertainty with regard to,
(41:18):
you know, the DEI issues and so forth. But I have no doubt that this is going to be successful.
I just see allies in the National Medical Association that could help even more than we think.
To just share the information that this is happening, that your high school
(41:39):
teacher may be able to apply for a AAMC summer experience or virtual experience or whatever.
Too much information never is, you know, a problem.
Right, right. This is one case where TMI is okay. It's a good thing.
Right. It's a good thing, and we need it because, you know.
(42:02):
Our children, our learners, and some of our educators don't know what they don't know.
Right. And so it's, I think part of it is our responsibility to say, well, now you know.
And how you're going to respond to it. And I think if they have data,
I mean, I keep stressing this, but it's because I think everybody feels more
(42:23):
confident in making a recommendation if you have some data that's creditable data.
Right. And so I think it's, you know, the opportunity is there for this group,
this consortium, to make great changes and improvements.
(42:45):
AAMC has projected a major shortage of physicians by 2036, as many as 86,000.
Well, that's kind of mind-boggling.
Yes, I think it's a complex issue. And so, at one level,
I think the AAMC is very committed to providing or advocating for an increase
(43:09):
in the number of federally supported positions for residency.
So there is a bipartisan legislation that was introduced in Congress,
the Resident Physician Shortage Reduction Act,
and this act would help address the physician shortage by gradually increasing
(43:32):
the number of Medicare-supported residency positions by 14,000 over seven years.
So, that's one element, I think, that we have to continue to seek funding for residency positions.
The other piece that, again, we've been really talking about,
(43:55):
I think, Dr. Morgan, is that.
We have to address the needs of those communities, again, that have historically
been marginalized, to get them in that pathway, right?
And I'm not only just talking about those that, not just talking about race
and ethnicity, but, you know, first generation, thinking about rural learners,
(44:21):
thinking about those with disabilities.
So, again, I think the only way that we can establish that is by doing the things
that we're trying to accomplish to, again,
prepare those younger learners so that if they choose,
they will be academically prepared and have the knowledge and understanding
(44:43):
of what it takes to get to that MD degree.
So, that's how I would answer that question. Well, I think it's an excellent answer.
And I see here this report by Trilliant Health of findings after this current
(45:05):
match day in 2024 showing that family medicine had significantly high amount
of unfilled residency positions.
So, as we're trying to add residency positions, there are a lot of unfilled
residency positions in primarily the primary care specialties.
And how are we looking, what solutions are we implementing to make a difference in those specialties?
(45:35):
And I know some of them are related to work time. Some of them are related to reimbursement.
But what does this mean?
Is this just an outlier, this particular statistic for this particular year?
(45:56):
I mean, there's so many students yet, and unfortunately, many of color who are not matching.
And, you know, what does it say about their experience of their choices,
maybe, in terms of specialties?
Yes. So, again, I'm not familiar with that article, so I just want to be transparent about that.
(46:18):
And any time that a position in any specialty, but I would say, given the context,
primary care ultimately is going to hurt those communities that need both primary
care and specialty physicians.
That it's a problem. And, you know, historically, there are specialties that sort of ebb and flow.
(46:46):
You know, they may be unmatched positions one year, and maybe in three years,
they matched all positions.
I think, you know, again, I'll just go
back to my main thought
here is that we know having a
diverse student body within undergraduate medical education is likely to lead
(47:13):
to better access for communities that are historically underserved,
right, that are medically underserved. So.
Do think that it's it's a
it's a concern i think it's complex i think you
know as you mentioned there are issues with reimbursement there
(47:35):
are issues with and i'm going to say this this may sound me be uh unpopular
or controversial but you know unfortunately i think you know medicine has become
a business and and less focused on really the the care of the patient and so i i think Like,
specialties like family medicine,
(47:56):
like peds, that are really providing the backbone of care,
in my opinion, often doesn't get the necessary resources that it needs.
That's just, I'm not talking as a double AMC person.
I'm talking as, you know, Jeff Young, who has some feelings about that.
(48:18):
But sometimes these reports and things that provide data may be a little skewed.
But I do think that the employment opportunities for physicians may have something
to do as well with specialty choices.
(48:39):
Since everybody's not going and hanging a shingle anymore and starting practice. this.
You are being employed by somebody. Some hospital system is going to employ you.
And I would think as long as that need is shown and.
(49:03):
Importance of those specialties is recognized monetarily, then there's probably
going to be a difference in these figures going forward.
But they are a little bit, you know, counter-current.
And so I think it's just going to be interesting to see all the predictions
(49:24):
and where we end up, and where we're going to end up is going to be nowhere
close to how many physicians we need, whether it's 2036 or 2056,
we're always going to be short.
But doing a better job is what we're trying to do for the most part to serve patients.
(49:45):
So finally, again, we're so pleased that you are serving as one of our key lecturers
or speakers tomorrow for our symposium.
And as you look at how we've laid the symposium out and we've had a couple of
discussions about it in preparation,
(50:08):
what would you hope would be the outcome of the symposium and next steps?
That's a great question. The first word that popped in my mind was empowerment,
recognizing that we collectively, with the appropriate partnerships,
(50:32):
with the level of commitment, we can make impact.
My hope is that the perspectives that the panelists will share might give someone
in the audience an idea or say,
(50:52):
hey, those are very similar kinds of things that we're thinking about.
How might we collaborate?
How do we create, if you will, stronger coalitions in order to,
really achieve and support, well, support the pathway programs that will enable
(51:14):
us to achieve, you know, true workforce diversity?
The other piece is that I hope that that we'll start thinking differently and
come out of our silos and recognize that I think we are stronger together than separate.
(51:36):
I think those are four key points. If we can achieve three of the four, I'll be really happy.
The Cobb Institute has reached 20 years of age and hopefully has a bright future.
But one of the things that we have tried to do is to.
(51:56):
Neck to silos. And so I think your point is well taken.
Several of the programs that we've had in the past four years or so have been
where we've had all the HBCU medical schools together,
talking about issues, whether it's COVID, whether it's this same issue of pipe wide and pathway,
(52:19):
focusing on admissions, but sort of to be the convener, the continual convener.
And in order to do that, you have to have successful outcomes in the programs
that you do or put on or else you have no credibility.
So that's why we're really looking forward to this program as sort of a statement.
(52:44):
You know, last year we looked at the impact of the Supreme Court ruling three
months, two months after the ruling particularly predicting what would happen,
predicting strategies.
Now, a year afterwards, go back and sort of see whether some of those predictions
(53:06):
were in the right space or not.
But in spite of that, how are we going to affect the pathway and the pipeline,
and gain that type of support that we need? eat.
So I appreciate your sharing with us today, and please continue to lift up the Cobb Institute at AAMC.
(53:31):
Whatever we can do to stir the pot, you know, we tend to have a lot of good trouble.
Yeah, good trouble is exactly what we do.
We have a lot of people that have a lot of opinions. Yes. Yes,
but they're informed opinions also.
And so I think that that's important.
(53:51):
We need all of that mixed in to have success. Yeah.
And I want to thank you for your leadership and for your commitment and the
work that you and others have done and continue to do,
thinking about health care of our communities.
(54:12):
It's well I appreciate it you do all this work you keep working keep seeing patients,
sit on this committee do this do that and it's just like it just keeps piling
up and then you look back over your shoulder and say whew,
that's a lot of stuff yeah yes and it's impactful hopefully yep wow alright
(54:37):
thank you thank you so much okay well thank you for having me.
Music.
For the first time, the AAMC has embraced the need to think about how we can
better have impact in that K-12 space.
And again, encouraging our member schools to be thinking differently about how
they show up in their communities.
The AAMC established a new strategic plan, and that plan includes 10 action
(00:26):
plans. And I was asked to lead one of them, looking at ways in which we can
diversify the health care workforce.
The Pathway community, the administrators, needed a place where they could come
together and basically talk.
So we've created a virtual community that's dedicated to those working to enhance
(00:49):
opportunities for our young learners.
And so what we want to do is that we want to develop and enhance external relationships
and leverage those relationships to co-create and contribute to initiatives
that include professional development toolkits and other resources and interventions.
(01:10):
Having a student that has attended a community college may be viewed less valuable
than someone that has not. So we have to address some of the biases that we
have within our own admissions processes.
We're not going to really be able to diversify the healthcare workforce until
(01:31):
we start doing things differently.
Music.
Welcome to this episode of Cobb & Company, the podcast of the W.
Montague Cobb Health Institute that is being recorded live at the National Medical
Association Annual Convention and Scientific Assembly in New York. I am Dr. Randall Morgan.
(01:57):
I'm the president and the CEO of the Cobb Institute, and I was one of the students
fortunate enough to attend Dr.
Cobb's lectures at Howard University, where he was our distinguished professor
of anatomy. We are delighted if this podcast series serves as your introduction to Dr.
Cobb. He was both a historian of medicine and a history maker.
(02:22):
Over the coming months, we will be featuring thought leaders in areas such as
health equity and initiatives, increasing diversity in the health care workforce. force.
Today, it's my great pleasure to welcome Dr.
Jeffrey Young from the Association of American Medical Colleges to the podcast.
(02:44):
Thank you for having me. I'm very excited to be here. Dr.
Young leads the Transforming the Healthcare Workforce portfolio,
an extension of his responsibility leading the AAMC's Strategic Action Plan
4, which seeks to diversify the healthcare workforce. force.
His portfolio's work is focused on the education,
(03:08):
professional development, and wellness of future health care workers and on
creating viable pathways for historically marginalized communities to enter
the health care profession.
Focus areas include disseminating research and and data that provide insights on trends,
(03:29):
structural inequities, and institutional culture that impact the diversity of
healthcare workforce and scanning
the full medical education continuum to highlight promising practices,
leverage points of intersection,
and inform resource development that support innovations to UME and graduate medical education.
(03:54):
His team is also recognized as a leader in holistic review and selection and
pre-medical and applicant resources, providing inspiration.
Resources, data, and tools so that anyone can aspire to a career in medicine.
Before joining the AAMC in 2011, Dr.
(04:18):
Young served in leadership positions in medical school admissions and student
affairs at Rutgers University,
Robert Wood Johnson Medical School, Virginia Commonwealth University School
of Medicine, and the Medical College of Georgia, Augusta University.
Dr. Young earned his B.A. from Hampton University and his M.A.
(04:41):
And Ph.D. in clinical psychology from the Ohio State University. Yes, the.
Does that get it, Dr. Young? That was perfect, Dr. Morgan. Thank you so much.
So I have a grandson that's entering the Ohio State University in about a week.
Okay, congratulations.
Yes, thank you very much. But I've been totally schooled on that university.
(05:05):
Yeah, I always say the myself because I'm fearful that they'll come and try
to take my degree back. Yeah. You have to say the, so.
Well, I grew up in Indiana, so we were on the poor side of the football team most of the time.
When Ohio State came to Indiana to play, it was usually kind of rough for Indiana.
(05:26):
The AAMC has been an organization that has meant a lot to me during my tenure
of leadership with the National Medical Association.
And I did serve as the president of the NMA in 1996 and 1997.
And I was very much influenced by Jordan Cohen. And he, in fact,
(05:50):
was one of my presidential awardees at the convention in Hawaii in 1997, this very convention.
And the Project 3000 by 2000 effort that was going on at the time was a significant
part of my presidency. So...
(06:12):
I've always been, of course, very impressed with the work of AAMC,
and now more than ever, as we need to understand data, it's so important.
So I'm sure you will share some of that with us.
But to get to our discussion today, can you describe for us your role at AAMC?
(06:34):
Sure. I'm happy to do that.
I've been at the AAMC, again, since 2011. When I started my career there,
I was hired really as a subject matter expert in student affairs services.
So that would be student affairs, admissions, student diversity affairs,
records, and financial aid.
(06:54):
And I also worked very closely then with the Group on Student Affairs,
as well as with the Organization of Student Representatives.
So, again, very focused on working with administrators that work closely with learners,
medical students, from recruitment through graduation and preparing them for
(07:17):
that transition to residency.
In 2020, the AAMC established a new strategic plan, and that plan includes 10 action plans.
And I was asked to lead one of them, and that is looking at ways in which we
can diversify the healthcare workforce. force.
(07:40):
And so in doing that, we have been working, you know, for the past really four
years doing a lot of listening,
meeting with learners from historically marginalized communities.
Working and listening to their needs.
(08:01):
And so what we've learned over the course of the past four years is the importance
of establishing new relationships in order to to really address the lack of
diversity within medical education specifically.
Let me just also say that that part of our work has been focused on addressing
(08:27):
the needs of our younger learners and and that is the k-12 space.
And in doing that, we've had the opportunity to talk with K-12 educators.
We had a summit, Pathway Education Summit, in 2023, where we brought together
(08:48):
administrators of NK-12 education, medical schools. We had federal agencies represented.
We had various pathway program schools talk about their work. And what we learned, Dr.
Morgan, is that everyone really wants to address this issue,
but we're doing it in silos.
And so part of our work is trying to think about ways in which we can bring
(09:13):
these voices together in order to try to really impact or increase the diversity
of those that are historically marginalized.
What would be the definition of the healthcare workforce in this scenario?
Yeah, that's a great question.
So, specifically for the AAMC, we're looking at medicine, right?
(09:36):
Really, how do we provide information, access, education about the pathways to medicine?
So, that's, from my standpoint, that is key.
I think the secondary gain, though, is if we are able to help a learner,
(09:57):
and again, when I say learner, I'm really talking further up, you know, younger.
If they decide that they want to be a dentist, if they decide they want to be
a nurse, if they decide they want to be more more technical within the health care workforce.
(10:17):
I have no problem with that because, again, I think we need diversity within all of those sectors.
And as you have interacted with K-12 programs,
which is something that I've been interested in even since my early days in
private practice where I was in Gary for 20, 30 years in orthopedics,
(10:41):
and, of course, that's where I grew up.
And my fourth grade teacher, when I went back, was in charge of gifted education for the city of Gary.
And so she was very interested in developing a pathway, pipeline program,
if you will, primarily looking at high school students in four different areas,
(11:02):
medicine, dentistry, law, and engineering. Erie.
And so I was actually helped to put that program together. And for over 20 years, we had that program.
Sadly, we didn't get the data that we should.
So I have a lot of, you know, information that is not as complete as it should be.
(11:23):
But the influence on the K through 12.
Primarily in this case, would be the secondary school student,
was immense having the Saturday opportunities for six to eight weeks and having
a chance to visit and to meet doctors, engineers, and, you know, in their space.
What have you found in terms of existing K-12 programs,
(11:50):
that seems to maybe be the most effective and the one that we could have the most confidence in.
So what we've learned, what I've learned, is that, first, many of our member
medical schools have pathway programs.
And so when I was at Robert Wood Johnson, when I was at the Medical College
(12:15):
of Georgia, working in the dean's office, those schools, those medical schools, had pathway programs.
So, we know that many of our member institutions have pathway programs that
may focus on high school, college.
Some may actually go further upstream and maybe have work with middle school age kids.
(12:40):
So, they exist. And so I think part of the issue is that while those programs,
in my humble opinion, are effective and can be more effective,
we have to really start thinking a little differently about how we integrate
some of the resources and the educational benefits within the actual curriculum in K-12 education.
(13:08):
So, just as an example, the AAMC, for as long as I've been there,
we recognize the importance of supporting pathway programs.
We have a very successful program ourselves that attracts students interested
in medicine, dentistry, public health, and that's a very successful program.
(13:28):
What we need to do, though, is to
basically provide information and resources to school systems and or those organizations
that live in the space of interacting with educators to basically share the resources,
(13:51):
talk about the critical competencies for medicine. Right.
And embed that so it doesn't become sort of just an eight-week or six-week, which is important.
But a student will potentially,
if a teacher knows, oh, I didn't realize that this particular lesson plan could
(14:14):
also be shaped to talk about health literacy or potentially becoming a physician
or a healthcare provider, wider,
then we have to embed that. So I think that's important.
It's a key point. Yeah. It's not one that is often appreciated.
Right. Thank you for that. And that's what we're learning. That's one of the things.
(14:38):
And the other piece that I think is important is that we have to engage the community.
So, it's good to expose a child to information.
It's wonderful when a physician of color can come and talk about his or her
(15:00):
path to medicine, because that, you know, I believe if you see one,
you can believe that you can be one.
That's really important. I think it's equally important, though,
that an educator be thinking about, wow, how might this lesson plan,
recognizing that there are national standards or whatever,
(15:22):
how might I build upon this in a way that may advance the workforce? force.
Have there been materials developed for broad dissemination in K through 12 so that.
The majority of these teachers are science teachers or advisors who really don't
(15:45):
have a good sense of what students need to do to get into competitive schools
like medicine, dentistry.
Is there more information that's being provided for them so they're just not
riding by the seat of their pants, so to speak? Right.
I would say we, the AAMC, what we're doing currently is developing relationships with organizations,
(16:11):
national organizations that actually are in, say, most of them are high school,
and they have access to educators.
And so we're working with them with the idea of sharing specific information
and the key competencies needed for medicine that can then potentially be shared
(16:33):
within that educational environment.
One of the things that we're also doing is, for the first time,
the AAMC has embraced the need to think about how we can better have impact in that K-12 space.
And again, encouraging our member schools to be thinking differently about how
they show up in their communities.
(16:55):
Many of our academic health centers are located in underserved communities,
and I think that they can be doing more.
So we're in the process. We've just actually hired, about two months ago,
a director of K-12 education initiatives.
And he is an experienced educator as well as administrator.
(17:18):
And we are working very closely with him to better understand the landscape of K-12 education.
And we are currently working or finalizing.
Key competencies that would be necessary for a pre-med.
(17:38):
We've translated that into language that a middle schooler could understand.
And so we're going to be developing or finalizing those resources so that we
can then push that out to those that would benefit from that.
So those are just some of the things that we're doing.
The work that AAMC does is authentic. It tells exactly the story.
(18:06):
It's totally up to date in terms of the requirements for achievement of students
in order to matriculate successfully in medical school.
And I would say that the more of this material that you just spoke of that is made available,
(18:26):
the deeper that it could be made available and the earlier that it could be made available.
Seventh graders, you know, seventh and eighth grade science. Right.
Where the teachers don't have to really try to make up the script.
Exactly. It's already there. And
so I'm just thinking about ways that that could happen in the communities and
(18:52):
maybe through our National Medical Association local societies where you have
a number of people that have family members or spouses that are teaching.
They're in the education system. And they'll make sure that that gets there
because so much of this material, this good material, sits on the shelf and people don't read it.
(19:18):
Or those of us who, for instance, are like our group of Bule members in Sarasota.
We have a very, very extensive mentoring program in three high schools in Sarasota.
And we also have a couple of middle schools that we've begun to do more work in.
(19:41):
And I've spoken to students about careers in health care and not just,
you know, medicine, because you lose a lot of them if that's the only point
that you're really making.
And so, because of that,
I think that if we could come up with some system of mass distribution where
(20:08):
every seventh grader would get certain information about the career described by AAMC,
that it would really help a number of schools that have no idea about how to advise.
That's exactly right. And that's ultimately what we hope to do.
(20:29):
What we hope to do is to create the resources and then provide them to a range
of users, potential users,
in education, in the community.
We've talked about the importance of, you know, Divine 9.
(20:49):
I mean, the whole spectrum that we just need to try to maximize the impact of
getting resources in the hands of those that have influence and can share that information.
And we're also thinking about we don't want anyone to have to create something from scratch.
So we want to provide various templates and ways in which they can do this work.
(21:13):
So it's not an add-on. It's just an included.
Okay. And so that's some of the things that we're doing.
You said a couple of other things that I think I just really wanted to share with you.
And what we've learned from our
time in listening and meeting with educators and
learners is that ideally what we need to be thinking about is how might we create
(21:41):
structured curricula between K-12 and college universities integrating health
career preparation and academic coursework?
Because you have to be academically prepared to do that.
We've also thought about how might we be able to create experiential partnerships
where students can gain clinical research, clinical and research experiences.
(22:07):
Again, that's critical to that pathway.
As we've talked about previously, is we also recognize that there's a need to
develop toolkits for academic health centers to facilitate engagement with school districts.
And then also really thinking about how might our academic health centers and
(22:30):
our medical schools really provide protected time for faculty and clinicians
to engage in K-12 education.
We think those are all really important. And then I'll say the final thing that
we heard consistently is that medical schools really need to be active in the
communities, listening to learners, parents,
(22:52):
educators, and education administrators.
So that's part of what our message is. And we, again, recognize that we can't do this by ourselves.
Our expertise is sort of in In that pre-med space, you and me,
undergraduate medical education, helping then the learner with that transition
to residency and then beyond.
(23:13):
So to be able to really work in the area of K-12 education, for me,
could be a real game changer. Well, I agree with you wholeheartedly.
And also, I think that you have information about how people progress through
(23:34):
medical education and why people don't progress successfully through medical education.
Is that being packaged in such a way that it can be shared earlier and by those
of us who are mentoring to just even emphasize certain points or maybe emphasize
(23:54):
certain points to the chemistry teacher who's in the community that seems to be interested? Yes.
Yeah. So that's an issue, right? And so the AAMC has a tremendous amount of data.
And so data, research and data analysis is a core area of the work that we're doing at the AAMC.
(24:16):
So just as an example.
You know, we've looked at the value, if you will, air quotes, of community college.
We know that many of our learners or diverse learners may start at community
college for multiple reasons before they go to a four-year college and get their degree.
What we've learned, though, is that in the admissions process of medical school,
(24:43):
having a student that has attended a community college may be viewed less valuable
than someone that has not.
So we have to address some of the biases that we have within our own admissions processes.
Another fact that we've just really done just really recently,
we have a data snapshot, that's what we call it, where we basically looked at
(25:07):
the number of colleges and universities in this country and then looked at how many of students,
how many students may come from a particular And what we found was that 3%,
3% of all four-year colleges produce 61% of all matriculates in medical education.
(25:33):
So that means roughly about 70 out of 2,300 schools.
And then when we break that down further, what we found is that the most selective
schools basically produce 50% of all matriculants.
So we're talking about a very narrow population.
(25:53):
Now, are we talking underrepresented or the entire? The entire.
The entire applicant pool.
We are actually having conversations about looking at that by race.
So those are the facts that people don't necessarily know about.
Or when I share this with others, they go, really? They're shocked.
(26:14):
But this is the kind of transparency I think that we need.
Well, I think that looking at the data of those who are successful,
underrepresented minority students who are successful in medical school,
and if even a small percentage of them went through community college pathways
(26:36):
and ended up being successful,
That evidence would probably begin to sway people who have sort of implicit
bias toward them because there are a lot of reasons why community colleges are
important, a lot of them now financial,
that the students just clearly can't afford to take the traditional track.
(27:02):
And then maybe sometimes they're able to get scholarships after they've performed.
So it's sort of the yin and the yang because there are a lot of programs now
where they're trying to edify community college education.
And then it would be sad if there was a pushback.
(27:24):
For those who actually were successful in traveling that way.
So what I'd like to kind of do now is just pivot to the reason you're here,
besides coming to see New York and go to a play or two or whatever.
But we at the Cobb Institute have a symposium tomorrow, which is a very important
(27:45):
symposium entitled Then and Now, Navigating Best-in-Class Mentoring Innovation.
The idea was planted by Dr.
Bright when he was chair of the Pathway and Pipeline Committee,
that we should talk about what's working and what isn't working.
And, of course, now we're looking at it through the lens of the Supreme Court
(28:07):
decision of June 2023 as well.
We're so pleased to have AAMC be a part of this discussion.
And, I mean, you've described several pipeline and pathway programs and innovations,
and the two or three that we'll be looking at are those that founded by members
of our board with the Cobb Institute and have been successful,
(28:31):
and they all have been 15-, 20-year programs.
And so that's kind of unique to have programs that were started by these people,
and they're here, and then to also compare them to what's going on in your case with AAMC, Dr.
Bright's case, what's going on in a typical undergraduate or medical school environment.
(28:54):
So we wanted to have a chance to maybe talk to you a little bit more about what
your thoughts are and the comments that you're going to be sharing with us tomorrow,
what you'd like to emphasize,
because we realize we only have a small period of time tomorrow.
And so we want to be able to use our podcast as well to amplify the points that
(29:17):
are being made and give some background.
Yeah, no, that's good. It's a nice pivot, as you indicated.
So, in essence, what I'm going to share tomorrow will really talk about some
of what I've stated already, that we're not going to really be able to diversify
the healthcare workforce until we start doing things differently.
(29:39):
And again, for me and for my team, and that's focused on working with younger learners.
And we also recognize that there are additional things that must be done.
So I'll just, if you don't mind, just sort of tick them off and please feel free to interrupt me.
One of the things that we've learned after, as I stated earlier,
(30:02):
we've been listening a lot to programs and what the needs are within the various communities.
So one thing that we've heard consistently is that there needs to be increased
capacity building for pathway programs. You know, as you indicated,
there are programs that are out there, they're doing the work,
but there may be some challenges.
And so some of the things that we've done at the beginning of this work was
(30:27):
we actually worked with the Morehouse School of Medicine and did a survey of pathway programs,
STEM pathway programs within our member medical school. Again,
just trying to understand the landscape.
We also heard continuously that the pathway community, the administrators,
(30:48):
needed a place where they could come together and basically talk, right?
Think about effective practices and talk about resources and financial support.
So we've created a virtual community that's dedicated to those working to enhance
opportunities for our young learners.
(31:10):
We've also heard very continuously, and this is something that you mentioned, Dr.
Morgan, was that one of the challenges that we've heard continuously is that
our pathway programs have a difficult time monitoring or tracking student outcome data.
And so one of the things that we've done is that we've just launched a pilot.
(31:33):
We call it the AAMC Educational Pathways Network.
That basically is, at this point, it's a longitudinal study that will help the
AAMC understand the current landscape of pathway programs.
Our hope is that it will allow medical schools and pathway program leaders to
(31:54):
access data on students' educational and professional paths.
We think that's really important. I've heard that since, for as long as I've
been in undergraduate medical education, going back to the 90s.
So this is something that we're very, very excited about.
We have also just initiated what we're calling the Minority Serving Institution Pathway Initiative,
(32:16):
which is modeled after the Robert Wood Johnson Foundation Summer Health Professions
Education Program, which is a AAMC in partnership with the AAMC.
We have a pilot grant program that's designed specifically to work with American
Indian and Alaskan Native learners.
Learners and then we've also just received application for a HBCU.
(32:40):
So again, those are things that we're doing at that level. I've talked a little
bit about, so that's one work stream.
The second work stream, and please interrupt me if you need to,
is the K-12 initiatives.
And I've talked a lot about that. And this work really is designed to advance
our goal of improving the K-12 pathway to healthcare professions for learners from,
(33:07):
again, historically marginalized communities.
And so what we want to do is that we want to develop and enhance
external relationships and leverage those relationships to co-create and contribute
to initiatives that include professional development toolkits and other resources
and interventions that can be used to support learners and their support systems and educators,
(33:33):
because I think the support system is so critical, and that could be mentorship, it could be family.
And I also mentioned that we're also working with,
various organizations that have access to younger learners and educators so
we're working with the national academy foundation academy's career and medical
(33:53):
i'm sorry medicine resources,
and we're also working with hosa future health professions health education
in that space the third area that we're focused on is resources and tools for
for learners and again those that that support them.
And so this is the reference that I made earlier, Dr.
Morgan, when I talked about, we have in essence translated the 17 pre-med competencies for medicine.
(34:24):
Into language that would be applicable to middle schoolers.
And so our goal is to really increase that awareness in careers of medicine
and then provide information about steps needed to pursue a career directly and indirectly.
So when we talk about the NMA-AMC collaborative, where do these action steps fit?
(34:53):
Yeah, so the collaboration, the action collaborative between the AAMC and the
NMA is one element of the,
one part of the six-pronged wheel. if you will.
This is work that was initiated by colleagues in the relationship between NMA
(35:15):
leadership and our equity, diversity, and inclusion unit.
And so the work of the AC is really focused on Black men.
And so I know that Dr. Bright will talk about this a little bit more tomorrow,
but we've identified key areas in addressing the lack of Black men in medicine over many years.
(35:40):
So one is thinking about pre-health advising.
Another is leadership accountability, again, within our medical schools in leadership.
Also about financing and funding, and then support systems, which would be part
of the mentoring work that I think we've been talking about.
(36:05):
So that's where that fits. So it is part of the larger scheme of work.
And I would, just from having attended one session or one series of meetings,
meetings feel that a lot of this information is pretty well verified,
(36:27):
shall we say, and,
getting it out in such form that everybody knows about it, or at least knows the basics.
Even in meetings like this, where.
All of us that attend this meeting are primarily working in our communities.
And so we're ambassadors for medicine, careers in medicine.
(36:51):
And so I think if we're distributing information, you know, that's been vetted
and approved by AAMC and NMA and whichever other, you know, organizations are there.
I would encourage, you know, earlier dissemination of the information,
I guess, is what I'm saying,
because it's really hard to influence what goes on in the community unless you
(37:16):
have some fairly convincing data.
Data and many times there's administrators that
are just not positive about the
ability of their students in their school unfortunately to be able to to do
this and it seems like it is possible i believe it is and if i didn't i i wouldn't
(37:43):
be having this conversation you know with you and,
But again, I think part of what I'm hearing you say, Dr.
Morgan, is that we collectively have to change our approach.
The way I look at this work, and I've described this to some colleagues,
is that, you know, we are trying to connect dots.
There are people that are committed, there are resources, there are folks that
(38:07):
want to do this but don't know where to start.
And so what I like to think about is that we're almost creating a web.
And as we strengthen that web, then my hope is that we're going to be better
able to capture, if you will,
those learners that hadn't
(38:30):
thought about a career in medicine or the health professions or had an interest
but didn't know where to start or provide resources to those mentors that could
be impactful on a young learner's life.
So my hope is that that web is going to be strengthened by the partnerships
(38:52):
that we're establishing now.
Yeah, certainly I feel that as well, and I think that's one of the reasons maybe
for having feedback back and constantly having updates about what actually is going on.
Of course, the different school systems are different as well,
but so many counselors and teachers, I think, feel a bit overwhelmed.
(39:20):
And they don't want to make a recommendation that a family may misconstrue or
take in such a way that it ends up, you know, harming the student.
So there's a bit of reality, a bit of honesty, but also a bit of hope,
you know, that they certainly can and deserve to succeed. Yes.
(39:42):
If I may just sort of piggyback on something that you said, you're right.
We need to be careful about the community's sensitivities to various things.
And so that's why our work, we are consistently talking about the importance
of engaging the local community.
(40:02):
So, just as an example, we are going to have focus groups with communities,
diverse communities within the D.C.
Area that, again, understand what those issues are and ways in which we can
do that. Because, again, it's part of that web, right?
And then the last thing that I'll share about that is I mentioned our new director
(40:25):
for K-12 initiatives, Dr.
Brian Ingram. we have just started working with a group.
Firm that's helping us to think about a change
theory to develop a K-12 education
roadmap so that we can then begin to roll
out to try to think how do we get influencers within the various systems to
(40:51):
potentially think differently about how we can share information and really
think about academic preparedness for those learners interested in pursuing
medicine or fill in the Right.
Well, I'm happy that this is taking place.
I'm happy that the momentum is picking up.
And particularly during this bit of time uncertainty with regard to,
(41:18):
you know, the DEI issues and so forth. But I have no doubt that this is going to be successful.
I just see allies in the National Medical Association that could help even more than we think.
To just share the information that this is happening, that your high school
(41:39):
teacher may be able to apply for a AAMC summer experience or virtual experience or whatever.
Too much information never is, you know, a problem.
Right, right. This is one case where TMI is okay. It's a good thing.
Right. It's a good thing, and we need it because, you know.
(42:02):
Our children, our learners, and some of our educators don't know what they don't know.
Right. And so it's, I think part of it is our responsibility to say, well, now you know.
And how you're going to respond to it. And I think if they have data,
I mean, I keep stressing this, but it's because I think everybody feels more
(42:23):
confident in making a recommendation if you have some data that's creditable data.
Right. And so I think it's, you know, the opportunity is there for this group,
this consortium, to make great changes and improvements.
(42:45):
AAMC has projected a major shortage of physicians by 2036, as many as 86,000.
Well, that's kind of mind-boggling.
Yes, I think it's a complex issue. And so, at one level,
I think the AAMC is very committed to providing or advocating for an increase
(43:09):
in the number of federally supported positions for residency.
So there is a bipartisan legislation that was introduced in Congress,
the Resident Physician Shortage Reduction Act,
and this act would help address the physician shortage by gradually increasing
(43:32):
the number of Medicare-supported residency positions by 14,000 over seven years.
So, that's one element, I think, that we have to continue to seek funding for residency positions.
The other piece that, again, we've been really talking about,
(43:55):
I think, Dr. Morgan, is that.
We have to address the needs of those communities, again, that have historically
been marginalized, to get them in that pathway, right?
And I'm not only just talking about those that, not just talking about race
and ethnicity, but, you know, first generation, thinking about rural learners,
(44:21):
thinking about those with disabilities.
So, again, I think the only way that we can establish that is by doing the things
that we're trying to accomplish to, again,
prepare those younger learners so that if they choose,
they will be academically prepared and have the knowledge and understanding
(44:43):
of what it takes to get to that MD degree.
So, that's how I would answer that question. Well, I think it's an excellent answer.
And I see here this report by Trilliant Health of findings after this current
(45:05):
match day in 2024 showing that family medicine had significantly high amount
of unfilled residency positions.
So, as we're trying to add residency positions, there are a lot of unfilled
residency positions in primarily the primary care specialties.
And how are we looking, what solutions are we implementing to make a difference in those specialties?
(45:35):
And I know some of them are related to work time. Some of them are related to reimbursement.
But what does this mean?
Is this just an outlier, this particular statistic for this particular year?
(45:56):
I mean, there's so many students yet, and unfortunately, many of color who are not matching.
And, you know, what does it say about their experience of their choices,
maybe, in terms of specialties?
Yes. So, again, I'm not familiar with that article, so I just want to be transparent about that.
(46:18):
And any time that a position in any specialty, but I would say, given the context,
primary care ultimately is going to hurt those communities that need both primary
care and specialty physicians.
That it's a problem. And, you know, historically, there are specialties that sort of ebb and flow.
(46:46):
You know, they may be unmatched positions one year, and maybe in three years,
they matched all positions.
I think, you know, again, I'll just go
back to my main thought
here is that we know having a
diverse student body within undergraduate medical education is likely to lead
(47:13):
to better access for communities that are historically underserved,
right, that are medically underserved. So.
Do think that it's it's a
it's a concern i think it's complex i think you
know as you mentioned there are issues with reimbursement there
(47:35):
are issues with and i'm going to say this this may sound me be uh unpopular
or controversial but you know unfortunately i think you know medicine has become
a business and and less focused on really the the care of the patient and so i i think Like,
specialties like family medicine,
(47:56):
like peds, that are really providing the backbone of care,
in my opinion, often doesn't get the necessary resources that it needs.
That's just, I'm not talking as a double AMC person.
I'm talking as, you know, Jeff Young, who has some feelings about that.
(48:18):
But sometimes these reports and things that provide data may be a little skewed.
But I do think that the employment opportunities for physicians may have something
to do as well with specialty choices.
(48:39):
Since everybody's not going and hanging a shingle anymore and starting practice. this.
You are being employed by somebody. Some hospital system is going to employ you.
And I would think as long as that need is shown and.
(49:03):
Importance of those specialties is recognized monetarily, then there's probably
going to be a difference in these figures going forward.
But they are a little bit, you know, counter-current.
And so I think it's just going to be interesting to see all the predictions
(49:24):
and where we end up, and where we're going to end up is going to be nowhere
close to how many physicians we need, whether it's 2036 or 2056,
we're always going to be short.
But doing a better job is what we're trying to do for the most part to serve patients.
(49:45):
So finally, again, we're so pleased that you are serving as one of our key lecturers
or speakers tomorrow for our symposium.
And as you look at how we've laid the symposium out and we've had a couple of
discussions about it in preparation,
(50:08):
what would you hope would be the outcome of the symposium and next steps?
That's a great question. The first word that popped in my mind was empowerment,
recognizing that we collectively, with the appropriate partnerships,
(50:32):
with the level of commitment, we can make impact.
My hope is that the perspectives that the panelists will share might give someone
in the audience an idea or say,
(50:52):
hey, those are very similar kinds of things that we're thinking about.
How might we collaborate?
How do we create, if you will, stronger coalitions in order to,
really achieve and support, well, support the pathway programs that will enable
(51:14):
us to achieve, you know, true workforce diversity?
The other piece is that I hope that that we'll start thinking differently and
come out of our silos and recognize that I think we are stronger together than separate.
(51:36):
I think those are four key points. If we can achieve three of the four, I'll be really happy.
The Cobb Institute has reached 20 years of age and hopefully has a bright future.
But one of the things that we have tried to do is to.
(51:56):
Neck to silos. And so I think your point is well taken.
Several of the programs that we've had in the past four years or so have been
where we've had all the HBCU medical schools together,
talking about issues, whether it's COVID, whether it's this same issue of pipe wide and pathway,
(52:19):
focusing on admissions, but sort of to be the convener, the continual convener.
And in order to do that, you have to have successful outcomes in the programs
that you do or put on or else you have no credibility.
So that's why we're really looking forward to this program as sort of a statement.
(52:44):
You know, last year we looked at the impact of the Supreme Court ruling three
months, two months after the ruling particularly predicting what would happen,
predicting strategies.
Now, a year afterwards, go back and sort of see whether some of those predictions
(53:06):
were in the right space or not.
But in spite of that, how are we going to affect the pathway and the pipeline,
and gain that type of support that we need? eat.
So I appreciate your sharing with us today, and please continue to lift up the Cobb Institute at AAMC.
(53:31):
Whatever we can do to stir the pot, you know, we tend to have a lot of good trouble.
Yeah, good trouble is exactly what we do.
We have a lot of people that have a lot of opinions. Yes. Yes,
but they're informed opinions also.
And so I think that that's important.
(53:51):
We need all of that mixed in to have success. Yeah.
And I want to thank you for your leadership and for your commitment and the
work that you and others have done and continue to do,
thinking about health care of our communities.
(54:12):
It's well I appreciate it you do all this work you keep working keep seeing patients,
sit on this committee do this do that and it's just like it just keeps piling
up and then you look back over your shoulder and say whew,
that's a lot of stuff yeah yes and it's impactful hopefully yep wow alright
(54:37):
thank you thank you so much okay well thank you for having me.
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