EVALUATION OF A POST-BACCALAUREATE MEDICAL EDUCATION PROGRAM FOR DISADVANTAGED STUDENTS TO DIVERSIFY THE HEALTHCARE WORKFORCE IN HAWAIʻI (1996 – 2016)

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2019
Authors
Purdy, Chanley Malia
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Braun, Kathryn
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Public Health
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In Hawai‘i, Native Hawaiians and other Pacific Islanders (NHOPI) comprise 26.2% of the population, but make up only 3.7% of the physician workforce. The Association of American Medical Colleges (AAMC), the American Medical Association (AMA), and the Institute of Medicine (IOM) have stated that a health care workforce reflective of the population it serves will help reduce health disparities and increase equity. This is, in part, because physicians from underrepresented minority groups tend to be more likely to serve patient populations that are underrepresented, underserved, and in rural areas, and because many underrepresented patients prefer race- and language-concordant providers. On average, less than 20% of John A. Burns School of Medicine graduates are of an underrepresented minority (JABSOM OSA, 2016). The Department of Native Hawaiian Health (DNHH) medical education division was created to increase diversity in the medical profession in Hawai‘i. The ‘Imi Hoʻōla Post-Baccalaureate Program (IH), although longstanding, has not been formally evaluated to determine whether they are meeting the mission of increasing diversity of the health care workforce. This dissertation included three studies. For the first, a secondary data analysis was conducted to determine profile differences between students who successfully completed the IH program, and those who did not. A high science grade point average (GPA) and attitude towards academic success are important predictors for IH program completion. Through a series of focus groups with program participants, the second study identified the key components of the IH program that led to successful matriculation and academic achievement in medical school. These included financial support, social support, and mentorship. The third study assessed the practice outcomes of IH graduates through a secondary data analysis and found that 58% of IH graduates practice primary care, 39% practice in Hawaiʻi or the Pacific Basin, and 44% practice in an underserved and/or rural area. The findings of this research suggest that IH admits students who are committed to its mission of producing physicians that practice primary care in medically underserved areas in Hawaiʻi and the Pacific Basin, and that pipeline and pathway programs such as IH are a successful way to increase diversity in the healthcare workforce. Taken together, recommendations for programming and policy include setting science GPA minimums for admission and increasing financial support and mentorship for participants of IH. Recommendations for future research include gathering better data on IH non-completers, and interviewing IH graduates to identify factors and barriers affecting their commitment to IH’s mission.
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Education, Public health education, imi hoola, medical education, pipeline program, post-baccalaureate, pre-medical, underrepresented minorities
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111 pages
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