The Underrepresented, Low Income, and First Time (UpLift) Project

Objective: Despite ongoing efforts to recruit minority, first-generation, and low-income (FGLI) students into medicine, these student groups continue to be underrepresented among medical school matriculants. The Underrepresented, Low Income, and First Time (UpLIFT) Project aims to create an open-access, scalable, web-based platform of comprehensive, up-to-date information about successfully applying to and matriculating into medical school. Background: Students from disadvantaged backgrounds being adequately represented among medical school applicants 1; however, data from the Association of American Medical Colleges Matriculating Student Questionnaire (a survey administered annually to all matriculating medical students in the U.S.) between 2007 and 2017 demonstrated that roughly 50% of matriculating students each year came from the top quintile of household income, with roughly 25% coming from the top 5% of household income. 2 One factor contributing to this disparity is a lack of reliable and affordable advisory resources necessary for successfully navigating the premedical and application process. A barrier analysis conducted in rural Michigan found that 90% of surveyed students reported having concern about academic readiness when considering a career in health care and 60% of students reported feeling concerned about financial barriers. 3 These challenges have likely been exacerbated by the COVID-19 pandemic as many students have reported difficulty navigating COVID-19-related changes to the medical school application process and premedical experience, and the pandemic has likely made adequate access to prehealth guidance counselors more challenging for FGLI students. Open-access advising resources are one possible way to address these issues. Design: Twenty-six students at the Perelman School of Medicine were recruited to write, design, and illustrate a comprehensive guide on the medical school application process, including guidance for completing premedical coursework, finding research/shadowing experiences, preparing for the Medical College Admission Test, requesting letters of recommendation, writing applications, interviewing, and navigating financial aid processes. The guide is accessible to all backgrounds and assumes no prior knowledge about medical school or medical careers. It also includes sample essays, email/letter templates, course schedules, and budgets. The guide received review from several faculty members at the Perelman School of Medicine and prehealth advisors at several undergraduate institutions. The guide was disseminated via multiple platforms, including the UpLIFT website (https://uplift.guide), social media, and direct outreach to undergraduate prehealth advisors. Downloads of the guide and website traffic were recorded, and end-user feedback was collected. Outcomes: The UpLIFT Guide was launched online on August 27, 2020. Over the course of 13 weeks, the guide has been viewed 7,223 times by 3,373 unique users, downloaded 303 times, and used by 34 undergraduate institutions. The UpLIFT Guide has been used as an official resource by national near-peer prehealth advising organizations and endorsed by medical school faculty members and undergraduate prehealth advisors at several universities. Innovations Strengths and Weaknesses: The UpLIFT Guide demonstrates how medical students may effectively reduce structural barriers to successful matriculation of underrepresented, low-income, and first-generation students to medical school. The guide effectively uses a “crowd-sourcing” model to compile reliable advice and demonstrates the feasibility of disseminating open-source resources via social media. Lastly, our data suggest that dissemination of such free resources targeting FGLI students is more successful through established and trusted sources of information such as premed advisors. One weakness is that the guide does require internet access which may be a barrier for some potential users. In addition, admissions outcomes among students who used the guide are pending but planned for future analysis. Feasibility and Transferability for Adoption: A recently launched, open-access, comprehensive guide to applying to medical school could mitigate the disparities in access to medical school for underrepresented premedical students and is easily accessible with feasibility for adoption by premedical offices and by interested students. Horace DeLisser, Dr. Ellen Mandell, Dr. Gita Pensa, Dr. Sharon Lewis, and Dr. Neha Vapiwala for their advice during the conception of this project and continued support of this work

Disadvantaged · Feeling · Medical education · Political science · Underrepresented Minority · Diversity and Career in Medicine · Global Health Workforce Issues · Medical Education and Admissions · Medicine · Psychology