Mapping Futures: Early Access to Mentorship Programs in Science and Medicine

Although the number of physicians from Underrepresented in Medicine (URiM) backgrounds in the United States has increased, the youth population's racial and ethnic diversity has grown even faster.1–4 As a result, the pediatric physician workforce is less diverse than the population it serves.5 Diversity within the physician workforce and racial and ethnic concordance between providers and patients have been shown to improve health outcomes. When patients have providers with shared cultural experiences, there is improved communication,6 care utilization,7,8 and patient satisfaction.9 To increase racially and ethnically concordant patient-clinician interactions, efforts must focus on building pathways to medical careers for underrepresented populations (URP). The National Institutes of Health defines an underrepresented population as a subgroup whose representation is disproportionately low relative to their numbers in the general population.10To promote health equity, greater focus should be placed on access to mentorship for early learners interested in science and medicine.11 There is a notable absence of URP in the science, technology, engineering, mathematics (STEMM) fields and an even greater deficit in the medical field.12 Young patients rarely interact with providers who share their cultural experiences and reflect their communities and identities.13 Despite increased attention to developing cultural humility in medical education, this is an imperfect substitute for the benefits of clinician-patient racial and ethnic concordance.14National organizations, such as the Association of American Medical Colleges and Accreditation Council of Graduate Medical Education, have developed initiatives to recruit, support, and retain individuals from underrepresented backgrounds.15,16 However, recruitment must begin before medical school; youth from URP face significant deterrents to pursuing medical careers. These include financial barriers, lack of exposure to STEMM-based careers, and lack of educational support and access to medical settings. Increasing access to pathway programs from kindergarten through postsecondary education can help reduce barriers and, in turn, inspire students to pursue medical careers earlier, increasing the number of learners from URP in STEMM fields. Consistent and targeted mentoring experiences and early exposure to STEMM fields have been shown to positively impact career decisions.17 In this feature, we outline a newly created resource to increase access to STEMM mentorship programs that ultimately could increase the number of future scientists, medical practitioners, and for the focus of our positionality, pediatricians.18After the murder of George Floyd and global civil uprisings in 2020, the Association of Pediatric Program Directors (APPD) created the Confronting Racism Action Team to address systemic racism in pediatrics. The APPD acknowledged that diversity is a core value for the medical profession and that more could be done to fight structural racism through self-reflection, recognition of needed change, and a commitment to moving forward to confront racism at all organizational levels.19,20 The action team includes a multidisciplinary group of APPD members, Council on Medical Student Education in Pediatrics members, trainees, faculty, and administrative staff. Subcommittees focus on antiracism efforts at various education levels required to become a physician. This included subcommittees on antiracism for APPD, faculty education, residency programs, mentoring before medical school, and visiting medical student rotations. The authors are members of a subcommittee focused on pathways into medicine for primary school learners from URP. The subcommittee focused on creating resources to increase the number of K through 12 learners from URP interested in science, medicine, and ultimately pediatrics. Through shared reflections and collaborative discussion, the subcommittee developed insights into positive approaches and barriers related to education and mentorship for students from URP. These collaborative discussions were crucial for the subcommittee to build a solid foundation and conceptualize our approach to promoting pathways.The subcommittee reviewed studies on the effects of mentorship on physicians from URiM backgrounds to identify best practices for mentoring learners from URP.21–28 The subcommittee actively networked with a successful STEMM-based mentorship organization, the Meyerhoff Scholars program,29 to understand students’ experiences planning for careers in STEMM and how new resources could support students' early educational growth. Based on this conversation, the subcommittee created a mechanism to connect students from URP interested in STEMM careers to low-cost or free mentorship resources and pathway programs nationwide. Key considerations were youth engagement, mentorship opportunities, and creating an early-in-education resource to explore STEMM careers. Figure 1 offers a visualization of the steps used from concept development to map creation. The APPD URiM Mentoring Map highlights STEMM program characteristics nationwide for students from URP backgrounds from kindergarten to postbaccalaureate as seen in Fig 2. Previous approaches to distributing information about mentorship programs, such as the Association of American Medical Colleges database,30 have largely been in a list form referencing academic institution-based programs. The URiM Mentoring Map utilizes a pathway schema involving multiple sites through a standardized uploading mechanism to highlight mentoring programs and resources from rural, academic, and community areas across the country in a visually appealing, user-friendly format that is accessible to all ages that supports the innovation, novelty, and necessity of the map.In January 2022, the URiM Pathways for Elementary School through College Summit, cohosted by APPD and Council on Medical Student Education in Pediatrics, introduced the APPD Underrepresented in Medicine (URiM) Mentoring Map. This tool highlights STEMM programs nationwide for students from URP backgrounds from kindergarten to postbaccalaureate. The URiM Mentoring Map has been presented at multiple national organization meetings and accessed over 750 times, with over 250 community submissions. Although broader data collection is underway, these metrics show promise for the map's impact on students' career exploration into STEMM fields.Future work includes research to assess the map's effectiveness in bridging pathway program enrollment and completion, as well as students’ entrance into STEMM careers. The subcommittee will survey medical students from URP to determine what type of mentorship experiences were most impactful to their career trajectories. This research will evolve with the community's needs.Creating the URiM Mentoring Map supported the mission to work toward improved access to resources for learners from URP, such as low cost or free mentorship programs around the country from urban to rural areas. The subcommittee continues to promote and update the map, both for mentorship programs to self-advertise, and for students, teachers, guidance counselors, and health care providers to easily learn about opportunities. The URiM Mentoring Map is the first tool of its kind to make early exposure to STEMM fields more accessible for students from URP. It is a meaningful step toward a more diverse and representative provider workforce, equitable care, and role models who might inspire future scientists and physicians.We thank the APPD for their support in the development and maintenance of the Underrepresented in Medicine (URiM) Mentoring Map; and we dedicate this resource to those before us who did not have the opportunity for mentorship or realizing their dreams of becoming physicians and to the next generation that we hope to support!