Journal of Clinical and Translational Science

ImportanceDespite the importance of clinician-scientists in propelling biomedical advances, the proportion of physicians engaged in both hypothesis-driven research and clinical care continues to decline. Recently, multiple institutions have developed programs that promote MD-only physicians pursuing careers in science, but few reports on the impact of these are available. ObjectiveTo assess if a cohort-based training program for MD-only physician-scientists that includes didactic and experiential curricula favorably informs participants scientific development. DesignThe Chan Zuckerberg Biohub (CZB) Physician-Scientist Fellowship Program (PSFP) conducted a study from July 2020 to August 2023. Participants24 inaugural program participants at UCSF and Stanford University (median postgraduate year at program start, 5.5; 17 clinical specialties represented; 10 [42%] identified as female; 7 [29%] identified as underrepresented in medicine). ExposuresThe CZB PSFP is a selective two-year career development program for MD-only physicians. Participants attended a two-week immersive training at the program outset, and subsequently, weekly curricular and scientific meetings throughout the program while conducting research. Main Outcomes and MeasuresPrimary outcome measurements included pre-, 1-month, and 12-month assessments of confidence in research skills, career skills, and self-identification as scientists. Program satisfaction and feedback related to program curriculum and community were collected at 1 month, 6 months, and 12 months. ResultsAfter 12 months, 100% (N=16) reported satisfaction with the program and participants demonstrated increased confidence in research skills [median (IQR), 4.0 (2.5-5.0) pre-bootcamp to 5.5 (4.0-6.0) 12-mo], career skills significantly increased [median (IQR), 4.0 (4.0-5.0) pre-bootcamp to 5.5 (5.0-6.0) 12-mo], perceptions of belonging significantly increased [median (IQR), 4.0 (2.5-5.4) pre-bootcamp to 5.5 (5.1-7.0) 12-mo], and scientific identity significantly increased [median (IQR), 5.0 (4.0-5.5) pre-bootcamp to 6.0 (5.5-7.0) 12-mo]. Conclusion and RelevanceParticipants demonstrated significant gains in confidence in core research and career skills as well as personal identification as scientists, demonstrating the efficacy of a longitudinal curriculum, peer support, and community building in fostering development as an investigator. The highly portable nature of this strategy may facilitate ready adoption and implementation at other institutions.

Poor retention of physician-scientists in the work force is a major impediment to progress in biomedical research, and the leaky pipeline of junior physician-scientists was exacerbated after the COVID-19 pandemic. We report the results of a multi-institutional survey aimed at assessing hiring practice patterns among academic deans and department chairs, with 34 responses before and 70 responses after the COVID-19 pandemic. We found that private institutions tend to provide greater startup support across all areas of research, including basic science, translational, and clinical arenas, with NIH funding and publication volume predicting the level of support. We found that half of respondents provide research RVUs. The COVID-19 pandemic adversely impacted the availability of supplemental internal funding and bridge funding, which catalyzed institutions to support junior faculty through endowments. Yet, we found that junior faculty had to rearrange clinical schedules to increase clinical productivity. We also found that childcare policies were more robust at private institutions. These data highlight hiring practices across a cohort of academic deans and department chairs to improve transparency of the hiring process for junior faculty candidates approaching their first independent position. Providing greater transparency in hiring practices can help physician-scientist trainees find a good fit for their faculty position and can help stave off attrition from this pipeline.

IntroductionPhysician-scientists are uniquely positioned to contribute translational research that will impact patient care and our understanding of disease. Having a diverse cadre of physician-scientists is critical to ensuring that the biomedical research enterprise explores the breadth of problems affecting the nations health. The National Institutes of Health has identified diversity, including educational background, to be important for the biomedical workforce. In 2020, less than ten percent of MD-PhD program matriculants were the first in their families to pursue higher education (first-generation) despite the majority of the US population having less than a Bachelors degree. Little is known about the specific challenges that first-generation students face, which makes it challenging to address this gap in matriculation. MethodsThis qualitative study used a phenomenological approach to examine the experiences of first-generation individuals, from the applicant stage to the early-career stage. We conducted semi-structured interviews with 41 participants and analyzed responses in accordance with a networked ecological systems theory. ResultsThe interviews revealed that first-generation individuals put together a patchwork of support. Whereas many MD-PhD trainees struggle at some point in their training, first-generation individuals tend to lack a support system that may provide proactive advice and prepare them for milestones. Interviews shared a common sentiment of isolation due to both a lack of social capital within medicine and academia, as well as a growing disconnect from their families and community. DiscussionKey interventions that would support first-generation students include greater access to high-quality information about the pathway, tailored mentorship throughout training, and more financial resources at the application stage. Trainees and early career physician-scientists seek more flexibility, opportunities for finding community, financial guidance and options, and mentorship around building their careers.

BackgroundClinical faculty at academic health centers may benefit from specific mentorship and proficiencies that are distinct from those on research tracks. We describe the creation, activities, and one-year impact of a faculty development program that included novel professional coaching training (the Clinical Faculty Mentoring Program, CFMP) which was supplemented by skills- and knowledge-building activities (the Clinical Faculty Development Series, CFDS). MethodsThe goals and components of the CFMP and CFDS are described in detail. A mixed methods evaluation plan guided collection of confidential survey and interview data before and after the first year of these activities. We used paired t-tests to identify statistically significant changes. ResultsThe 43 clinical mentors reported significant gains in job satisfaction, teaching attitudes, knowledge of mentorship competencies, and confidence with coaching skills for mentorship (all p<0.05). Of mentor respondents, 88% found the coach approach to mentoring program to be "very" or "somewhat" helpful. Coaching behavioral domains with the greatest evidence of improvement were supporting the mentee to integrate new awareness, insight, learning into their worldview and behaviors (p=0.0503) and managing time and focus of mentoring sessions (p=0.022). All 37 mentees had at least one meeting with a mentor (100%). Over 9 months, 39 virtual CFDS sessions had an average participation of 38 participants (range 22-59). A majority of surveyed faculty (>55%) agreed or strongly agreed the CFDS sessions provided valuable opportunities for skills development with teaching, leadership, wellness, diversity, equity, inclusion, and promotion. ConclusionsAmong clinical mentors, our novel coach approach to clinical faculty mentoring and skill-building had favorable effects on job satisfaction, knowledge of mentorship competencies, and confidence in coaching skills. Outcomes from the clinical faculty development series supported the mentoring program outcomes. Longitudinal follow-up is needed to determine how this program will impact mentees.

IntroductionFood is Medicine (FIM) interventions, such as medically tailored meals, groceries, and produce prescriptions, are increasingly embedded in healthcare delivery. To inform future policy and practice, the American Heart Associations Healthcare by Food initiative supported pilot studies to test scalable FIM models. This manuscript compares two such pilots, NutriConnect (Washington University in St. Louis) and Makin Healthy Groceries (Louisiana Public Health Institute), using the RE-AIM framework to highlight cross-site lessons for design, delivery, and implementation. MethodsWe conducted a comparative analysis of two FIM trials. NutriConnect enrolled adults [&ge;]18 years recently discharged from Barnes-Jewish Hospital with diet-sensitive chronic conditions and food insecurity, randomizing participants to digital coupons, home-delivered produce boxes, and usual care. Makin Healthy Groceries enrolled adults [&ge;]50 years with uncontrolled hypertension at University Medical Center in New Orleans, randomizing participants to in-store debit vouchers or online grocery credits. Across both studies, we applied RE-AIM domains (Reach, Effectiveness, Adoption, Implementation, Maintenance) to examine participant characteristics, intervention delivery, operational challenges, and contextual facilitators. ResultsReach was constrained by digital barriers in both trials: NutriConnect participants struggled with email coupon redemption, while Makin Healthy Groceries online arm faced low digital literacy and payment concerns. Effectiveness data were collected through validated dietary questionnaires; full quantitative results will be reported separately. Adoption depended heavily on retail system readiness, NutriConnect benefited from tighter integration with the grocer, Schnucks, loyalty program, while Makin Healthy Groceries encountered gaps in staff training and voucher controls at the participating grocery. Implementation challenges included high staff burden for manual troubleshooting and rapid customization of digital platforms, though both studies demonstrated strong adaptive capacity. Maintenance challenges included high program costs and reliance on sustained funding, yet technical enhancements (e.g., automated coupon systems) showed potential for broader scalability. ConclusionThis comparison highlights the heterogeneity of FIM trial design and delivery, underscoring the importance of aligning interventions with participant behaviors, retail system readiness, and digital accessibility. Successful scale-up will require hybrid models that combine technology with human support, strong cross-sector partnerships, and sustainable reimbursement pathways. Insights from these pilots inform the next generation of equitable FIM implementation strategies.

Digital health technologies are powerful-enhancing data collection, participant engagement, and personalized health interventions-yet their rapid proliferation has outpaced guidance for research participant protection. Current practice assists researchers in identifying risks but provides limited support for comprehensive risk management. To address this gap, we developed the Digital Health Checklist-Risk Management (DHC-RM) Tool, which integrates the established Digital Health Checklist with approaches from safety risk management. We conducted a study (n=40) comparing the DHC-RM Tool with current practice using a randomized experimental difference-in-differences design. Primary outcomes were the quantity, variety, and novelty of risks identified; secondary outcomes were the same constructs applied to risk control development. Compared with current practice, use of the DHC-RM Tool resulted in dramatically improved performance across all primary outcomes. Users identified on average 14.7 additional risks (compared to baseline) versus 0.26 in the control group and a higher number of risks in each of six pre-identified risk domains. Half of all distinct risks identified in the comparison phase were identified exclusively using the tool. The tool also improved risk control design, producing 9.63 additional risk control strategies per participant compared with 0.15 for current practice and yielding substantially greater novelty and variety. User feedback was also positive: 75% of participants reported they would use the tool again, citing its structured workflow, just-in-time examples, improved insight into risks, and its value for IRB communication. Suggestions for refinement focused primarily on expanding training examples and providing additional support for risk control development. The DHC-RM Tool significantly improves risk management practice in digital health research. By embedding structured, ethics-informed risk management into digital health research design, the DHC-RM Tool has the potential to improve participant protection while also streamlining ethics approval. Author SummaryDigital health research can put participants (and others) at risk in ways that dont always occur to the researchers who are designing a study. Researchers also face challenges in prioritizing risks and coming up with ideas to reduce those risks. We developed a new approach, the Digital Health Checklist - Risk Management Tool (DHC-RM Tool), to give researchers the support they need to identify, assess, and address research participant risks in this fast-moving field. Our experimental study found that use of the DHC-RM Tool led to a very large improvement in how well researchers managed the risks of digital health research studies. Using the toolkit, they were able to identify more risks than they identified using current practice-including risks they would not otherwise have considered. They were also able to come up with more changes to reduce the risks associated with digital health research studies, including changes they would not otherwise have considered. Those who used the toolkit found it beneficial and easy to use. The DHC-RM Tool fills an important gap in the science and practice of participant protection in digital health research.

African American, American Indian and Alaska Native, Hispanic (or Latinx), Native Hawaiian, and other Pacific Islander groups are underrepresented in the biomedical workforce, which is one of the barriers to addressing cancer disparities among minority populations. The creation of a more inclusive biomedical workforce dedicated to reducing the burden of cancer health disparities requires structured, mentored research and cancer-related research exposure during the earlier stages of training. The Summer Cancer Research Institute (SCRI), a multicomponent 8-week intensive summer program funded under the Partnership between a Minority Serving Institute and a National Institutes of Health-designated Comprehensive Cancer Center. This study assessed whether students who participated in the SCRI Program report greater knowledge and interest in pursuing careers in cancer-related fields than their counterparts who did not participate in SCRI. Successes, challenges, and solutions in providing training in cancer and cancer health disparities research to improve diversity in the biomedical fields were also discussed.

BackgroundPoor diet is the leading cause of global disability and premature death, contributing to 11 million deaths annually. Despite this, nutrition remains underemphasized in medical education, with over 70% of United States (U.S.) medical schools failing to meet the National Research Councils 1985 recommendation of 25 hours of nutrition training. In 2022, the U.S. House of Representatives passed a bipartisan resolution calling for meaningful nutrition education for health professionals. Amid this gap, unreliable media sources frequently shape patient nutrition knowledge rather than professional sources such as registered dietitians or licensed physicians. Strengthening interprofessional collaboration with nutrition professionals could enhance dietary counseling and patient care. MethodsIn response, one student implemented a pilot three-part clinical nutrition lecture series at the University of Miami Miller School of Medicine (UMMSM). Resulting student enthusiasm catalyzed the formation of a 50-member taskforce formed to expand and integrate nutrition longitudinally. A pre- and post-lecture survey around the first of three planned sessions (Npre = 98, Npost = 77) assessed knowledge, perceptions of nutrition training, and comfort with dietary counseling. ResultsKnowledge of evidence-based nutrition improved significantly (p < .001). Post-lecture, students reported greater confidence applying nutrition in clinical practice and increased interest in lifestyle medicine training (p < .001). ConclusionsThe first session enhanced students practical skills and understanding of nutritions role in health. This trajectory illustrates how even a small pilot can stimulate sustainable reform. We discuss key elements of an effective, multifaceted nutrition curriculum and propose a roadmap adaptable to other institutions.

IntroductionPhysician assistant (PA) programs face persistent challenges in recruiting and retaining clinical preceptors due to time constraints, administrative burden, lack of compensation, and limited training. Additional pressures, such as health care consolidation, program expansion, clinician burnout, and financial implications of paid clinical sites, further strain preceptorship capacity. This study examines motivators and barriers influencing clinicians willingness to precept PA students. MethodsThis mixed-methods study used snowball sampling to recruit current, former, and non-precepting PAs across North Carolina. Participants completed surveys with Likert-scale and open-ended items adapted from the 2011 National Survey of Physician Assistants. Four virtual focus groups, selected from survey respondents, underwent semi-structured interviews informed by Self-Determination Theory (SDT). Quantitative data were analyzed using descriptive statistics and ordinal logistic regression; qualitative data underwent thematic analysis with deductive SDT coding and inductive refinement. Triangulation integrated findings. ResultsRespondents (N = 158) represented diverse clinical experience. Top motivators included student quality (66%), program support (53%), and financial compensation (51%). Key barriers were student quality (61.29%), burnout (53.23%), and lack of compensation (46.77%). From the focused group discussion, four themes emerged: Student Quality, Financial Compensation, Non-Financial Incentives, and Administrative Support. Student preparedness acted as both motivator and barrier; compensation concerns focused on fairness. DiscussionPreceptorship relies on relational and professional factors, student quality, recognition, and institutional alignment, rather than financial incentives alone. System inefficiencies, inadequate preparation, and misaligned compensation hinder engagement. Improving student readiness, enhancing institutional support, and implementing transparent, layered incentives may strengthen recruitment and retention.

BackgroundParticipating in research during medical school is supported by institutional programs and may influence subsequent professional development. ObjectiveWe aimed to describe the current status and heterogeneity of scholarly research programs for medical students in the United States, including expectations, support, and key structural features. MethodsWe conducted a cross-sectional web audit of official webpages for all accredited US MD- and DO-granting medical schools (search performed September 2024 to January 2025). Extracted variables included participation requirements, mentorship, timing and duration (overall and dedicated research time), expected scholarly outputs, funding sources, stipend information, and stated program goals. We compared Carnegie tier R1 (Very high research activity) versus other institutions, QS Top-50 versus other institutions, and MD versus DO schools using {chi}2/Fisher exact tests for 2x2 tables and exact trend or Freeman-Halton tests for multicategory variables. ResultsPrograms were identified for all 202 institutions. Funding was explicitly mentioned by 61.9% (125/202) of programs, 27.0% (51/189) were compulsory, 98.9% (188/190) reported faculty mentorship, and 91.0% (171/188) were exclusive for medical students. Program duration, dedicated time, expected outcomes, stipend reporting, funding sources, and stated goals varied widely. Carnegie R1 institutions had longer duration (P=.002) and tended to report external funding more often than other institutions (25/104, 24.0% vs 9/98, 9.2%; OR 3.13, 95% CI 1.38-7.10; P=.008). QS Top-50 institutions were more likely to require compulsory participation than other institutions (11/19, 57.9% vs 40/170, 23.5%; OR 4.47, 95% CI 1.68-11.87; P=.003). No significant differences were observed between MD and DO programs across most measured characteristics. ConclusionsScholarly research programs for medical students are ubiquitous across US medical schools but heterogeneous in structure, expectations, and support. Research-intensive and top-ranked institutions may have more external funding and sometimes may put together longer and compulsory programs Further evaluation of student experiences and outcomes is warranted.

The SingHealth Duke-NUS Academic Medical Center manages over 2,800 clinical faculty members and processes over 400 appointments and promotions annually. The current Promotion and Tenure documentation includes over 30 documents, making it difficult and time-consuming for the faculty to locate specific appointment information. We developed "AskADD" in response to requests for clearer academic career development guidance. This study reports initial alpha testing and subsequent beta testing with 35 faculty members using AskADD. AskADD aids the faculty--physician-educators, physician-scientists, physician-innovators, and physician-leaders--in navigating academic career paths while increasing transparency and trust in appointment, promotion, and tenure processes. Our AI-integrated systems, initially tested using low or no-code Microsoft platforms and later developed with a custom GPT, deliver contextualized responses to promotion and tenure queries. The faculty and staff participated in user testing, providing feedback for improvements. Alpha and beta testing conducted with the same group of users indicated that a substantial portion of participants found the tool beneficial; suggestions were given for further refinement. Our experience contributes to the limited literature on AI-driven faculty advancement in academic medical centers and offers a novel paradigm for academic career support.

Improving diversity in U.S. Alzheimers disease (AD) research is a pressing need. By 2050, Hispanic and Latino Americans will comprise 30% of the population. Hispanics are 1.5 times more likely and Blacks are twice as likely to develop AD compared to Whites, yet both remain vastly underrepresented in clinical trials research. Aging and AD research mentorship of underrepresented STEM undergraduates is designed to promote entry into related professions by students committed to decreasing disparities in AD research participation and clinical care. The NIA-funded MADURA program recruited 93 students from backgrounds historically underrepresented in STEM majors and/or from NIH-defined disadvantaged backgrounds. Trainees were placed in aging/AD research labs and received weekly training and mentorship from faculty research PIs and other types of supervisors (postdoctoral researchers, graduate students, research assistant staff...) Our study examined student ratings of the program and mentor behaviors, using a program-specific survey and the Mentoring Competency Assessment-21 (MCA-21). Trainees were highly satisfied with both mentoring relationships and the overall program. Student rated MCA-21 competency areas were quite high for both P.I.s and other types of research mentors. However, there were striking differences in associations between competencies and relationship and program satisfaction, by mentor type. For PI mentors, no MCA-21 competencies were associated with relationship satisfaction, but five of six competencies were associated with relationship satisfaction for other mentor types. Similarly, no PI mentor competencies were significantly correlated with overall placement satisfaction, but all six competencies were correlated with overall placement satisfaction for other mentor types. The authors discuss the likelihood of differing student expectations of faculty PI versus other types of research mentors, recommendations for assessing role-specific student expectations (including functions primarily possible only for senior faculty PIs), and utilizing nearer-peer plus PI faculty mentors to comprehensively address the gamut of mentee needs.

BackgroundStudent-run clinics (SRC) serve a unique role in healthcare by addressing the needs of underserved communities while providing medical students hands-on learning experiences. The Houston Outreach Medicine Education and Social Services (HOMES) Clinic is a SRC and a program of Healthcare for the Homeless - Houston that provides medical care to individuals experiencing unstable housing in Houston, Texas. Amid a growing shortage of primary care physicians in the United States, understanding factors that influence specialty choice is critical. This study aimed to explore whether volunteering at HOMES Clinic is associated with an increased likelihood of matching into primary care specialties. MethodsThis study used a retrospective cohort design of HOMES Clinic volunteers from 2014-2025. Students who volunteered at HOMES Clinic represented the exposure group (n=1,157), while non-volunteers served as the reference group (n=3,666). The primary outcome was the association between volunteering and matching into primary care specialties. Secondary outcomes included residency program rank, in-state residency placement, and induction into the Alpha Omega Alpha and Gold Humanism Honor Societies. ResultsHOMES Clinic volunteers matched into primary care specialties at a 7.5% higher rate than non-volunteers (p=1.3x10-5; OR=1.38; 95% CI = 1.20-1.59). Conversely, HOMES volunteers showed a 5.3% lower proportion of students who matched into surgical specialties (p=8.9x10-4; OR=0.76; 95% CI = 0.65-0.89). Volunteers also showed a modest association with matching into higher-ranked residency programs (p<0.05) and had 25% higher odds of Alpha Omega Alpha induction and 41% higher odds of Gold Humanism Honor Society induction. ConclusionsVolunteering at HOMES Clinic showed a positive association with matching into primary care specialties. This trend likely reflects both self-selection of students interested in primary care and the influence of SRC experience on shaping student residency specialty choices. Our results provide insights into how medical schools and SRCs foster the development of the next generation of primary care physicians.

The problem and opportunityThere is a critical and growing need to train globally focused, culturally fluent clinicians and scientists who can collaboratively defeat current and future public health threats across international boundaries. In parallel, academic conferences bring together thousands of diverse international healthcare professionals every year, yet their potential to provide the crucial professional development training necessary to advance internationalized medicine is often underutilized. The solutionWe developed and now first report an innovative healthcare education program that used an academic conference as the framework around which to build a structured, non-incidental virtual exchange (VE) for training globally and culturally proficient healthcare professionals. Herein we further describe the programs design and content, successes and challenges, and lessons learned. Program OverviewUsing a smartphone based social-networking and conference management app with available translation capabilities, pre- and post-graduate trainees prepared and participated in poster presentations, seminars, and workshops to learn current research and best-practices in COVID-19 medicine, while engaging with their international peers in networking and professional-development exercises. The 2-week intensive program included daily synchronous interactive seminars on various topics in COVID-19 medicine, international team-based asynchronous activities such as preparing, presenting, and constructively critiquing research posters at virtual poster sessions, and expert-led wellness and cultural-competence workshops. Participants received initial training in the norms of intercultural communication, syllabus content and expectations, incentives, icebreaker activities, and program technology. They learned then-current COVID-19 medical research, therapies, and best practices, as well as professional "soft skills" including leadership, team building, scientific/clinical presentation, verbal/written communication skills, and intercultural competence. The program vastly expanded participants international professional networks to enhance their mentorship and career development opportunities. ConclusionsParticipants reported receiving substantial benefits from the program, with many reporting immediate translation of lessons learned toward improving healthcare education or practice in their home communities. TEASERWidespread innovative use of academic conferences as vehicles for structured non-incidental virtual exchange, professional development, and global medical education could improve healthcare education, capacity, and outcomes worldwide. KEY MESSAGESO_LIWe developed and piloted a novel virtual exchange modality to connect international health science trainees and practitioners for unique collaborative training opportunities. C_LIO_LIOur "nested virtual exchange" concept employed an academic conference framework as the vehicle for providing structured cross-national didactics and professional development activities. C_LIO_LIThis model aims to train a globally proficient next generation of clinicians and scientists who are optimally equipped to tackle current and future global health concerns. C_LIO_LIOur highly scalable, flexible, and efficient model can be adapted to any scientific or medical topic or focus, and is suitable for in-person, virtual, or hybrid approaches. It is especially suitable for student/trainee-led initiatives. C_LIO_LIWidespread adoption of this innovative training approach by universities, professional societies, and conference planners worldwide would equip many more healthcare providers and scientists with the knowledge and skills required to tackle public health challenges across international boundaries, thus improving global health outcomes. C_LIO_LIWe hope that other universities, conference planners, and especially students and trainees will accept the baton to develop and launch similar programs to expand internationalized science and medicine worldwide. C_LI

The McMaster Racialized Resident Mentorship Program Evaluation will formally evaluate the effectiveness of a racialized resident mentorship network at increasing racialized residents sense of belonging to the medical training environment and reducing the racial attainment gap in medical careers. The program is composed of three phases. Phase 1 is an acceptability study of the collection of race0based data from all matriculating residents at McMaster University. Phases 2 and 3 will focus on family medicine residents. Phase 2 is a formal program evaluation of a mentorship network connecting matriculating racialized residents with racialized physician mentors, intended to run for 24 months and using repeat focus groups to explore the impacts of the program on residents sense of belonging. Phase 3 is a cross sectional study of graduating family medicine residents, examining associations between residents identities and attainment within residency training. The program evaluation will involve formal mentor training, a mentor Community of Practice, and mentor and resident focus groups examining experiences within the program and sense of belonging to the Department of Family Medicine and their training sites. The program process inputs will include: the number of faculty who attend mentor training, and the number of racialized faculty mentors and racialized residents who register for the program; attendance at the Community of Practice; and attendance at focus groups of mentors and residents. An exit survey will assess the number of residents who participated in the program, the duration of participation, expected graduation time, number of mentor meetings. Short term outcomes will be measured at the phase 1 survey and at program enrollment and include: resident awareness of racialized mentors, and sense of support and sense of belonging. Long-term outcomes for the program will be assessed in phase 3, examining associations between resident social identities (including race) and family medicine residency training outcomes. The project results will represent the first investigation of racial attainment in postgraduate medical training in Canada, with changes in residents sense of belonging and attainment during residency as indicators of Mentorship program effectiveness.

BackgroundDespite decades of calls for increased diversity in the health research workforce, disparities exist for many populations, including Black, Indigenous, and People of Color individuals, those from low-income families, and first-generation college students. To increase representation of historically marginalized populations, there is a critical need to develop programs that strengthen their path toward health research careers. High school is a critically important time to catalyze interest and rebuild engagement among youth who may have previously felt excluded from science, technology, engineering, and mathematics (STEM) and health research careers. MethodsThe overall objective of the MYHealth program is to engage high school students in a community-based participatory research program focused on adolescent health. Investigators will work alongside community partners to recruit 9th through 12th graders who self-identify as a member of a group underrepresented in STEM or health research careers (e.g., based on race and ethnicity, socioeconomic status, first generation college student, disability, etc.). MYHealth students are trained to be co-researchers who work alongside academic researchers, which will help them to envision themselves as scientists capable of positively impacting their communities through research. Implemented in three phases, the MYHealth program aims to foster a continuing interest in health research careers by developing: 1) researcher identities, 2) scientific literacy, 3) scientific self-efficacy, and 4) teamwork and leadership self-efficacy. In each phase, students will build knowledge and skills in research, ethics, data collection, data analysis, and dissemination. Students will directly collaborate with and be mentored by a team that includes investigators, community advisors, scientific advisors, and youth peers. DiscussionEach year, a new cohort of up to 70 high school students will be enrolled in MYHealth. We anticipate the MYHealth program will increase interest and persistence in STEM and health research among groups that have been historically excluded in health research careers.

BackgroundFemales have been underrepresented in preclinical and clinical research. Research on females is important for conditions that directly affect women, disproportionately impact women, and manifest differently in women. Sex and gender mandates were introduced, in part, to increase womens health research. This study aimed to understand how much of womens health research is being funded in open grant competitions in Canada that fall under the top burden and/or death of disease for women globally. MethodsPublicly available funded Canadian Institute of Health Research (CIHR) project grant abstracts from 2009-2023 were coded for the mention of female-specific research to assess what percentage of grant abstracts focused on the top 11 areas of global disease burden and/or death that disproportionately affect females. We also examined changes from 2020 to 2023 in the representation of grant abstracts that mentioned sex, gender, or two-spirit, lesbian, gay, bisexual, trans, queer, intersex (2S/LGBTQI). ResultsThe percentage of abstracts mentioning sex or gender doubled whereas the percentage of abstracts mentioning 2S/LGBTQI quadrupled from 2020 to 2023, but remained at under 10% of overall funded abstracts. In contrast, female-specific research representation remained at ~7% of all research. Under 5% of the total funded grant abstracts mentioned studying one of the top 11 global burdens of disease and/or death for women over 15 years. Of the 681 female-specific grants, cancer research accounted for 32% of funding (or 2.09% of overall grants), whereas the other top 10 collectively accounted for 38% of female-specific funding (or 2.45% overall) across 15 years. The percentage of overall funding towards understanding female-specific contributions to cardiovascular disease was 0.83% followed by diabetes (0.41%), HIV/AIDS (0.4%), depression (0.35%), anxiety (0.16%), musculoskeletal (0.12%), dementia (0.08%), respiratory (0.08%), headache (0.01%) and low back pain (0.01%). ConclusionsResearch acknowledging the sex and gender population in CIHR abstracts is increasing but remains at under 10% while the percentage of funding for womens health remains unchanged at 7% of funded grants across 15 years. HighlightsO_LIFrom 2020 to 2023, funded grant abstracts that mentioned sex, gender or 2S/LGBTQI populations doubled or quadrupled. Across the same time period, funded grant abstracts that mentioned female-specific research increased by less than a percentage. C_LIO_LIWomens health research accounts for 7% of all funded grant abstracts and increases were not observed over 15 years. C_LIO_LIOver 15 years, only 4.5% of funded grants examined the 11 causes of global disease burden and/or death that disproportionately affect females using female-specific populations. C_LIO_LIOf these female-specific grants, cancer (breast and gynecological) accounted for over 32% of all the female-specific funded grants whereas headache disorders and depression/anxiety accounted for 0.15% and 6.9% respectively across 15 years. Given the significant burden of these diseases, greater efforts are needed to expand the breadth of womens health research. C_LI Plain English SummaryWomens health research has historically been underrepresented and underfunded. Here, we examined 15 years of funding data from the Canadian Institute of Health Research (CIHR), Canadas major funder of medical research, to understand what type of womens health research is being funded using the top 11 burdens of disease or death globally for women. From 2020 to 2023, the percentage of abstracts mentioning sex or gender doubled, whereas those mentioning 2S/LGBTQI populations quadrupled, yet still remained under 10% of all funded research. In contrast, across the same time period, womens health research representation increased by less than a percentage and remained at ~7% of all funded research. We also examined the amount of funded research dedicated to the top 11 global burdens of disease and/or death that affect women across 15 years (from 2009-2023). Across these 15 years, we observed that cancer accounted for 2.09% of all funded research and received approximately the same amount of research representation as the 10 other global burdens of disease and death combined (2.45% of all funded research). Despite CIHRs mandates to encourage the integration of sex and gender into research, sex and gender representation is low and mandates did not increase womens health research. More efforts and support beyond sex and gender mandates are needed to increase and diversify womens health research to achieve personalized medicine and close the womens health gap.

BackgroundEvidence supports the key role research mentors play in bolstering the success of early stage investigators (ESI). However, there are limited data about the impact of supplemental, cross-disciplinary career mentorship and professional development opportunities for ESIs seldom included during academic training. We assessed the perceived value of this approach among post-doctoral fellows and early career faculty who participated in a multi-component career mentoring program organized by the University of California, San Francisco Center for AIDS Research (UCSF CFAR). MethodsWe surveyed past program participants (2005-2020), assessing demographics, current career status, perceived impact of the program, and feedback on program elements. We performed thematic analysis on open-ended responses to explore program benefits. ResultsOf 146 program participants contacted, 102 responded (70% response rate). Over two thirds (65%) were female, and 38% self-identified as underrepresented minority (URM) investigators. A majority of respondents now dedicate >70% of their time to research. All would recommend the program to ESI colleagues, and over 80% reported that their CFAR mentors influenced their career trajectories in several ways, including help with grant writing, linkage to researchers sparking new collaborations, and support through personal challenges or navigating conflict with primary research mentors. While 90% of URM ESIs valued advice from CFAR mentors, only a third reported receiving specific support around challenges faced as minoritized investigators. ConclusionsA career mentoring program designed to complement the support offered by research mentors positively influenced the career trajectory of ESIs. Focused efforts are needed to support URM investigators who face ongoing structural barriers to success in academic settings.

ImportanceWith USMLE Step 1 becoming pass/fail, subjective clinical evaluations will hold greater weight in residency applications. However, no longitudinal studies exist that examine the role of race in clinical success during medical training. ObjectiveUtilizing Alpha Omega Alpha (AOA) as an objective marker of clinical achievement, I investigated the relationship between race and AOA membership at Northwestern University Feinberg School of Medicine over a span of 15 years. Design, Setting, and ParticipantsTo accomplish this retrospective, single center, multi-year cohort study, names of all Feinberg graduates between 2003 and 2018 were collected via the schools public website. Images for each student were gathered by social media, assigned an ethnic identity by a blind evaluator, and confirmed by an unblinded evaluator. Finally, each name was verified against the AOA database to determine membership status. Main Outcomes and MeasuresAOA membership among medical students of various racial groups at Feinberg. ResultsFrom a 2,466 student body, there were 546 (22.1%) Eastern/Southeastern Asian, 123 (5.0%) African-American, 102 (4.1%) Hispanic/Latino, 399 (16.2%) South Asian, 59 (2.4%) Other, and 1205 (48.9%) Caucasian students, with 32 (1.3%) exclusions. Within this collective group, 428 students were inducted to AOA: 62 (14.5%) Eastern/Southeastern Asian, 4 (0.9%) African-American, 10 (2.3%) Hispanic/Latino, 70 (16.4%) South Asian, 10 (2.3%) Other, and 270 (63.1%) Caucasian students, with 2 (0.5%) exclusions. By class/year, the percentage of Caucasians inducted into AOA were higher than the class percent in 15 out of 16 classes, compared to 1 by Eastern/Southeastern Asians and 7 by South Asians. Odds ratio analysis demonstrated Eastern/Southeastern Asian (OR, 0.44; 99.67% CI, 0.28 - 0.69) and African-American (OR, 0.12; 99.67% CI, 0.03 - 0.53) students were at disadvantage relative to Caucasians for AOA membership. ConclusionI revealed Eastern/Southeastern Asian and African-American students were statistically less likely to be selected for AOA compared to Caucasian counterparts. Additionally, Eastern/Southeastern Asian students were under-represented almost every year despite being the most represented minority demographic. These results demonstrate subjective bias in AOA membership for both under- and over-represented minorities and suggests the recent Step I paradigm shift may disproportionately affect certain students over others. KEY POINTSO_ST_ABSQuestionC_ST_ABSWhich minority groups are disadvantaged compared to Caucasian counterparts for AOA membership? FindingsIn this longitudinal, retrospective cohort study spanning fifteen years at Northwestern Feinberg School of Medicine, I found Caucasian students were 2 and 8 times more likely to obtain AOA membership than Eastern/Southeastern Asian and African-American medical students respectively. MeaningCertain bias underlying AOA admission may exist and are possibly stable over time, which is concerning given the recent Step 1 policy changes and thus eventual shift away from objective evaluations in residency applications.

PurposeHealth disparities impact those minoritized by race, class, gender nonconformance, and rurality. There is an urgent need to shift scholarly focus from merely documenting health disparities to effecting change through health equity research. The present mixed-methods study explores the motivation, opportunities, and barriers in performing health equity research in a majority white college of medicine. MethodsWe use landscape analysis: surveys, focus groups, and interviews with expressly interested faculty. Results: Our findings suggest there are barriers to communication, access, and recognition for health equity research that impact and influence the existence and possibilities of health equity scholarship in Vermont. ConclusionColleges of medicine are increasingly recognized as being responsible for advancing Health Equity. Our findings underscore the necessity of this work within the state of Vermont and offer recommendations to remove barriers at our institution and others similarly situated.