In 2003, the Institute of Medicine recognized the need to diversify the medical workforce, noting that having more clinicians from various racial and minority backgrounds would have a positive effect on communication and engagement between physicians and patients and improve health care inequalities. The American Society of Hematology (ASH) responded to this call by developing the Minority Recruitment Initiative (MRI), which was succeeded by ASH’s Hematology Inclusion Pathway this year, to recruit physicians and scientists from backgrounds underrepresented in medicine to the field of hematology. Now, 21 years later, researchers have evaluated the outcomes of the MRI, which have been published in Blood Advances.
“We were able to show the MRI worked quantitatively, as awardees were more likely than expected to pursue hematology-oncology. The national estimate of minorities in the field is 5.7% compared to 14.4% of the medical student awardees, and 88.5% of the early-career awardees remain in the field of hematology. Additionally, many MRI alumni actively engage with ASH following their award,” said study author Deirdra R. Terrell, PhD, of University of Oklahoma Health Sciences Center in Oklahoma City.
Between 2004 and 2022, there were 405 awardees across the six different programs, including 240 awardees of the medical student program. The fellow and graduate student awards are the newest awards, implemented between 2020 and 2022, with 17 and 19 recipients, respectively.
Except for the early-career award, the majority of awardees were women. Most awardees self-identified as Black, although more than 40% of awardees who received an early-career, fellow, or graduate student award identified as Hispanic/Latino.
Among the 240 medical school program awardees, 161 (67%) self-identified as female. When considering composition from the perspective of race and ethnicity; 162 (67.5%) self-identified as Black/African American/African, 59 (24.6%) as Hispanic/Latino, nine (3.8%) as Native American, three (1.3%) indicated they were biracial, and seven (2.9%) identified in other ways. Among the 37 resident award recipients (2017-2022), 23 (62.2%) self-identified as female. Further, 20 (54.1%) self-identified as Black/African American/African, 14 (37.8%) as Hispanic/Latino, and one each (2.7%) as Native American, biracial, or in other ways.
The authors found that MRI awardees were less likely to discontinue their degree programs than their peers when compared to national averages of students from underrepresented communities. From 2004 to 2018, medical school attrition of 181 program participants was 2.2% compared to the national minority medical school attrition of 5.6%. Similarly, graduate school attrition of 32 participants from 2011 to 2017 was 0%, significantly lower than the 36% attrition rate for minority doctoral students in science and engineering fields.
Additionally, between 2004 and 2014, of the 97 board-eligible/board-certified medical student cohort awardees, more than half (n=55; 56.7%) held an academic position (not currently in training). Furthermore, 14.4% were board eligible or board certified in hematology.
Twenty-five of the 26 early-career recipients (96%) remained in academia. Twenty-three (88.5%) of the awardees are practicing hematologists. Early-career recipients specialties included adult hematology (n=14; 54%), pediatric hematology (n=6; 23%), hematopathology (n=3; 11.5%), transfusion medicine (n=1; 3.8%), psychiatry (n=1; 3.8%), and pulmonary medicine (n=1; 3.8%).
MRI alumni were engaged in hematology research beyond their MRI experience. From 2004 to 2022, 225 (n=380; 59%) awardees were authors on 1,105 abstracts presented at the ASH annual meetings. Forty-five program alumni also remained actively engaged in ASH through volunteer leadership roles.
“A major takeaway [from our analysis] is that programs that are intentional about improving diversity do in fact work. Qualitatively, this can be seen by just walking around this year’s ASH annual meeting and seeing all the of the individuals from communities underrepresented in hematology in attendance, which was not the case in 2003 when this program began,” Dr. Terrell said.
“Another major takeaway for other societies who would like to develop or sustain similar programs is to use evidence-based methods that have been shown to be effective, be flexible, allow feedback for what is working and what is not working, and truly be committed to the program,” she added. “The part that you can’t measure from a quantitative analysis is how programs like this allow for informal and formal networking among peers, which helps combat the feeling of being ‘the only’ person of color in your program.”
The study authors would like to add a standard annual assessment tool for all awardees, allowing for long-term tracking of additional outcomes of interest. They also plan to conduct formal mixed-methods assessments to elucidate the impact of the award on an awardee’s career.
“I have had previous awardees tell me that receipt of this award changed their lives and their career trajectory,” Dr. Terrell said. “I would love to hear even more of those stories, which really make you feel good about the work being done.”
Any conflicts of interest declared by the authors can be found in the original article.
Reference
Rollins MR, Warsame RM, Smith M, et al. American Society of Hematology: building a comprehensive minority recruitment and retention professional program [published online ahead of print, 2024 Oct 21]. Blood Advances. doi: 10.1182/bloodadvances.2024013519.
