Context: The Aspiring DOctors PreCollege Program at the Ohio University Heritage College of Osteopathic Medicine Cleveland Campus is unique among other precollege pipeline and mini-medical school programs in that it engages learners from urban underserved communities for an entire academic year as a cocurricular adjunct to their high school course load. One day per month, students are brought to the medical college campus and introduced to the field of osteopathic medicine. Students also participate in activities related to preparing for college admissions, diversity in higher education, mental health and wellness, and financial stewardship. All these activities are done with the goal of increasing the number of underrepresented minority (URM) students in the health care professions. Objective: Self-efficacy has been identified as a measure of internal motivation and belief in one’s ability to succeed in the face of challenges. The purpose of this study is to determine what effect, if any, participation in this program has on URM student self-efficacy. Methods: Students were asked to complete a validated self-efficacy questionnaire at the start and end of this program to determine their levels of self-efficacy and if there were changes after participating in this program. Results: Ten of the 12 seniors completed pre- and post-self-efficacy surveys. Two main discoveries were made through this pilot. First, when tested at the beginning of the program, all students had high levels of self-efficacy (mean score, 4.45 of 5). Second, 2 items were specifically increased by a statistically significant amount. The students increased in self-efficacy concerning the responses “I can learn what is being taught in class this year” ( P = .024) and “My ability grows with effort” ( P = .015). Conclusions: With the competitive standards of acceptance into the Aspiring DOctors PreCollege Program, students enrolled in this program had high levels of self-efficacy from the onset. While there was modest increase across the board, many of these indicators remained consistently high after the program. Using self-efficacy as a screening tool for premedical students may be helpful in identifying candidates likely to succeed in a future medical career.

Historically, the physician workforce has been a profession disproportionately constituted of White and male doctors. 1 In Europe and North America, efforts have been made to increase the number of under-represented minority (URM) medical students and practicing physicians. 2,3 As defined by the Association of American Medical Colleges, "Underrepresented in medicine means those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population." 4 While the number of women entering medical training has continued to rise to levels nearing representation within the general population, 5 disparities persist amongst the ethnic and racial backgrounds of medical college applicants. 1 In Canada, for example, First Nations/Inuit groups make up approximately 4% of the population, but account for less than 0.25% of physicians. 6 In the United States, African-Americans represent approximately 13% of the population, but only account for 5% of physicians. 1 Across the globe, programs designed to increase the numbers of applicants from minority racial groups have made progress in promoting the physician diversity, however,

Background Access to professional health care providers in Loja Province, Ecuador can be difficult for many citizens. The Health Care Access Barrier Model (HCAB) was established to provide a framework for classification, analysis, and reporting of modifiable health care access barriers. This study uses the HCAB Model to identify barriers and themes impacting access to health care access in southern rural Ecuador. Methods The research team interviewed 22 participants and completed 15 participant observation studies in the study area. Interviews and a single focus group session of artisans were recorded and transcribed from Spanish to English, and thematic analysis was performed. Results The thematic analysis found financial, structural, and cognitive health care access barriers. Cost of medications, transportation, missed responsibilities at work and home, difficulty scheduling appointments, and misconceptions in health literacy were the predominant themes contributing to health care access. These pressure points provide insight on where actions may be taken to alleviate access barriers. Conclusion Modifiable health care access barriers outlined in the HCAB are evident in the study area. Further research and implementation of programs to resolve these barriers, such as the creation of health care subcenters and/or mobile clinic, insurance coverage of specialized care, increasing availability and accessibility to affordable transportation, improving roadways, introduction of a 24/7 call center to schedule medical visits, monetary incentive for primary care physicians to practice in rural and underserved areas, provision of affordable work equipment, and emphasizing the improvement of health care literacy through education, may diminish current barriers, identify additional barriers, and improve overall health in the rural area of Loja, Ecuador and similar rural regions around the world.

serves to introduce underrepresented minority (URM) high-school students to careers in health care as well as introducing URM high-school students to medical student mentors. Each month, medical students and their student mentees connect through a variety of activities on the medical college campus. While the program has significant benefit for the mentees, it also provides professional development opportunities for the medical students as mentors. Many researchers have written on the value of mentored relationships between medical students and established physicians; however, exploring the benefits of medical student mentorship has yet to be discussed in the literature. Objectives: The primary objectives of this study are to understand medical student perceptions of being a mentor and describe the contributions to their medical education. Methods: Semistructured interviews were conducted with student mentors regarding their experiences serving in this program. These interviews were inductively coded for significant ideas, themes, and patterns. Results: A series of 12 research interviews were conducted with medical students who have participated in The Aspiring Doctors program for at least three semesters. Major themes that emerged from the analysis include the following: the importance of guidance in medicine through person-to-person mentoring, and identification of future career aspirations. Summary/Conclusions: Medical student mentors found this program to be a valuable addition to their educational experience. Mentoring URM high-school students offers pre-clinical medical students the opportunity to connect with their community and envision themselves serving as physicians in underresourced communities. Simultaneously, it provides a meaningful way of paying-it-forward during their education. Further studies can be done to track the outcomes of the medical students with respect to their designations stated while participating in this program, the role of mentorship on professional identity development, and possible effects on preventing/mitigating burnout.

Introduction Routinely faced with potentially traumatizing situations, resilience is critical for military physicians. However, related studies are limited in scope. The current study distinctively combines hyper-realistic immersion training for military medical students with emotional intelligence and hardiness measures. With self-reflection shown to improve performance, qualitative inquiry was concurrently conducted in a mixed methodology approach to provide a uniquely comprehensive perspective on the resilience training needs of this population. Materials and Methods Thirty-four osteopathic military medical students participated in a week-long training simulating real-life combat and mass casualty events. The Emotional Quotient-Inventory 2.0 (EQ-i 2.0) and Hardiness Resilience Gauge were administered as pre- and post-test measures. Paired t-tests were used to determine statistically significant gains, and a multiple case study analysis of a six-student focus group allowed for the synchronization of quantitative and qualitative data. Institutional Review Board approval for the study was obtained through Rocky Vista University with a reciprocal agreement with Touro University California’s Institutional Review Board. All students participating in the study received written informed consent. Results Qualitative findings for this study aligned with this current year’s findings of statistically significant results in the improvement of the Overall EQ-i and Overall Hardiness. Qualitative responses thematically analyzed demonstrated environmental realism, adaptation, increased awareness, and positive interpersonal and clinical outlook. Notable increases occurred in all EQ-i domains except Decision-Making and Stress Tolerance. The Self-Perception domain saw significant increases in Self-Regard and Emotional Self-Awareness while Well-Being and Optimism simultaneously improved. Conclusion This unique pilot study showed that quantitative and qualitative results aligned, supporting the finding that a safe trauma-related training environment can improve the confidence and resilience in military medical students. The goal of this training was to promote resilience and mitigate trauma. Results demonstrate improved self-efficacy and enhanced commitment. Increases in self-awareness and confidence made participants more inclined to see their worth and strengthened their sense of duty as described in their qualitative responses. Pervasive gains suggest that the training aligned well with its purpose, and the methods employed enhanced participant experience. Long-term follow-up studies are needed to assess outcome sustainability.