Much has been written about the need for and barriers to achievement of greater diversity in the biomedical workforce from the perspectives of gender, race and ethnicity; this is not a new topic. These discussions often center around a ‘pipeline metaphor’ which imagines students flowing through a series of experiences to eventually arrive at a science career. Here we argue that diversity will only be achieved if the primary focus is on: what is happening within the pipeline, not just counting individuals entering and leaving it; de-emphasizing achieving academic milestones by ‘typical’ ages; and adopting approaches that most effectively develop talent. Students may develop skills at different rates based on factors such as earlier access to educational resources, exposure to science (especially research experiences), and competing demands for time and attention during high school and college. Therefore, there is wide variety among students at any point along the pipeline. Taking this view requires letting go of imagining the pipeline as a sequence of age-dependent steps in favor of milestones of skill and talent development decoupled from age or educational stage. Emphasizing talent development opens up many new approaches for science training outside of traditional degree programs. This article provides examples of such approaches, including interventions at the post-baccalaureate and PhD levels, as well as a novel coaching model that incorporates well-established social science theories and complements traditional mentoring. These approaches could significantly impact diversity by developing scientific talent, especially among currently underrepresented minorities.

This article reviews the barriers to diversity in biomedical research, describes the evolution and efforts to address climate issues to enhance the ability to attract, retain and develop underrepresented minorities (URM) - underrepresented minorities whose underrepresentation is found both in science and medicine, in the graduate school biomedical research doctoral programs (PhD and MD/PhD) at Mount Sinai School of Medicine (MSSM). We also describe the potential beneficial impact of having a climate that supports diversity and inclusion in the biomedical research workforce. MSSM diversity climate efforts are discussed as part of a comprehensive plan to increase diversity in all institutional programs PhD, MD/PhD, MD, and at the residency, post doctoral fellow, and faculty levels. Lessons learned from four decades of targeted programs and activities at MSSM may be of value to other institutions interested in improving diversity in the biomedical science and academic medicine workforce.

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