An assessment of physician assistant student diversity in the United States: a snapshot for the healthcare workforce

Abstract

Background: The Physician Assistant (PA) workforce falls short of mirroring national demographics mainly due to a lack of diversity in student enrollment. Few studies have systematically examined diversity across PA programs at the national level, and little is known about best practices for consistently graduating a diverse group of students. We descriptively characterized the extent to which PA programs are graduating a diverse group of students and identified top performing PA programs.Methods: Data from the Integrated Postsecondary Education Data System (IPEDS) were used to calculate the number and proportion of racial or ethnically diverse graduates. The study sample included 139 accredited PA programs that had graduated a minimum of five cohorts from 2014-2018. Within each of the United States Census Divisions, programs were ranked according to the number and proportion of graduates who were underrepresented minority (URM) race, Hispanic ethnicity, and of non-white (URM race, Hispanic, and Asian).Results: Amongst PA programs in the United States, a large disparity in the number and proportion of racial and ethnic graduates was observed. Of 34,625 PA graduates, only 2,207 (6.4%) were Hispanic ethnicity and 1,220 (3.5%) were URM race. Furthermore, a large number of diverse graduates came from a small number of top performing programs. Conclusion:Despite the abundance of evidence for the need to diversify the healthcare workforce, PA programs have had difficulty recruiting and graduating a diverse group of students. This study provides empirical evidence that PA programs have not been able to attain the level of diversity necessary to shift the lack of diversity in the PA workforce. Based upon this study's findings, the top performing PA programs can be used as role models to establish benchmarks for other programs. The results of this descriptive study are currently being used to guide a qualitative study to identify the top performers' strategies for success.

The Influence of Patient Care, Shadowing, and Volunteer Experience on Diverse Applicant Matriculation Into Physician Assistant/Associate Programs

“…18 A handful of PA programs that admit relatively high proportions of URiM students have seemingly overcome systemwide barriers. 33 Program culture and thoughtful approachesfor example, revising the types of attributes desired for admission to include skills such as language interpreting that may improve an applicant's ability to provide care in medically underserved communities-seem to contribute to their success. 34 Our study results suggest that by helping individuals with URiM backgrounds gain desired experiences, pathway programs also offer some promise for improving URiM applicant acceptance rates to health professions programs.…”

Predictors of applicant pool racial and ethnic diversity among physician assistant education programs: a national cross-sectional cohort study

“…The primary predictors of interest included variables for which we a priori believed may be associated with increasing or decreasing diversity in the applicant pool. These included (1) Accreditation Status (Provisional, Continuing, or Probation), ( 2) Academic Health Center Status (binary), (3) Public versus private institution (binary), (4) GRE required for admission (binary), ( 5) the number of applicants, (6) the number of matriculants, and (7) the Urbanicity of the institution as determined by its Rural-Urban Continuum Code (RUCC; 1 = Metro area with population > 1 million; 2 = Metro area with population 250,000-1 million, 3 = Metro area with population < 250,000, and 4-9 = Non-metro area).…”

“…To increase the diversity of the health care workforce, we must first increase the diversity of the student body and, before that, the diversity of the applicant pools from which programs choose future practitioners. While many programs, such as the University of Utah PA program, have made significant strides by increasing multiple dimensions of diversity (e.g., age, racial and ethnic background, socioeconomic status) of the students in their program, the rate at which PA programs graduate students from historically excluded backgrounds remains unacceptably low [ 5 ], with a recent study finding that between 2014 and 2019, PA programs only 3.5% of PA program graduates were URM, and only 6.4% were Hispanic or Latino/a/x ethnicity [ 6 , 7 ]. Among the strategies used, holistic admissions and universal faculty commitment to support diversity are major drivers for their success.…”

Factors and barriers that influence the matriculation of underrepresented students in medicine

“…In the 1960s, the importance of these provider inequities was first investigated and the federal government along with organizations such as the Association of American Medical College (AAMC) eventually created initiatives and programming to expose and prepare underrepresented populations for careers in healthcare (Petersdorf, 1992;Nickens et al, 1994;Hayes-Bautista et al, 2000;Smedley et al, 2003;Sullivan, 2011;Bennett et al, 2021). A similar situation is seen in other health professions such as dentistry and pharmacy (Campbell et al, 2021;Nalliah et al, 2021;Bradley-Guidry et al, 2022;Chisholm-Burns et al, 2022). The AAMC describes those underrepresented in medicine (URiM) as "racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population" (Association of American Medical Colleges, 2004).…”