Increasing diversity in cardiothoracic surgery: First-generation medical students

Abstract

First-generation college-graduate medical students are those whose parents have not earned a postsecondary undergraduate degree (including associates, bachelor's, master's, or doctorate). 1 The mountain is steep and the climb is daunting for first-generation college graduates attending medical school, who will be termed first-generation medical students for this commentary. Up to 20% of medical students are first-generation and half of them are underrepresented minorities (URM). 1,2 These individuals find that the challenges they encountered in college persist as they progress to medical school. These may include racial/ethnic discrimination, lack of work-life balance, difficulties with studying and time management, financial insecurity, feelings of imposter syndrome, and the fear of failure. 1 CHARACTERIZATION OF FIRST-GENERATION AND CONTRIBUTIONS TO HEALTH CAREDespite these challenges, first-generation medical students have noteworthy qualities to offer to the field of cardiothoracic (CT) surgery. The training and lifestyle within this field requires resilience, grit, and the ability to overcome adversity. Having overcome the challenges of entering postsecondary school (eg, acquiring cultural and academic capital and finding support or mentorship), firstgeneration medical students have developed resilience and a growth mindset. Alvarado and colleagues 3 performed a questionnaire among first-generation college students and their counterparts, which included the Brief Resilience Scale to qualitatively measure level of resilience. The study found that first-generation college students were more resilient than their counterparts. 3 Further, a cited study by Schneider and colleagues 4 demonstrated that emotional intelligence directly enhances thinking, problem solving, and creativity in these individuals. These qualities can augment a growth mindset, where talents or skills can be developed by hard work, resilience, accepting feedback, and learning and growing from experiences, subsequently allowing for a more positive affect. 3 These traits are helpful for CT surgeons faced with long hours, difficult and taxing surgical procedures, and the management of patients with complex cardiothoracic conditions. Empathy, cultural competence, and an insight into health and health care disparities are also valuable qualities of first-generation medical students. 1 A first-generation medical student described an experience in an article published by the Association of American Medical Colleges. 5 Addressed are the striking reflections of herself and her family members in patients when they share their stories with her.

Opinion & Special Articles: Examining the Hidden Curriculum of Medical School From a First-Generation Student Perspective

“…10 However, without strong mentorship relationships, FGLI students may be less likely to consider these careers because of an incomplete sense of each specialty and/or wariness that they would be out of place. 11 One of the most effective measures to demystify the path through medical school will be to establish robust peer and faculty mentorship structures for FGLI students at an early time point. At the most basic level, simple awareness of FGLI faculty can lower the activation energy to finding mentorship among less frequently pursued specialties such as neurology.…”

“…10 However, without strong mentorship relationships, FGLI students may be less likely to consider these careers because of an incomplete sense of each specialty and/or wariness that they would be out of place. 11…”

Commentary: The important contributions that first-generation medical students offer to the field of cardiothoracic surgery

“…Robinson and Do-Nguyen 2 describe the noteworthy contributions that first-generation medical students can bring to the field of cardiothoracic surgery. By overcoming the obstacles to entering postsecondary school, first-generation medical students have developed resilience and a growth mindset that can make them capable of enduring the rigorous and challenging training associated with cardiothoracic surgery.…”

“…Robinson and Do-Nguyen 2 are to be congratulated for advocating for first-generation medical students. The recommendations made in their editorial are important first steps toward a series of changes that need to be implemented to increase diversity in cardiothoracic surgery.…”

Commentary: Do you have any doctors in your family?

“…Robinson and Do-Nguyen 1 describe firsthand the struggles first-generation medical students may face along their path to becoming cardiothoracic surgeons. The authors initially emphasize how the lack of a consistent definition of first-generation medical student has made it difficult to identify those in need of extra resources such as mentorship, financial support, and early exposure to competitive fields within medicine.…”